Many US Hospital Organizations.....Non-Profit, For-Profit and Governmental ones.....receive many different US Governmental Subsidies, including Disproportionate Share Hospital Payments, graduate medical education payments, and many more.
With the new Affordable Care Act, many hospital organizations will be substantially stepping up their hospital operating profits. This is due to a substantial reduction in Bad Debts Expense and also a substantial increase in charity care income, both due to many uninsured getting insured and to many underinsured getting better insured.
Especially given the over $16 trillion of US debt, I think it makes a lot of sense that any Hospital Organization should return its US Government Subsidies in any year where it is already making a reasonable hospital operating profit.
Thus, my recommendation here is that any Hospital Organization which receives US Government Subsidies in any year which results in Hospital Operating Income (HOI) of more than 3.0% of Total Operating Revenue will need to refund these US Government Subsidies to the extent that the resultant hospital operating income is more than 3%.
To illustrate, say that in a given year, a Hospital Organization generates HOI of $50 million and Total Operating Revenues of $1 billion, thus a HOI of 5.0% of Total Operating Revenues. Included in this HOI are Total US Government Subsidies of $15 million. Since exclusive of all of these US Government Subsidies, HOI would be $35 mil, which at 3.5% of Total Operating Revenues, is still more than 3.0%, then all $15 million of these US Government Subsidies will be refunded to the US Government.
On the other hand, if the Total US Government Subsidies were instead $45 million in that same year, then the US Government Subsidies which will be refunded to the US Government would be $20 mil, or the smaller of $45 million and (5.0% Actual - 3.0%) X $1 bil Total Operating Revenues.
This is a much fairer way to reduce US Government Spending than to cut Medicare, Medicaid and Social Security
Benefits.
