The Jan. 15 editorial ("Wanted: an effective advocate for not-for-profit healthcare," p. 26) misinterprets the facts regarding not-for-profit vs. investor ownership. The implication that VHA has "defected to the investor-owned camp" is not only untrue, it grossly oversimplifies this complex, dynamic challenge that requires innovative thinking and behaving. The anecdotal list of events that purport to "highlight" the problem begs clarification in some cases and rebuttal in others.
VHA's involvement with InteCare is not designed to promote conversions of not-for-profit organizations to for-profit status. On the contrary, the joint venture will allow community-focused healthcare providers to maintain their local governance and commitment to community-based values while supplying them with needed capital to invest in the technologies and practices essential for survival.
"Providing sufficient care to the poor" is only one basis for tax exemption and not the sole reason as implied. The IRS defines a "community-benefit standard" that recognizes many other unprofitable services rendered by community-focused healthcare entities.
As for the Kaiser Foundation poll, the editorial neglected to mention other findings. Consumers believe not-for-profit providers are considerably more helpful to their communities than their investor-owned counterparts, cost less, and that the trend toward for-profit healthcare is a "bad thing" for America.
Not-for-profit healthcare as the predominant mode of healthcare delivery in America has many effective champions. They work in the institutions and live in the cities served by these community-sponsored organizations. The trustees of these institutions are respected civic, business and religious leaders linked by commitment and history to their founders. These leaders are their own best advocates. If most of us were asked today to identify those institutions we want to protect, to nourish and, bottom line, to receive care in, we would point with conviction to the not-for-profit community hospital.
C. THOMAS SMITH,
President, chief executive officer
VHA, Irving, Texas