Readers Write: (Jan. 11): The terminology of aging, nonprofit health care, liquor sales

The new terms used in dealing with retiring baby boomers as detailed Jan. 4 ("Boomers' behest: Just don't call me old") led me to think that a similar approach is necessary for the other end of the age spectrum, dealing with children and schools. Hence:

The Jan. 4 article about aging speaks to the power of words and the need to get it right. Who wouldn't, for instance, want to live in a "community" rather than a "facility"? The trick to getting words right, however, is in reflecting reality. Having researched long-term care facilities, I assure readers that most are not yet up to the reality of being called communities, the term suggested in the article. Yet social workers and other reformers have been working hard to change facilities into communities that foster successful aging.

"Social worker" — now that's another term suggested for relabeling, to "concierge" (defined broadly by Merriam-Webster as someone to make arrangements and run errands). Really? Does that capture the work described above? Indeed, social workers have been working in many arenas — physical and mental health, community and social policy and programs — to support and foster vital involvement for older adults. I suggest that the marketers return to the drawing board to find a term that truly speaks to the contributions of this profession.

The writer is director of the School of Social Work at the University of Minnesota.

• • •

In the same issue of the Star Tribune, columnist Gail Rosenblum reports: "People age 65 and older, according to the survey of more than 2,300 Americans, are happier than any other age group." Apparently, most people 65 and above are mature enough to ignore marketing propaganda suggesting that we are all miserable.

Many of us are comfortable with our age and don't feel that any euphemism is needed to describe us. Marketing companies may want to play semantic games to suggest otherwise, but those of us not taken in by such self-serving manipulations beg to differ.

A Jan. 4 commentary ("Can you heal me now?") decried the unwarranted profitability of a number of large Minnesota health care nonprofits, citing some pretty large dollar "margins." No revenue numbers were given. I took a quick look on the Mayo Clinic's website, and the most recent full-year financials (2012) on the site show operating income (excluding donations and earnings on the investment portfolio) at 4.4 percent of operating revenues, with these earnings equaling about 6.5 percent of operating (again, non-endowment) assets. Contrast this with toy company Mattel for the same year: margins of 16 percent on sales, returning 15.6 percent on the asset base. I see this a lot: Financial returns on critical products and services are unwarranted, greedy, whatever, while returns on toys or teen fashions, etc., are — who cares?

Would it be a better world if returns on capital in critical industries and nonprofit entities (which retain and reinvest it all) were squelched so that the most productive investments were in toys? I wonder where the capital would flow. Maybe the donors to Mayo would be interested in backing another Barbie accessory line, since this is a more fair utilization of their capital.

• • •

While "margin of revenue" may be a little different from profit, the article warns that the public is essentially subsidizing nonprofit Minnesota hospitals. That is, these charitable organizations may not be meeting the expectations or the definition of community service.

With the inauguration of the Affordable Care Act, which is yet a work in progress, it would seem this "margin of revenue" index will increase. Since the public was led to believe that the objective of the ACA was to compensate losses due to charity care, unreimbursed costs and bad debt, to name a few difficult-to-recover industry expenses, perhaps these nonprofit health care systems could be a little more charitable.

• • •

The authors of the commentary properly ask for accountability for the tax-exempt status of nonprofit health care organizations. In 2013, Fairview Health Services provided $292.6 million in community benefits under the Catholic Health Association/VHA guidelines. This includes charity care, community services, costs in excess of Medicaid payments and other items. See the Fairview Community Benefit Report.

For more than a century, Fairview has served individuals and families to fulfill its mission of improving the health of Minnesota's growing and diverse communities. As someone who has fulfilled clinical roles in Fairview's acute-care settings, support services, Fairview Foundation and community health programs for more than a quarter century, it has been my experience that the majority of employees who comprise our organization (and other nonprofit health care systems) are driven by a call and desire to utilize their time, talent and, yes, treasure to provide some of the best health care in the world. That is a global mission that we can all embrace.

The Jan. 4 article about municipal liquor stores struggling to innovate in the face of competition ("Liquor chains uncork battle for customers") raises the question: Why are Minnesota cities in the liquor business?

The job of the city government is to collect taxes and fees, not squelch competition by running profit-oriented retail businesses. Taxes paid by private businesses, not the elimination of free enterprise, help to offset property taxes. Why is the government selling alcohol? By doing so, these cities are preventing investment, thwarting entrepreneurial business, encouraging the employment of more government (taxpayer-supported) employees, and going against the very principles of free enterprise and competition. I challenge supporters to prove that government-run liquor stores are better than freedom of choice.