Maximizing Gain

[ebayuser]

Did you know that well over half of our hospital are non-profit and must show now profit. Well, how is that done when they do a $30K surgery and only have $5K-$10K of costs? When they charge $10K per bed per day?

You really don't understand how non-profit works, do you?

Even going by your views it is very easy: Hospitals have lots of real losses. Every time a homeless patient walks into the ER and needs surgery that's real loss. Not because of the difference in billed and contracted rates but because the hospital spends real money (i.e. pays wages, electrical bills, OR equipment, medications, etc.) so their loss goes up but income does not (no re-imbursement from the homeless patient for even a dollar). This offsets the income from a paying patient on their balance sheets.

Again, I ask how does any of these arguments justify paying more for a tradesman just because it is after hours? Which is what I took issue with originally and set you off.

[Brian57]

You really don't understand how non-profit works, do you?

Even going by your views it is very easy: Hospitals have lots of real losses. Every time a homeless patient walks into the ER and needs surgery that's real loss. Not because of the difference in billed and contracted rates but because the hospital spends real money (i.e. pays wages, electrical bills, OR equipment, medications, etc.) so their loss goes up but income does not (no re-imbursement from the homeless patient for even a dollar). This offsets the income from a paying patient on their balance sheets.

Again, I ask how does any of these arguments justify paying more for a tradesman just because it is after hours? Which is what I took issue with originally and set you off.

Hospitals are rarely stiffed 100%. They are compensated by the State and Fed for bums and illegals.

As for the OP, he disappeared or refuses to respond. I asked what was the scope of work and what did he pay. I will make my own professional assessment whether he got charged 3x. Also, it was the OP that brought up the medical industry, not me.

[Who'sThatGuy]

I don't work with too many hand surgeons but of the one's I have worked with NONE have ever billed $28K for carpal tunnel and certainly never been paid $9K just for the surgeons fee. I will post back after checking.

I can only tell you what I have seen on my paperwork. Doctor billed $28,000 and was paid $9,000. Maybe my situation was more complicated as I was attacked buy a dog that grabbed my wrist?

[Brian57]

I can only tell you what I have seen on my paperwork. Doctor billed $28,000 and was paid $9,000. Maybe my situation was more complicated as I was attacked buy a dog that grabbed my wrist?

The $28K is a fake number that is on all EOB's. Your doctor may have been paid $9K but wasn't a formal surgical center involved..with nurses, staff and supplies?

BTW - This thread should have been named 'minimizing gain.'

[Taxing Matters]

I did not say private practice doctors can write off the difference, I said hospitals can.

They cannot deduct unearned income as an expense on their federal income tax returns. Unearned income is simply income that is not included for tax in the first place. You may have either misunderstood what the author said, paraphrased it incorrectly, or the author himself got it wrong. The only time it is deducted is when the income had already been included earlier, as occurs with accrual accounting when income may be recognized prior to actually getting the payment, unlike cash basis taxpayers (like the vast majority of individuals) who do not recognize income until they actually get paid. But make no mistake, there is no extraordinary tax benefit that hospitals are getting out it.

[Brian57]

They cannot deduct unearned income as an expense on their federal income tax returns. Unearned income is simply income that is not included for tax in the first place. You may have either misunderstood what the author said, paraphrased it incorrectly, or the author himself got it wrong. The only time it is deducted is when the income had already been included earlier, as occurs with accrual accounting when income may be recognized prior to actually getting the payment, unlike cash basis taxpayers (like the vast majority of individuals) who do not recognize income until they actually get paid. But make no mistake, there is no extraordinary tax benefit that hospitals are getting out it.

I would like to see you debate your ideal tax law against Dr Keith Smith's actual experience in his industry and running his facility. Know that he hires doctors that work for the non-profit hospitals across town.

I highly doubt you understand the allowances one of the biggest Lobby's has paved for one of the most corrupt and lucrative industries. Listen to him and tell me he's wrong.

[PayrolGuy]

Brian, you don't get to show a loss for taxes just because you made up an inflated price and then accepted a lower price. If that were the case every piece of bubblegum would cost $1,000,000 but they would be willing to actually sell it for $0.05 and take the $$999,999.95 loss for taxes.

[Brian57]

Brian, you don't get to show a loss for taxes just because you made up an inflated price and then accepted a lower price. If that were the case every piece of bubblegum would cost $1,000,000 but they would be willing to actually sell it for $0.05 and take the $$999,999.95 loss for taxes.

Then maybe you can explain how the Fed and State can require that a privately owned business gives free services? What book does that come from?

My point is that the most corrupt systems (healthcare) makes their own laws.

BTW - I realize that we cannot do that.

[jk]

Then maybe you can explain how the Fed and State can require that a privately owned business gives free services? What book does that come from?

My point is that the most corrupt systems (healthcare) makes their own laws.

BTW - I realize that we cannot do that.

The requirement to provide free services is relatively new, like in its part of Obamacare. Prior to that time a hospital, for profit or non profit, was not required to provide free services. There are government hospitals (commonly called county hospitals) that do have to provide service to the indigent and always have.

You also dont undestsnd the requirements under EMTALA which limits the amount of treatment a hospital must provide that indigent person walking in needing surgery. Hospitals are not required to Provide more than adequate services necessary to stabilize a patient to the point s/he can be transported.

Now heres something else you apparently don’t know;

Non profit hospitals (I don’t know if it applies to for profit hospitals) cannot charge a patient without insurance more than a patient that has insurance. (Yes, an Obamacare requirement)

Of course managed health care providers (such as PPO insurance providers or HMO’s) who have contracts with medical providers do receive discounts under such a contract but that is not the same thing as charging la different price. It is a negotiated discount based on the contractual relationship and is applied to the same price everybody else is charged.

[Taxing Matters]

I would like to see you debate your ideal tax law against Dr Keith Smith's actual experience in his industry and running his facility. Know that he hires doctors that work for the non-profit hospitals across town.

I highly doubt you understand the allowances one of the biggest Lobby's has paved for one of the most corrupt and lucrative industries. Listen to him and tell me he's wrong.

I'd have to first see what he says to debate it. I'm simply taking issue with your characterization of it. Your characterization may misstate what he's said for all I know. But as I have over 30 years of experience in tax law, I submit I know it far, far better than you do. That is not a slam against you. As I understand it, you are a contractor and thus would know far more about the details of type of construction contracting than I do. So you might consider that I may know more about tax law than you do.

Then maybe you can explain how the Fed and State can require that a privately owned business gives free services? What book does that come from?

Exactly what “free services” are you arguing that the government is requiring hospitals to provide, and are you talking about all hospitals or just those that are tax exempt under IRC § 501(c)(3)?