Whatever the other merits of this proposal, funneling another ~$30B to hospitals is the antithesis of "targeted relief."

A dozen hospital chains just presented at #JPM21, two weeks ago.

General theme: Financially speaking, hospitals are doing quite well. 1/n

We have, for example, Community Health Systems, which operates 89 hospitals in 16 states, many of them in smaller towns / metro areas.

Through the pandemic, CHS's EBITDA margin never even fell into single digits, and profitability actually *increased* in 2020.
Meanwhile, Lifepoint Health (84 hospitals, 30 states) also saw profits increase in 2020, while its cash-to-debt ratio fell. Pretty solid year.
ProMedica Health (non-profit, 13 Midwestern hospitals) actually saw profits increase even in *the first half of 2020,* when hospitals were supposedly facing catastrophe.

They finished the year with ~$440M of EBITDA, and $2.3B of cash on hand.
Baylor Scott & White (52 hospitals) saw its profit margin *more than double* during the pandemic year, and ended September with $7.8 billion of cash and portfolio investments.

That's about $600M more than they had pre-pandemic.
Mass General Brigham's cash pile is now over $11 billion, which is roughly twice what Congress proposes to allocate to all rural hospitals in this proposal.

That number is *up* by ~$2B from the start of the pandemic, which is quite something.
Head down the Atlantic coast to NY, and we find that (non-profit) Northwell Health's EBITDA margin did dip a bit in 2020, but not dramatically.

And, like every other chain in this thread, Northwell ended up with a healthier balance sheet than at the beginning of the crisis.
If we turn back to the Midwest, we might look to OhioHealth, a highly profitable "not-for-profit" with 12 hospitals.

Not clear why they need $6.2 billion of cash on hand (4x their total debt), but they have it, which must be nice.
While we're in the neighborhood, we may want to look north, toward Michigan, home to Henry Ford (5 hospitals) and Spectrum Health (14 hospitals).

And...yup! Cash upon cash. Spectrum's cash pile increased by a quarter (~$1B) in the year to September.

Why?
We could also take a look around Illinois, Missouri, Oklahoma and Wisconsin, perhaps through the lens of SSM Health's 23 hospitals in those states.

SSM enjoyed revenue growth in 2020, and currently sits on a tidy pile of $4.4 billion.
Let's keep heading west. We'll make a stop in Utah, where local giant Intermountain is giving Mass General a run for its money. As a...portfolio manager.

Another hospital chain, with $11B of cash on hand, and a nice healthy profit margin.
And now, to the Pacific Coast. Providence is a good example - 51 hospitals from California to Alaska, along with a few facilities in MT, NM and TX.

EBITDA margins were down a smidge, but cash was up by $2B to an eye-popping $14.5B.

Is that a lot? It seems like a lot.
We can keep going, though I am not sure we need to.

There's Tenet, with its 40% EBITDA margin on surgical facilities. Or UHS, where free cash flow more than doubled in 2020...

But, at this point, I think the picture is clear. Congress is wasting your money. /n

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Patriotism is an interesting concept in that it’s excepted to mean something positive to all of us and certainly seen as a morally marketable trait that can fit into any definition you want for it.+


Tolstoy, found it both stupid and immoral. It is stupid because every patriot holds his own country to be the best, which obviously negates all other countries.+

It is immoral because it enjoins us to promote our country’s interests at the expense of all other countries, employing any means, including war. It is thus at odds with the most basic rule of morality, which tells us not to do to others what we would not want them to do to us+

My sincere belief is that patriotism of a personal nature, which does not impede on personal and physical liberties of any other, is not only welcome but perhaps somewhat needed.

But isn’t adherence to a more humane code of life much better than nationalistic patriotism?+

Göring said, “people can always be brought to the bidding of the leaders. That is easy. All you have to do is tell them they are being attacked, and denounce the peacemakers for lack of patriotism and exposing the country to danger. It works the same in any country.”+

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The article is, at heart, deeply weird, even essentialist. Here, for example, is the claim that proposing climate engineering is a "man" thing. Also a "man" thing: attempting to get distance from a topic, approaching it in a disinterested fashion.


Also a "man" thing—physical courage. (I guess, not quite: physical courage "co-constitutes" masculinist glaciology along with nationalism and colonialism.)


There's criticism of a New York Times article that talks about glaciology adventures, which makes a similar point.


At the heart of this chunk is the claim that glaciology excludes women because of a narrative of scientific objectivity and physical adventure. This is a strong claim! It's not enough to say, hey, sure, sounds good. Is it true?