Is IACS The Clinton
Foundation Equivalent?: What’s Going On In There?

By

Leonard Zwelling

         I have been struck by the huge amount of discussion in two
spheres.

         The first is over the Clinton Foundation—the good it does
vs. the questions surrounding whether it became part of a play-for-pay scheme
at the State Department. Did large donors to the Clinton Foundation get unusual
access to the Secretary of State when Mrs. Clinton held that job? Was Bill
Clinton receiving $500,000 per speech from countries wanting to curry favor
with his wife when she was in the Cabinet? What should happen to the Clinton
Foundation and its relationship with all three Clintons if Mrs. Clinton becomes
President?

         It is my belief that we need hard answers to these
questions—now!

         If there is any record of people gaining leverage with the
then-Secretary of State through contributions to her family’s foundation, let’s
find out now. If not, let’s put the past to rest.

         That Bill Clinton was paid exorbitant speaking fees is not
news. If there is any evidence that those who paid him did so to gain a leg up
at the State Department, let’s see the evidence. If there is none, leave it
lie.

         There is absolutely no doubt that Bill, Hillary, and Chelsea
Clinton must dissociate themselves from the Clinton Foundation should Mrs.
Clinton be victorious. That’s a conflict of interest of the first order. Yes,
that means you, Chelsea!

         There seems to be consensus that the Clinton Foundation has
done good work around the world and is likely to continue to do so.
Nonetheless, the President of the United States must be free of all
entanglements with NGOs doing work in foreign countries or even in the US
itself. If Mrs. Clinton wins, she and her family must get out of the Clinton
Foundation completely. Its work can go on without them and if donations dry up
because they are out, so be it.

         The second sphere of discussion is the budget “shortfalls”
at MD Anderson. The administration of Anderson in the form of Mr. Fontaine
seems to be saying this is just a minor shortfall, it was all anticipated due
to EPIC and that if the clinical faculty would just see a patient or two extra
per week, all would be well.

This
is despite the fact that the shortfall appears to be upwards of $400 million:

http://www.beckershospitalreview.com/finance/md-anderson-points-to-epic-implementation-for-77-drop-in-adjusted-income.html

         This is beginning to strain credulity.

         What seems more likely is a recurrence of the shortfall of
2008.

         That shortfall appeared to me to be due to overspending and
the damage done to the investment portfolio by the stock market crash. That
suggested to me that MD Anderson was living beyond its operating revenue and
needing non-operating revenue to make a profit. When that non-operating revenue
vanished, so did the margin.

         I think the same is true today.

         The EPIC “shortfall” has unmasked additional overspending
that was dependent on patient revenues to sustain. However, the only way to be
sure is to see a fully allocated income statement that leaves nothing out. All
revenues and all expenses must be in the mix and identified including IACS.
This should be a line-by-line analysis. Any MBA knows that it is the notes from
an annual report that reveal the truth about a company’s health. Where are
those notes for the MD Anderson Financial Statements? Nowhere that I have
seen.

         Until a full accounting of all revenue and expenses is
presented to the faculty and staff in an unambiguous fashion, unencumbered by budgetary
projections which are frankly irrelevant, no one will know where the money is
coming from, where it is going, and how to fix any perceived shortfall.

         Seeing one extra patient may be a good idea, but only if the
templates can take additional entries. This may not be the case as long as EPIC
slows everything down. However, for sure, cutting spending is always a good
idea, especially if it is being used for non-revenue generating projects—like
IACS.

         It is time for Dr. DePinho to explain the truth about the
finances of the organization that he leads and to reveal plans to improve the
finances if, as implied by Mr. Fontaine, some work is necessary due to EPIC or to
any other activity.

         Like this, for example:

https://www.washingtonpost.com/business/on-leadership/why-this-former-billionaire-party-boy-donated-50-million-to-transform-ibms-watson/2015/06/26/a223ee36-9c1f-11e4-bcfb-059ec7a93ddc_story.html

http://nypost.com/2016/02/28/malaysia-goldman-sachs-and-mystery-millionaire-probed-in-one-of-worlds-largest-frauds/

Leonard Zwelling