By Dana Mincer, DO, Local Physician and Mom
Jefferson Health operates in our Abington–Glenside community under nonprofit status.
That designation comes with a social contract: in exchange for not paying taxes, these institutions are supposed to serve the community.
But what happens when that promise is no longer being upheld?
A Patient Doing Everything Right—Failed by the System
I recently cared for a patient who has been stable from opioid use disorder for many years.
She is not just surviving—she is thriving.
She holds a job. She teaches Pilates. She is living a full, meaningful life.
That stability exists because of buprenorphine—a medication that saves lives by preventing relapse and protecting patients from the deadly risks of street opioids.
But here’s what most people don’t understand:
Not all generic medications are truly identical in real-world clinical effect.
While generics are labeled “bioequivalent,” there can be meaningful variation in:
- Inactive ingredients (fillers and binders)
- Absorption and dissolution characteristics
- Patient-specific response
For many patients, this difference is negligible.
But for others—especially in conditions like opioid use disorder—even small variations can lead to real instability.
This patient has only remained stable on one specific generic formulation—manufactured by Rhodes Pharmaceuticals.
She has tried others.
They did not work for her.
For years, we maintained that stability.
Until the system made that impossible.
The Pharmacy System Is Not Built for Patients
Large chain pharmacies will not order specific generic manufacturers. They purchase the cheapest version available that aligns with insurance reimbursement.
Patient outcomes are not part of that equation.
A small independent pharmacy was willing to help—but they hit a wall:
They could not obtain the medication at a price that would allow them to break even under the patient’s insurance plan.
In any normal market, the solution would be simple:
The patient pays the difference.
But in healthcare, that’s considered “upcharging”—and it’s effectively prohibited.
This is prohibited by a regulatory system designed and lobbied for by the health insurance industry itself.
So even when a patient is willing to pay more to stay alive, the system blocks it.
Then Comes the Stigma
When patients call pharmacies asking about buprenorphine, they are often treated with suspicion.
They are told:
“We can’t give that information. Have your doctor send the prescription.”
This creates a chaotic loop:
- Prescription sent
- Pharmacy declines
- Doctor resends elsewhere
- Repeat
It’s inefficient. It’s dehumanizing. And for patients in recovery, it’s dangerous.
Turning to a Nonprofit Hospital… and Being Told “No”
After exhausting every option, I contacted the pharmaceutical manufacturer.
Their recommendation was logical:
Try a hospital pharmacy.
So I contacted Jefferson’s pharmacy at Abington Hospital—a nonprofit institution embedded in our community.
The answer was immediate:
They do not dispense controlled substances to anyone who is not a Jefferson employee.
No escalation.
No exception.
No solution.
Just “no.”
This is a patient with a documented history of stability, trying to access a medication that prevents relapse and death.
And the system designed to serve the community refused to help.
Now Zoom Out—Because This Is Bigger Than One Patient
Jefferson Health is a 501(c)(3) nonprofit organization.
That means:
- It pays no federal income tax
- It pays no state income tax
- It pays no property taxes
And this is not a small footprint.
Jefferson:
- Owns $6.2 billion in real estate across five counties—tax free
- Operates 32 hospital campuses—tax free
- Runs over 700 outpatient sites—tax free
That is billions of dollars in property that does not contribute to the local tax base—schools, infrastructure, public services—all of which the community depends on.
On top of that:
- It borrows money at below-market rates because bondholders receive tax-free interest
- It funnels approximately $47 million annually to executive compensation for 28 executives
At the same time:
- It has reported $200 million in operating losses
- It has laid off 600–700 employees
And Then There’s This
Jefferson recently secured naming rights to the Philadelphia Eagles training complex—one of the most visible and valuable branding platforms in the region.
The financial details of this deal have not been disclosed.
But we do have context.
In 2001, Novacare paid approximately $60 million for those same naming rights.
That was over two decades ago.
In today’s vastly expanded sports media and corporate branding market, it is almost certain that this deal is significantly more expensive.
So let’s be clear about the contrast:
A system that:
- Reports losses
- Lays off hundreds of employees
- Refuses access to essential medications for community members
…is simultaneously investing in high-cost, high-visibility corporate branding deals.
That’s not just contradictory.
It’s revealing.
Meanwhile, Patients Are Being Charged 5–10x More for Care
Let’s talk about cost.
An outpatient MRI at an independent imaging center costs roughly $400–$600.
The same MRI in a hospital system?
$3,000–$4,000.
Same scan.
Same technology.
Wildly different price.
There is no transparency.
Patients:
- Don’t know what they’ll be charged
- Don’t know what insurance will cover
- Get bills weeks later that can be financially devastating
So what happens?
People avoid care.
Not because they don’t care about their health—
But because they are afraid of the bill.
This Is Vertical Integration Without Accountability
Jefferson is not just a hospital system.
It now owns an insurance company—Health Partners Plans.
That means it can:
- Set prices
- Control reimbursement
- Own the care delivery system
- Capture revenue at every level
All under nonprofit status.
So Let’s Ask the Question Clearly
If a system:
- Pays no taxes
- Controls massive market share
- Charges multiples of fair-market pricing
- Limits access to medically necessary care
- Invests in large-scale branding deals
- Pays executives tens of millions of dollars
…what exactly is the community receiving in return?
Because nonprofit status is not supposed to be a loophole.
It is supposed to be a responsibility.
The Reality
What we are seeing is not charity.
It is a highly sophisticated, vertically integrated business model—
Operating under the protections of nonprofit status.
This is venture capital behavior, wrapped in nonprofit language.
And the Cost Is Human
If my patient cannot access the medication that has kept her stable for years, the outcome is predictable:
Relapse.
Exposure to street opioids.
Possible death.
This is not theoretical.
This is happening now.
This Has to Change
If nonprofit healthcare systems are going to continue receiving massive tax advantages, then accountability must follow.
That means:
- Real price transparency
- Measurable community benefit
- Patient-centered flexibility
- Reevaluation of nonprofit status when actions no longer align with mission
Because right now, the message is clear:
Even if you do everything right…
Even if you rebuild your life…
Even if you stay stable for years…
The system can still fail you.
And that is not just broken.
It is unacceptable.
What You Can Do
If you are from the Philadelphia region and this concerns you, there are things you can do.
Start by contacting your elected officials.
Write to your congresswoman, your congressman, your state representatives—tell them what you are seeing and what needs to change.
It can feel like individual voices don’t matter.
But they do.
And when enough people speak up, change follows.
If you are an Abington resident, this becomes even more real.
We are being told that taxes need to increase to support critical infrastructure—like a new middle school building that is desperately needed. The current school is outdated and bursting at the seams, and our children deserve better.
But ask yourself this:
What if Jefferson Health paid property taxes?
On $6.2 billion in real estate.
Across 32 hospital campuses.
Across 700 outpatient sites.
Those funds could meaningfully support the very things our community is being asked to fund on its own—like building modern, safe, and adequately sized schools for our children.
This is not abstract.
This is local.
This is personal.
This affects all of us.
Reaching out to your representatives is not difficult. Most have simple online forms where you can submit a message in minutes.
To make it even easier, here is a letter you can copy, paste, and send:
Sample Letter to Your Representative
Subject: Urgent Concern Regarding Nonprofit Hospital Accountability and Community Impact
Dear [Congressperson’s Name],
I am writing as a concerned resident of the Philadelphia region to bring attention to an issue that directly impacts our community: the accountability of large nonprofit hospital systems.
Institutions like Jefferson Health operate under 501(c)(3) nonprofit status, meaning they pay no federal income tax, no state income tax, and no property taxes—even while owning billions of dollars in real estate across multiple counties.
This tax-exempt status is intended to support community benefit. However, many residents and physicians are increasingly concerned that the current system is not fulfilling that promise.
Patients are facing:
- Limited access to necessary medications
- Significant barriers within hospital systems
- Extremely high and often unpredictable healthcare costs
At the same time, these systems continue to expand, acquire assets, and engage in large-scale corporate investments.
At a local level, communities like Abington are being asked to increase taxes to fund essential infrastructure, including a new middle school that is urgently needed due to overcrowding and outdated facilities. It is reasonable to ask whether institutions that occupy significant land and resources—yet contribute no property tax—should play a more direct role in supporting the communities they serve.
As a constituent, I am asking for:
- Greater transparency in hospital pricing and billing practices
- Clear, measurable standards for what qualifies as “community benefit”
- Oversight and accountability for nonprofit hospital systems that do not meet these standards
- Reevaluation of tax-exempt status when community obligations are not being fulfilled
This is not about opposing healthcare systems—it is about ensuring alignment between their privileges and their responsibilities.
I urge you to take this issue seriously and advocate for policies that protect patients, support communities, and restore accountability.
Thank you for your time and your service.
Sincerely,
[Your Name]
[Your Address]
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