Hospitals that make profits should pay taxes • Hacker News Board

Re: Hospitals that make profits should pay taxes

#41

Post by MattGaiser » Sun, Apr 14, 2024, 5:33 PM UTC

throwaway918274 wrote: post #12

1. I go into hospital and come out with 90k bill - I have insurance and I pay my copay of $130. 2. Insurance says "nah, we'll give you 18k" 3. Hospital goes "ok". 4. Hospital writes off as a 72k loss, which essentialy is a "tax deduction". This is good for me, but such a perverse incentive for the hospital.

That is a loophole every business would use if it worked that way. Why wouldn't every banana Walmart sells be $500 on their books then? Losses need to be actual losses, not profits that never materialized.

Re: Hospitals that make profits should pay taxes

#42

Post by ec109685 » Sun, Apr 14, 2024, 5:33 PM UTC

Isn’t the distinction that non-profit hospitals have to plow surplus’s revenue back into the hospital versus distributing profit to investors / owners?

If so, the tax exempt status seems aligned with how for profit businesses are taxed?

Re: Hospitals that make profits should pay taxes

#43

Post by Zigurd » Sun, Apr 14, 2024, 5:34 PM UTC

Mountain_Skies wrote: post #23

jraph wrote: post #19

They should be a well funded public service that don't make a profit in the first place.

Like universities?

There should be more public university capacity to compete with private university tuition rates. Some things, like health care, may be so shot through with perverse incentives in both for-profit and nonprofit configurations it should just become a public good.

Re: Hospitals that make profits should pay taxes

#44

Post by echelon » Sun, Apr 14, 2024, 5:35 PM UTC

jraph wrote: post #19

They should be a well funded public service that don't make a profit in the first place.

Random things like cancer and genetic diseases happen, but an awful lot of disease is caused by personal choice. Drinking, smoking, unhealthy lifestyle, etc. Personal behaviors are the cause of a huge portion of our healthcare costs.

I feel the same way about the recent auto insurance increases being caused by the shopping behaviors of others. Expensive EVs get completely totaled in accidents, and now everyone has to share in these high costs brought on by the choices of others.

The healthcare system is already one of the biggest line items for the US federal budget, yet you can see the largesse and inefficiency. Perhaps we should think very carefully about putting more money into it.

Re: Hospitals that make profits should pay taxes

#45

Post by ryanSrich » Sun, Apr 14, 2024, 5:35 PM UTC

throwaway918274 wrote: post #12

1. I go into hospital and come out with 90k bill - I have insurance and I pay my copay of $130. 2. Insurance says "nah, we'll give you 18k" 3. Hospital goes "ok". 4. Hospital writes off as a 72k loss, which essentialy is a "tax deduction". This is good for me, but such a perverse incentive for the hospital.

Or. It's more like this

- $90k bill - you pay your annual $10k deductible - the remaining $80k is only covered 80% because emergency visits only have 80% co insurance - you now owe $16k, after you've already paid $10k out of pocket for the deductible

This is a real thing that happened to me recently. Not to mention I pay $1500/month for a family of 4.

Nothing, absolutely nothing about the U.S. healthcare pricing structure is good for patients.

It seems to have worked out for you because you appear to have very good insurance. Most people are like me, and have the type of insurance that should be illegal.

Re: Hospitals that make profits should pay taxes

#46

Post by forinti » Sun, Apr 14, 2024, 5:35 PM UTC

jeffbee wrote: post #8

And virtually every other non-profit org should also pay taxes, including churches. This is not just a federal income tax thing. The variety of local property tax abatements for supposed community benefit organizations is incredible.

There's a huge golf course in my neighbourhood that doesn't pay property taxes, but they can't build on the land.

If they had to pay property taxes, the land would probably be parceled and built upon.

I don't like it that rich people don't have to pay taxes on their little game, but I think the neighbourhood is better off with this green area.

Re: Hospitals that make profits should pay taxes

#47

Post by lupire » Sun, Apr 14, 2024, 5:35 PM UTC

wormius wrote: post #40

jraph wrote: post #19

They should be a well funded public service that don't make a profit in the first place.

As a kid I didn't know much about "government", but I thought surely it must be Police, Firefighters and Medical Professionals. If you have a siren on your truck, you are government was my thinking. These are all "public goods" and even as a kid with minimal "civics" education (and what I had was pretty much 100% Pro Usa America Is A Christian Nation for those formative years that I'm talking about). I understood tha…

Even if you consider ambulance emergency service should be public service, that "sirens" argument doesn't apply to non-emergency care where you have time to make a selection among private competitors.

Re: Hospitals that make profits should pay taxes

#48

Post by admax88qqq » Sun, Apr 14, 2024, 5:35 PM UTC

dboreham wrote: post #20

lxm wrote: post #3

Wouldn't this create an incentive for increased management bonuses in order to "tax-optimize" the profits?

All corporations have this incentive. It's how the tax system is designed to operate.

This is silly and false. Corporations that inflate management expenses will generate less profit for shareholders. I don't think any shareholders would like that idea.

Re: Hospitals that make profits should pay taxes

#49

Post by INTPenis » Sun, Apr 14, 2024, 5:36 PM UTC

ec109685 wrote: post #42

Isn’t the distinction that non-profit hospitals have to plow surplus’s revenue back into the hospital versus distributing profit to investors / owners? If so, the tax exempt status seems aligned with how for profit businesses are taxed?

They can just create their own medical equipment supplier and funnel money that way.

Bottom line is that when you let privat businesses decide they will always choose profit over people.

Re: Hospitals that make profits should pay taxes

#50

Post by throw0101c » Sun, Apr 14, 2024, 5:36 PM UTC

iscrewyou wrote: post #9

ysofunny wrote: post #2

so should religions that make profits pay taxes, something tells me neither will happen

There are religious organizations that own hospitals. I was flabbergasted when I found out about this recently. My first thought was how they’ve got a perfect system to avoid all taxes. Edit: it seems like the typical derailment is happening when it comes to religion. The topic is about taxes. I mentioned taxes. Not if religious organizations should own hospitals.

> There are religious organizations that own hospitals. I was flabbergasted when I found out about this recently.

Why would you be surprised at this? In (e.g.) Christianity, caring for the poor and sick has been one of the central tenants since its inception, so why wouldn't formal institutions be organized doing so?

Before the welfare state—which is a fairly recent invention—the largest organization would have been the Church (and its various religious orders: Dominicans, Franciscans, etc), which would have worked towards its three-fold mission of worshipping God, evangelizing, and serving the poor:

* https://www.youtube.com/watch?v=O9m-pNsFPV0

It can reasonably be argued that the very idea of taking care of the poor, etc, only came into Western civilization because of Christianity. As someone who presumably lives with-in Western civilization and adheres to its (general) values, you take the idea for granted, without perhaps examining where it/they came from:

* https://en.wikipedia.org/wiki/Dominion_(Holland_book)

* https://en.wikipedia.org/wiki/The_WEIRDest_People_in_the_Wor...