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1. Thanks for the nuanced view. I agree that zero charity care doesn't necessarily mean greedy execs.

2. In my mind keeping costs lower is a form of charity. Especially with something as frequently difficult to understand as health care costs.

3. Executives do deserve to make a fair amount for their skills and effort. I'm not sure myself what salary I consider it fair pay vs taking greedy advantage of not-for-profit status.

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On your last point: I think it's useful to think in multipliers and desired outcomes.

Do you want the best doctors involved in care for patients and training juniors, or do you want them to spend time jockeying for a position in the hierarchy because that's a plausible but also the only way to 2x their income?

This doesn't fully answer the question, of course, but it suggests that large pay disparities are extremely wasteful for society as a whole.

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