In NCR(eporter), Joe Feuerherd with a good piece on current pressures on Catholic health systems, here:

There are lots of problems and Grassley is very serious about it,” said John Olinger, a Washington lobbyist whose clients include nonprofit hospitals. The Senate Finance Committee chairman is expected to introduce legislation early next year that may seek to repeal some tax breaks nonprofits have enjoyed for generations. Further, noted Olinger, at a time of ballooning federal deficits, the committees charged with overseeing health care are also those responsible for raising revenue. “You start making changes [to the nonprofit health care system] and you can bring in a lot of money,” said Olinger.

“This is part of a big mosaic of trouble that the Catholic Health Association and the American Hospital Association” — the largest interest groups advocating for nonprofit hospitals — “have to some extent brought upon themselves,” said James Unland, president of the Health Capital Group, a consulting firm, and editor of the Journal of Health Care Finance. Unland poses the questions provocatively. “Has it gotten to the point where a nonprofit hospital is basically a front to allow doctors and administrators to make money? Is their very existence fraudulent? These are the questions being asked at all levels of government.”

Sr. Carol Keehan, president of the 2,000-plus member Catholic Health Association, takes the inquiries presented by Congress, regulators and interest groups seriously, but noted that nonprofit hospital providers have seen such queries before. “Sure, sometimes we don’t like the way some of the questions are asked,” said Keehan, a member of the Daughters of Charity, but given the growth of the nonprofit health care sector, and the dramatic though high-cost improvements in care, such scrutiny is to be expected. Keehan said the oversight provides an opportunity to “take a look and make sure that in every way we are being what we want to be for our communities.”

Compensation

Under IRS regulations, the nation’s nonprofit institutions — not only hospitals but universities, local charitable groups, and such national players as United Way and the Salvation Army — are prohibited from paying “excessive” salaries. The problem: One person’s “excessive” is another’s “comparable market rate.”

The other issue is billing of the uninsured, a subject discussed here before. It’s a good overview of the problems.