billfriedman9987 t1_je00if6 wrote
UPMC’s status as a non profit needs to be revoked while we are at it
Sybertron t1_je091xw wrote
Not just UPMC but Pitt and CMU as well. I'm too lazy to do it but I bet if you highlight all the properties they own or at least have major stake in across the city you look at like 1/4 of the city is taken up by them.
Aggravating_Foot_528 t1_je1bhyw wrote
Non profit status isn't a binary. The institution can be a non profit but have divisions or properties that are not ..and those can be taxed. UPMC has a number of for profit divisions including the health plan.
CantImagineBeingYou t1_je1rz0a wrote
Same for Highmark/AHN.
ktxhopem3276 t1_je0ojgw wrote
I wonder if the amount of property tax the city could collect from the non profits is worth it if it means transforming health care and education to for profit enterprises. I’d rather not have my healthcare and tuition to go to Wall Street investors. Since most cities have a lot of universities and non profit hospitals, why does this seem to be such a problem for Pittsburgh specifically?
RunningOnPunkTime t1_je4wivf wrote
They already operate as if they were for-profit.
ktxhopem3276 t1_je4wst6 wrote
They don’t generate profit for investors on Wall Street. They are greedy self serving entities, but siphoning money for investors would be a whole new level of exploitation
RunningOnPunkTime t1_je4xxry wrote
You don't need to be owned by Wall Street investors to be "for-profit". They're already siphoning money (profits) for executives.
ktxhopem3276 t1_je4ybcw wrote
For profit companies run 10%-20% profit margins. Upmc pays 1% to executives. It’s not a even a close comparison. Striping their non profit status won’t make them pay executives any less. They will probably pay them more and our hospitals bills will go up. I don’t get the point of that.
RunningOnPunkTime t1_je4zp7d wrote
Are we just going to ignore their monopolizing tendencies?
ktxhopem3276 t1_je50gfv wrote
I think the nonprofit debate is a distraction from the monopolization issue. They should be forced to divest at least two hospitals in the county.
dazzleox t1_je5cma5 wrote
They're not different issues because congress has granted anti trust exemptions to non profit hospital systems, and seems unlikely to change that.
ktxhopem3276 t1_je5dc46 wrote
Could you share a source on that issue? I’m not finding much.
https://lowninstitute.org/why-antitrust-laws-arent-stopping-some-hospital-mergers/
This says the states can take antitrust action against hospitals
dazzleox t1_je5fe3e wrote
The Vanderbilt piece is from 1999 when, say it says, circuit courts were divided on the non profit factor. The way the case law has since settled is the FTC retains jurisdiction to review mergers regardless of status, it is prohibited to enforce anti trust laws against non profit health care entities generally. UPMC's growth lately has not been mergers but building new facilities.
FTC Chairman Joseph Simons said his team would like to do more to address Grassley's concerns but that they are butting up against statutory limitations.
"We're very interested in looking at unilateral conduct by hospitals, that are problematic under the antitrust laws," Simons said. "But, generally when we do that, we find that they're nonprofits, and we don't have jurisdiction over them."
"That's another reason why we've been asking the Congress to eliminate our exemption for nonprofits," Simons said.
"Gosh, I never gave that any thought," Grassley replied. "We ought to consider that."
I'm generalizing a bit. The DOJ retains jurisdiction over non profit hospitals but a more narrow set of issues, but has gone after some for wage collusion.
ktxhopem3276 t1_je5g1xw wrote
> Unlike the FTC, the DOJ does have authority over nonprofits, said Makan Delrahim, assistant attorney general for the DOJ's antitrust division.
Also, what is stoping the state from regulating UPMC?
dazzleox t1_je5my93 wrote
DOJ has jurisdiction over a fairly narrow set of issues though, like bribery/FCPA and criminal matters. That's good but it would take the FTC to break up a hospital system or HMO, and that would take an act by congress and/or a better SCOTUS.
The state could pass more regulations regarding hospitals, as long as it's not preempted. But state anti trust law is complicated in that some things would preempted and some would not, but either way, I don't imagine new laws passing a divided state legislature that does very little except at budget time. PA anti trust law is generally aimed at gas station price fixing, resale price maintenance, bid rigging for state contracts -- not at big stuff that the feds handle like corporate mergers.
ktxhopem3276 t1_je5plt1 wrote
How does the FTC decided what is nonprofit and what isn’t? Wouldn’t it use IRS rules instead of the PA law at issue here?
Material_Cable_8708 t1_je3q837 wrote
I have a lot of gripes with pitt but they are not a for profit institution
Sybertron t1_je6bsi0 wrote
Eh endowment of 5.5 billion. Budget of 2.5 billion they doing well enough to pay taxes.
ahhhhhhhhyeah t1_je08977 wrote
What about AHN?
billfriedman9987 t1_je0dw5n wrote
Them too.
ktxhopem3276 t1_je5j1vv wrote
What do you think it will accomplish? They will raise hospital bills to pay tax so it’s a back door tax on anyone who goes to the hospital
billfriedman9987 t1_je5ojig wrote
Have you seen hospital bills? They are already insanely high and the insurance pays for most of it
ktxhopem3276 t1_je5qrgz wrote
Physicians go through ten years of training and nurses are in high demand so it costs a lot to get personalized service like healthcare. Billing transparency would help a little bit and imposing higher safety standards and avoiding unnecessary procedures could help.
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