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Time for Hospitals To Act as Good Corporate Citizens

Malinda Markowitz commentary, California Healthline, 4/9/13

The California Assembly Health Committee holds the first hearings April 2 on two bills sponsored by the California Nurses Association, including one that has already drawn considerable interest on holding hospitals more accountable in meeting their charity care and community benefit obligations.

Malinda Markowitz
Co-president, California Nurses Association


Has therapeutic healing and recovery become a vanishing mission among California hospitals? Are California hospitals operating as big corporations more devoted to piling up cash than to assuring the delivery of care?

A look at how California's private, not-for-profit hospitals are meeting their responsibilities for providing charity care and community benefit programs suggests many have lost their way.

In 2010 alone, not-for-profit hospitals pocketed $1.8 billion dollars in government subsidies through their tax breaks and other benefits above what they returned to patients in charity care, as documented in a California Nurses Association report based on public data.

Nearly half that total was recorded by just two of California's biggest hospital chains, Kaiser Permanente and Sutter Health, which also happened to account for almost half of the 100 not-for-profit hospital executives who received pay packages of more than $1 million a year.

While many hospitals are no doubt good corporate citizens, these numbers undermine credibility for the hospital industry as a whole, especially when some apparently count marketing, cost-cutting and other dubious practices as their community benefit program.

Instead of opposing a common sense bill like AB 975, just as they have fought nearly every reform aimed at strengthening patient protections in California, hospital lobbyists should welcome this legislation as a way to restore public confidence that they are being genuinely transparent, accountable and acting in good faith in the delivery of charity care and community benefit.

California's nurses salute Assembly members Bob Wieckowski and Rob Bonta for introducing AB 975. The bill is supported by California Nurses Association and an array of other labor and consumer groups, as well as elected leaders who believe we need common standards and a level playing field with equal expectations for all not-for-profit hospitals that reap the rewards of their tax exempt status.

Regrettably, implementation of the Affordable Care Act will not end the health care crisis. We continue to see patients skipping needed medical treatment, cutting prescription pills in half, unable to pay exorbitant hospital bills and facing huge out-of-pocket costs for insurance they can barely use.

Until we can achieve more far-reaching health reform, it is more important than ever for hospitals to compete in providing appropriate and equitable levels of charity care and community benefit, and not in who can most resemble Lehman Brothers or Goldman Sachs

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