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FWIW.. my mother's childhood friend is a nun who (successfully) ran a hospital in the Buffalo NY area for years up until the late 90s/early 2000s. She was replaced by a series of "civilian" CEOs after that. AFAIK, the quality of care OR the finances of the place didn't improve one iota.

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This is exactly it. Many charity hospitals were started by religious orders sworn to poverty. Things change the moment the laity step in. Lay ceos want to make money. Nuns cannot.

IIRC there was a phase in between with a hierarchy based on salaries. Surgeons were in charge. They created a salary scale above filled with people who know nothing about healthcare. Not to forget about investors in stead of public funds and donations.

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