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akmalhot t1_jdzhqpo wrote

UPMC shouldn't have not for profit status. Medical systems in PA use this status to drive wild profits, which they just reinvest in growing the business and paying outsized salaries to c suite .. they can't retain 10% of the profit so they buy up buildings, build new treatment centers ... The status probably forces their reinvestment in growth

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Aggravating_Foot_528 t1_jdzhxog wrote

Wonder if this is a move to get them to negotiate higher PILOTs as legal settlements.

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tesla3by3 t1_jdzt1in wrote

UPMC shouldn't have nonprofit status, agreed.

But there's nothing preventing UPMC from retaining 10% of their profit. In fact, best practice for nonprofits is to have enough can available to meet a drop in income; usually 3-6 months of expenses. At the end of 2021 UPMC had enough cash on hand to cover 148 days of expenses. $10.7 Billion in total cash and investments.

Their stated reason for expansion is "expanding access to healthcare", while at the same time doing things like closing Braddock and expanding in Monroeville.

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dmcd0415 t1_jdzvvr2 wrote

What cities are the most attractive places to large employers in the United States and what are those cities' quality of life for the people who live in them? Asking because I'm a person not a large employer so that's what I care about.

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AbbeHuet t1_jdzw5s4 wrote

> "It’s roughly $36 million per year."

Minus all the expenses for future lawsuits, of course.

More seriously, the city's current total revenues is about $706m per year (link). So this would only increase the city's revenue by 5% (assuming they succeed in all cases)? Did they end up finding fewer 'fake' tax-exempt properties than they thought? Or was that always the expectation?

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dmcd0415 t1_jdzwlci wrote

Is $36 million not enough? How much would make it worth it? Why do we all have to pay our fair share and insanely profitable international corporations don't?

Who would turn down a 5% raise?

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kielBossa t1_jdzx6q2 wrote

Considering the last mayor and county exec completely ignored this issue, I’d wager there’s a major backlog. The deadline to challenge tax assessments with the county is end of March.

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AbbeHuet t1_jdzxuej wrote

$36m is nice, and I'm all for proper enforcement of tax law. But that's an amount comparable to usual fluctuations from year to year in revenues. It doesn't hurt, but this was a big theme during the elections last year and seen as key to Pittsburgh's progressive agenda. Surely they had other aspirations than fighting for what is roughly a rounding error in the annual budget?

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BeefyHoagie t1_jdzy651 wrote

My wife works at a small nonprofit that gets a lot of funding from UPMC. She’s worried about this.

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dmcd0415 t1_jdzydya wrote

The IRS would be coming at me or you for that rounding error. Why should corporations be held to a lower standard and why are you arguing to keep said standard as low as possible? It just makes no sense at all. What are you afraid of happening? What are the possible downsides for the city taking that $36 million from upmc?

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mr_finley_ t1_je00euk wrote

They can afford to pay their fair share and they should.

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billfriedman9987 t1_je00if6 wrote

UPMC’s status as a non profit needs to be revoked while we are at it

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AbbeHuet t1_je00wog wrote

Since I apparently didn't write clearly: my disappointment is that there is so little money coming from all this. Not that we should forgive UPMC &co. And I should add that Gainey was fine leaving $115m on the sideway with OnePGH (link. So yeah, that $36m is a bit underwhelming in my view, especially since Gainey already promised a chunk to the police force.

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egJohn t1_je03yc2 wrote

crazy idea but maybe taxing these 'community partners' could help fund gutted social services in the city and bring crime down.

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peenweens t1_je056c3 wrote

So multi-billion dollar health care companies shouldn't pay their fair share of taxes? I'm confused. If your wife's company somehow lost funding from this, blame the greedy C-suite who won't take less in bonuses and instead gut small nonprofits?

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aesthetichovvell t1_je05bn4 wrote

I went to propel Northside for middle school and for being a title 1 school, I do recall them having quite a bit of amenities

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dmcd0415 t1_je05ntb wrote

Seems like a roundabout way of saying, "what about OnePGH" or "what about not defunding the police," or whataboutism. If you want me to point out he failed in those areas I'll gladly do so, and if you want me to vote for a more progressive candidate I'll gladly do so, but I'll also gladly say "fuck you upmc, pay your shit."

You have also left questions I've asked elsewhere unanswered to spout out this whataboutism

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ce_confessor t1_je06j93 wrote

UPMC is not non-profit across the board. Divisions that work in for-profit sectors, such as the insurance division are designated for-profit. Why this concerns me is that people seem to be suggesting that the hospitals, which are non-profit, should have their status revoked. For-profit hospitals are not something I want to see any more than for-profit prisons or other services that should not be profit driven. If the lines are blurred in places, it should be reviewed and changed if needed, but I don’t like the idea of a blanket revoking of the status particularly where hospitals are concerned.

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AbbeHuet t1_je08gbq wrote

I don't enjoy interactions with insults, but I'll respond one last time.

If you care about the money, then saying "great, $36m" should instead be: "it sucks, we are still have $79m ($115-$36m) less than what we should to fund important stuff". It's not whataboutism: it's about the scale of the problem, and that small victories don't compensate (in my view) for much bigger screw-ups.

As for your other message (which I missed): I'm not afraid of anything? Why would I be afraid? As I said twice: it's great that they are getting this money (if they ever get it). But I would feel better if (a) they hadn't wasted three times that amount for seemingly no good reason, and (b) I was confident they would use it on something more else than more law enforcement.

In the end, I find this administration disappointing: it neither provides progressive policies (universal income was abandoned on day 1, the PD gets more money than ever, blaming local residents for lack of check on crime) nor more centrist ones (see the thread about downtown). At this stage, I find the weekly "CommUnity" tweets hard to swallow. But given the downvotes I'm receiving, I'm glad to see that others are more optimistic.

With this being said: this is one of these discussions which would be easier around a beer. I wouldn't be surprised if we agreed on more than what our exchange would suggest.

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ahhhhhhhhyeah t1_je08pob wrote

People here will bite off their nose to spite their face just to stick it to UPMC because UPMC sucks. But all of these decisions would affect AHN and any other health provider.

If people think health care is expensive, wait until hospitals have to shift costs they would lose from other areas.

Gainey isn’t the first to try this and it won’t go the way he plans because it’s a bad idea

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ahhhhhhhhyeah t1_je08y0x wrote

UPMC pays taxes on their health insurance division. They have two different entities, one that is non-profit hospitals, and the other is a good old fashioned health insurance company that guts you. The latter pays taxes.

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Sybertron t1_je091xw wrote

Not just UPMC but Pitt and CMU as well. I'm too lazy to do it but I bet if you highlight all the properties they own or at least have major stake in across the city you look at like 1/4 of the city is taken up by them.

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dfiler t1_je09gzk wrote

Is revoking the tax-exempt status of some properties the same as revoking an entity's non-profit status in its entirety?

I'm sure this will end up in court, nailing down the specifics of that distinction. Either way, this will likely be the most significant thing any mayor of Pittsburgh has done for a very long time. For a city with this many non-taxable entities and properties, this will have a major impact on city finances.

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YIMBYYay t1_je09qpc wrote

Pittsburgh's non-farm job growth was an anemic 1.8% in February 2023. One of the lowest rates in the country. Compared to other similarly sized cities, Nashville 4.5%. Austin 4.8%. Indianapolis 3.3%. Portland 2.9%. Charlotte 3.1%. Raleigh 3.9%. Seattle 3.7%. Jacksonville 5.6%...

Columbus was a surprisingly low .7%, but they also just landed the $20 billion Intel plant, so there's that.

Hilarious, downvoting actual stats from the US BLS. Pittsburgh's job growth rate is basically half the national average, and this sub thinks that's okay.

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akmalhot t1_je0baak wrote

the expanding access schtick is used to justify everything and anything.

In dentistry corporate DSO's use it to justify them owning and pulling money out of the entire system and allowing them to outright own offices. To expand access to care - yet all they do is open offices in highly competitive markets and close them in rural areas.

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antlerstopeaks t1_je0dfnn wrote

The fact that an insurance company can own the hospital they are charging for their services is completely insane. They should be completely separate entities and in no way working together.

They essentially get to decide what they charge themselves with made up numbers to screw people over.

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dazzleox t1_je0dnrv wrote

Yes almost definitely. It reads to me "hey we're going after your parking facilities and empty lots now, and those are not charitable so we'll win. Settle before we challenge Presby Hospital..."

Considering some successful challenges of hospitals like Pottstown, it'd be wise for the big non profits to settle before they get HUP test cases from a state Supreme Court that labor helped elect.

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Avocado_Amnesia t1_je0f550 wrote

That's based on the assumption that the money saved on taxes is going to reducing treatment cost, rather than paying out bonuses to executives and building fancy new facilities that don't meet the needs of the people working in them.
I've seen a couple studies over the years that suggest NFP hospitals have costs mostly in-line with those of for profits, but they are losses of absolutely massive tax sources for their cities, leaving local services devoid of huge opportunities they could have otherwise.
And that's not even regarding hospitals that are also the biggest name in insurance in their local areas as well.

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dmcd0415 t1_je0fb96 wrote

It's whataboutism because your entire premise is based on you, for whatever reason, thinking I'm 100% supportive of Gainey and thinking his administration has no fuck ups, which is completely false. I would also love to take money away from police but we all know that's not going to happen so if we can make upmc some it's a win. You're speaking of this negatively because you would feel better if they did something else? Politics is a bus not a cab, man.

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dazzleox t1_je0fcrq wrote

They claim even physically disconnected parking lots and empty lots for future development that they own are non profit as well. I do not think if these cases go through the HUP test that UPMC will prevail.

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littlerossybaby t1_je0fsd8 wrote

Dang. N i just saw homie rollin some dice n the cut..

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Ellis4Life t1_je0fyom wrote

This was essentially Highmark’s stance when UPMC decided to get into the insurance game. Once they failed to prevent that though, they said two can play at that and founded AHN to get into the hospital game. This model has been such a detriment to the city in regards to affordability and access to care.

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MadameTree t1_je0gbiv wrote

O'Hara, so it's because I'm in a good school district that I'm paying through the nose. It's a long story, but I'm trying to afford a house that was in my family as a single woman. I can't sell until the end of next year and I'm spending almost 1/3 my take home pay on taxes alone. My Allegheny County taxes were still $1500.

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ahhhhhhhhyeah t1_je0h0x4 wrote

This won’t stop the building of new facilities that don’t fit what people need, it won’t make a more equitable health care environment at all. It will just make the expense of running hospitals more stringent. What people also miss here is that UPMC operates hospitals that take people without insurance, which operate on huge losses. Tightening their bottom line is going to mean these are some of the first hospitals to close, and others are likely to follow for a system that was not setup for this kind of tax burden.

Having more hospitals isn’t the best thing but for some rural areas it is absolutely necessary.

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ce_confessor t1_je0h5vk wrote

There are tons of problems. And my comment isn’t meant to be pro-UPMC. I’m commenting on my hesitation to support for-profit schools and hospitals. In general, their business models have always seemed a bit evil.

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AbbeHuet t1_je0h9n7 wrote

I'm genuinely confused: I have no thoughts about your ideas/beliefs. What makes you think I do? I reacted on a public forum about a piece of news, that's it. I even said I'm happy that people seem heartened by this update - and I mean it!

To borrow your metaphor: I'm a bus passenger who is a bit grumpy that we are taking a 30 minute detour but just informed by the driver than he made up 10 minutes via shortcut. I'm not telling the driver to drop me on my front porch.

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YIMBYYay t1_je0ig6d wrote

Here's a link to a list of the properties being challenged. It's really small potato stuff like the clubhouse at the Village of Shadyside, a parking lot at AGH, and some private property that really shouldn't be off the tax rolls. The only high-profile properties are a parking garage attached to the CMU School of Engineering, and the UPMC-owned Iroquois Building on Forbes.

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dazzleox t1_je0itpq wrote

It gives a chance to escalate during possible negotiations too imho.

Some really interesting stuff from the list of parcels: one is owned by a fired cop convicted of sexual abuse. I have no clue how it got non profit status. Another is a museum that seems mostly to be a wedding venue and another is a private swimming pool in a development. This is only after auditing the first 10% of properties.

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AntiStatistYouth t1_je0j15d wrote

This is indeed the strategy, although it remains unclear whether it will work. UPMC has shown itself willing to spend huge sums of money on legal fees to fight taxation, even in excess of the initial tax amount itself. They might decide to fight a long legal battle now over the small stuff, even if they don't expect to win because it will delay and deter future efforts to tax the big stuff. UPMC can drain the cities coffers with legal fees and tie this effort up in court for long enough, they come out ahead.

UPMC has explicitly threatened to bankrupt the city with legal fees if their tax exempt status is revoked entirely. I suspect even trying to tax them at the edges is going to be a fight.

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YIMBYYay t1_je0j2zd wrote

It's $36 million/year in total untaxed property, including parcels owned by the City of Pittsburgh. The tax value of the parcels on this list isn't anywhere close to that amount.

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dazzleox t1_je0k0on wrote

They've never had to fight that long in Pittsburgh. Peduto pulled the lawsuit shortly after Ravensthal began it, starting a pointless eight year negotiation over a non PILOT for his "One Pittsburgh" plan that got us no where. But in hospitals they bought that where a PILOT was in place, UPMC has honored it:

https://www.publicsource.org/erie-hospital-pilot-upmc-ahn-pittsburgh-gainey

"In 2020, Erie collected $13.39 per capita in PILOT contributions. Pittsburgh collected $1.07."

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AntiStatistYouth t1_je0lmo8 wrote

I'm curious to see how far the Gainey Administration is willing to take the fight and if he's willing to play real hardball. Long-term, the city can't maintain it's infrastructure or services without getting some of the larger "non-profits" to contribute. What that will looks like is the big question. There has to be leverage to get UPMC to agree to a new PILOT. Whether that's revoking the tax-exempt status of certain properties, or getting down in the trenches and revoking/blocking work permits for new hospitals and administrative buildings, UPMC isn't going to do it voluntarily

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ktxhopem3276 t1_je0ojgw wrote

I wonder if the amount of property tax the city could collect from the non profits is worth it if it means transforming health care and education to for profit enterprises. I’d rather not have my healthcare and tuition to go to Wall Street investors. Since most cities have a lot of universities and non profit hospitals, why does this seem to be such a problem for Pittsburgh specifically?

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ktxhopem3276 t1_je0ozao wrote

I think the issue is UPMC should be broken up into smaller pieces like separating insurance and hospitals and spinning off a few hospitals so they don’t own half the hospitals in the county. The non profit status is a deflection from the real issue of market concentration.

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ktxhopem3276 t1_je0qcfm wrote

The c suite bonuses are an insignificant fraction of UPMC’s budget and they are taxed as income. Look at for profit hospitals and how much money they give to Wall Street investors. This is a distraction from the real issue of market concentration - UPMC is too big and should be broken up into smaller pieces to improve competition that would drive down health care costs for residents. I don’t think charging upmc property taxes will come out of executive bonuses. It is robbing Peter to pay Paul - it will lower residents property taxes but raise hospital bills. Pushing hospitals and universities to operate as for profit companies is a scary idea. I think the whole state needs to figure out a solution for hospitals and universities to contribute to city services without designating them as for profit.

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ktxhopem3276 t1_je0r6ut wrote

They ignored it because it’s a fools earned to rob Peter to pay Paul. Primary voters were upset at peduto over this and it cost him his job so Gainey is going to do this publicity stunt to placate the voters who would rather cut off their nose to spite their face and think turning our hospitals and universities into for profit enterprises is a net benefit

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ktxhopem3276 t1_je0rki1 wrote

It’s a publicity stunt to placate the people that voted out peduto because he refused to pick a fight with upmc and cmu. I do like the idea of going after parking garages though bc it will incentivize public transit

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dazzleox t1_je0xcvu wrote

When? They've never followed through in 2013 because Peduto pulled the lawsuit after winning election, so we don't know what will happen. But there have been four cases recently of hospitals losing HUP test challenges even for main facilities, never mind the sort of parking lot/empty lot parcels that this administration is starting with

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dazzleox t1_je0ybdr wrote

  • It was $115 million in pledges including money the non profits are already spending on charitable giving over 5 years. No new dollars actually hit the streets in seven-ish years of negotiations. UPMC would have done a significant $40 million up front on housing (with a possible preference for their own employees?), but then the combined contribution of every non profit would have been only about $15 million a year for five years, including loans (see below.) There was no commitment beyond the five years.
  • None of them money would have been democratically accountable to elected government/the citizens since they would have gone to the One Pittsburgh non profit organization who had an un-elected board of directors. So if Pitt said they wanted their contribution to go to a Mon Valley connector, they could have determined that since it wouldn't have gone through city budgeting/voting.
  • The $115 million also would have included low interest loans -- which is hardly a grant -- from PNC, Citizens, and FNB to community development organizations.

If Peduto got the proposal operating in time, maybe he would have been re-elected, but he didn't.

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dazzleox t1_je0z3in wrote

There is a non profit exemption with hospital systems in antitrust law, so it would have to come back to the non profit issue anyway, unless congress would pass a law taking away the anti trust exemption.

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alexp8771 t1_je18m7b wrote

There was a case recently where another PA hospital was challenged and they lost. IIRC it was because the way the law works in PA you have to not be "profit motivated" or something, and of course 99% of the executive's emails are about increasing profit lmao.

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Aggravating_Foot_528 t1_je19vwm wrote

That's amazing. No idea. It sounds like this is just one round of many to come. Good for Gainey for thinking a bit outside of the box. The previous 2 mayors tried to go head to head with UPMC and got nowhere. This will at least start to provide some more tax revenue and begin to move the needle..

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Aggravating_Foot_528 t1_je1c9i4 wrote

You're conflating tax emptions for properties vs. institutions. this is going over tax exempt parcels that they're saying shouldn't be. and I looked at the list and there are only 6 upmc parcels on it. It won't be worth their while (upmc) most likely to drag this out in court beacuse I'm also sure that Gainey made sure that the parcels they picked were very egregious examples.

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Aggravating_Foot_528 t1_je1cggr wrote

So what it seems like for propel is that propel set up a shell non-profit to own the parcel that their northside school is on and then they rent it to Propel school. You can't do this -- Propel itself could own the parcel and not pay taxes on it, but a separate company that owns the property is making rent on it, and that's taxable.

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Aezon22 t1_je1e6su wrote

> UPMC has explicitly threatened to bankrupt the city with legal fees if their tax exempt status is revoked entirely.

This statement alone should disqualify them from tax exempt status. "We're going to be spiteful if we are forced to contribute to the city which we profit entirely too much."

I'm so tired of this shit man.

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Aezon22 t1_je1ekcd wrote

I'm just a simple country chicken, but I don't understand why "non-profit" company leaders can make 7 figures and not pay taxes, but I gotta shell out thousands every year just to have a cheap house. Isn't housing non-profit? Isn't housing "unrealized gains" as they say? BAAAAAAAAAAAWK.

Ooops, for a second there, I thought you was corn.

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AntiStatistYouth t1_je1zpth wrote

Maybe, but large organizations like UPMC, whether they call themselves 'non-profit' or not, are driven by profit. Diverting police away from the hospitals is likely just going to create a public relations nightmare.

The effective way to pressure UPMC is to impact their bottom line. Use the permitting process to prevent their new hospital wing or administrative building from opening for even a couple months and they will lose millions of dollars. And that is money they will lose immediately, before they can effectively retaliate monetarily by forcing the city to pay legal fees fighting in court.

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sparrowmint t1_je292r7 wrote

Not sure how much they have in terms of amenities these days. Propel enrollment is way down, so their funding would be way down. It's also quite unequal across the board with their schools. Some schools have jackshit, and their teachers make do with the bare minimum (or pay a ton out of pocket for their own stuff).

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Aggravating_Foot_528 t1_je2idgi wrote

Fuck them. Wow. They're taking $$$ from the department of Ed and then also turning around and avoiding property taxes. Assholes.

All while surviving on taxpayer money. That's balls.

That explains the shell company. So they can keep getting a shit ton from DOE to reimburse leases.

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Walkedtheredonethat t1_je377ox wrote

That sounds like upside down logic to me, but I came from TX (born and raised in PA but never a homeowner in PA). In TX, my 805 sq. ft. house was going to hit $5000 in property taxes this year. That’s why I left, I was tired of having my blood drained.

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ktxhopem3276 t1_je4ybcw wrote

For profit companies run 10%-20% profit margins. Upmc pays 1% to executives. It’s not a even a close comparison. Striping their non profit status won’t make them pay executives any less. They will probably pay them more and our hospitals bills will go up. I don’t get the point of that.

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paddle_forth t1_je59jdf wrote

The other variable is how often the houses are reassessed. PA doesn't have a mandatory reassessment timeline like other states, so some municipalities will reassess as soon as you buy, others do it randomly. It's a really confusing system and that's why you will see posts in this sub pretty often asking questions about property taxes.

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dazzleox t1_je5fe3e wrote

The Vanderbilt piece is from 1999 when, say it says, circuit courts were divided on the non profit factor. The way the case law has since settled is the FTC retains jurisdiction to review mergers regardless of status, it is prohibited to enforce anti trust laws against non profit health care entities generally. UPMC's growth lately has not been mergers but building new facilities.

https://www.ftc.gov/system/files/documents/public_statements/1520570/slaughter_-_hospital_speech_5-14-19.pdf

https://www.healthleadersmedia.com/strategy/nonprofit-hospitals-and-antitrust-enforcement-should-ftc-have-jurisdiction

FTC Chairman Joseph Simons said his team would like to do more to address Grassley's concerns but that they are butting up against statutory limitations.

"We're very interested in looking at unilateral conduct by hospitals, that are problematic under the antitrust laws," Simons said. "But, generally when we do that, we find that they're nonprofits, and we don't have jurisdiction over them."

"That's another reason why we've been asking the Congress to eliminate our exemption for nonprofits," Simons said.

"Gosh, I never gave that any thought," Grassley replied. "We ought to consider that."

I'm generalizing a bit. The DOJ retains jurisdiction over non profit hospitals but a more narrow set of issues, but has gone after some for wage collusion.

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ktxhopem3276 t1_je5g1xw wrote

> Unlike the FTC, the DOJ does have authority over nonprofits, said Makan Delrahim, assistant attorney general for the DOJ's antitrust division.

Also, what is stoping the state from regulating UPMC?

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dazzleox t1_je5my93 wrote

DOJ has jurisdiction over a fairly narrow set of issues though, like bribery/FCPA and criminal matters. That's good but it would take the FTC to break up a hospital system or HMO, and that would take an act by congress and/or a better SCOTUS.

The state could pass more regulations regarding hospitals, as long as it's not preempted. But state anti trust law is complicated in that some things would preempted and some would not, but either way, I don't imagine new laws passing a divided state legislature that does very little except at budget time. PA anti trust law is generally aimed at gas station price fixing, resale price maintenance, bid rigging for state contracts -- not at big stuff that the feds handle like corporate mergers.

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ktxhopem3276 t1_je5qrgz wrote

Physicians go through ten years of training and nurses are in high demand so it costs a lot to get personalized service like healthcare. Billing transparency would help a little bit and imposing higher safety standards and avoiding unnecessary procedures could help.

0