My Point of View: Should rules for nonprofit hospitals be modified?

Published 10:00 pm Monday, October 30, 2017

My Point of View, By Ebenezer Howe

Next year’s general election will be for governor and the constitutional offices on the top of the ticket. We have seen an uptick in the opportunities to attend forums and debates lately. In fact, there have been two in Rochester for governor candidates in the last two weeks — DFL candidates on Oct. 17 and GOP candidates on Oct. 23. These forums were, in my opinion, put on by the medical folks — for the medical folks — to show what have you done for me lately and what are you going to do for me next.

Ebenezer Howe

I generally like these forums or debates. That is when you can sift through what they say and compare to what they have done or claim to have done. Chasing down their claims and determining fact or fiction can be challenging sometimes.

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I was disappointed that the same questions were not asked at both DFL and GOP forums. At the DFL forum, I think close to half of the questions and answers were related to rural health care and Save Our Hospital, but at the GOP forum there was not a question regarding either. Now, I don’t know if the medical folks who put on the forums controlled the questions or if the moderators were in control of the questions. Moderator for the DFL forum was Jay Furst of the Rochester Post-Bulletin. The GOP moderator was Tim Overlie from KTTC TV.

I have had the opportunity to attend three governor forums for Republicans so far, and instead of spreading the field, it has compressed. One candidate I was pretty down on at first has done the best — with me at least. Oh, and I so wanted him to just suck at these.

Some candidates from both parties, and some opinion writers, talk about what is not functioning so well — the government — and then turn right around and propose the application of more government to straighten out the dysfunctional parts. Well, if it is not working, maybe it should just go away.

Some problems are caused by laws, rules or regulations put in place to fix a perceived ill. In most instances, lobbying was going on to point out the ill that was in need of correction and then out of the goodness of their hearts, the same lobbyists provide the wording for the new law, rule or regulation. These solutions provided by lobbyists are in most cases written so as to make it harder for their competition.

Save Our Hospital in Albert Lea is seeing the effects of one such law on hospital construction moratorium. A second provider just can’t come into town and open a new hospital because of it. But, when that law was written, it was to correct or prevent some perceived ill.

On Oct. 23, Fox News had an opinion piece that pointed to another issue affecting not only our local issue with Mayo but all of health care: “The charitable health care racket — Trump should slap new regulations on nonprofit hospitals” by Ned Ryun. The following is from that op-ed.

“But one area of the health care industry that hasn’t been examined hard enough is where the bulk of health care takes place: hospitals, especially nonprofit hospitals.

“… nonprofit hospitals are designated as such by the IRS for complying with the not-for-profit guidelines, such as who owns the hospital … how much “free care” they provide to indigent patients and other benefits the hospital shares with the community.”

These next two sentences were so important to the writer that he included them twice in his op-ed. “As Politico recently noted, the nation’s top seven U.S. hospitals collected more than $33.9 billion in revenue in 2015. But their spending on free treatment for low-income patients shrank from $414 million in 2013 to $272 million in 2015.”

Interesting to me in this op-ed was that Mayo was never mentioned. They didn’t make the top seven nonprofit hospital list. Ned Ryun’s suggestion to Trump was to bypass the do-nothing-Congress and instruct Treasury Secretary Steve Mnuchin “… to change the charity regulations to require tax-exempt hospitals to post their prices for care. Further, the regulation changes should require that anything over $20 million in revenue will not be treated as tax exempt unless the providers post prices, have complete cost transparency and can have real evidence that at least 10 percent of their care is charitable. If they will not post prices, they will have their tax-exempt status withdrawn.”

However nice this sounds, I can’t bring myself to believe that this additional application of government will produce market-driven resolution to some health care costs as Ned did in the conclusion of his op-ed. But it sure is nice to dream of such things.

Alden resident Ebenezer Howe is chairman of the Freeborn County Republican Party. His views do not necessarily reflect the views of the local party members.