Politico: Tax-exempt Mayo Clinic grows, but rural patients pay a price

EXCERPT: “The Mayo Clinic, which sprawls across this Midwestern city, is the nation’s top-ranked hospital, according to U.S. News & World Report. But that might undersell its prominence: The clinic is arguably the best-regarded health care system on the entire planet…Patients from nearly 150 countries travel to Mayo Clinic sites in Minnesota, Arizona, Florida and beyond. Famed filmmaker Ken Burns is making a documentary about Mayo and the story of its founders — Will and Charlie Mayo, a pair of brothers and doctors who have assumed near-mythic status in the health care field. It’s the system that lawmakers around the nation cite when pushing health reforms, and that clinical researchers praise as a model for other caregivers…But in Albert Lea, Minnesota, a small city set among cornfields and lakes about 64 miles from Rochester, the Mayo Clinic is something else: the enemy…Mayo took over the hospital that serves the 18,000-person city in 1996, and residents have seen services and supports slowly bleed away ever since..The anger in Albert Lea highlights what some critics insist is a massive loophole in U.S. health care policy: Nearly 5,000 hospitals are given tax-exempt status to raise large amounts of charitable money and avoid paying state and local taxes, as well. In return, they’re loosely required to pursue a public mission, to put patients’ needs first, while channeling any profits back into their facilities. But under IRS rules, there’s no minimum level of community service that hospitals must provide to qualify as tax-exempt, nor limit on annual profits despite their ‘not-for-profit’ status…That lack of standards can become a problem. To justify the expansive facilities and highly specialized services that they often acquire, hospitals need patients — lots of them. Major teaching hospitals like Johns Hopkins in Baltimore and Massachusetts General in Boston have taken over suburban hospitals in an effort to capture market share in population-rich areas — a process that, many argue, has given those institutions disproportionate clout in setting health-care premiums with insurers.” FULLSTORY: http://politi.co/2zPvLUd