[pastacacioepepe]

It's just a very foreign concept to me as a european. Perhaps I'm more inclined to the idea that institutions like education and healthcare should be publicly funded and shouldn't aim to be economically sound, as some services can only be done properly at loss.

In 1992 in Italy hospitals became "hospital companies", meaning what was once a public service with the sole aim of providing the best possible treatments to citizens for no cost, became at all effects a business (although still state owned) with incomes, expenses and a budget. You may think this makes sense, but since then our healthcare quality has tanked.

One notable side effect is that all hospital companies cut on the intensive treatment beds to save on costs, which backfired heavily during covid since we didn't have enough beds and many patients died without proper treatment as a consequence.

[chrisseaton]

> It's just a very foreign concept to me as a european.

But it comes from Europe.

https://en.wikipedia.org/wiki/Financial_endowment#History

https://en.wikipedia.org/wiki/Financial_endowment#Modern_col...

> incomes, expenses and a budget

Government-provided healthcare also has an income, expenses, and a budget. They don't just spent whatever they want with no planning and no income.

[pastacacioepepe]

I mean, the roman empire, ancient greece and in modern times Britain. Britain is European as much as USA is. Not really common in contemporary Europe.

The article itself notes that it's common practice only in North america, and when it is used outside of USA it's in a different way:

>In the United States, the endowment is often integral to the financial health of educational institutions. Alumni or friends of institutions sometimes contribute capital to the endowment. The use of endowment funding is strong in the United States and Canada but less commonly found outside of North America, with the exceptions of Cambridge and Oxford universities

> Government-provided healthcare also has an income, expenses, and a budget. They don't just spent whatever they want with no planning and no income.

Of course, but there is a big difference in having a regular accountability and starting to think in terms of business. Suddenly intensive treatment beds become "centers of cost", not vital but expensive tools required to save lives.