Pharmaceutical costs, gasoline prices, doctor’s fees, insurance company antics, and other rip-offs are deservedly under fire most of the time by an outraged public. But why are nonprofits immune to criticism?
Nobody is screaming bloody murder over the cost of higher education even though colleges and universities are constantly growing in wealth as they charge steadily rising tuitions and at the same time lay off more and more employees.
It was announced recently that one of the nation’s most prestigious universities is letting nearly 200 staffers go because one of their endowments has been reduced to $ 26 billion. Neither the president, nor the department heads, nor any of the faculty will be affected, and neither will the construction of new buildings.
Building will always continue because with nonprofits the money must be spent. The balance sheets at the end of the year cannot show a profit. There is a profit to be sure, ever larger each year, but it cannot be seen as a profit. It must appear as an investment in the institution itself.
The only difference between a for-profit and a nonprofit corporation is in where the profit goes. In the corporate world, it goes to the stock holders. In the nonprofit realm, it goes to the organization’s important people, to beneficial projects of all kinds, and largely to new buildings.
Even though tuition keeps going up, and even though the excess income is difficult to hide, the quality of education does not change. The old principle that you get what you pay for does not fit well when it comes to higher education.
It is possible, however, to get an under-qualified student admitted to a high-ranking university by making a large but very proper contribution to the venerable monument of academia. Then you do get what you pay for. If you have enough money, your kid can go the college of his or her choice.
The same game goes on with nonprofit hospitals. A woman I know spent most of her adult life until retirement as an accountant for two major hospitals in the Philadelphia area. As the end of each fiscal year approached, she needed more than one glass of sherry to help her relax when she got home. Hiding the money seemed impossible but somehow she and her team did so successfully year after year.
As hospital costs keep rising, the care of poor people in the emergency rooms or clinics keeps getting worse. A hospital in Jacksonville Florida flatly turns away poor people consistently by using some barely legal excuse. Other hospitals simply make uninsured patients wait until they either go away or develop an actual emergency.
If your case becomes critically urgent, you are more likely to be seen by someone, but still there is no guarantee, especially if you don’t have insurance. Poor people who die waiting are not likely to sue. The population that is likely to bring a lawsuit goes to the head of the line. Those darn lawyers!
Sometimes, even with the best insurance, your care will be delayed or simply not given. I took my mother to the ER one time when she was dehydrated plus exhibiting cardiac symptoms, and because the staff recognized her, she was reluctantly taken into an examining room.
She laid in a bed in that room for a full 30 minutes, until I, in a fury, marched up to the nurses’ station, where I found them sitting around chatting and chuckling. I was forced to demand that she be seen.
There was certainly no shortage of money at that hospital. They were in the midst of three construction projects, and I could hear the heavy equipment rumbling outside my mother’s unattended room. The building contractors were very busy, but the nurses were chatting, and no doctor was seen anywhere I looked.
These kinds of abominations keep on increasing because nobody complains. The corporate world receives all the fire, but the nonprofits just keep getting fatter.
My own income is very small, so I have to try to get health care from a public clinic that is under the Florida Department of Health. My pharmacy had to call the clinic seven times before a refill on my blood pressure medicine could be obtained. Nobody answered the phone.
When I went to my last appointment for a checkup, scheduled three months in advance, I was turned away because they were awaiting their Medicare re certification. They were too busy relaxing to call me and reschedule, so they waited until I arrived.
I can’t get much medical care in that place, but the building is stunning!