But like nearly all prestigious American medical centers, the UPMC is nonprofit, so it pays almost no U.S. property or payroll taxes. Until the 1960s, most hospitals and doctors had to do charitable work. Laws and codes of ethics said sick people should be treated even if they couldn’t pay. By 1969 most Americans were insured, so the IRS defined a new standard for hospitals that wanted to keep their tax-exempt status: these institutions had to provide “charity care and community benefit.”
