Category Archives: Charity and philanthropy

COPN’s Regional Monopolies Helped Boost Virginia Hospitals’ Operating Margins to more than 3x National Median in 2020

by James C. Sherlock

Virginians have been assured forever by the hospital lobby that the non-profit regional monopolies established and protected by COPN nearly everywhere but Richmond:

  • are benign public servants with a charitable mission;
  • certainly don’t drive up costs;
  • that competition does not matter;
  • that the State Medical Facilities Plan on which COPN is based, like government 5-year industrial plans everywhere, is both well- managed and prescient; and
  • that limiting capacity is the key to cost containment. (It turned out that limiting capacity was also the key to hospitals being overwhelmed by COVID. Clearly disaster preparedness is not among COPN criteria.)

Well. The median operating margin for Virginia’s 106 hospitals in 2020, the latest year for which data are available, was 9.2%. Nationally, that margin was 2.7%.

Virginians paid over $1.5 billion more for hospital visits than they would have if our hospitals had cumulatively posted a 3% operating margin, which has been at or near the national median  for years. Continue reading

VMI Alumnus Redirects Intended $900,000 Gift

by James A. Bacon

Colleges and universities have long been prone to clashes between strong-willed presidents and prominent alumni. Over the years there have been numerous well-publicized episodes of donors retracting their benefactions after some run-in with the forces of political correctness. But as “wokeness” becomes the prevailing ideology on many college campuses, and as many alumni have decided they’re mad as hell and aren’t going to take it anymore, these episodes are occurring with ever-greater frequency.

One such incident occurred at the Virginia Military Institute in connection with Governor Ralph Northam’s recent speech at the Institute. On Nov. 14, an alumnus sent the following email (bold face in the original) to Superintendent Cedric Wins and other figures in the VMI leadership:

Good evening. I am a 198- [date redacted] VMI graduate. Two requests, please:

  1. Please immediately cancel Ralph Northam’s speech at VMI Monday, 15 November. He’s a disgrace and a woke buffoon. Don’t subject the Corps of Cadets to his lunacy.
  2. If you won’t accommodate request number one above, then please make his talk optional and not mandatory for the Corps of Cadets. Continue reading

This Tax Credit Saves the State $8.5 Million

Source: “Scholarship Tax Credits in Virginia”

by James A. Bacon

The Virginia Education Improvement Scholarship Tax Credit Program, which provides state tax credits for charitable donations to approved foundations, saves the Commonwealth $1.78 for every $1.00 in lost tax revenue, concludes a study by Richmond-based Mangum Economics.

In tax year 2019, reduced public school enrollment generated $19.5 million in state savings with a net positive fiscal impact of $8.5 million after accounting for the lost tax revenue, according to the study, “Scholarship Tax Credits in Virginia.

The study was sponsored by the Thomas Jefferson Institute for Public Policy (TJI), Virginia Council for Private Education, McMahon Parater Scholarship Foundation, Catholic Diocese of Arlington, Virginia Catholic Conference, Anna Julia Cooper School, Virginia Jewish Day Schools, Association of Christian Schools International, and Renewanation. Continue reading

Virginians’ Money and Our Tax-Exempt “Public Charity” Healthcare Monopolies

The Business of Healthcare

by James C. Sherlock

A generally accepted rule of thumb for the minimum profitability required for a hospital to maintain operations and fund its future is 3%.

Virginia’s community hospitals as a group in 2019 had an operating margin of 10%. Most of them are filed with federal and state governments as not-for-profit public charities and are untaxed at any level of government.

I yesterday wrote a  column that disclosed 34% increases in the 2019 profitability of Virginia hospitals that were generated by taxpayer funds sent directly to the hospitals through Medicaid expansion and increases in Medicaid payments passed by the General Assembly in 2018.

There were several good reasons for Medicaid expansion. Better access for the poor. Financial stability for rural hospitals. I was for Medicaid expansion myself, and Republican votes put it over the top. Continue reading

Good Neighbors

Shu-Jin Wu

by Kerry Dougherty

In these hyper-partisan pandemic times it often seems we will never come together as a country.

We are too far apart politically. We spend too much time insulting each other. We can’t agree on the simplest things. We’re sick of the pandemic, divided about restrictions and gloomy about the future.

Even the vaccine isn’t bringing us the joy it should because know-it-all doctors on TV warn that nothing must change — masks, distancing, gatherings — once we’re fully vaccinated.

Some of us thought the point of a vaccine was a return to normalcy.


But then Saturday happened and once again, I was buoyed by the basic kindness and generosity of Americans. Especially my neighbors in Virginia Beach. Continue reading

Probably a Coincidence – COPN, the Monopolization of Health Care and the Marginalization of the Poor

by James C. Sherlock

The Business of Healthcare in Virginia

I have been asked many times about how freer markets in healthcare can coexist with our need to treat the poor. I will try to briefly cover some of the complexities of the answer to that question.

And I will show that of all of the government healthcare control systems, COPN is the only one that has proven to disproportionally hurt poor and minority populations by its decisions and their effects.  

And it does so by design. Continue reading

COPN Scores a Kill

by James C. Sherlock

More than eleven months ago I wrote an essay titled, “The Legal Corruption of (Virginia’s Certificate of Public Need) COPN.” That system needs overhaul, not adjustment, and the people of Hampton Roads need help.  The Governor needs to lead in both efforts.

Today I offer the third in a series (first two here and here ) of essays providing background and potential future solutions to the closure of Bon Secours DePaul Hospital in Norfolk.

This is the story of the public, state-sponsored execution of DePaul and a simultaneous attempt to create a bleak future for Bon Secours in Hampton Roads.

COPN mortally wounded that hospital in 2008. It lasted until now as Sentara gnawed away at it  Its death was announced this past week. Pending is how Bon Secours will look at its future in Hampton Roads.

Continue reading

DePaul Hospital’s Closing Presents a Unique Opportunity for Hampton Roads

De Paul Medical Center Jan. 29, 2021. Photo Credit: James C. Sherlock

by James C. Sherlock

Not too long ago, before the decline of the malls and COVID, the healthcare community coined what they called the Nordstrom Rule.

The meaning was that if you wished to optimize profits in your healthcare business, build it close to a Nordstrom. The theory was that Nordstrom had already done the market research to identify concentrations of wealthy customers.

I wrote yesterday about the Sisters of Charity and Bon Secours, Catholic charities both. The Sisters were not in it to serve wealthy patients. They purposely located their hospitals among the poor. So 19th and 20th century of them.

Sentara, a more sophisticated public charity, avoids locations close to the poor.

In 1991, Sentara purchased the Humana Bayside Hospital in Virginia Beach, renaming it Sentara Bayside Hospital. That cleansed Virginia Beach of a competitor. But Bayside served Virginia Beach’s largest concentration of economically disadvantaged minorities. So Sentara closed it at the first opportunity.

The Virginia Department of Health brokered the closing of Bayside in 2008 under the cover of the Certificate of Public Need (COPN) process that fatally wounded DePaul, allowing Sentara to relocate the Bayside beds to the new Sentara Princess Anne, far from the minority citizens of Bayside.

The closest hospital for many residents served by Bayside was then, you guessed it, DePaul. No longer. Continue reading

Better Angels

by James C. Sherlock

“Though passion may have strained, it must not break our bonds of affection. The mystic chords of memory will swell when again touched, as surely they will be, by the better angels of our nature.” 

Abraham Lincoln, first inaugural address, March 4, 1861

Sisters of Charity
Photo Credit: Sisters of Charity

DePaul Hospital Closing

The DePaul Hospital closure announcement was short. A press release dated January 26, 2021, said in part:

Bon Secours today announced that it will be consolidating acute care and emergency services across the South Side, from Bon Secours DePaul Medical Center in Norfolk to Bon Secours Maryview Medical Center in Portsmouth, by the end of the first quarter 2021.

Robust efforts have been taken over the years to help sustain acute and emergency hospital operations at the facility. While these efforts offered temporary benefit, they were not enough to sustain acute and emergency care in an environment of significant decline. 

Throughout its long history in Norfolk, DePaul has been known for its exceptional, personalized care. While this transition is underway, we will honor the legacy of DePaul Medical Center, continue to serve our patients with compassion and dignity, and will remain focused on our founding congregations’ steadfast commitment to ensuring that compassionate care is available for each of our patients, communities and associates – especially in times of need.

DePaul Hospital did not just die, it was murdered by Virginia’s COPN process, but that is for another column.

This one will celebrate its life and the lives of the women who founded and ran it for 141 years.  Continue reading