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Tax skirting by hospital systems?

The issue of avoiding federal taxes is in the news these days with Apple being in the spotlight.  Most of the times big companies avoid paying US taxes by skirting their profits to tax havens.  Healthcare giants can do the same theoretically.  Imagine if there were a health care giant that opens up shop in tax haven islands and then uses the same technique that commercial entities use to skirt their profits out of the country, thereby avoiding taxes.  This is very much possible.  The of shore clinics can be potentially used to complicate the tax return filing system here in US.  I could never understand why a completely US hospital system would like to open up a clinic in Bahamas.  These clinics are portrayed as the global reach of the entity but who do they actually serve.  We never hear about them in press or public.  These clinics are apparently manned by some doctors we never hear about.  How does this system work?  I really don't know.  I think this needs to be investigated further.

Comments

Hussain said…
Big hospital systems do not have to go abroad to save on taxes, most of them already have a non-profit status leading to tax exemptions. Whether that is justified or not (how much charity care do they actually provide) is debatable.

The hospital extensions abroad in the Gulf and Ireland etc. are for-profit entities, and the hospitals have to pay corporate rate taxes, if they repatriate the money being earned there, back to the US. I am not sure whether they decide to park that money abroad in off-shore tax havens or actually bring it back and pay taxes in it (though I doubt the latter).

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