To the Editor:
Re “Nonprofit Hospitals Are Focused More on Dollars Than on People,” 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, “substitute some financially minded members with community-minded ones,” and change 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 can pay better consideration to those that eat and supply their companies when their boards enhance their illustration of girls and folks of colour to extra intently mirror the demographic make-up of stakeholders — sufferers, college students, staff and surrounding communities.
Interviewees in a national report we wrote stated gender and racial board variety will increase effectiveness in serving customers and prompts boards to pay better 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 staff.
To hasten change, the Girls’s Nonprofit Management Initiative joined with main organizations and people throughout america to petition the I.R.S. in June to require massive 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 Girls’s Nonprofit Management Initiative.
To the Editor:
Hospitals of all kinds present unparalleled advantages to their communities. But the writer of this visitor essay ignores these advantages in an unconvincing effort to say that hospitals are usually not residing as much as their mission.
Cherry-picking statistics and weaving collectively unrelated points to attempt to construct a false narrative undermines the exhausting work and societal contributions of the hospital area that gives 24/7 medical care (which is usually uncompensated or undercompensated), and different important companies, together with emergency care.
In a report ready for the American Hospital Affiliation, an business group, the accounting agency EY, beforehand Ernst & Younger, estimates that each greenback invested in nonprofit hospitals ends in $9 in benefits delivered back to the community. Tax-exempt hospitals provided $129 billion in total benefits to their communities in 2020, a rise from prepandemic ranges and a unprecedented feat given the acute stress Covid-19 created for America’s well being system.
Hospitals present excess of medical care; they supply social companies, meals insecurity packages, 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 typically present. Nevertheless, it affords 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 revenue was $7.4 billion; its expenses, $6.8 billion. It paid no taxes. In 2022, I, as a semiretired doctor, paid 9.1 % of my gross revenue as federal tax.
The Supreme Court docket, in Citizens United v. Federal Elections Commission, has, in impact, declared that companies are individuals. Why are they not subjected to a progressive revenue tax?
Marc H. Lavietes
New York
The author is a pulmonary and significant 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 end result could also be in danger and that nonprofits could change into no higher than investor-owned services.
His proposal that boards be reconstituted and reward group service as an alternative of economic efficiency is a obligatory however an inadequate response.
Why do these establishments behave as they do? Until we perceive and deal with these causes, his suggestions could be not more than a limited-impact Band-Assist.
We have to take a look at the complete U.S. well being care system. Why is our system the costliest on the planet but produces mediocre combination outcomes? Why do hospitals, nursing properties and insurance coverage firms consider they must be bigger and bigger? Simply to eradicate the competitors? So the managers (and shareholders within the case of for-profit companies) can enrich themselves?
After we get the solutions to these and different questions, we are able to determine cheap adjustments that assure that everybody has entry to the care they want. These reforms will probably be exhausting to realize, although, as a result of the organizations that drive the developments he describes have the political energy to withstand elementary 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 Price of Lying 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 legislation 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 skin world, broke and damaged.
Simply one other piece of collateral injury 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 all the things to please his boss.
The picture of Mr. Giuliani strolling resolute by the rubble of 9/11, defiant and decided, has way back light from sight. The glory days are endlessly 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 staff whom he defamed so egregiously “could be the tip of Mr. Giuliani.”
It will be attention-grabbing to study whether or not the jurors awarded as a lot as they did as a result of they didn’t consider what the lawyer stated or as a result of they did.
Steven P. Grossman
Baltimore
The author is professor emeritus on the College of Baltimore College of Regulation.
Why the Pessimism?
To the Editor:
Re “It’s No Surprise That America Is Pessimistic,” by David Wallace-Wells (Opinion, Dec. 10):
It must be no shock that conventional financial theories based mostly on information and laptop modeling fail to attach elementary 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 data and conspiracy theories, 24/7. One want solely evaluate the variety of subscribers to conventional media (The New York Occasions, The Washington Submit) and the variety of subscribers to social media (Fb, X) to search out the reply.
Mary Frankel
Bryn Mawr, Pa.