Nonprofit to for-profit conversions by hospitals, health insurers, and health plans

Public Health Rep. Mar-Apr 1999;114(2):108-19. doi: 10.1093/phr/114.2.108.


Conversion of hospitals, health insurers, and health plans from nonprofit to for-profit ownership has become a focus of national debate. The author examines why nonprofit ownership has been dominant in the US health system and assesses the strength of the argument that nonprofits provide community benefits that would be threatened by for-profit conversion. The author concludes that many of the specific community benefits offered by nonprofits, such as care for the poor, could be maintained or replaced by adequate funding of public programs and that quality and fairness in treatment can be better assured through clear standards of care and adequate monitoring systems. As health care becomes increasingly commercialized, the most difficult parts of nonprofits' historic mission to preserve are the community orientation, leadership role, and innovation that nonprofit hospitals and health plans have provided out of their commitment to a community beyond those to whom they sell services.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Community-Institutional Relations
  • Consumer Advocacy
  • Health Care Reform
  • Health Facility Merger / organization & administration*
  • Hospitals, Proprietary / organization & administration*
  • Hospitals, Voluntary / organization & administration*
  • Humans
  • Insurance Carriers*
  • Managed Care Programs / organization & administration*
  • Organizational Objectives
  • Ownership*
  • Public Assistance
  • United States