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Comment by smeej | Hacker News Reader

How many people do you think the hospital can treat with the $3 billion (yes, with a B) that Langone helped raise? Or even just the $200M he personally donated?

Which is better for the individual people who might (and I stress "might," since the hospital denies it) have to wait slightly longer on a day he needs care? To wait slightly longer there, or to wait slightly longer because they had to route to a different hospital that's struggling to deal with the demand?

If you remove Langone from the situation, you're not simply left with "everybody gets seen one person sooner." That's a small-picture view. You're left with "many of these people just can't be seen here at all."

I'm not saying people have to like the rich. I'm just saying if I'm next in line after him at NYU Langone hospital, I'm glad I have that hospital to go to, even if that bumps me to 2nd priority in the room.

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The US government, which only provides treatment for its own employees, retirees (including veterans), the poor, and the old spends more per capita on healthcare than the UK government, which covers everyone. On top of that employers and employees spend trillions a year.

Why do we need billions in donations on top of that? Where is all the money going? Let’s ask NYU Langone executives that.

Seems logical if you disproportionately treat poor and old/retired people you have to spend more per capita than a healthcare system that treats much younger and therefore healthier people.

That’s per capita over the entire population.

If you took longer to treat him after he raised that money, he can’t then go back in time and stop himself from raising that money. Presumably the argument should be around his future actions not his past ones.

As to the hospital, “The octogenarian had stomach pain, and Room 20 was kept empty for him, medical workers said.” “One doctor was surprised to find an orthopedic specialist in the room awaiting a senior hospital executive’s mother with hip pain.” This is a larger disruption than just the time he was physically being treated so presumably it’s more than just a one person delay.

Sure one possibility is they have more space than workforce so keeping the room empty has minimal downsides, but maintaining a separate space for VIP’s requires more overhead than an empty room. Essentially you need to decide if anyone showing up is a VIP and that slows everything down even when there aren’t VIPs. “Major trustee, please prioritize” is vastly more disruptive than just putting someone ahead of a line.

“It’s the fact that I am getting multiple calls, from multiple people, asking me to drop everything to treat a V.I.P.” If nothing else if the hospital wants to start “acting as businesses“ for VIPs then it should be giving up it’s non profit status and thus the tax deductions for the donors.

It doesn’t just influence his future actions, but rather the future actions of all possible large donors.

Further, I can’t imagine that the premise of this prioritization did not come up in discussions with the development staff as they were finalizing the details of a 10-figure donation. In that regard, this policy probably did influence his past actions as well.

Detailed arrangements would likely be tax fraud on a tax deductible donation, so I doubt they made such things explicit.

Just because something is called a donation doesn’t mean it qualifies as one.

The amount which is tax-deductible is the amount donated, minus the fair market value of any goods and services and received. If Foo donates $3B for a non-profit hospital in exchange for a promise to slightly bump the priority and treatment Foo and Foo's family, I'd estimate that at least $2.999B of that was tax-deductible. (Is the promise of better treatment worth more than $1M of NPV? I don't think so.)

He donated 200M, the fair market value of priority treatment at a hospital for himself and family via a special phone number for decades could represent a significant fraction of that 200 Million.

Pulling numbers out of a hat, 200k/year * 5 people * 25 years is 25 million. Though the IRS could easily define the fair market value as whatever the minimum donation to receive this level of service.

Sure running the phone number isn’t currently that expensive, but fair market value of this service is limited by their ability to provide it. They would essentially need to auction off a fixed number of slots per year and in NYC that those slots wouldn’t run cheap. Alternatively, they would need a lot of full time specialists who mostly waited around for VIP’s.

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