 20020728.00

     Although in their origins charitable and profitable
corporations are very different from each other, in contemporary
society, for whatever reasons, there has been a remarkable degree
of assimilation, in that charitable corporations if they are to
survive, must be managed run in a business-like manner; while
business corporations, if they are to be politically acceptable,
must presume, in pursuing their own economic advantages.  to
serve the public interest.  Consider the many essential functions
served by business corporations: public transportation, airlines
and railroads, oil companies, electric power companies, telephone
companies, etc.  Adam Smith provides the theoretical basis of the
presumed public benefit of private enterprise.  The G.E.
advertising slogan: "We bring good things to life", reflects this
duality of purpose.  Lumber manufacturers promote themselves with
the assurance that they plant trees to replace those they have
destroyed; strip mining companies advertise themselves with
pictures of reclaimed land. Charitable institutions make
monumentally successful investments (e.g. Harvard), and require
payments for services from their beneficiaries, museum visitors,
college students or hospital patients, as the case may be.

     The reason for this assimilation is that both kinds of
organizations are subject to the same economic and social
pressures; and it is these pressures rather than theoretical
preconceptions which determine the corporation's function.

     In the original charitable corporations the workers were
volunteers, and received remuneration sufficient only for their
subsistence.  In the original business corporations the workers
were de facto slaves whose labor was exploited for the benefit of
the owners.

     Consider the two types of corporation as expressions of
Aristotelian "causes", material, formal, efficient and final
causes.  The problem can then be defined as an ambiguity of final
causes: is the purpose of a dialysis business to make money or to
help patients? Contemporary theory would have it that the two are
not mutually exclusive and may even reenforce each other.

     If it is a determination of public policy, public perception
and of law and regulation that the two corporations must perform
the same functions, that the product must be the same, then
ultimately the differences between the two types of dialysis
corporations lies in their differing ideologies.  Do ideologies
matter?  Is function affected by, modified by ideology?  If it is
not, then the difference is illusory, is in name only, and is a
matter of indifference.

     Or might there be subtle differences which are not
superficially apparent, but which might become evident on closer,
more sensitive examination?  (such as the difference between
Veterans Administration Medicine and that provided by non
governmental agencies?)  differences which are perhaps
identifiable only by individuals with experience and expertise?
differnces to which the average patient is oblivious?  Are such
differences in name, in brand, in appearance only, differences as
between generic and proprietary drugs, or are they of practical
consequence?

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