I make ten million dollars a year.
A gentleman at CommonSpirit was paid nearly twenty-eight million in a single filing year. He served three days of it before he stepped down.
Three days.
I try not to think about it.
Some men are simply better at mercy than I am.But let me be clear about the floor.
I would not do this work for less than five.Below that number, a man cannot reasonably be expected to serve people experiencing poverty, and mine is five.
Do You Know How Much They Love Me
You have never seen love until you have seen a community love its nonprofit hospital.
I saved their grandparents.
I saved their parents.
I delivered their babies.
Now, when they say that, they do not mean me.
They mean the physicians.
They mean the nurses.
They mean the woman who sat with their father at three in the morning, holding his hand, telling him it would be all right, while I was asleep in a house they will never see.
They mean her.
They say me.
I take the credit. All of it.
I stand at the gala in a tuxedo and accept a standing ovation for work performed by people I am, at that moment, negotiating against.
And the truly beautiful part is that I never have to lie.
I never once said I did it.
I never said I did not.
Gratitude is the cheapest input in my supply chain. It arrives free. It never unionizes. And it goes directly onto my name.
You Believe I Am a Charity
I want to say this gently, because I am fond of you.
You believe I am a charity.
You have believed it your entire life.
Your mother believed it.
You will teach your children to believe it, and one day they will drive past my tower on their way to a bill they cannot pay, and they will feel grateful.
I have never corrected you.
Why would I?
It is the nicest thing anyone has ever done for me, and you did it for free.
The Cross Does Legal Work
There is a cross on my building.
A saint’s name is on my letterhead. Some order of nuns founded this place in 1890 with four beds and a cart. They are gone. Their descendants would not recognize what I have built, and if they arrived asking questions, my general counsel would have thoughts.
I keep the name.
A patient who walks under a cross does not ask for an itemized bill. The cross is a pre-approval. It arrives before I do. It answers the question before the patient thinks to ask it. It says: whatever happens to you in this building, it was done in love.
That is the most valuable real estate I own, and it is on the roof.
You have called your hospital a charity your entire life. It has never once described itself that way to the government.
Read the whole thing. It costs you nothing, and it changes nothing. That is the beauty of it.
Eleven Letters
Since you have been so generous with me, allow me to be honest with you.
The word nonprofit is not a promise.
It is not a vow. It is not a moral condition.
It is a tax election.
That is all it has ever been.
Eleven letters and a filing.
I did not swear anything.
I did not renounce anything.
I did not kneel.
I filled out a form, and a clerk approved it.
And out of that form came a cathedral, a saint, a stained glass atrium, and a city full of people who believe I personally saved their mother.
The finest word in the English language, and it cost me the postage.
I Could Have Been a Banker
Nobody ever asks me this, so let me volunteer it.
I had the grades. I had the temperament.
I could have gone into private equity.
I could have run a fund.
The arithmetic is identical.
Buy the asset.
Raise the price.
Extract the margin.
Tell the partners a story about value creation.
But private equity has a problem nobody mentions.
Nobody thanks you.
You take the same margin, and they call you a vulture. You attend the same dinners and no one claps. No one names a wing after a managing director. No bronze bust of a general partner sits in any lobby in America.
I looked at the two paths, and I chose the one with the gala.
Same extraction.
Better applause.
I do not manage capital. I steward the mission.
We Do Not Have Profit. We Have Surplus.
Appreciate the craftsmanship.
The word says only that I do not distribute profit to shareholders. That is the entire promise. It says nothing about mercy. Nothing about the poor. Nothing about what becomes of the money.
So I do not distribute it to shareholders.
I distribute it to me. To the tower. To the thirty vice presidents. To the bond covenant. To a reserve fund that would embarrass a university endowment.
Every dollar stays in the mission.
I am the mission.
And the word profit appears nowhere in my filings. It would look terrible.
So I call it surplus.
I call it operating margin.
I call it reserves.
I call it days cash on hand.
I run a billion dollar surplus and an investment portfolio that would make a hedge fund blush, and not one word of it is a lie.
I did not hide anything.
I changed the noun.
Community Benefit, My Masterpiece
They do ask me to justify the exemption.
There is a form for that too.
I fill it out myself.
I define the number.
I count the number.
I report the number.
There is no floor.
There is no minimum.
There is no penalty. Nobody audits it.
So I count the discount I never collected on a bill nobody was ever going to pay.
I count the Medicare shortfall I would have absorbed anyway.
I count the residents who staff my hospital on a federal subsidy.
I count the health fair.
I count the tote bags.
I add it up, and it comes to exactly enough.
It always comes to exactly enough.
The Man Across the Street
Now let me tell you about my competitor.
The for-profit hospital.
He pays property tax.
It funds your schools.
He pays income tax. Some of it funds Medicaid, which pays for the poor, which is supposedly my entire reason for existing.
He has never once been to a gala.
And you despise him.
You call him greedy. You call him corporate.
You write letters to the newspaper about him.
Then you walk under my cross, into my building, and you accept a bill you cannot pay from a nonprofit that pays its administrator ten million dollars a year.
And you thank me on the way out.
I am not a better man than he is.
I picked a better tax status.
The Verdict
So yes. I love the word nonprofit.
I love that it sounds like a vow and functions like a shelter.
I love that it makes an accounting term sound like a beatitude.
I love that eleven letters bought me a cathedral, a saint, a standing ovation, and a tax bill of zero. But mostly I love that you gave me the halo yourself.
I never asked for it. I never claimed it. I never had to.
I did not take a vow of poverty.
I filed a form.
Poverty is what I sell.
It is not what I practice.
-Rojas out.
