To the Editor:
Re “Nonprofit Hospitals Are Centered Extra on {Dollars} Than on Folks,” by Amol S. Navathe (Opinion visitor essay, Dec. 4):
Dr. Navathe says nonprofit hospital boards have to give attention to mission, communities and sufferers greater than income, “change some financially minded members with community-minded ones,” and develop into extra accountable to the I.R.S. and native governments.
His message additionally applies to nonprofit faculties/universities, lots of which function hospitals. These largest and most influential public charities pays larger consideration to those that devour and supply their companies when their boards improve their illustration of girls and other people of coloration to extra carefully mirror the demographic make-up of stakeholders — sufferers, college students, workers and surrounding communities.
Interviewees in a nationwide report we wrote mentioned gender and racial board variety will increase effectiveness in serving shoppers and prompts boards to pay larger consideration to high quality and affected person security, to look past numbers and funds to affected person expertise and satisfaction, and to pay extra consideration to the welfare of scholars and workers.
To hasten change, the Ladies’s Nonprofit Management Initiative joined with main organizations and people throughout the USA to petition the I.R.S. in June to require giant public charities to report the demographic make-up of their boards on their annual Kind 990 tax return. Including one easy query to that type would give stakeholders the knowledge they should maintain these boards extra accountable.
Vicki W. Kramer
Carolyn T. Adams
Philadelphia
The writers are co-chairs of the Ladies’s Nonprofit Management Initiative.
To the Editor:
Hospitals of every type present unparalleled advantages to their communities. But the writer of this visitor essay ignores these advantages in an unconvincing effort to assert that hospitals usually are not residing as much as their mission.
Cherry-picking statistics and weaving collectively unrelated points to attempt to construct a false narrative undermines the onerous work and societal contributions of the hospital subject that gives 24/7 medical care (which is commonly uncompensated or undercompensated), and different important companies, together with emergency care.
In a report ready for the American Hospital Affiliation, an trade group, the accounting agency EY, beforehand Ernst & Younger, estimates that each greenback invested in nonprofit hospitals leads to $9 in advantages delivered again to the neighborhood. Tax-exempt hospitals supplied $129 billion in whole advantages to their communities in 2020, a rise from prepandemic ranges and a rare feat given the intense stress Covid-19 created for America’s well being system.
Hospitals present excess of medical care; they supply social companies, meals insecurity applications, maternal and prenatal training, transportation, housing and financial alternatives. They’re the center of their communities and deserve our assist, not false narratives.
Rick Pollack
Washington
The author is president and C.E.O. of the American Hospital Affiliation.
To the Editor:
Dr. Amol S. Navathe’s essay describes clearly each the surplus revenue that nonprofit hospitals make and the insufficient care they usually present. Nevertheless, it presents solely an imperfect answer: to give attention to the actions of their boards of administrators.
A greater answer? Tax the hospitals. N.Y.U. Langone has loved tax-exempt standing since 1998. In 2022, its income was $7.4 billion; its bills, $6.8 billion. It paid no taxes. In 2022, I, as a semiretired doctor, paid 9.1 p.c of my gross earnings as federal tax.
The Supreme Court docket, in Residents United v. Federal Elections Fee, has, in impact, declared that firms are folks. Why are they not subjected to a progressive earnings tax?
Marc H. Lavietes
New York
The author is a pulmonary and important care physician and the secretary of the New York Metro chapter of Physicians for a Nationwide Well being Program.
To the Editor:
Dr. Amol S. Navathe’s essay is disturbing as a result of a few years of analysis present that nonprofit hospitals present higher care than for-profit ones. The development he describes means that outcome could also be in danger and that nonprofits could transform no higher than investor-owned amenities.
His proposal that boards be reconstituted and reward neighborhood service as a substitute of economic efficiency is a needed however an inadequate response.
Why do these establishments behave as they do? Except we perceive and deal with these causes, his suggestions may be not more than a limited-impact Band-Assist.
We have to take a look at your complete U.S. well being care system. Why is our system the most costly on the planet but produces mediocre mixture outcomes? Why do hospitals, nursing properties and insurance coverage corporations consider they should be bigger and bigger? Simply to eradicate the competitors? So the managers (and shareholders within the case of for-profit corporations) can enrich themselves?
After we get the solutions to these and different questions, we will establish cheap modifications that assure that everybody has entry to the care they want. These reforms might be onerous to realize, although, as a result of the organizations that drive the tendencies he describes have the political energy to withstand basic change.
Stephen M. Davidson
Philadelphia
The author is professor emeritus of well being care coverage and administration at Boston College.
A Disgraced Rudy Giuliani
To the Editor:
Re “Giuliani Finds Value of Mendacity Is $148 Million” (entrance web page, Dec. 16):
This was not how Rudy Giuliani imagined the final years of his life. As soon as the regulation and order boss of New York Metropolis, adopted by a dalliance with the Republican nomination for president. Now however a punchline, disgraced and, to the surface world, broke and damaged.
Simply one other piece of collateral harm within the orbit of Donald Trump. Mr. Giuliani, making an attempt desperately to maintain his quarter-hour of fame going just a few extra seconds, acted with clear calculation and no ethical restriction, doing something and every little thing to please his boss.
The picture of Mr. Giuliani strolling resolute via the rubble of 9/11, defiant and decided, has way back pale from sight. The glory days are ceaselessly gone. Now all that continues to be is a tragic, pathetic, hollowed-out shell of a person.
Robert S. Nussbaum
Fort Lee, N.J.
To the Editor:
Rudy Giuliani’s lawyer claimed that the financial damages awarded to the 2 Georgia election employees whom he defamed so egregiously “could be the top of Mr. Giuliani.”
It could be attention-grabbing to be taught whether or not the jurors awarded as a lot as they did as a result of they didn’t consider what the lawyer mentioned or as a result of they did.
Steven P. Grossman
Baltimore
The author is professor emeritus on the College of Baltimore College of Legislation.
Why the Pessimism?
To the Editor:
Re “It’s No Shock That America Is Pessimistic,” by David Wallace-Wells (Opinion, Dec. 10):
It must be no shock that conventional financial theories primarily based on information and laptop modeling fail to attach basic financial indicators (now up) to client sentiment (now down). The economists are barking up the fallacious, albeit conventional, tree.
Look to the sway of social media, rife with unsubstantiated info and conspiracy theories, 24/7. One want solely evaluate the variety of subscribers to conventional media (The New York Instances, The Washington Put up) and the variety of subscribers to social media (Fb, X) to seek out the reply.
Mary Frankel
Bryn Mawr, Pa.
