Below here are the Operating Losses and Total Operating Revenues of each of these 21 Texas County District Non-Profit Hospital Organizations:
| Operating | Total | ||||
| Income | Operating | ||||
| Most | (Loss) | Revenues | |||
| Recent | Most | Most | Operating | ||
| Annual | Recent | Recent | Income | ||
| Fiscal | Annual | Annual | (Loss) | ||
| City | Year | Fiscal | Fiscal | Margin | |
| Texas County | HQs | End | Year | Year | % |
| mils $s | mils $s | ||||
| Texas County District Non-Profit Hospital Organizations | |||||
| Dallas (Parkland) | Dallas | Sep 2012 | (433) | 1,235 | -35% |
| Bexar | San Antonio | Dec 2012 | (195) | 773 | -25% |
| Harris | Houston | Feb 2013 | (560) | 593 | -94% |
| Tarrant | Fort Worth | Sep 2012 | (291) | 442 | -66% |
| ElPaso | El Paso | Sep 2012 | (18) | 376 | -5% |
| Midland | Midland | Sep 2012 | 8 | 231 | 3% |
| Ector | Odessa | Sep 2012 | (41) | 211 | -19% |
| Hunt Memorial | Greenville | Sep 2012 | (7) | 97 | -7% |
| Nacogdoches | Nacogdoches | Jun 2012 | (15) | 74 | -20% |
| Titus | Mt Pleasant | Sep 2012 | (4) | 62 | -6% |
| Hopkins | Sulphur Springs | Sep 2012 | (8) | 53 | -15% |
| Metagorda | Bay City | Sep 2012 | (8) | 37 | -22% |
| Angleton-Danbury | Angleton | Sep 2012 | (1) | 30 | -3% |
| Gainesville | Gainesville | Sep 2012 | (9) | 26 | -35% |
| Andrews | Andrews | Sep 2012 | (8) | 24 | -33% |
| Wilson | Floresville | Sep 2012 | 1 | 22 | 5% |
| Scurry | Snyder | Dec 2012 | (4) | 20 | -20% |
| Gaines | Seminole | Sep 2012 | (6) | 19 | -32% |
| Deaf Smith | Hereford | Sep 2012 | (1) | 18 | -6% |
| Dawson | Lamesa | Mar 2012 | (2) | 17 | -12% |
| Mitchell | Colorado City | Sep 2012 | (2) | 15 | -13% |
| Total all 21 | (1,604) | 4,375 | -37% | ||
Yeah, these 21 Texas County District Non-Profit Hospital Organizations posted Total Operating Losses of a massive $1.604 bil in the most recent fiscal year, which was a negative 37% of their Total Operating Revenues.
So, just how are these massive continuing Operating Losses being funded?
Well, it's predominantly with Property Taxes. Below here are Operating Losses and related Property Tax Funding for the Big 4 in the most recent year:
| Operating | % | ||||
| Most | (Loss) | Operating | |||
| Recent | Most | Loss | |||
| Annual | Recent | Property | Funded | ||
| Fiscal | Annual | Tax | By | ||
| City | Year | Fiscal | Revenue | Property | |
| Texas County | HQs | End | Year | Funding | Tax |
| mils $s | mils $s | Revenues | |||
| Big 4 Texas County District Non-Profit Hospital Organizations | |||||
| Dallas (Parkland) | Dallas | Sep 2012 | (433) | 420 | 97% |
| Bexar | San Antonio | Dec 2012 | (195) | 281 | 144% |
| Harris | Houston | Feb 2013 | (560) | 508 | 91% |
| Tarrant | Fort Worth | Sep 2012 | (291) | 279 | 96% |
| Total Big 4 | (1,479) | 1,488 | 101% | ||
Yeah, Property Taxes Funded 101% of these Total Operating Losses.
If I were paying these Property Taxes which are being used to fund these massive Operating Losses, I would be very interested in how to wisely reduce these massive Operating Losses, thus my Property Taxes would also be reduced.
There is a way to wisely eliminate nearly all of these massive Operating Losses. It's Medicaid Expansion in Texas. And I think some States should be permitted to do a creative disguised, effective Expansion of Medicaid.
How could that be?
Well, these massive Operating Losses are due to the uninsured and underinsured going to the hospital emergency rooms.
Under the Affordable Care Act (ACA), Hospital Organizations' both future Hospital Operating Income and Bottom Line Income will be bolstered very robustly due to many of the Uninsured getting insurance and also due to the many of the Underinsured getting much better insurance.
And for Hospital Organizations operating hospitals in States electing to Expand Medicaid, this future Profit growth will be exceptionally robust.
There are specifically two items which will drive higher Hospital Organization profits due to the ACA and also especially due to States electing the Expansion of Medicaid.
First, there is the Operating Statement Provision for Bad Debts' earnings charge which will be dramatically reduced due to the substantially better insurance situation of hospital patients. This Provision for Bad Debts' earnings charge is usually a separate report line on a Hospital Organization's audited Operating Statement.
And second, there is the Operating Statement Uncompensated Charity Care Costs' earnings charge for the amounts hospitals spend on charity care which will also be dramatically reduced. This Estimated Costs for Uncompensated Charity Care is usually disclosed in a Hospital Organization's footnotes which accompany its audited financial statements.
So what about the amounts of these two items? Well, they are very large, especially when compared to the related Hospital Operating Income.
From a review of EMMA, below here are the Provisions for Bad Debts and the Costs of Uncompensated Charity Care disclosed in the most recent audited financial statements and related footnotes of each of these 21 Texas County District Non-Profit Hospital Organizations. Houston Harris County surprisingly did not disclose its key Provision for Bad Debts, which has to be just huge, after all its current year Uncompensated Costs of Charity Care disclosed were $537 mil, which were 40% of its related Charity Care Charges Foregone disclosed of a massive $1.346 bil. In addition, San Antonio Bexar County, El Paso County and several smaller ones disclosed Charity Care Charges Foregone instead of Uncompensated Charity Care Costs. These two items offset and thus the below Total Earnings Charges for these two items combined of $2.936 bil shouldn't be very far off.
| Most | One Year | One | One | |||
| Recent | One Year | Estimated | Year | Year | ||
| Annual | Provision | Cost of | Total | Hospital | ||
| Fiscal | For | Uncompensated | Earnings | Operating | ||
| City | Year | Bad | Charity | Charge | Income | |
| Texas County | HQs | End | Debts | Care | of Both | (Loss) |
| mils $s | mils $s | mils $s | mils $s | |||
| Texas County District Non-Profit Hospital Organizations | ||||||
| Dallas (Parkland) | Dallas | Sep 2012 | 311 | 409 | 720 | (433) |
| Bexar | San Antonio | Dec 2012 | 82 | 491 | 573 | (195) |
| Harris | Houston | Feb 2013 | 537 | 537 | (560) | |
| Tarrant | Fort Worth | Sep 2012 | 338 | 152 | 490 | (291) |
| ElPaso | El Paso | Sep 2012 | 130 | 196 | 326 | (18) |
| Ector | Odessa | Sep 2012 | 80 | 5 | 85 | (41) |
| Midland | Midland | Sep 2012 | 49 | 10 | 59 | 8 |
| Hunt Memorial | Greenville | Sep 2012 | 16 | 5 | 21 | (7) |
| Nacogdoches | Nacogdoches | Jun 2012 | 9 | 11 | 20 | (15) |
| Metagorda | Bay City | Sep 2012 | 14 | 4 | 18 | (8) |
| Gainesville | Gainesville | Sep 2012 | 9 | 6 | 15 | (9) |
| Titus | Mt Pleasant | Sep 2012 | 14 | 1 | 15 | (4) |
| Angleton-Danbury | Angleton | Sep 2012 | 12 | 1 | 13 | (1) |
| Hopkins | Sulphur Springs | Sep 2012 | 8 | 4 | 12 | (8) |
| Dawson | Lamesa | Mar 2012 | 4 | 2 | 6 | (2) |
| Wilson | Floresville | Sep 2012 | 5 | 1 | 6 | 1 |
| Deaf Smith | Hereford | Sep 2012 | 4 | 1 | 5 | (1) |
| Scurry | Snyder | Dec 2012 | 4 | 1 | 5 | (4) |
| Andrews | Andrews | Sep 2012 | 3 | 1 | 4 | (8) |
| Mitchell | Colorado City | Sep 2012 | 3 | - | 3 | (2) |
| Gaines | Seminole | Sep 2012 | 3 | - | 3 | (6) |
| Total all 21 | 1,098 | 1,838 | 2,936 | (1,604) | ||
| Provision for Bad Debts | 1,098 | |||||
| Estimated Costs of Uncompensated Charity Care | 1,838 | |||||
| Operating Income Excluding Bad Debts and Uncompensated Charity Care Costs | 1,332 | |||||
So, these 21 Texas County District Non-Profit Hospital Organizations had Audited Total Hospital Operating Losses of a massive $1.604 bil in the most recent fiscal year. Causing these Total Hospital Operating Losses of $1.604 bil were Total Provisions for Bad Debts of a massive $1,098 bil and Total Costs of Uncompensated Charity Care of another massive $1.838 bil. Thus, exclusive of these two huge earnings charges, Total Hospital Operating Income would have been $1.332 bil, which is $2.936 bil better than the reported Total Hospital Operating Losses of $1.604 bil.
Granted these two earnings charges will not be totally eliminated with the ACA and in combination with States electing to Expand Medicaid, but a substantial amount of these two earnings charges will be eliminated, and especially so if Texas wisely elects to Expand Medicaid, which is the predominant driver of these two earnings charges being very substantially reduced.
These massive ongoing annual Total Operating Losses should be eliminated for the most part by Texas Expanding Medicaid. Thus in all fairness, the related Property Taxes funding these losses should also be eliminated, for the most part. Property owners getting this huge tax relief should be extremely pleased with this outcome. And no one dislikes paying taxes more than Texans.
