Monday, September 26, 2011
Whenever I talk about tax-exemption for nonprofit hospitals, I generally take pains to note that while I am opposed to exemption for a number of such hospitals, some such hospitals "clearly" should continue to enjoy exempt status. Teaching hospitals (e.g., university-affiliated medical centers that have a primary mission of educating doctors as part of the university's MD degree program) and children's hospitals have always been my leading examples.
Now, I'm not so sure. This story in the Bellingham Herald summarizes a study done by Kaiser Health News on children's hospitals, and it appears that some of the same issues that currently are under discussion with general acute care nonprofit hospitals - lack of charity care coupled with significant net revenues and building programs gone wild - are surfacing in the children's hospital area.
I think I need to avoid generalities these days. SOME children's hospitals certainly should enjoy exemption, just as SOME general acute-care hospitals also should. But instead of starting with a presumption that nonprofit hospitals are charities, why don't we start with the presumption that they are all big businesses, and let them carry the burden of proving their "charitable-ness"???