Live data from Hacker News

Hospitals that make profits should pay taxes

statnews.com

161–170 of 212 posts

Re: Hospitals that make profits should pay taxes

#161
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.

Hospitals were invented by religious organizations. It’s not strictly going to be driven by tax avoidance

Re: Hospitals that make profits should pay taxes

#162
post #77

This strikes at an issue we haven't really addressed enough in non-profits: how much community benefit do they need to offer? A non-profit simply means that there are no investors who can profit from the business. However, I think we haven't really thought enough about how much community benefit they need to offer to justify being tax exempt - and it's a hard problem. For example, let's say I run a non-profit hospita…

This is a great comment. It speaks to the tensions between being ethical/doing the right thing and running a business.

Re: Hospitals that make profits should pay taxes

#164

Earlier quoted context omitted.

Not to mention that NP doesn’t prevent certain administrative and executive employees from getting excessive salaries.

But then they pay personal income tax on the salaries. Which is the same thing that would happen to the equipment supplier. You're in no way avoiding the tax, you're just having the equipment supplier pay it on their profits.

Not at all.

The tax rates aren’t the same and non-profits aren’t forbidden from hiring businesses for contracts, pooling money, buying property, nor securing loans.

It’s a good model for small NPs. It’s rife for large scale corruption at the scale of hundreds or thousands of employees.

The point is that we see executive salaries for NPs that match salaries for for-profits. That indicates a broken system.

Re: Hospitals that make profits should pay taxes

#165

Earlier quoted context omitted.

But then they pay personal income tax on the salaries. Which is the same thing that would happen to the equipment supplier. You're in no way avoiding the tax, you're just having the equipment supplier pay it on their profits.

Not at all. The tax rates aren’t the same and non-profits aren’t forbidden from hiring businesses for contracts, pooling money, buying property, nor securing loans. It’s a good model for small NPs. It’s rife for large scale corruption at the scale of hundreds or thousands of employees. The point is that we see executive salaries for NPs that match salaries for for-profits. That indicates a broken system.

> The tax rates aren’t the same

At anything that could be considered a "high" salary, the personal income tax rates are higher than the corporate rates. Also, they would be exactly the same if the for-profit entity was an LLC or some other passthrough entity.

> non-profits aren’t forbidden from hiring businesses for contracts, pooling money, buying property, nor securing loans.

Neither are for-profit businesses. And then any businesses they hire would also be paying taxes on their profits.

> The point is that we see executive salaries for NPs that match salaries for for-profits. That indicates a broken system.

It indicates that the cost of hiring someone who knows how to run a hospital is the same regardless of whether you separately pay profits to shareholders.

Re: Hospitals that make profits should pay taxes

#166

Earlier quoted context omitted.

But you’re already paying for other people’s illnesses through insurance with the downside of layers of middlemen taking a profit. At least here in the UK an emergency or cancer won’t bankrupt me, for the rest of it I can choose to get private health insurance if I like or wait for the NHS to work through the queue (which is sadly becoming increasingly common as our government is obsessed with copying what America do…

In the US it is not a necessity. There are private insurance plans with entry restrictions (e. g. you are ineligible if you smoke)

Sure but you’re still paying for people’s poor health. Insurance administration costs, charging insured patients more to cover uncovered patient costs, increased equipment costs due to increasing demand from an increasingly unhealthy population, high doctors salaries because of skills shortages, the list goes on. There is simply no way to isolate yourself from the cost of other people’s health choices.

A fully privatised system gives the illusion of choice and isolation.

Re: Hospitals that make profits should pay taxes

#167
post #77

This strikes at an issue we haven't really addressed enough in non-profits: how much community benefit do they need to offer? A non-profit simply means that there are no investors who can profit from the business. However, I think we haven't really thought enough about how much community benefit they need to offer to justify being tax exempt - and it's a hard problem. For example, let's say I run a non-profit hospita…

The problem is more obvious in reverse: profit is money extracted from community wealth. It may be reinvested to create more community wealth. But until that happens it's effectively removed from the collective resource pool and monopolised by private owners for private ends. This is not great when it's abstract numbers, but it inevitably seems to concretise as privileged individual control over property, land, exclu…

>The problem is more obvious in reverse: profit is money extracted from community wealth.

On the contrary, profit is the part of the wealth generated by the company that remains with those who generated it!

Re: Hospitals that make profits should pay taxes

#168
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…

As a consequence of the two intersecting facts that this is in fact a for-profit company and the United States is organised such that this, as with many things, is regulated by the fifty States rather than federally, there's not even a training requirement. That is, the people driving a police car, fire truck or ambulance might have no training in how to do so properly, despite the (not unreasonable) expectation from…

[deleted]

Re: Hospitals that make profits should pay taxes

#169

Earlier quoted context omitted.

Yes but the salaries have to be reasonable. You can’t setup a charitable organization and then pay yourself $10 million a year to run it. And the people getting paid are usually separate from the people in charge. Most of the time board members of non-profits are either unpaid or are paid a small token amount. When they are paid, it’s not going to be a meaningful chunk of the profits.

Note that in the article, non-profit hospitals paid their top three CEOs $20 million. "The top three hospital administrators there made nearly $20 million in salaries."

The CEO is an employee of the board. From a non-profit perspective that’s no different than spending $20 million on a building.
Post reply on HN