Category: Economics

Nonprofit Hospitals Get $60 Billion in Annual Tax Breaks in Order to Aid the Poor, but Often Use High-Pressure Opaque Tactics to Collect Full Payment

(p. A1) Nonprofit hospitals must have financial-assistance policies for needy patients, under federal requirements tied to an estimated $60 billion in annual tax breaks.

They often make that aid hard to get. Hospitals put up obstacles, delay checking eligibility and sometimes press for payments that aren’t refunded even if a patient eventually gets qualified for assistance.

That is according to a Wall Street Journal analysis of thousands of nonprofit hospital policies in filings to the Internal Revenue Service and posted by hospitals, as well as thousands of pages of internal documents from government hospitals obtained through public-record requests and the experiences of dozens of advocates and patients who have (p. A9) applied for aid.

. . .

An earlier Journal analysis of Medicare filings highlighted how little of nonprofit hospitals’ billions in revenue goes toward financial help for low-income patients. The new analysis uncovered the barriers many hospitals place in the way of patients who should qualify for assistance—even under the hospitals’ own criteria.

Under tax laws, nonprofit hospitals are set up to function as charities benefiting their communities. Government facilities, whose policies the Journal also looked at, are also intended to serve the public, though they aren’t subject to all the same IRS requirements as private nonprofits. The Journal found that many of these hospitals act like for-profit businesses in their efforts to get paid, even by those who can’t afford it.

. . .

Separate from the analysis of nonprofit hospitals’ IRS documents, the Journal also obtained internal documents on patient-billing procedures from large state and local government hospitals, including academic medical centers, through public-records requests. These hospitals share a similar mission with private nonprofits to serve communities.

The thousands of pages of procedures, scripts and other training material for hospital staff give an inside look at how some hospitals routinely push patients toward payment, including through installment plans that may come with interest. The guidelines often play down or don’t raise the option of financial assistance. Adding to the pressure, these tactics are often deployed before the patient gets care.

In a document titled “Collections Scripting for Non-Emergent Visits,” used by Georgia-based Augusta University Health System, staffers are supposed to start by requesting the entire amount due from the patient, saying, “How would you like to take care of that today?”

For the full story, see:

Anna Wilde Mathews, Andrea Fuller and Melanie Evans. “Some Hospitals Skimp on Aid.” The Wall Street Journal (Friday, Nov. 18, 2022): A1 & A9.

(Note: ellipses added.)

(Note: the online version of the story has the date November 17, 2022, and has the title “Hospitals Often Don’t Help Needy Patients, Even Those Who Qualify.”)

“Woke” Bankman-Fried’s FTX Played “Dumb Game” of Virtue Signaling

(p. A17) There was a time when people engaged in doing good addressed problems that, so to speak, you could get your arms around, such as improving school performance, providing potable water or preventing malaria. But at some point, the impulse to do good transformed into a combination of moral tendentiousness and grandiosity.

. . .

. . ., inside the Bankman-Fried fairy tale rests a smaller tipping point, which suggests his generation senses that their preachy elders may have led them down a moral garden path.

In an exchange with Mr. Bankman-Fried, a writer for Vox asserts, “You were really good at talking about ethics.” He replied that “I had to be” because of “this dumb game we woke westerners play where we say all the right shibboleths and so everyone likes us.”

He is describing what has come to be known in our time as virtue signaling, . . .

For the full commentary, see:

Daniel Henninger. “WONDER LAND; The Moral Vanity of FTX.” The Wall Street Journal (Thursday, December 1, 2022): A17.

(Note: ellipses added.)

(Note: the online version of the commentary has the date November 30, 2022, and has the title “WONDER LAND; The Moral Vanity of Sam Bankman-Fried.”)

Due to Xi’s Communists, China’s “Depressed” Tech Entrepreneurs Spend “Their Time Hiking, Golfing and Drinking”

(p. B1) For decades, China’s business class had an unspoken contract with the Communist Party: Let us make money and we’ll turn a blind eye to how you use your power.

Like most Chinese people, they bought into the party’s argument that its one-party rule provides more efficient governance.

Now, the tacit agreement that entrepreneurs had come to count on is dissolving in front of their eyes.

. . .

(p. B5) “Under the leadership of this dictator, our great country is falling into an abyss,” said a hardware tech executive in Shenzhen. “But you can’t do anything about it. It pains and depresses me.”

Despite many conversations over the years, we never talked about politics. I was surprised when he called after the party congress to talk about his “political depression.” He said he used to be very nationalistic, believing that the Chinese were among the smartest and hardest-working people in the world. Now, he and many of his friends spend most of their time hiking, golfing and drinking. “We’re too depressed to work,” he said.

Until a year ago, his start-up was doing so well that he was planning to take it public. Then he lost a big chunk of his revenues, and his new hires sat idly with nothing to do when cities were locked down under the “zero-Covid” rules. He said now he had no choice but to lay off more than 100 people, sell his business and move his family to North America.

“Since the dark night has descended,” he said, “I’ll deal with it the dark night way.”

The tech entrepreneur from Beijing who texted me after the party congress recounted a chilling experience. In May, when there were rumors that Beijing could be locked down, he felt he could not tell his employees to leave work early and stock up on groceries. He was worried that he could be reported for spreading rumors — something that had gotten people detained by the police. He told them only that they should feel free to leave early if they had things to take care of.

This successful businessman is now applying to emigrate to a European country and the United States.

Just like many ordinary Chinese people, the executives I spoke to said they were horrified by the video of Hu Jintao, Mr. Xi’s predecessor as China’s top leader, being abruptly led out of the closing ceremony of the party congress. They did not accept the official government explanation that Mr. Hu had to leave early because of health issues.

If Mr. Xi could remove his predecessor like that, several of them said, he could do anything to anyone.

A well-connected investor in Beijing said his friends who were entrepreneurs now realized they could no longer remain indifferent to politics. At social gatherings, they have started discussing which countries to seek passports from, and how to move their assets offshore. At social gatherings, hosts are asking friends to surrender their phones to be kept in a separate place for fear of surveillance.

For the full commentary, see:

Li Yuan. “Xi Is Scaring Away China’s Business Elite.” The New York Times (Tuesday, November 8, 2022): B1 & B5.

(Note: ellipsis added.)

(Note: the online version of the commentary has the date November 7, 2022, and has the title “China’s Business Elite See the Country That Let Them Thrive Slipping Away.”)

U.S. Elites Win Short-Term Profits from Pleasing the Chinese Communist Party

(p. C9) “Red-Handed: How American Elites Get Rich Helping China Win,” by Peter Schweizer, is an eye-opening book that highlights a legacy of entanglement that senior U.S. government officials have had with the Chinese Communist Party, or CCP, over the last couple of decades.  . . .  . . .–the entanglement between our officials and those of China’s ruling party has led to the trading of our collective security for the short-term high of profit.

For the full review, see:

Mike Garcia. “12 Months of Reading; Mike Garcia.” The Wall Street Journal (Saturday, Dec. 10, 2021): C9.

(Note: ellipses added.)

(Note: the online version of the review has the date December 8, 2022, and has the title “Who Read What in 2022: Political and Business Leaders.”)

The book praised by Mike Garcia is:

Schweizer, Peter. Red-Handed: How American Elites Get Rich Helping China Win. New York: Harper, 2022.

Entrepreneur Kerns’s Internal-Combustion-Engine Electric Generators Gave Power to the People

(p. A21) Robert D. Kern, a mechanical engineer who in the mid-1950s started a company in a garage making portable backup power generators and then transformed the business into an industry leader known as Generac, selling it in 2006 for an estimated $1 billion, died on Nov. 8 [2022] in Waukesha, Wis.

. . .

“The company is way beyond anything we dreamed about,” Mr. Kern said in an interview with the Grainger College of Engineering at the University of Illinois, his alma mater. “My vision was incredibly small compared to what it became, but tenacity is what it is all about.”

He and his wife and a few investors started the business after the rise of the airline industry had cost Mr. Kern his job making motors for railroad cars. Generac became a leading developer, manufacturer and marketer of portable and backup electric generators for homes and industry.

Today, Generac, based in Waukesha, about 18 miles west of Milwaukee, accounts for roughly 75 percent of standby home generator sales in the United States.

. . .

Mr. Kern was hired by the Waukesha Motor Company to design generators for combustion engines to be used on railway passenger cars. With the growth of the jet airline industry, rail travel in the United States plummeted, and Mr. Kern’s division was eliminated.

But remaining passionate about internal combustion engines, he decided to adapt developing technologies in generators for potential new markets and establish his own company to reach them.

In 1954, with his wife as the new company’s bookkeeper, he began making portable generators for recreational vehicles and for farmers and construction crews out of a garage in the village of Wales, Wis., about 28 miles west of Milwaukee. The business, originally called Electric Controls Inc., marketed the gear through Sears under the Craftsman brand. It became Generac in 1959, combining the word generation with AC.

. . .

Generac also developed an affordable backup generator for home emergencies and then expanded the business to produce permanent emergency generators for the commercial and industrial markets.

In 1967, the Generac factory in Waukesha burned to the ground, but with help from the local community, production resumed six days later, and the plant was rebuilt in seven weeks, without layoffs.

For the full obituary, see:

Sam Roberts. “Robert D. Kern, 96, Engineer Whose Idea For Portable Generators Produced Riches.” The New York Times (Thursday, November 24, 2022): A21.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the obituary has the date Nov. 22, 2022, and has the title “Robert D. Kern, 96, Whose Emergency Generators Produced Riches, Dies.”)

Corrupt and Bankrupt FTX Got Higher ESG Rating for “Leadership and Governance” Than Exxon Mobil

(p. A14) Crypto dark knight Sam Bankman-Fried may have deceived investors, customers and various journalists and politicians. But now the FTX founder is at least telling the truth about a few things. Lo, he says that environmental, social and governance (ESG) investing is a fraud, and so was his progressive public posturing.

. . .

“Problems were brewing. Larger than I realized,” he tweeted. “In the future, I’m going to care less about the dumb, contentless, ‘good actor’ framework,” he added. “What matters is what you do—is *actually* doing good or bad, not just *talking* about doing good or *using ESG language*.”

Mr. Bankman-Fried is also acknowledging that he genuflected to regulators and Democratic lawmakers to win political protection. ESG ratings company Truvalue Labs even gave FTX a higher score on “leadership and governance” than Exxon Mobil, though the crypto exchange had only three directors on its board.

For the full editorial, see:

The Editorial Board. “Sam Bankman-Fried, ESG Truth-Teller.” The Wall Street Journal (Friday, Nov. 18, 2022): A14.

(Note: ellipsis added.)

(Note: the online version of the editorial has the date November 17, 2022, and has the title “Sam Bankman-Fried Becomes an ESG Truth-Teller.”)

Inequality Has Not Increased If Government Transfer Payments Are Included in Income

(p. C10) This book—by Auburn University economist Bob Ekelund, economist and consultant John Early, and former U.S. Sen. Phil Gramm—shows that the political debate over inequality since the 1960s has had almost nothing to do with reality.   . . .   When the Census Bureau, which provides the source data everyone uses for inequality, calculates income, it counts only cash income. Nearly every transfer payment—money redistributed by the government for the purpose of attacking poverty—is left out! Once you include that money, the bottom half of the income distribution has almost exactly the same income from top to bottom. “The Myth of American Inequality” is in my view the most important book published this year.

For the full review, see:

Kevin Hassett. “12 Months of Reading; Kevin Hassett.” The Wall Street Journal (Saturday, Dec. 10, 2021): C10.

(Note: ellipsis added.)

(Note: the online version of the review has the date December 8, 2022, and has the title “Who Read What in 2022: Political and Business Leaders.”)

The book praised by Kevin Hassett is:

Gramm, Phil, Robert Ekelund, and John Early. The Myth of American Inequality: How Government Biases Policy Debate. Lanham, MD: Rowman & Littlefield Publishers, 2022.

Dependent, Missionless Resignation Can Be “Fundamentally Degrading”


(p. A13) At the Harvard Business Review, Joseph Fuller and William Kerr wrote this spring that the Great Resignation was an “unprecedented mass exit” but also the reversion to a long-term trend, one we’re “likely to be contending with for years to come.” Quit rates have been rising steadily for a long time. When the pandemic first hit, workers held onto their jobs for fear of layoffs and recession. But by 2021 stimulus money hit the system and uncertainty abated. That’s when the Great Resignation hit. “We’re now back in line with the pre-pandemic trend.”

. . .

. . . political economist Nicholas Eberstadt of the American Enterprise Institute . . . notes that recent workforce changes follow a postwar pattern. Usually after recessions, male labor-force participation drops, and when the recession ends it ticks up, “but never gets back to where it was.” Labor-force participation for both sexes, he notes, peaked in 2000 at 67%. We’re now 5 points lower than that.

The work rate for those in their prime working years, 25 to 54, has been declining since the turn of the century. The economic implications are obvious—slower growth, less expansion—and the personal implications are dire. “By and large, nonworking men don’t ‘do’ civil society,” Mr. Eberstadt says. They stay home watching screens—videogames, social-media sites and streaming services. There is something “fundamentally degrading” in this, and Mr. Ebestadt refers to an “archipelago of disability programs” that help make not working possible.

Staying apart, estranged from life and not sharing a larger mission can create “really tragic long term consequences,” Mr. Eberstadt says. These young people aren’t taking chances, leaving a job to start a small business. They aren’t finding themselves. They aren’t even looking.

For the full commentary, see:

Peggy Noonan. “DECLARATIONS; The ‘Great Resignation’ Started Long Ago.” The Wall Street Journal (Saturday, July 23, 2022): A13.

(Note: ellipses added.)

(Note: the online version of the commentary has the date July 21, 2022, and has the same title as the print version.)

An Economist with “Enough Steel” to Cut “the Tentacles of Restrictive Government Regulation”

(p. A9) When Elizabeth Bailey was appointed in 1977 as the first woman to serve on the Civil Aeronautics Board, or CAB, she saw her job as freeing the airline industry “from the tentacles of restrictive government regulation.”

During a confirmation hearing, Sen. Ted Stevens of Alaska asked Dr. Bailey, a Republican with a Ph.D. in economics, whether she had “enough steel” for the task.

“I hope so,” she said. “I’m tougher than I look.”

The Airline Deregulation Act of 1978, approved by Congress with strong bipartisan support, led to abolition of the CAB at the end of 1984 and freed airlines to set fares without government permission. During her six years on the board, Dr. Bailey proved one of the most ardent advocates for swift deregulation, a process that reduced fares, increased choice and doomed inefficient airlines.

. . .

One summer, she accepted an offer to join a group studying regulatory issues at Bell Labs. She gave a presentation on regulatory distortions to a panel of economic advisers to AT&T, including William Baumol and Alfred Kahn.

Dr. Baumol helped her gain admission to Princeton as a doctoral candidate in economics. She delved into business-competition issues and received her Ph.D. in 1972.

Those studies prepared her to oversee economic research at Bell Labs and advise AT&T on its impending breakup by regulatory authorities. “We said, ‘Look, if the government is going to bust you up, there are some ways that are going to be a lot less costly and a lot more efficient than others,’ ” she recalled.

Dr. Kahn, later chairman of the CAB, became her mentor and ally at the agency, where she rose to vice chairman.

For the full obituary, see:

James R. Hagerty. “Economist Helped Free Airlines From Red Tape.” The Wall Street Journal (Saturday, Sept. 3, 2022): A9.

(Note: ellipsis added.)

(Note: the online version of the obituary has the date September 1, 2022, and has the title “Elizabeth Bailey Helped Free Airlines to Cut Fares.”)

U.S. Chips+ Act Rewards Intel for Being Less Innovative Than TSMC


(p. A15) Intel, with huge profit margins on its Pentium microprocessors, could spend more than its competitors on state-of-the-art fabs, but innovation eventually was pushed aside for predictability. Intel would get one fab working and then “copy exactly” new cookie-cutter fabs. For smaller feature sizes, Intel looked at the new Extreme Ultraviolet technology from Dutch equipment company ASML and thought it too expensive and risky to use. TSMC embraced ExtremeUV and won, especially for lower-power chips for mobile devices. TSMC can now spend more than anyone else on fabs.

With the Chips+ Act chock full of $52 billion in subsidies and tax credits for chip makers, Congress is saying that real countries have fabs. The act also authorizes $1 billion for carbon removal—weird, because chips are made from silicon. Worse, the U.S. is rewarding Intel, which just announced a disastrous quarter, for coming in third place behind TSMC and Samsung.

Nothing is free. Even Commerce Secretary Gina Raimondo admitted “there’s a lot of strings attached” in the 1,054-page law. National Economic Council director Brian Deese endorsed command-and-control industrial policy: “The question should move from ‘Why should we pursue an industrial strategy?’ to ‘How do we pursue one successfully?’ ” This is as wrong as Soviet or Chinese five-year plans. Industrial policy eventually leads to disaster. Japan’s Ministry of International Trade and Industry micromanaged the country’s domestic semiconductor industry and ended up presiding over its decline. Today no Japanese semiconductor company sits in the global top 10. Because China doesn’t have access to ASML ExtremeUV equipment, it has made little progress in advanced chips.

Yes, we need domestic supplies of advanced chips in case China invades Taiwan. But subsidies are the wrong approach.

. . .

Instead, the U.S. could enable suppliers to place large orders for chips for the military, intelligence agencies, whatever. They could even prepay. Silicon Valley was originally built on orders for transistors for intercontinental missiles and the space program.

For the full commentary, see:

Andy Kessler. “INSIDE VIEW; The Semiconductor Boondoggle.” The Wall Street Journal (Monday, Aug. 15, 2022): A15.

(Note: ellipsis added.)

(Note: the online version of the commentary has the date August 14, 2022, and has the same title as the print version.)

Steve Case’s “Heroic Push” to Encourage Entrepreneurship Outside Silicon Valley, in “Surprising Places”

(p. C12) This is why one of the most energizing books I read this year was Steve Case’s “The Rise of the Rest.” It chronicles Steve’s journey to nurture tech startups in what some might consider “surprising” places. Think: Milwaukee vs. Silicon Valley.

. . .

Steve’s book is a heroic push encouraging us to widen the aperture. With the right investments and visibility, we can change the American landscape for the better, leveling the playing field and creating a more inclusive economy for years to come.

For the full review, see:

Asutosh Padhi. “12 Months of Reading; Asutosh Padhi.” The Wall Street Journal (Saturday, Dec. 10, 2021): C12.

(Note: ellipses added.)

(Note: the online version of the review has the date December 8, 2022, and has the title “Who Read What in 2022: Political and Business Leaders.”)

The book praised by Asutosh Padhi is:

Case, Steve. The Rise of the Rest: How Entrepreneurs in Surprising Places Are Building the New American Dream. New York: Avid Reader Press, 2022.