OK, let me get this straight--and see if I can keep a straight face: Even if hospitals use only a tiny fraction of their revenues to directly subsidize care for poor people, they're still saintly benefactors to their community.
Want an example of this mentality? Check out the new community benefit report from the Connecticut Hospital Association. According to the report, the state's hospitals are bastions of charity, but at the same time, only $29 million dollars went directly to subsidizing care for the poor--of a claimed $718 million mind you. And that $29 million was spread across 28 facilities. Geez, guys, you spend more than that on those fancy board retreats to Orlando. What gives?
In its report, the CHA also cites dollars paid to make up for the costs of treating Medicare and Medicaid patients ($434.3 million), as well as uncompensated care, including charity care and bad debt ($228.8 million). Neither are that unreasonable: federal payers aren't cutting the mustard reimbursement-wise, and even professional associations waver a bit when splitting hairs over what's bad debt and what's charity care in some cases.
The thing is, if there's any reason at all to give local organizations a tax exemption, it's to allow them to find out where people are who need care, and give it to them on dignified terms. While "charity care" gets many people's back up--and only tends to be requested when they show up in the emergency department in a moment of extremity--subsidized services are a fair, dignified way of letting the less well-funded know that this is their emergency department, too. Which one seems a more appropriate way of using their untaxed revenues?
You want to write in and tell me I'm being unfair? Go ahead! Maybe I'm going a bit overboard in my critique. After all, I don't have the raw financial data, so some of my guesses may be off-base.
Still, I think there's a point to be made here, nonetheless. Even if no one erupts in a populist rage over this type of benefit spending, is it really good business to keep an approach in place that encourages people to avoid hospitals until they're in trouble? I don't think so, and I doubt Chuck Grassley would either. Maybe the CHA would like to tweet Sen. Grassley and ask him. - Anne