Tag Archives: James A. Bacon

Virginia’s Child-Immigrant Non-Scandal

 The Shenandoah Valley Juvenile Center

In the fall of 2017, three migrant children detained by the federal Office of Refugee Resettlement (ORR) at the Shenandoah Valley Juvenile Center filed a class action lawsuit alleging abuse by guards. This June, amidst national media coverage of the separation of children from parents on the U.S. border, news media discovered the lawsuit and reported on the allegations.

As I summarized the charges in a blog post: “Allegedly, teenagers were restrained, handcuffed, and made to sit with bags over their heads. Some were stripped of their clothes. Some were locked in solitary confinement, some beaten, left with bruises and broken bones and kept shivering in concrete cells.” I added: “The claims, if true, are shocking and must be addressed immediately.”

Well, the Northam administration promptly looked into the issue and has published its report. The findings? As I should have surmised from the hysterical, almost apocalyptic nature of the immigrant-children coverage by the national media, the state Department of Juvenile Justice “found that there was no evidence of abuse or neglect.”

DJJ staff interviewed all of the federal residents of SVJC. The team was unable to substantiate the conditions described in the lawsuit concerning the operations of SVJC or the mistreatment of residents. After obtaining permission from ORR, the team returned on June 25 and reviewed case files, medical files, room confinement forms, and other documentation to assess compliance with regulations relating to the quality of care.

The immigrant children held at SVJC aren’t toddlers separated from their parents. They are unaccompanied minors under the age of 18 with no parent or legal guardian in the U.S. Many have suffered trauma; some belong to gangs such as the infamous MS-13. Many display behavioral issues presenting disciplinary challenges.

One technique used by SVJC is “room confinement” to “ensure the safety and security of residents, staff, and the facility.” The DJJ found no incidents where residents were confined longer than 24 hours. With the exception of one 23-hour incident, confinements typically lasted four hours.

SVJC staff also used, though rarely, a “restraint chair” for out-of-control residents “who cannot be safely restrained by less intrusive methods. While in the chair, a mesh spit guard can be placed on the resident’s head to prevent spitting or biting.”

In sum, the center faced difficult conditions. “Young people who have been frequently exposed to high levels of trauma, who are separated from their families, and who confront numerous language and cultural barriers” comprise a “uniquely challenging group,” the DJJ report says. The center should provide staff with professional development “in the areas of positive youth development, cognitive behavioral interventions and trauma informed care” and should increase “understanding and sensitivity toward the unique cultural backgrounds of the youth in the federal program.” DJJ also recommended more training in the use of physical and mechanical restraints, and in the effective use of de-escalation techniques.

Bacon’s bottom line: In other words, while the Shenandoah Valley Juvenile Center could benefit from some tweaks, investigators found no real problem there. What this story highlights — although you’ll never see a mainstream media outlet framing the issue this way — is an endemic feature of illegal immigration. Many children are unaccompanied by parents or relatives. Many suffered trauma — not at the hands of Americans but of their fellow countrymen (or perhaps Mexicans, which many had to pass through to get to the U.S.). And many pose special behavioral problems requiring their confinement and costing U.S. taxpayers.

The national media is largely uninterested in such issues, of course, so I anticipate zero follow-up. If U.S. immigration policy cannot be blamed, there’s nothing worth writing about.

Here’s what I would like to know. Who were the children who made the allegations and had a suit filed in their name? More importantly, who were the attorneys filing the suit on their behalf? How did those attorneys gain access to the children? Are they just random lawyers off the streets of Staunton, or are they part of a nonprofit organization? If they were part of a nonprofit, what is that organization’s aims and who is funding it? Could there have been political motivations behind the lawsuits? None of that information, as I recall, was reported by the media. What a surprise.

Bacon Bits, Your Tasty Morning Info Treat

More hidden deficit spending. Virginia devoted 33% less to capital spending on K-12 schools (inflation-adjusted) in 2016 than in 2008, according to the left-leaning Center on Budget and Policy Priorities. That compared to a 26% reduction nationally. The cuts, say CBPP, “mean less money to build new schools, renovate and expand facilities, and equip schools with more modern technologies, further diminishing the environment in which teachers educate and children learn.”

The CBPP made no effort to correlate the capital spending with K-12 enrollment, which has increased only modestly nationally since 2008 after years of strong growth. Presumably, stable enrollment limits the need to build new schools. However, it should surprise no one if school systems were engaging in hidden deficit spending by deferring maintenance and repairs.

Best colleges for the money. From Money magazine, which considered graduation rates, tuition charges, family borrowing, alumni earnings, and 22 other data points to rate educational value: University of Virginia, 10th best in the country; Washington & Lee University, 24th; Virginia Tech, 29th; James Madison University, 39th. Four Virginia colleges in the top 50. Not bad.

What if there aren’t any fascists to fight? When there weren’t any fascists to be found at weekend rallies in Washington, D.C., and Charlottesville, Antifa, the so-called anti-fascists, found someone else to fight. Yesterday, I noted how they turned on the police. Today, the Washington Post’s Avi Selk details how they turned on the media. “Videos show Antifa members accosting reporters specifically because they’re reporters.” Antifa uses the cause of anti-racism to shield the fact that they are enemies of a free society.

Coal mines and methane. Three hundred active and 200 inactive coal mines identified by Climate Home News account for one-tenth of all U.S. methane emissions into the atmosphere. Methane has 34 times the global warming effect of carbon dioxide.

Environmentalists have criticized natural gas as an electric power source. Although natural gas combustion produces less CO2 than coal combustion, the argument goes, when methane leakage from gas pipes and wells is taken into account, the natural gas supply chain is just as bad for global warming. I responded that the argument failed to take into account the massive outpouring of gas from coal mines, but I had no hard data. Now I do. Thanks Climate Home News!

Solar, Location-Variable Costs, and the 21st-Century Grid

California is pushing solar energy more aggressively than any other state in the union, and the debates unfolding there may presage controversies likely to occur in Virginia. One of those debates is the relative value of utility-scale versus community versus individual rooftop solar, which is intimately tied to the issue of location-variable costs.

Building so-called utility-scale solar — essentially vast solar farms — allows economies of scale in installation and generates electricity at the lowest cost per kilowatt. Power companies like them because they typically own the utility-scale production and get to generate a profit off them. One drawback is that utility-scale production consumes vast swaths of land. Another is that solar farms rely upon high-capacity transmission lines to move their electricity to distant locations, while local generation can feed into local distribution grids.

Utility-scale solar is going gangbusters in Virginia, but opportunities for communal and rooftop generation are limited by state law. A huge sticking point here, as it is in California, is how much utilities should reimburse small-scale producers for the electricity they generate. To what degree should small-scale producers share in the cost of maintaining the larger distribution and transmission grid they rely upon when the sun isn’t shining?

Steven Sexton, an associate professor of public policy and economics at Duke University, is skeptical of the numbers that California officials are using to justify a mandate requiring all new houses built in the state to be equipped with solar panels. In a Wall Street Journal column today, he introduces an element into the debate that I haven’t heard discussed here in the Old Dominion: grid congestion. He writes:

Regulators should tailor policy to reflect routine variation in the value of solar generation across the state’s congested electricity grid. Solar panels are most effective when installed where transmission constraints make supply relatively scarce — not on every roof in California.

In other words, the value of rooftop/community solar generation varies depending upon its location on the electric grid. The value is greater where grid congestion is worse and the alternative is spending tens of millions of dollars upgrading the transmission system — often adding to visual blight in the process. The value of rooftop/community solar is less where grid congestion is not an issue.

I would add a corollary to that observation: Rooftop/community solar generation has greater value in remote, hard-to-serve areas where new development would require the installation of additional sub-stations and distribution lines. Back in the days when I wrote about land use, I advocated the principle that all property owners should pay the location-variable costs of their decisions about where to build. The biggest of those location-variable costs is transportation infrastructure, but a not-insignificant one is the supply of electricity. Why should city dwellers, who require less electric infrastructure per-capita, pay extra to subsidize rural dwellers? Conversely, why shouldn’t rural dwellers who generate some or all of their own electricity, receive some benefit when they avoid some of the cost of building rural electric infrastructure?

The root of the problem is that electric utilities charge a flat rate for all customers within the same class (residential, commercial and industrial) regardless of the variations in cost of serving those customers. I haven’t heard anyone in Virginia challenge that premise, but charging location-variable rates may be a necessary step for building an electric grid for the 21st century.

Fizzle

Jason Kessler defiled the American flag yesterday by associating it with racism. With his latest rally a pathetic bust, Virginians can only hope we have seen the last of him.

So much for the Alt-Right.

Denied a permit to hold a really in Charlottesville, Alt-Right agitator and provocateur Jason Kessler organized a rally in Washington, D.C., on the anniversary of last year’s Unite the Right rally that resulted in widespread violence and the death of a counter-protester. Thousands came — but they were almost all counter-protesters. The Washington Post reports that Kessler attracted only 40 to his “white civil rights rally.”

Other than Kessler and the media, which still hews to the philosophy that if it bleeds, it leads, the group most disappointed by the pathetic Alt-Right showing likely was the radical left.

Antifa members vented their frustration at not being able to confront the rallygoers by lighting smoke bombs and firecrackers and throwing eggs in the direction of police. By then, a steady rain was falling, however, and the protest was fizzling. Most began heading home, but police kept a watchful eye as the black-clad group carrying umbrellas wandered about knocking over trash cans, chanting “Bust a window!” and yelling at police to get out of their cars and “meet us in the streets.”

Meanwhile, in Charlottesville, counter-protesters gathered despite the absence of any white supremacists at all. Last year, lefties criticized the police for letting the situation spiral out of control. This year, they criticized the police for their excessive presence. Reports the Washington Post:

Protesters screamed at police officers, whom some demonstrators had all weekend tried to associate with racism and fascism.

The night before, protesters had gathered at the steps of the Rotunda at the University of Virginia, before a giant banner that said, “Last year they came with torches; this year they come with badges,” and then marched through the streets for hours. On Sunday, the protesters, who had come out to combat absent white supremacists, were trying to combat the police, too. They cursed them. Insulted their looks. “Blue lives don’t matter,” the crowd chanted. And: “We don’t need cops.”

The radical left desperately needs a radical right to give itself meaning and legitimacy in the eyes of the broader public. Take the radical right out of the equation, and the radical left has to find new enemies — and it looks like the police are the most likely candidates. Unlike the Alt-Right, which appears to be imploding, the radical left isn’t going away.

A PETA-Free Zone for Tarheel Ponies

The Bacon family is vacationing in Emerald Isle again this summer, and today we took an excursion to Shackleford Banks near Beaufort, N.C. Shackleford Banks is a beautiful barrier island uninhabited except by a small herd of ponies. As with the famous swimming of the ponies from Assateague, Va., to Chincoteague, in which wild ponies are auctioned off by the community, Carolinians cull the pony population of Shackleford to keep the herd to a size consistent with the island’s ecological carrying capacity. There is no swimming from island to island, however, and, as far as I know, no ponies have died — as happened in Assateague last week in a freak accident. So far, the Beaufort community has avoided getting in the crosshairs of People for the Ethical Treatment of Animals (PETA). Let’s hope it stays that way. The Bacons enjoyed their visit to Shackleford Banks so much that they have resolved to return for a longer visit and more wide-ranging exploration of the island.

The Far Right Is in Decline. If Only the Same Were True of the Far Left

Good news is a scarce commodity these days, but here’s a heartening headline from the Wall Street Journal: “A Year After Charlottesville, the Alt-Right Movement Frays.”

Alt-Right rallies around the country are fizzling as white supremacist groups are hampered by lawsuits, infighting and a social media crackdown. “It’s been a total fracturing of the right,” the Journal quotes Jason Kessler, organizer of last year’s Unite the Right rally, as saying.

Hopefully, white supremacists will continue their downward spiral into total irrelevance. The answer to identity politics on the left is not identity politics on the right. Let progressives claim the banner of resentment and grievance. Conservatives and Libertarians need to preach a gospel of aspiration, prosperity, opportunity and uplift for all Americans.

According to a spreading progressive doctrine, racism by definition can exist only on the right, not the left. The expression of resentment, antagonism and hatred of ethnic/racial minorities, born of powerlessness, cannot be racism. Only those in power can be guilty of racism. From everything I’ve seen, those who hew to the white supremacist movement are, from a socioeconomic perspective, a bunch of sad, pathetic losers. Plumbers, truck drivers and gun-store clerks living in their parents’ basement have no power. But in places like Charlottesville and Portland, leftists control the levers of government. How’s that for irony?

Hypocrisy aside, if the left wants to make the argument that hatred is legitimate as  long as the haters are leftists, let them make that argument. That makes the choices all the more stark.

Speaking of which… Don’t miss Reed Fawell’s series of posts on “Charlottesville’s Path to Polarization,” which are based upon the meticulous and scrupulously even-handed, “Independent Review of the 2017 Protest Event in Charlottesville,” We published Part 1 a couple of days ago, and Part 2 will be forthcoming in a day or two, with the rest to come (hopefully) within a few days after that. The posts are long but immensely informative. Make sure you read them.

Moneysaurus and the Trumpenproletariat

Since the end of World War II, the nonprofit sector has consumed an increasing share of the United States economy. Health care, which is dominated by nonprofit hospitals, now hogs an 18% share. The growth of higher education, an overwhelmingly nonprofit industry, continues to outpace the general economy. Millionaires and billionaires are converting wealth into non-taxable foundations on an unprecedented scale, supporting the proliferation of tax-exempt foundations and nonprofit enterprises.

There are now some 1.6 million nonprofit institutions in the U.S. employing 11.4 million people and comprising the third largest employer in the country after retail and manufacturing, according to the Independent Sector website. In 2016 the PHP Staffing Group reported that employment over the previous 10 years had grown 20%  for non-profits compared to 2% to 3% for the for-profit sector.

Americans typically think of the U.S. economy as divided between the government sector and the private sector. But that view grossly oversimplifies the modern American economy. The nonprofit sector, which comprises 10% of the economy, belongs in category by itself. Nonprofit entities are private in the sense that they are not government organizations. But they behave very differently from for-profit enterprises. Most importantly, they aren’t accountable to the public in the same way that government and corporations are.

Americans have a U.S. Constitution and 50 state constitutions with checks and balances. We hold elections to throw out politicians we don’t like. We have the right to attend public meetings and to petition the government. We have transparency rules governing access to information. We have a fourth estate which, though diminished in size and capacity, views its central mission as acting as a watchdog over government. Governance leaves much to be desired — gerrymandering is a travesty of democracy — but the public is acutely aware of the inadequacies, and people are working to fix them.

We have a different set of mechanisms to hold corporations accountable. Executives of U.S. corporations answer to boards of directors, to equity investors, to bond holders, to banks and other financiers, and, most dramatically, to the marketplace. Unlike failed governments, failed corporations go out of business. Their corporate DNA exits the economic gene pool. Government functions as an additional backstop against corporate abuses against the public health and safety.

To whom do nonprofits answer in exchange for the massive benefit of being exempt from taxes? Nonprofits do have boards of directors (or trustees) but they don’t have investors capable of overthrowing them in a shareholder revolt or otherwise enforcing accountability. Most nonprofit boards are docile; they rubber stamp management’s vision for institutional advancement. While nonprofits aren’t as immune to catastrophic failure as governments are, they don’t pay the same price that corporations do for failure. Indeed, nonprofits with large endowments can be immune to outside pressure. Not that anyone notices. Transparency standards are minimal compared to those for government and publicly traded companies. Billions of dollars of so-called “dark money” slosh through the nonprofit system with almost no oversight and accountability. Except when scandals erupt, the fourth estate considers nonprofit activities of secondary interest. 

The political economy of nonprofits. Nonprofit entities have fundamentally changed the nature of American society, the economy. and the political system. Americans have been astonishingly sanguine about the creation of a new set of winners and losers.

Who are the winners? There are two sets of clear-cut winners — the millionaires and billionaires who get to shelter their wealth, and the nonprofit managerial class that gets to administer it. Insofar as the nonprofit managerial class is comprised of university-educated progressives who prioritize social justice issues, poor people and minorities are intended beneficiaries. However, insofar as the therapeutic ministrations of social-justice minions are counter-productive — a point I have argued repeatedly on this blog — the poor and minorities may be in actuality more victims than beneficiaries.

Whatever may be the case in that particular regard, the priorities of millionaires, billionaires and nonprofit administrators rarely extend to the well-being of working-class and middle-class Americans — especially the alienated, white Trump-voting segment of the electorate whom some have labeled the Trumpenproletariat.

These biases are most clearly visible in the higher education sector. The number one goal of the managerial class at colleges and universities is institutional advancement: building edifices, programs, and bureaucratic empires that maximize the prestige of the institution. In the pursuit of this goal, the managerial class is responsive to two main constituencies: (1) affluent alumni and their offspring (commonly referred to as legacies) whose good will they cultivate for gifts and benefactions, and (2)  lower-income and minority Americans in alignment with the leftist, politically correct value system of academe. The Trumpenproletariat, representing some 40% or so of the nation’s population, has zero influence. Continue reading

Graph of the Day: Virginia’s Declining Fertility Rate

Source: StatChat blog

The number of births in Virginia continues declining, reaching the lowest level in years in 2017 — only 100,248. A decade before, births had numbered 108,884.

Demographers Savannah Quick and Shonel Sen at the Demographics Research Group at the University of Virginia attribute the overall dip in fertility decline to a dramatic decline for 15- to 19-year-olds and 20- to 24-year-olds and a slight increase for 30- to 24-year-olds and 35- to 39-year-olds. In other words, many women are postponing childbirth, not choosing not to have children.

This is a classic good news/bad news story. The good news is that more women are taking control of their fertility in order to pursue education and improve their job prospects before having a child. Modern-day child-raising is an exhausting, all-consuming activity. It is all but impossible for women to hold down a full-time job, raise a child (or children), and continue their education — especially if there’s no father in the picture. The persistence of poverty in a society characterized by abundant avenues for upward mobility is, at its heart, a demographic issue. If lower-income women are having fewer children, fewer children will be raised in poverty.

The bad news is that the United States needs more citizens to enter the workforce and pay payroll taxes to help support a Medicare and Social Security system that is careening toward fiscal insolvency. But incremental changes in fertility are unlikely to make much difference. The Medicare and Social Security trust funds will dissipate before children born today can enter the workforce.

Dominion Seeks Approval for Experimental Wind Turbines

Dominion Energy rendering of the experimental wind turbines.

Dominion Energy Virginia has submitted to the State Corporation Commission a proposal to build two wind-generating turbines 27 miles off the coast of Virginia Beach — arguably the most expensive research project ever funded by the Commonwealth. The experimental turbines will not produce 12 megawatts of electricity at a remotely economic cost. But they will provide data that could pave the way for a vast wind farm that would produce electricity far more economically.

The project will test new designs to anchor the turbines in seabed conditions found off the Virginia coast and to withstand hurricane-force winds. The feedback is necessary before anyone undertakes utilizes the technology in a wind farm with dozens of turbines potentially costing billions of dollars.

The power company has been trying to advance the two-turbine project for several years but refrained from filing with the SCC for fear that the Commission would reject it as too risky and expensive. What’s different this time? First, it has lined up an experienced partner, Ørsted, a Danish company that has installed more than 1,000 turbines in European waters, to manage the project. Second, it has brought down the cost to about $300 million, significantly lower than previous iterations. Third, with the enactment of the Grid Modernization and Security Act, the state has declared wind power to be in the public interest.

And fourth, Dominion says that it can build the turbines without increasing rates. The project, said CEO Thomas F. Farrell II at the announcement in Norfolk yesterday, “will not increase customer rates even a penny.”

Here’s how I understand how that works. Before enactment of the Grid Transformation Act, Dominion would have paid for a large capital project like this one through a Rate Adjustment Clause, in which capital costs would be passed along to customers. The selling point of the Grid Transformation Act is that rates remain frozen but Dominion will apply excess earnings, which normally would be returned to customers, to renewable energy, energy-efficiency and grid-upgrade projects instead. It’s a convoluted way to go about things, but it has the virtue of stability.

I’ll be interested to see how Steve Haner, Bacon’s Rebellion’s electric consumer advocate, responds to this development. 

One last point: Just because the General Assembly has declared wind energy to be in the public interest, that’s no guarantee the SCC will go along. The SCC still has to balance cost, reliability and environmental sustainability — along with risk. Three hundred millions dollars is a lot of money to spend on what amounts to a research project. In analyzing the pros and cons of the experimental wind turbines, the SCC presumably will look also at the pros and cons of the wind farm that the experimental turbines would make possible. Given the lack of an established wind-power infrastructure on the East Coast, how much would a full-fledged wind farm cost to build? How would the cost of electricity compare to other energy sources? And would such an intermittent energy source improve or diminish the reliability of Virginia’s electric power supplies?

Health Care Dies in Darkness

VCU Health System has broken ground on a $349 million outpatient facility, the largest investment in its history.

The City of Richmond has an annual budget of about $700 million a year. The city gets loads of coverage by local media. Henrico County has an annual budget of about $1 billion a year. County government doesn’t warrant the same number of column inches or minutes of air time, but local media do catch the highlights.

The publicly owned and operated VCU Health System has a budget of about $1.5 billion a year. The quality of medical care there has just as critical an impact on the lives of the Richmond-area residents as, say, schools, roads, and municipal services. Moreover, increases in hospital charges have rapidly outpaced the increase in local tax rates for years — perhaps decades. Yet no one raises a peep, and local media tell us nothing about the hospital’s internal deliberations.

My purpose here is not to dis local media, which are under tremendous cost-cutting pressure and have shrinking resources to cover the news. It is simply to suggest than an institution so large and vitally important to a community — and the same could be said of Sentara in Norfolk, Riverside in Newport News, Carilion in Roanoke, Inova in Northern Virginia, and the University of Virginia Hospital in Charlottesville — needs public accountability. Oversight is all the more imperative when an institution enjoys nonprofit status that frees it from the burden of paying property taxes, sales taxes, corporate income taxes, and miscellaneous levies and excises.

It’s fair to say that the general public knows almost nothing about how VCU is run, what it’s long-range goals are, or how well it’s doing its job. Its annual report (like all annual reports) is essentially a public relations document. The only glimmer of accountability comes from the Virginia Health Information website, which compiles hospital data and publishes some “efficiency” metrics,  but provides no narrative analysis.

VCU Health generated an operating income of $136 million in fiscal 2016 — $120 million, if non-operating gains and losses are taken into account. It enjoys a protected market thanks to state and federal restrictions on competition. What is the public getting for the quasi monopoly status conferred upon VCU and the massive profits it generates? Not efficiency, that’s for sure.

Source: Virginia Health Information

Virginia Health Information compares gross and net hospital revenues per admission, adjusting for the acuity of cases. (As a tertiary care hospital and trauma center, VCU gets a disproportionate share of the hard cases, but the VFI methodology accounts for that.) For both categories, VCU falls within the most expensive quartile of hospitals, as shown in the table above.

Source: Virginia Health Information

VHI also looks at underlying costs. Again, VCU consistently comes out as one of the most expensive hospitals in Virginia, whether labor cost per admission, non-labor cost, or capital cost. Other tables shows that productivity/utilization ratios fall in the bottom two quartiles.

Despite these unfavorable comparisons — which VCU undoubtedly will say are unfair, perhaps with good reason — the health system retains $120 million a year in profits (what VHI terms “Revenue and gains in excess of expenses and losses”). An industry rule of thumb is that hospitals need to retain 3% of their earnings to reinvest in new plant, equipment and technology. VCU retains 8%, a difference of about $75 million a year.

In theory, VCU could rebate that $75 million a year to the community in the form of lower charges to patients. But hospital management, with the backing of the VCU board, has chosen to invest in institutional expansion. That includes, most controversially, significant expenditures to create the Virginia Treatment Center for Children, even though philanthropist William H. Goodwin had pledged to give $350 million to create an independent children’s treatment and research hospital. VCU declined to collaborate with Goodwin, preferring to charge ahead with plans to keep the children’s hospital under its own corporate umbrella. Goodwin has not announced how he might otherwise dispose of his proposed gift, but there is no guarantee that the Richmond community will be the beneficiary.

Nonprofit hospitals, like colleges and universities, are not profit-maximizing institutions — they are prestige-maximizing institutions. Hospital administrators don’t go into the hospital business to make massive fortunes (although they do very nicely). They go into the hospital business to enhance the status of the institutions with which they are affiliated. Nonprofit status is not some magic fairy dust that makes self-interest and self-dealing disappear. As with the quest for profit, there is no limit to how much money hospital leaders will spend to advance their institutional standing in a never-ending race with other institutions seeking to do the same.

These massive revenue- and profit-generating enterprises — VCU is hardly alone — operate with no effective restraint or public oversight in Virginia. For time immemorial, Virginia’s news media has defined its mission as holding government entities accountable. It’s high time they begin holding nonprofit universities and hospitals accountable as well. But they can’t — they lack the resources. As nonprofit universities and hospitals metastasize, growing swaths of Virginia’s economy function in darkness.