There's an often-quoted saying that war is too important to be left to the military. Increasingly, the same principle can be applied to charity care and community benefits. More public officials and other critics outside the industry are taking aim at hospitals. Consider these developments:
The New Hampshire attorney general's office said the two private hospitals in Manchester violated state charity-care laws by consolidating some services at one site after their merger. The office said Optima Health erred by trying to eliminate acute-care services at one facility without obtaining probate court approval of a change in mission for the hospital, a charitable institution. The state also said Optima stripped both not-for-profit hospitals of their local governance by effectively transferring control to a regional board, violating the hospitals' charitable missions and promises to the community.
A national taxpayer watchdog group has set its sights on not-for-profit hospitals and charity care. Citizens Against Government Waste examined not-for-profit hospitals in the Washington area and concluded that despite the considerable wealth of some not-for-profits, their charity-care spending is minimal. An official of the group said, "Citizens in their towns have to make sure the local hospital is returning something to their community."
One could add that hospitals ought to make sure of the same thing. And they ought to document their efforts in detail and widely disseminate the information.
Finally, a striking comment emerges in the New Hampshire attorney general's report: "Optima appears to have developed a corporate culture, led by management and acquiesced in by its trustees, which assumes that the delivery of healthcare is best left exclusively to the sole judgment of management."
That may or may not be a fair criticism of Optima. But any executive who subscribes to that theory needs to realize that healthcare, like war, now has civilian oversight.