The supreme cynicism (and greed) of hospital executives
It takes a very... special... attitude to use sick kids for fundraising while your "nonprofit" is making $2 billion a year in PROFIT, even after paying dozens of execs millions each.
None of us are angry enough about the American medical system.
Ryan Werner, an Unreported Truths reader from Utah, just sent me this note:
I’m sending you an email I received from Intermountain Healthcare’s Foundation (and my quick reply)…
Attached was a fundraising email titled, “Can you give $5 to help a patient at Primary Children’s?”
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(Apparently Intermountain wouldn’t pay up for a trademarked cartoon character, thus the generic star and mask on this generic (AI-generated?) kid)
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Yes, Ryan, you have a chance to make a meaningful difference in the life of a child! Who wouldn’t want to do that? Are you a sucker good person, Ryan?
I had not heard of Intermountain. It turns out to be yet another of the hospital chains that have expanded over the last two decades into regional oligopolies, jacking up prices and executive pay as they go.
Based in Salt Lake City, it owns 33 hospitals, mostly in Utah and Colorado. It had $18.5 billion in revenue in 2025 and roughly 70,000 employees. It also has its own insurance company, called Select Health, which covers about 1.1 million people.
Both Intermountain and Select are nominally “nonprofits,” which doesn’t prevent them from making profits — or paying many executives seven-figure salaries.
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Don’t donate to hospital chains! Donate to Unreported Truths!
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Ryan Werner didn’t find this tug on his heartstrings amusing.
His emailed response:
Seriously? Your network had a reported net profit of $2.6 billion, Robert Allen [Intermountain’s chief executive] made a reported $6.29 million. I won’t even get into how much your physicians make or Select Health (your wholly owned insurance arm). And you want me to give you $5 so you can pad your pockets more?!?
How about you just offer some kids free care who can’t afford it? Or at least give them a freaking discount on your exorbitant costs.
Good grief.
Good grief indeed. I must warn Ryan his email got one fact wrong.
Not the $2.6 billion in profits.
Figuring out Intermountain’s finances isn’t easy. The company is a web of nonprofits, each with its own federal Form 990 statement reporting to the Internal Revenue Service. Its biggest subsidiary is something called IHC Health Services, which reported revenues of $10.7 billion and “revenues less expenses” of $1.14 billion in 2024.
But Becker’s Hospital Review, a newsletter that covers the industry, put Intermountain’s overall net income at $2.6 billion for 2025, up from $1.7 billion in 2024, and Becker’s is a very solid source.
Ryan was wrong about how much Intermountain chief executive Robert W. Allen makes, though.
Sure, in 2023, his first full year as CEO, Allen had to get by on $6.3 million. But in 2024 he got a slight raise, to $9.7 million.
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(Not all heroes wear capes! Meet Robert W. Allen. Your $5 could make a meaningful difference in his life. With just another 54 percent raise, you can bring his salary over $15 million, where it belongs!)
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We don’t have Allen’s 2025 pay yet, but whatever it was, I’m sure he deserved it! After all, who better to run a group of hospitals than a doctor MBA like Allen. (MD, MBA, easy mistake!)
I don’t mean to pick on this guy, though of course I do. He well deserves it.
But he’s no different than the thousands of hospital executives making millions or sometimes tens of millions of dollars figuring out how to squeeze every possible dollar out of patients, insurers, and the government, even as they spend fortunes to brand themselves as “nonprofits.”
Intermountain’s top outside vendor is a company called R1 RCM, which is in the “revenue cycle management” — aka upcoding insurers and chasing patients — business. Intermountain paid R1 RCM $247 million in 2024. Can’t make it up.
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(Not making it up. Reporting it. With your help.)
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None of us are angry enough about the American medical system.
Not even close.
Alex, I will continue my refrain. There is plenty of blame to go around. But the foundational bad actors are the providers and the reason is the incentives put in under Obamacare make such actions almost impossible to resist. Providing full dollar coverage to everyone for everything is the road to ruin -- and it is unreasonable to think that people will look at free money and just ignore it.
Health plans make money, but there are limits on what they are allowed to make...unlike providers where there are none. Pharmas are their own problem, but under the Trump administration they actually have retreated on many of the drugs that are most used, bringing prices down substantially and, one hopes continuing to do so because of the new inability to differentially price from other countries....MFN is a great way to lower costs.
The foundational issue is the complete decoupling of patients from ANY financial decision with regard to their health. This puts large numbers of people (not including the unfortunate middle class that cannot get free insurance like illegals, anyone that claims to be poor, etc.) in the enviable position of requiring every procedure known to man for every ache and pain every day. I could tell you stories that would make your blood curdle.
The health systems have a spigot that always pays -- the wonder of government. In fact, the only modest impediment is health plans who try to restrict payouts, usually to the hew and cry of everyone who is agitated that great grandma is not getting her third hip surgery.
Remove the government intervention and this all self cures easily. Go back to selling catastrophic insurance....there are catastrophes and it is good that they can be covered. But that is NOT the expensive part of health. Let everyone (not just high deductible plan folks) keep an HSA where they can put discretionary dollars away for health.. They can then spend it on more insurance, the gym, doctor's visits -- what ever makes sense to them. And return to Direct Primary Care (really taking off...no insurance involved) for better, family-oriented care at at fraction of what is being spent now.
When offered an MRI with a 0,1% chance of finding something, patients will likely say no if it is their first dollar to decide; today they say yes because why not? When offered exactly the same colonoscopy with exactly the same anesthesia/doctors/etc. as an outpatient for $1000 or as a "hospital outpatient" (like at Intermountain) for $15,000 (fairly real numbers) they will likely take the regular out patient option if they are paying first dollar. Today, the hospitals make a ridiculous amount of undeserved money from the HOPD business (with these kinds of price differentials for, essentially, indistinguishable services) and there is nothing to stop it because the actual consumer has no skin in the game. Heaven knows the insurers have tried. Doctors cannot fix this because Obamacare forced them all to be hospital employees so they just nod their heads and watch the impossibly overpriced colonoscopy feed $$ to the administration for important things like DEI officers and very high salaries.
So you are right -- people are not mad enough. The substantive changes to fix this are not that difficult. But they will take away a lot of wealth transfer and thus a lot of cheap votes. As long as Obamacare forces me to buy a sex change inclusive policy (as Obamacare does) and insists on full coverage of anything someone in the mental health industry (yes it is an industry) decides to label in the next DSM as a disease instead of living normal life, this will go on. The question is, will anyone upset the apple cart? You are trying, so this should give you more directions to think through.
As in the other articles: when there are no public prices and insurance covers everything from oil changes to wiper fluid (human equivalents) because "somebody else is paying" there are no market forces or competition to stop it. It is disgusting.