A capital way to serve the poor

The Wall Street Journal, February 2, 1998

Any implication of greed on the part of nuns and sisters who choose to live on $40 per month is preposterous on its face. Rather, the sisters take very seriously the public trust and charity with which they live their mission, and are thus careful with profits.

[This letter to the editor was in response to a Wall Street Journal feature article critical of the Daughters of Charity for having large financial reserves.]

Your article on the Daughters of Charity National Health System (“Nuns’ Zeal for Profits…,” page one, Jan. 7) seems to suggest that a $2 billion dollar reserve is evidence of greed and a steering off course from the Daughters’ mission to serve the poor. This thesis is absurd and naive.

Any implication of greed on the part of nuns and sisters who choose to live on $40 per month is preposterous on its face. Rather, the sisters take very seriously the public trust and charity with which they live their mission, and are thus careful with profits.

The naiveté is in failing to recognize the current harsh and cutthroat nature of today’s health care market. Hospitals, particularly those that care for the indigent, stand on very shaky ground as payments are capped rather than based on cost, more and more people show up for care with no health insurance at all, and care is shifting from the inpatient to the outpatient setting.

In this environment, any major player must utilize the best and the brightest talent to compete. If the Daughters hire lay persons for part of their financial work, then sobeit. The Daughters, serving in this country since 1823, did not get to be the largest nonprofit healthcare system in the nation by praying a lot and spending down all of their resources. Setting aside $2 billion in reserve makes sense in light of the instability and may actually be more a reflection of investments doing well in a bullish stock market.

The relatively recent takeover of health care by the for-profits has resulted in an all-too-tempting potential for abuse, as these investor-owned healthcare systems must answer first to shareholders, second to patients. Witness the largest, Columbia/HCA, undergoing a massive federal investigation into jaw-dropping allegations of systematic overbilling of Medicare. If for nothing else, the Daughters’ strong sense of mission is a powerful influence on the for-profits to turn some of their profits back into local communities.

To me, your article’s litany of the Daughters’ sound business practices supporting their fiscal acumen is comforting. It reassures me, as a nurse who has practiced at the bedside for 19 years, that the Daughters of Charity will keep an eye on the bottom line, that they will compete and thrive in a turbulent, harsh environment, and that the care I lovingly give to patients will result in profits that are responsibly stewarded and turned right around into my community to serve the poor.

Toni Inglis, MSN, RN CNS (retired), FAAN, a lifelong Austin resident and retired neonatal intensive care nurse and editor of NursingNews, writes a monthly opinion column for the Austin American-Statesman editorial page.