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Hospitals that make profits should pay taxes

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Re: Hospitals that make profits should pay taxes

#51

Post by tyre »

lupire wrote: post #47
wormius wrote: post #40

Earlier quoted context omitted.

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.

If it is non-emergency, why do they need sirens?

Re: Hospitals that make profits should pay taxes

#52

Post by [deleted] »

missedthecue wrote: post #24
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.

99% sure that's now how accounting works. A loss is when expenses are more than revenue, not when you earn less than you wanted to. Roofing and construction contractors would be all over this if they could avoid taxes simply by negotiating down an invoice.

[deleted]

Re: Hospitals that make profits should pay taxes

#53

Post by nradov »

rjzzleep wrote: post #15
nullindividual wrote: post #11

Earlier quoted context omitted.

What's worse is they enforce their religious worldview at these hospitals, denying legal medical treatments based off of the largest human hoax and political control mechanism ever invented by man.

In Germany some of the best hospitals are Christian (catholic I believe, but may be wrong). The US is a really weird place.

The same is true in the US. Some of the best hospitals (and complete integrated health systems) are run by Christian churches. This is largely for historical reasons: decades ago, churches stepped in to deliver healthcare as part of their mission because governments and secular organizations weren't doing enough. Some of them do refuse to perform certain services, particularly certain women's reproductive services, on moral grounds. This can make it difficult for women in some areas to access care.

Re: Hospitals that make profits should pay taxes

#54

Post by megaman821 »

ryanSrich wrote: post #45
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 stru…

What is your max out of pocket that you paid $16k in a year?

Re: Hospitals that make profits should pay taxes

#55

Post by lupire »

nradov wrote: post #30
jama211 wrote: post #4

Wait… they don’t already? What is even going on over there?

For-profit hospitals that actually turn profits do pay income taxes. The concern is with non-profit hospitals. They don't distribute profits to shareholders. But some do pay high salaries to employees or have large and growing endowment funds. The author is arguing that threatening to tax some of those funds would incentivize non-profit hospitals to lower prices and give out more charity care. This isn't necessarily…

It gets into more arcane policy than clear economic effects.

Why are dividends taxed, but not investments in a shell company that collects dividends? Corporations aren't natural people (spare me the inane conflation of "legal person" with "natural person", everyone who doesn't understand why those two concepts have distinct legal names), so there is no inherent reason why there's any need to tax organizations instead of the people who profit from them as owners or wage earners or vendors.

Re: Hospitals that make profits should pay taxes

#56

Post by Y_Y »

tyre wrote: post #51
lupire wrote: post #47

Earlier quoted context omitted.

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.

If it is non-emergency, why do they need sirens?

To lure sailors to their deaths

Re: Hospitals that make profits should pay taxes

#57

Post by colinmorelli »

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.

This is not really what happens.

Hospitals and payers negotiate rates and contract at that rate before the service is provided. Assuming the service is not denied by the payer, the hospital knows that they'll only be reimbursed 18k from your insurance company (or at least has the data to know in advance, putting aside whether any one person could tell you what it will be). The 90k only served as a starting point for negotiation with payers and is usually obscenely high due to other regulatory and contractual reasons related to the negotiation process. Their "list rate" is shown on your bill, but was absolutely never expected to be received.

As a result, it's not a "loss" of revenue at the time of service, and isn't recognized as one.

Now, because GAAP requires revenue be recognized when realized and earned, that service became "revenue" to the hospital after service, even though they haven't been paid. They might later "write that off" (I.e. recognize a loss) if the payer ultimately denies that claim, or you refuse your responsibility (I.e. your copay). But in that case, the hospital did not, in fact, make the money.

Re: Hospitals that make profits should pay taxes

#58

Post by aaomidi »

echelon wrote: post #44
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…

It’s really amusing when tech people who have a full understanding of singletons and basic statistics always refer to themselves when making a broader statement about society.

I always wonder why people seemingly can’t apply their experiences beyond themselves when they already do that day to day at work.

A lot of “personal decisions” are consequences of society. Depending on where you are in society, you’re going to sometimes be forced to live an “unhealthy” life.

Beyond that, most medical care are for older folks, so you’re likely not going to notice anything until you are older.

The thing that bothers me with this personal choice thing is, our society basically expects there to always be poverty. Heck the rate of poverty across America has a “healthy” value that we aim to actually keep. Of course that same percentage is going to be leading a more unhealthy life.

Eh, rant over.

Re: Hospitals that make profits should pay taxes

#59

Post by ryanSrich »

megaman821 wrote: post #54
ryanSrich wrote: post #45

Earlier quoted context omitted.

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 stru…

What is your max out of pocket that you paid $16k in a year?

I'd have to look again, but it's right around $18k. It's like $17,950 or something like that. It's an odd number.

Re: Hospitals that make profits should pay taxes

#60

Post by vuln »

ryanSrich wrote: post #45
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 stru…

I just had ~250k$ billed to me for a surgery and a 4 day hospital stay. I walked out with only paying 2500$. Just a touch over 1% of the total cost billed. I pay ~400$ a month. I’m in the US.
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