A few weeks ago I spoke at the Center for Non Profit Management at the University of Miami. While my subject was about non-profits, one of the biggest concerns the attendees had was about their finances.
Not necessarily about how to raise money but instead how to reconcile their mercenary need for money with the altruistic good works they were committed to doing.

It reminded me of an issue we had when we worked for Jackson Memorial Hospital, the medical center that provides indigent care to 's underserved communities as well as setting high standards for private care.

Jackson's visionary leader, Ira Clark, believed that the poorer population the hospital served deserved every bit of the quality care that his private pay insurance patients received. Because of this, he wouldn't allow niceties such as paid valet parking, upgraded (and more expensive) private rooms or extra cost special meals even though survey after survey of more affluent patients showed that they would pay for these very profitable services.

It should come as no surprise that the lack of upscale amenities at Jackson opened a window for competing private hospitals to cater to Jackson's highly coveted affluent consumers. Today, private flourishes in South while Jackson is suffering serious financial setbacks.

How much easier (and more profitable) it could have been if Jackson's administration accepted that there is no mission without margin and had set the hospital on a course for profits which they could have then spent to better serve their indigent patients.

My friend Randy Gage wrote a blog post on this recently titled Living Life by a Coherent Philosophy. In his article Randy asks “Are people in wheelchairs better than blind people?  Do they deserve better treatment?

” A harsh question perhaps, but one Randy believes is justified because “You can't really test your beliefs until you carry them out to their logical extension.”

Is it unfair, then, to offer valet parking only to those who can afford it or for an altruistic non-profit to spend time and energy on fund raising. Or if indeed there is no mission without margin, is it not only fair but also critical?

I'd love to hear what you think.

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