High CEO Salaries at Nonprofit Hospitals Under Scrutiny…Once Again

Shock and outrage ensue every time the press gets wind of the million-dollar-plus salaries and other perks reaped by some CEOs at nonprofit hospitals. This year is no different—except that the ongoing recession that is forcing states to make painful budget cuts, especially by slashing Medicaid programs, is making the compensation reports especially hard to stomach.

In New York, for example, a state Medicaid-redesign commission recently recommended cuts to health care spending that total $2 billion. But while the proposal includes limiting home health care, increasing co-pays for Medicaid recipients, reducing their dental and mental health services, and putting a $250,000 cap on malpractice claims, there was no mention of limiting what the New York Times calls “lofty” salaries for CEOs at nonprofit hospitals.

According to the Times, “At Bronx-Lebanon, a hospital that exists only by the grace and taxed fortunes of the people of New York State, the chief executive was paid $4.8 million in 2007 and $3.6 million in 2008, records show. At New York-Presbyterian, a hospital system that receives nearly half a billion dollars annually in public money, the chief executive was paid $9.8 million in 2007 and $2.8 million in 2008.” St. Vincent’s Medical Center, a 150-year-old institution in Manhattan’s Greenwich Village closed last year, but not before the top 10 executives took home about $6 million.

In fact, Joanne Doroshow, executive director of the Center for Justice and Democracy, writes in the Huffington Post, “the 21 top-earning New York hospital executives collectively earned $64.3 million in 2008. If New York simply capped annual hospital executive salaries to the level of the ‘cap’ to which they want to condemn the sick and injured for a lifetime ($250,000), we'd have $63 million for the Medicaid budget, right there.”

Non-profit hospitals and health care centers are exempted from paying income, property and sales tax in exchange for providing “community benefits” such as uncompensated care, education and outreach programs. But oddly, the Internal Revenue Service does not set a minimum level for what portion of a hospital’s revenues must go toward these charitable activities. In 2009, the IRS published a survey of nearly 500 nonprofit hospitals across the country and found that hospital CEO compensation averaged nearly $500,000 whereas uncompensated care expenditures as a percentage of revenues averaged about 7 percent.

But there is a wide range in CEO salaries (in California alone from $136,000 to $7.8 million, for example) and compensation is not always consistent with the size, revenues or charitable contribution of the institution.

As the authors of a 2009 working paper produced by the University of Connecticut School of Business   write, ideally “not-for-profit status should mean hospital CEOs are compensated based upon their relative success at fulfilling the charitable mission of their organizations.”

In fact, the opposite often appears to be true. Hospitals that serve a larger percentage of private payers and provide less charity care pay their CEOs more. In Connecticut, for example, the working paper authors found that a “10 percent increase in the fraction of revenues devoted to uncompensated care lowers CEO pay by 1.5 percent.” Additionally, a 10 percent increase in the share of revenues coming from government payers lowered CEO pay by slightly over 19 percent.

Meanwhile in the real world where a different economic model is dictating compensation for nonprofit hospital CEOs, “the CEO may be more interested in expanding the size of the organization, maximizing revenues to finance discretionary expenditures, or increasing the structural quality of the institution. Pursuing individual goals may be relatively unconstrained because the CEO often plays a pivotal role in the selection of various board members,” according to the University of Connecticut report. In the typical nonprofit hospital, the “CEO faces an incentive to increase the occupancy rate of privately-insured patients and possesses little incentive to provide additional community benefits at the margin.”

Finally, the authors conclude, “the compensation of hospital CEOs may be unrelated to their on-the-job performance particularly with respect to satisfying the charitable mission of the organization.”

Health care executives defend the half-million-dollar-plus salaries (and added bonuses, deferred income, retirement plans, and other perks) as the only way they can attract the top people to their organizations. They argue that nonprofit hospitals compete with for-profit facilities, which also get a large share of their revenues from Medicaid and Medicare.

According to Roy Poses, writing on the blog Health Care Renewal, “The usual explanation by organizational spokespeople, and occasionally boards of trustees is that this is the sort of compensation needed to attract the best and the brightest, a variation of the ‘pay for performance’ meme that resounds throughout business schools and executive suites.”

In Washington State, reporter John Ryan from KUOW News (Puget Sound Public Radio) used public records to find out pay for nonprofit hospital executives in his state. In his report, which aired this past December, Ryan found that 15 hospital executives in Washington made $1 million or more in 2009. The biggest winner was John Koster, CEO of Providence Health and Services, a Catholic ministry that operates 27 hospitals in 5 states. Koster earned a cool $2.4 million in 2008, according to Ryan’s research. Executives (including Koster) would not talk with Ryan, but a human resources officer at the nonprofit said of the hospital chain, “So our mission is to reveal God's love and care for the poor, especially for the poor and vulnerable, through our compassionate care. To be able to do that, we need to make sure that we can attract and retain the best talent. So, yes, we need to make sure that we're paying at least market for any of our employees that serve.”

But what is this measure of “performance” when it comes to the CEOs of non-profit hospitals? Is it how well a CEO does in leading his or her hospital in providing community benefits like uncompensated care for the poor, or is it how successful the CEO is in building cardiac centers and laser-surgery programs that attract private-pay customers? The expansion of many nonprofit hospitals, the duplication of imaging and specialized surgery centers and investment in other features designed to draw in private-pay customers suggests the latter.

In another post, Poses looks at nonprofit hospital CEOs in Florida, Texas and North Carolina where salaries and bonuses often top $1.5 million (all the way up to the $3.4 million that Carolinas HealthCare paid CEO Michael Tarwater in 2009) and writes, “the sorts of compensation reported in [those states] are a product of the current management culture that has been infused into nearly every health care organization in the US. That culture holds that managers are different from you and me. They are entitled to a special share of other people's money. Because of their innate and self-evident brilliance, they are entitled to become rich. This entitlement exists even when the economy, or the financial performance of the specific organization prevents other people from making any economic progress.”

Jay Hancock, a columnist at the Baltimore Sun recently wrote a piece titled, “For hospitals, non-profit stops with CEO’s salaries.” In it Hancock reports, “Eight top Baltimore hospital executives pulled in more than $1 million each in fiscal 2009, according to newly detailed disclosures from the Internal Revenue Service.”

“Close to a dozen had personal dues for ‘social clubs’ financed by your charitable donations, tax dollars and health insurance premiums. Many enjoy lavish and opaque executive retirement plans that also put upward pressure on the medical costs that threaten government budgets and the economy.”

The recent flap over hospital CEO pay is just the most tangible issue in the overall controversy over whether or not nonprofit hospitals and health care chains actually earn their tax exemptions. I wrote about how in May 2009, the Senate Finance Committee chairman Max Baucus, and ranking Republican Charles Grassley introduced a bipartisan proposal that would have required nonprofit hospitals to provide a minimum level of charity care, limit how much they charge the uninsured, and to scale back aggressive collection processes or face an excise tax or even an end to their tax-exempt status.

When the Affordable Care Act was enacted a year ago, a watered-down version of the Finance Committee proposal was adopted. Under the health bill, hospitals still do not have to provide a minimum amount of charity care, but they must make financial assistance information readily available to patients, they have to limit the fees they charge people receiving this assistance, and hospitals have to cut back on aggressive bill collection processes. The other big change is that every three years the Treasury Department will review the community benefit activities of each tax-exempt hospital. But there is nothing that specifically regulates executive salaries—other than the existing requirement that they be “reasonable.”

This “presumption of reasonableness” falls squarely on the shoulders of the IRS. But the agency has a fairly vague definition of what is reasonable. According to its 2009 “Exempt Organizations Hospital Study”:

“An organization may place the burden of proving excessive compensation on the IRS by using disinterested persons to review comparability data (including, in appropriate circumstances, that of for-profit organizations) to establish compensation, and by properly substantiating the process used to set compensation.”

To translate this from agency-speak, hospital boards and compensation committees use outside consultants (the so-called “disinterested persons”) to come up with the salaries, incentives and other perks offered to hospital CEOs. The consultants survey the field, looking at salaries of CEOs at nonprofit and for-profit institutions, see what the 50th percentile is and then in many cases offer 20% or 30% above to qualified candidates. Mathematically, this keeps the 50th percentile moving up and what the IRS considers “reasonable” also moves up. The consultant is not really “disinterested,” he or she would like to keep top hospital executives and the board (often allies of the CEO) happy in order to increase the chance the firm will be given future work.

“Right now, it’s not clear what power the IRS has in terms of nonprofit hospitals,” says Kester Freeman   former CEO of Palmetto Health in Columbia, SC who blogs at the site Action for Better Healthcare. “The IRS now has all the information it needs and if I worked for the IRS and I saw the CEO of a hospital with four hundred beds making four million dollars I would investigate.” The agency has the power to remove a hospital’s not-for-profit status, but that almost never happens—when it does occur (as in the Supreme Court case of Provena Hospitals in Illinois) it’s almost always instigated by state or local officials who have an interest in recouping valuable property and sales taxes. In Provena’s case, the Supreme Court found that the hospital set aside just $831,000, or 0.7% of its revenue in 2002 for community benefit, less than the $1.1 million in tax breaks it stood to receive. Freeman believes that the IRS should have the authority to go to a hospital’s compensation board and say, “this salary is excessive,” it’s just not warranted.

For now, public opinion and state legislators are the de facto policemen when it comes to CEO compensation. As part of the tax reporting process, nonprofit hospitals must disclose yearly salary and other compensation information for their five top-paid executives. A new version of the forms (called 990’s) requires more details and stricter reporting of perks. Reporters and advocacy groups who hope to bring public attention to the issue of excessive compensation are increasingly mining these disclosure data. In California, for example, Payers and Providers, a publication covering the health care industry, conducted a survey of 118 nonprofit hospitals and found that the base salary for CEOs averaged $514,000 (similar to the national average). But with bonuses, retirement money, reimbursement for education costs, and expense accounts, the average total compensation for those CEOs rose to $732,000.
The survey also identified 17 hospitals in California where the total compensation to CEOs exceeded the cost of charity care.

“It would be outrageous if hospitals are paying more to their (entire) executive teams than in indigent care in their community,” Anthony Wright of Health Access California told the Ventura County Star:  “For some hospitals to provide more to one individual just seems wrong.”

The Baltimore Sun’s Hancock agrees, “Hospitals aren't Goldman Sachs. They're not Stanley Black & Decker or Microsoft, either. They're nonprofits, getting charitable donations and huge government subsidies beyond all the loot they rake in from Medicare and Medicaid. If the newly required disclosures on the IRS "Form 990" put pressure on hospital boards and CEOs to tone it down, it's about time.”

In Massachusetts, home to seven major tax-exempt teaching hospitals that reap billions in federal health dollars, Attorney General Martha Coakely’s office is investigating executive compensation practices of nonprofit health care systems and insurers in the state. Likewise, in New Hampshire, Gov. John Lynch raised the issue of administrators' compensation at the state's nonprofit hospitals, noting the top 200 administrators earned $60 million last year.  He has warned non-profit hospitals that high executive salaries will have to be cut as the state institutes major cuts in Medicaid and other state health programs.

Some state legislators are calling for caps on hospital executive salaries: Last month in Maine, State Rep. Brian Bolduc proposed capping a hospital administrator's total compensation at $70,000, the same salary as the governor. The bill, which got a “cool reception with no co-sponsors” was easily defeated, according to a report in the Sun Journal. Meanwhile, two state senators in Washington are sponsoring a bill that would require nonprofit hospitals to publish their top executives’ incomes each year and provide proof that their paychecks are comparable to those for similar jobs in the public sector. Others have suggested that executives at nonprofit hospitals should be held to the same standard as their counterparts at firms bailed out by TARP—earning no more than $500,000.

Where do we go from here?

It’s clear that without any new limits on CEO compensation in the health bill, more transparency and stricter reporting requirements will be vital for raising the curtain on excessive salaries and perks. Faced with unsustainable budgets, states are putting pressure on nonprofit hospitals to cut these salaries and bring the outliers in line with the average. There will likely be more local challenges to hospitals tax-exempt status too as legislators look for new revenue streams.

According to a report on executive compensation at nonprofit health care centers by the Alliance for Advancing Nonprofit Health Care, “boards of many nonprofit health care organizations have begun to eliminate elements of their executive compensation programs that are most vulnerable to criticism.” These include previously standard perks like country club memberships, company cars, severance benefits and lucrative retirement plans, that might look bad to local communities and state regulators.

The Alliance report recommends that to avoid “avoid publicity” from regulators and stakeholders, “boards would be wise to take this opportunity to reform executive pay by (1) avoiding the types of practices that attract and deserve the most criticism and (2) rewarding executives for outcomes that represent prevailing public views of what nonprofit health care organizations’ goals should be.” That presumably is serving the poor and providing other community benefits—not building another open heart surgery center in an area already served by two others.

The outcry over high health care executive salaries will not go away any time soon. Insurers who continue to raise premiums are under scrutiny for the hefty compensation packages they use to reward their top executives. Hospitals that depend on Medicaid and Medicare—two programs that are facing drastic cuts over the next decade or so—will be under greater pressure to bring CEO salaries in line with other austerity measures. But all this depends on the power of public opinion and state action.

As health care reform kicks in and more Americans are covered by insurance, hospitals will be providing less charity care. Perhaps it’s time to rethink the non-profit exemptions of many hospitals—setting stricter limits on how much community benefit they must provide and ensuring that CEO salaries and tax exemptions don’t exceed the value of a hospital’s good works.

23 thoughts on “High CEO Salaries at Nonprofit Hospitals Under Scrutiny…Once Again

  1. Being naive and hopelessly idealistic I reject the entire phrase as “Hospital Industry” (profit or non-profit)
    The incentives for “patient health” are extremely perverse or non-existant.
    I say to all the CEOs who have MBAs – trade them in for MPH’s.
    The era of US medicine as a treatment oriented mega-business is over.
    Dr. Rick Lippin

  2. Amen!
    I remember the CEO of a small, rural, community hospital in California where I once worked. He made$300,000/yr and got a big bonus for successfully fighting efforts by Respiratory therapists and the LPNs (who could not join the RNs in the CNA union we had) to organize.
    Meanwhile, our idea of cardiac monitoring of heart patients in the ER was hooking them up to a Zoll defibrillator and watching two rooms from a table in the hallway because there was no way to monitor anything at the nurse’s station.
    This administrator would give the ER docs and PAs a hard time if they refused narcotics to our well known drug seekers . . . he needed them to dole out the drugs so he could increase the Medicaid reimbursement.

  3. Great post! Unfortunatly this is a topic that has been on the radar for some time and yet CEO salaries at non profit institutions continue to rise.
    Health care reform resulting in more megolithic health care organizations will likely exacerbate the problem. Boards continue to be constructed of fellow CEOs and buisiness leaders rather than reflective of the community served by the hospital. Money and profit remain the principle measure of CEO performance despite these being non-profit organizations with supposedly philanthropic missions. Additional resources (that is proftis) allow the more successful organizations to buy up medical practices and merge in other hospitals, resulting in increased total revenues. More revenues equate to increased compensation for the management team since the more you manage, the more you should receive in compensaton under this warped system. While nearly every other job category has had stagnant growth in compensatoin, we continue to see a persistent rise in executive compensation in nearly every area of endeavor that has led to ever increasing income polarization, with a small elite class consolidating ever greater wealth while the middle class faces extinction. To say the least, I don’t see any evidence that this will change anytime in the near future.

  4. Executive compensation and the amount of charity care provided by non-profit hospitals are two separate and distinct issues. First, to provide any charity care at all, any hospital needs its overall revenue to exceed its expenses. No margin, no mission. To the extent that Medicaid pays hospitals well below their cost of providing services, it reduces the ability to provide charity care. If policymakers want to establish some definitive criteria related to the minimum amount of charity care as a percentage of revenues that hospitals need to provide to justify their tax exemption, they should do so.
    Regarding executive compensation, I learned a long time ago that having the right person in a key spot in any organization can make a big difference in how well it performs. There is a national market for capable leadership at the CEO level. Any organization that expects to be successful needs to be able to pay all of its employees enough to attract and hold people who can perform their jobs in a competent and professional manner. The notion of capping hospital CEO pay at $250K in NYC of all places is preposterous. If the top five executives of every non-profit hospital in the country all worked for $1 per year and the savings were used to reduce hospital prices, the savings would likely amount to less than 1%. If we want to attack the excessive growth of the cost of hospital care as well as the rapid increase in prices per procedure year after year, we would insist on disclosure of actual contract reimbursement rates so more business could be driven to the most cost-effective providers and either force the high cost providers to lower their prices, reduce their number of licensed beds or close altogether.

  5. Sorry, Barry. I don’t buy your arguments on compensation.
    It’s the same dull mantra of CEO’s on Wall Street. The same CEO’s who ran their banks and corporations into the ground, and were given bonuses for it.
    In a recent spat between the two big hospital “non-profits” in my area, the smaller (and weaker of the two) had its traditional geographical territory infringed on by the other, larger, megalithic wannabe who built a free-standing ER there, unattached to any actual hospital.
    And by ER, I do mean the full blown traditional ER that takes everything and falls under EMTALA.
    Smaller hospital protests to the state and tries to get a CON denied based on the “market share” argument.
    Doh! Needless to say, no one had much sympathy at the state level.
    They should have argued that a free standing ER, without access to an OR, cath lab, or ICU, was not a good idea for patient safety. If a patient comes in with an MI, stroke, or trauma, minutes count. They have to transfer their patients 30 minutes down the road to Megalithic Wannabe Hospital if they need any kind of critical care, or even a basic hospital admission.
    No one’s died . . . yet.

  6. Panacea —
    Hospitals will compete for market share no matter what the CEO is paid. One doesn’t have anything to do with the other.

  7. Barry,
    I disagree that executive compensation and charity care have nothing to do with each other. Take a look at the Connecticut study to see that hospitals that pay their CEOs the most tend to do the least direct charity care. And as for hospitals competing for market share–they specifically make the point (as do you) that paying top dollar for a CEO is the way to make sure you get one that performs well. Performing well, as I point out in the post, has little to do with expanding the mission of nonprofit hospitals to provide community benefit. Performing well means grabbing more market share–especially among private-pay customers–and opening up a stand-alone ER is a perfect example.

  8. Naomi –
    I don’t think the inverse correlation between high hospital CEO compensation and the amount of charity care provided is meaningful. If the governing body of a hospital wanted charity care and community benefits ramped up sharply, it could make that clear to either the existing CEO or one who is just being hired and it could make progress toward those objectives a key metric in determining the CEO’s bonus. As I said in my original comment, however, every hospital needs to generate enough revenue to cover its costs, not necessarily in each year but over time. Hopefully, if health reform is successful in significantly reducing the number of uninsured, there will be a lot less need for charity care in the future.

  9. Naomi,
    My guess is if you look at the places that pay the CEO the most and do the least charity care, this relationship would have more to do with where the hospital is located. Suburban hospitals have less uninured and underinsured patients and thus a higher percentage of paying customers. They consequently make a higher profit and end up paying the CEO more for excellent financial performance, even if this is largely due to the luck of being in a lucrative location.
    It make my point that CEOs are paid for how well they do financially, rather than some measure of overall community health, which would seem more applicable to a non profit hospital.
    The financial health of hospitals depends on location, location, location. The ones with more money sloshing around are likely to pay their administration more.

  10. Again I say — This is an Old Story. A couple of bloggers get upset and there are a few negative news stories come out.
    Then the hospital PR spin machine emits a bunch of positive news about these same institutions being job creators, and health care innovators, and really not well paid in comparison to what they could make elsewhere, how giving and nice the executives are etc. etc.
    Everyone knows the story, I believe most folks agree that healthcare is a field where those in power pay themselves royally and really don’t care about much else.
    I have actually heard senior citizens say that they have been damaged by these hospitals and yet they will not say anything bad about the hospitals because (especially as a senior citizen) they may need healthcare in the future and believe that the hospital may not treat their illness well if they squack.
    Can you imagine that — Afraid of being harmed by those entrusted to help maintain health. That simply says it all. Ask a few seniors in your neck of the woods if they feel the same should they squack about a local hospital.
    Nothing happens and may never happen. Those with power over our health are kings, they have the ultimate power over us, pain and death.

  11. Everyone knows the story, I believe most folks agree that healthcare is a field where those in power pay themselves royally and really don’t care about much else.

  12. Barry: but the CEO will be paid a big fat bonus when he increases his market share.
    Health care should not be about market share.

  13. That isn’t a surprise, the executives get all the doe, while the workers are scum cause they fight for an extra 5o cents on their checks, what’s wrong with this picture, and they said unions caused the problem, when these executives are pushing 7 figure incomes.

  14. im trying to find the past 3 years salary for mr Carperter C E O of nkc hospital , a non for profit owned by the city of north kansas city mo can you tell me where to find this info, ? it should be public info . thanks , best regards , Gary Sirna 1421 murray str. nkc mo 64116

  15. Pingback: Health Care Prices “Are Too Damn High” |

    • Hospitals are not making 11.7% in profits.
      Hospitals with Huge endowments have been making nice profits on investments.
      But operating margins for non-profits are, by large, pretty low.
      But hospitals could tighten their belts by reducing waste–improving their systems, following
      evidence-based guidelines and reducing errors.

      • Barry–
        1979 is an appropriate beginning point because it was the eve of a major turning point in
        American history: the election of Ronald Reagan, and the beginning of what is now known as the Greed Decade.”
        Programs to help the poor were slashed. (Reagan’s lies about “welfare queens” were very effective.”
        Schoarships based on need and merit to help low-income and middle-class kids go to college began to disappear. They would be replaced by loans to help upper-middle-class and upper-class families send their kids to college while continuing to “shop until they dropped” — while also chasing growth stocks. Most states that had regulated hospital prices were taken over by conservatives who “de-regulated” everything in sight– including hospitals. Only Maryland continue to keep a lid on hospital prices, and has done a very good job. The administration has asked Maryland to come up with some ideas about regulating other areas of health care. Yes, Medicare and Medicaid pay more in Maryland–but health care inflation is lower than in most of the nation. The system works–as the Obama administration understands– .
        At the same orporations began “down sizing”– white collar unemployment would reach a high in the early 1990s, causing great pain.
        Meanwhile, wages for the middle-class stagnated (no one dared ask for a raise), CEO salaries skyrocketed, and the wealthy created a stock market bubble that led to the crash of ’87. (I wrote a cover story for Barron’s predictng the crash about 2 weeks before it happened. Many of my sources saw it coming. ) We cut taxes further, and Fed Chariman Paul Volcker, who brought an end to runaway inflation) was replaced by Alan Greenspan. Greenspan would feed the bubble of the 1990s with low interest rates. Those low rates in turn led to the real estate bubble. Greenspan single-handedly did more harm to the economy than any single individual I can think of. And he wasn’t even very bright. He just used big words (poorly) which led some people to think he was intelligent. (See the section on Greenspan in Bull!)

        On Cherry-picking the Data– This is from the Economoist (hardly a left-wing rag)

        A conservataive friend argues that “America’s wealthy already pay at least their fair share of the cost for the public goods they depend on to prosper. He notes that in recent years, the top 5% of earners have received 32% of the country’s adjusted gross income, but paid 59% of federal individual income taxes. “If that’s not giving something back, what is?”, he asks.

        “This is a case of cherry-picking the data. Yes, the federal income-tax system is progressive through most of the income distribution—although it becomes extremely regressive at the high end, because of the low rates applied to qualified dividends and long-term capital gains (as Mitt Romney can attest).

        “However, federal income taxes account for just 27% of total government revenue collected in America. And the remaining three-quarters of the tax pie is quite regressive. The middle class may not pay much federal income tax. But they sure pay the payroll tax for Social Security and Medicare, which the rich can mostly skip out on since it only applies to the first $110,000 of wage income. (The Medicare levy, unlike its bigger Social Security counterpart, is not capped). The masses also pay a much greater share of their income in sales and excise taxes than the rich do, because they cannot afford to save.The fact of the matter is that the American tax code as a whole is almost perfectly flat. The bottom 20% of earners make 3% of the income and pay 2% of the taxes; the middle 20% make 11% and pay 10%; and the top 1% make 21% and pay 22%. Steve Forbes couldn’t have drawn it up any better.

        “A charitable interpretation of the position that the rich already pay enough taxes is that its advocates have simply made a good-faith oversight about all those other pesky levies that the vast majority of Americans get stuck with. If they really think that a world where people earning the top 32% of income pay 59% of the taxes is fair, then they should support radical reform to make that a reality.

        “To start, we’d have to eliminate the flat payroll tax and its $110,000 income ceiling, and replace those revenues with the progressive income tax. We’d also need to tax dividends and capital gains as ordinary income. Then we’d have to modify sales taxes—by, say, taxing things rich people buy, like yachts, at a higher rate than things poor people buy, like generic-brand groceries.

        “However, I am yet to see the Cato Institute or Tax Foundation beating the drums for such policies. That suggests a somewhat less sympathetic account: that they are trying to focus public attention on a narrow slice of data that justifies letting the rich pay as little as possible, while obscuring the full picture, which leads to precisely the opposite conclusion.http://www.economist.com/blogs/democracyinamerica/2012/07/taxes-and-rich-0

  16. Would getting a large portion of the executives’ salaries back to the nonprofit calm much of the public’s concerns over executive pay? What if CEO’s got paid the same but also paid back much of their salaries down the road? Here’s the idea. What if the CEO, rather than getting the $1MM in salary, took, let’s say, $250K as salary and $750K annually as a loan? A life insurance policy death benefit would secure full repayment. LifeSolutionz offers that option to nonprofit executives. It cuts the salary expense that the employer shows, and the nonprofit gets a really nice check once the CEO passes. (Even the CEO would like it for tax reasons.) I’d really like to know how you would feel about loans replacing salaries and bonuses in total or in part for highly paid executives. If helpful to you, check out http://www.lifesolutionz.org.

  17. There are 440,000 people dying in our country from preventable medical errors. These do not include the figures which are hidden or the gray figures that never made it as part of the statistics. Depending on what article you read, the figures could be anywhere between 750,000 and 1,000,000. This is genocide. Why? Our government is so corrupt they refuse to acknowledge this is happening and are ignoring it. The difference between genocide in the United States and elsewhere is, nobody is singled out. Babies, children, young, old, black, white, all are dying across the board.

    Our country passed laws preventing Americans from getting justice and accountability. Americans can not even have the right of due process under our 7th Amendment Constitutional Right. Yet, we preach to the world about “rights” under the guise of respectability. The fact is, we are corrupt and have lost our humanity years ago. We sold our soul to the company store.


    Sending you a link to show you the best medical care given in our country could possibly be the veterinarian clinics. Maybe the most merciful way to end a patient’s suffering would be pulling the trigger. You judge.

    If you find yourself in Texas, make sure your life insurance policy is paid in full.

    If you are in NYC, avoid the doctor mentioned. The Texas Medical Board failed to police after their own.

    FYI: Dr. Javier Andrade apparently did not do well in New York City and is headed to Miami. If you have loved ones in South Florida, feel free to share.

    Thank you for your time,

    Cilla Mitchell

    A Texas nurse and US Army vet.

    • Cilla–

      Unfortunately, preventable errors is a huge problem.
      Though under the ACA hospitals will no longer be paid for preventable errors.
      This will create some pressure to do pay more attention to patient safety.

      We also need new laws to protect doctors and nurses who speak out about sloppy practice.