Charities

The corporatization of hospital systems

A hospital sign with the 'H' replaced with a dollar sign.
Illustration: Lazaro Gamio/Axios

Not-for-profit hospital systems increasingly operate more like corporate titans on the stock exchanges than the charities they promote themselves to be.

The big picture: As hospital systems have gotten larger, they have hosted more investor calls, released more financial data and attended more conferences and roadshows to attract banks and municipal debt buyers — all while health care spending continues to soar.

Charitable giving declined in 2018 thanks in part to the GOP tax overhaul

Trump and Paul Ryan
Former House Speaker Paul Ryan and President TRump. Photo: Alex Wong/Getty Images

Charitable donations in the U.S. dropped an inflation-adjusted 1.7% to $427.7 billion in 2018, the first overall drop since the Great Recession, according to Giving USA's annual report.

The big picture: Giving by individuals dropped an inflation-adjusted 3.4% to $292 billion as a result of changes in the federal tax law and a dip in the stock market late last year, despite an overall strong economy, the Wall Street Journal reports. Giving by individual Americans had previously grown for four straight years by at least 2.4%. In 2017, U.S. giving exceeded $400 billion for the first time.