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Ownership conversions in health care organizations: who should benefit?

Because equity capital is becoming an important financing source for health care organizations, the conversion of many such organizations from nonprofit to for-profit status is a significant public policy issue. Since many states require converting nonprofits to repay the "community" for its investment during the nonprofit status period, three questions arise: (1) How much is the entity worth? (2) How much of that worth should be returned to the community? (3) In what form should it be returned? The paper addresses these questions, and demonstrates why responsible public policy calls for them to be carefully considered if community interests are to be preserved.

Health Facility Planning↗

Capital finance and ownership conversions in health care.

This paper analyzes the for-profit transformation of health care, with emphasis on Internet start-ups, physician practice management firms, insurance plans, and hospitals at various stages in the industry life cycle. Venture capital, conglomerate diversification, publicly traded equity, convertible bonds, retained earnings, and taxable corporate debt come with forms of financial accountability that are distinct from those inherent in the capital sources available to nonprofit organizations. The pattern of for-profit conversions varies across health sectors, parallel with the relative advantages and disadvantages of for-profit and nonprofit capital sources in those sectors.

Capital Financing↗

Nonprofit ownership, private property, and public accountability.

Mark Schlesinger and Brad Gray have summarized research comparing nonprofit and for-profit health care in a remarkably useful form. Their paper effectively demonstrates how nonprofit and for-profit health care differ. However, their proposal for community control over nonprofit health care organizations in exchange for tax exemption, like many current proposals requiring nonprofit hospitals to provide free care for indigent patients, risks undermining the purpose of the nonprofit organizations and the care they provide. These trade-offs are significant yet have not been acknowledged in policy debate.

Community-Institutional Relations↗

Ownership and maintenance of dental records.

The maintenance of good dental records is essential for the defense of a professional liability claim. If a dentist must give records and radiographs to a patient, insurance carrier, or succeeding practitioner, he should always give copies and maintain the originals. As a professional liability claim can often be filed long after treatment ceases, the dentist should retain his records permanently. The right of a patient to gain access to his medical or dental records has been granted by recent court decisions as well as by laws and regulations enacted in some states. The court decisions granting a patient access to his records are law in the jurisdictions in which the cases were decided. However, those decisions would present persuasive authority in a stage having no case law or statute regarding access by the patient to medical or dental records. The dentist should consult his attorney to determine the local law before allowing a patient access to his records and radiographs.

Dental Records↗

Health care markets in Australia: ownership of the private hospital sector.

Over the past decade, the Australian hospital sector has undergone a massive economic and administrative reorganization with ramifications for both the private and the public sectors. Changes such as privatization, deregulation, and the entry of foreign capital into the hospital sector are occurring in the hospital systems of many countries, including Australia, the United States, and the United Kingdom. These developments are radically transforming the hospital sector, altering established relationships between the state, the medical profession, the consumer, and the corporate investor, and raising important questions about the future of hospital services in regard to equity, accessibility, and quality.

Australia↗

The value of cat ownership to elderly women living alone.

A survey of elderly women was carried out to discover their attitudes towards pet cats. The women were living in publicly-owned pensioner housing in two New Zealand cities. In one city cats were allowed in the pensioners' housing and in the other city they were not. Attitudes towards cats were more positive in the city where cats were allowed, and more positive if pensioners owned a cat, or wished to own one. As positive attitudes towards cats outweighed negative ones, the City Authority which had prohibited cats reversed its policy. There was conflicting evidence about the role of cats in reducing feelings of loneliness. It appears that "loneliness" signifies the loss of many aspects of social interaction and that pets may substitute for only some of these interactions.

Aged↗