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Fees on nonprofits resurface in Mayor Ravenstahl’s proposed budget
Sept 23, 2009;
Pittsburgh Tribune-Review | This article hints at the danger to the entire nonprofit sector posed by nonprofit hospitals whose nonprofit credentials are somewhat suspicious. The young mayor of Pittsburgh, Luke Ravenstahl, is taking aim at nonprofit hospitals and universities among others for payments in lieu of taxes to help the city reduce a crushing municipal budget problem. Large hospitals are at the center of the controversy. When Mercy Hospital completed a mammoth merger to become the University of Pittsburgh Medical Center, UPMC offered to pledge $100 million over some period of time toward a scholarship program for Pittsburgh public school students and cited its estimate of $500 million in charity care and community benefits programs. It’s not clear that the City is as happy with a scholarship program as opposed to a payment in lieu of taxes (PILOT) that would go into the municipal treasury. An umbrella group of nonprofits—the Pittsburgh Public Service Fund, roughly 100 nonprofits—”donated” $14 million to the city budget between 2005 and 2007 and has offered $5.5 million for 2008 through 2010, an offer the City’s finance people have not yet accepted. UPMC calls itself a major participant in the Service Fund which is debating the city’s revenue plan. The part of the city’s plan that actually affects nonprofits is a $15 million raiser that includes various unspecified fees on all-day parkers, college students, and hospital patients and increased water fees on large nonprofit water users, clearly hospitals and universities. The challenge for nonprofits is how much are the majority of nonprofits which are tiny (93% are below $1 million in total revenues) affected by changes in government treatment of the largest, wealthy nonprofits like hospitals and universities, and if state and local governments change the terms on the property tax or fee treatment of large nonprofits like hospitals and universities, when (and for how long) should all nonprofits go to the mat for the biggest ones?—Rick Cohen

Hellman nonprofit to boost local news coverage
Sept 25, 2009;
San Francisco Chronicle | The idea that journalism’s future lies within the nonprofit realm recently got a boost in northern California. Warren Hellman, a local financier, is investing $5 million to create an online news outlet that will provide regional reporting and feed local NPR station KQED. In addition to a full-time staff, the new venture will partner with UC Berkeley Graduate School of Journalism.—Timothy Lyster

The social entrepreneur: getting results where angels fear to tread
Sept 23, 2009; INSEAD Knowledge | When you see some statements, they reek of unintentional self-parody. Try this one: “What do Richard Branson and Mother Theresa have in common? They have both been agents for change. But when you put them together, you get—the social entrepreneur.” Calling Christopher Hitchens for a response, please! Or the headline: “The social entrepreneur: getting results where angels fear to tread.” Even the angels have some measure of humility, unlike the social entrepreneurs described here.—Rick Cohen

Hospital Closings Test Unions’ Ability to Defend Poor Communities
Sept 22, 2009; Labor Notes | The health care insurance debate is framed incorrectly or inaccurately. It’s not simply insurance, since no matter what bill passes Congress, millions will be left without insurance, a weird concept of universal coverage if there ever was one. It is a health care supply, access, and delivery issue in addition to one of insurance coverage. Labor Notes describes the problems of nonprofit and public hospitals facing unionized workers looking for decent pay and benefits. Interestingly, however, the article mentions nonprofit hospital chains trying to shut down urban hospitals while they build and expand facilities in the suburbs. Cited is a report from a Boston University professor who counted 52 “major” cities reporting a loss of 218 hospitals between 1980 and 2003. However, he concluded that “a community’s racial composition was a better guide to which locations closed than hospital efficiency,” that is, profitability. Worth noting is the development of a two-tiered system of hospital charges, helping hospitals justify closing down urban hospitals in favor of suburban, and we quote: “Facilities just miles apart will also charge different prices for the same service. Health care workers charge that in hospitals targeted for closure, management deliberately charges more than patients can pay. This creates mounds of “debt”-and a reason to close them down. For instance, Sutter’s San Leandro hospital charges $750 for two looks at a chest X-ray, while another Sutter hospital in a richer area five miles away lists the procedure at $233.” It appears to us that our national debate about health insurance has missed much of the issue of health care delivery. Nonprofits ought to take the lead in refocusing the policy debate appropriately.—Rick Cohen


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