As the feds dole out billions to hospitals fighting COVID-19, should well-endowed tax-exempt health systems be at the back of the line?
Struggling hospitals and those hardest hit by COVID-19 should get more federal funding than nonprofit hospital systems with large endowments, patient safety advocates and other critics say.shows the 20 nonprofit hospitals ranked by investments reported more than $116 billion in investments, including endowments. And although flush with money, critics say the tax-exempt systems also failed to adequately invest in basic emergency planning before the pandemic.
"The money going to hospitals is not free, it comes off the backs of American workers, over 10% of whom are unemployed," says Dr. Marty Makary, a Johns Hopkins University public health professor, patient safety advocate and author."The hospitals who need it should be prioritized, not those with billion-dollar endowments and large cash reserves that provide little charity care. Not all hospitals function similarly.
Because the initial $30 billion was needed so quickly, it had"only a loose relationship to which hospitals actually needed the money," said Roy, a senior advisor to the Bipartisan Policy Center. Thomas Meier, treasurer of the Kaiser Foundation Hospital and Health Plan, the insurance arm of Kaiser Permanente, said the CARES Act funds "will promote stability in the health care system and be a critical part of how we can continue to operate and deliver care during this unprecedented time."
The public pressure goes beyond current funding. Policies should require the wealthiest nonprofit hospitals use more of their assets to help other hospitals with emergency preparedness, some say. "Just in time" ordering of supplies by hospitals, which is recommended for efficiency, led to most having just a week or so stock of masks and other protective equipment. Hospitals started moving toward just in time ordering as profit margins shrank, costs rose and reimbursement rates were cut. Keeping a limited amount of supplies on hand lowers costs.
Candie St. Jean is a nurse case manager at Cooley Dickinson hospital in western Massachusetts, where the union has been fighting to have the ratio of nurses to patients reduced. The hospital is owned by Boston-based Partners Healthcare, which is ranked third by Open the Books with more than $9 billion in investments.
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