Indeed, institutional survival in the nation's cutthroat health-care market involves business acumen a lot more than it does charity. And without leadership from the board on down, the custom of routinely asking everyone to give naturally atrophies. Some foundations do well, but others don't even come close to covering the amount of free care their parent institutions render in any given year. Whether that is true of Millennium, I don't know. What I do know is that Millennium, like teaching hospitals everywhere, is locked in the jaws of a berserk system in which control has largely passed from the doctors and the hospital administration to insurance companies.
Cost is managed, care is rationed.
If you're an insured, basically healthy, but momentarily sick person, the system works fine. If not, you're in big trouble, and philanthropy will make little or no difference to you. And that's what they must do to survive. Henry Goldstein, president of the Oram Group in New York, is a regular contributor to these pages. Click here to send an email .