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Originally Processed With FOIA(s):
FOIA Number:
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FOIA
MARKER
This is not a textual record. This is used as an
administrative marker by the George Bush Presidential
Library Staff.
Record Group/Collection:
George H.W. Bush Presidential Records
Collection/Office of Origin:
Speechwriting, White House Office of
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Snow, Tony, Files
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Subject File, 1988-1993
OA/ID Number:
13900
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13900-011
Folder Title:
[Yale Program on Non-Profit Organizations, 7/19/91]
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3
1
Yale University
Program on Non-Profit Organizations
Campus address:
P.O. Box 154 Yale Station
88 Trumbull Street
New Haven, Connecticut 06520-0154
Telephone
203 432-2121
July 19, 1991
Ms. Barbara G. Kilberg
Deputy Assistant
Heb") PLs.
to the President
Room 128
Old Executive Office Bldg.
The White House
Washington, D.C. 20500
John SIMON- yalclaw school
Dear Ms. Kilberg:
(28)432-2698
(285) 432-4987
I just finished preparing letters to our three major
supporters -- The Ford Foundation, the Hewlett Foundation, and
the Rockefeller Brothers Fund -- to report on the past year's
activities at PONPO. This seemed to be an opportune time to
update members of PONPO's advisory committee as well. I plan to
be in contact soon about arranging a meeting of the advisory
committee.
In last year's report to the foundations, I emphasized all
of the work that had to be done to get PONPO functioning after
the hiatus following Paul DiMaggio's term. I wrote of hiring
staff, the challenge of ascertaining the status of ongoing
activities, the acquisition of new equipment, the partial
renovation of the building, and so forth. It was a pleasure not
to have to discuss such matters again. Many things that were a
challenge in my first year are now routine. PONPO is functioning
smoothly and has a growing set of activities.
John Simon and Paul DiMaggio have maintained their active
interest in the Program and are frequent sources of counsel.
They, along with Henry Hansmann and Susan Rose-Ackerman from the
Law School, Deborah Minkoff (a new faculty member in sociology),
and Peter Hall agreed to serve as an informal advisory group with
whom I can meet on occasion to discuss PONPO and potential
activities. As part of our new project on religion, a new cast
of characters has become involved in with us. The project's
advisory group includes Thomas Ogletree, the new dean of the Yale
Divinity School, and Professors Kai Erikson (Sociology), Perry
Dane (Law), Sharon Oster (School of Organization and Management),
and Jon Butler (Religious Studies). Awareness of and interest in
PONPO has increased at Yale.
Notable activities at PONPO during the past year were:
Initiating major new projects on churches as nonprofit
organizations and on the changing dimensions of trusteeship.
Both of these projects are being supported by the Lilly
Endowment with grants totaling more than $900,000. As a
side benefit, these grants gained us a front page headline
in the Yale Bulletin and gave PONPO more visibility. See
the enclosed.
The operation of the John D. Rockefeller 3rd Summer
Fellowship Program for doctoral students, which was
supported in 1990 by a special gift from Mrs. Blanchette
Rockefeller. As in the past, the program was not limited to
Yale students. A list of the 1990 Fellows and their
projects is appended, as is a list of the 1991 crop (though,
strictly speaking, they don't belong in this report on last
year).
The publication of 15 new PONPO Working Papers. A list is
appended; I will be happy to send along any that may
interest you. Several of the items on it are outgrowths of
activities that I mentioned in last year's report --
including papers by former JDR3 fellows Javier Diaz-
Albertini and Rebecca Bordt, and by Kirsten Gronbjerg. We
continue to receive several requests per day for copies of
working papers.
Regular notices are now included in The Chronicle of
Philanthropy about PONPO Working Papers as they are
published, and The Philanthropy Monthly published several
articles (by its editor) discussing new PONPO Working
Papers. Beyond these developments, PONPO's work continues
to be widely cited in the scholarly and practitioner
literature.
The regular PONPO luncheon seminar continued. There is
regular group of participants, including faculty and
graduate students from many parts of Yale, plus non-Yale
people such as Henry Suhrke, Dick Magat, and Tom Buckman.
We generally have 25-30 people at these bi-weekly sessions.
A listing of the 1990 and Spring 1991 seminars is appended.
It shows involvement by a variety of Yale faculty members
and a distinguished group of visitors.
Publication of issue #9 of our newsletter, Research Reports.
With Peter Hall as editor, it put current activities into
the larger context of previous research at PONPO. You
should have received a copy at the time; a more recent one
has also been published.
We were joined by Hayden Smith following his retirement from
the Council for Aid to Education. He is here two days per
week and is working on several projects pertaining to
corporate giving and contributions to higher education.
PONPO provided office space and incidental support for the
year to Professor Uri Yanay of Hebrew University in Israel,
who studied voluntary citizen actions in response to the
threat of crime.
Under a grant from the Association of Fund Raising Counsel
Trust, Peter Hall is busy with an extraordinary documentary
history of philanthropy, going back to the 17th century. The
book will be made up of excerpts from primary source material,
with sections and particular items introduced by Peter. The
first third of the manuscript is complete, and it is safe to say
that nothing that even approaches it now exists.
A portion of my time during the grant period was spent in
revising the manuscript for my book, The Profit Motive and
Patient Care: The Changing Accountability of Doctors and
Hospitals, which was published in 1991 by Harvard University
Press. (I'll not try to list all of the publications, speeches,
advisory activities, etc. of the various PONPO people this past
year. However, I hope you will forgive the shameless plug for my
own book; I'll even include a copy of the review from the Sunday
NY Times, though I must ask you not to read the last paragraph.)
Also completed this past year was Francie Ostrower's
doctoral dissertation, Why the Wealthy Give: A Study of Elite
Philanthropy in New York City. Francie was involved with PONPO
in various capacities over the years. Her study is quite
outstanding and is likely to be published. Francie moved to an
assistant professorship at Harvard. Three or four graduate
students -- from public health, sociology, and religious studies
-- currently have a substantial ongoing involvement with PONPO.
With this being the final year of our three major general
support grants, we have naturally begun looking to the future.
We have some ideas and some news that we would like to discuss
with you. But I will save that until the advisory committee can
meet. I will be in touch about that.
In the meanwhile, if you would like additional information
about anything I have discussed herein, I would be happy to
provide it. I have not communicated as much as I have intended -
- it's hard to get any work done around here during much of the
year because they have these people at Yale called students! --
but things have been going very well. Lots of back burner items
are being moved up now that summer is here, and there will be
much to discuss when we meet.
With best regards,
Bill
and
Professor (adjunct) of
Research in Public Health
Yale Program on Non-Profit Organizations
Working Papers Published in 1990
PONPO Working Paper-147 "Planning As Crisis Management: An Analysis
of London's Voluntary Sector," by Jennifer R. Wolch (February
1990). (33 pp.)
PONPO Working Paper-148 "Private Higher Education Worldwide,' by
Daniel C. Levy (February 1990). (46 pp.) In: Burton R. Clark and
Guy Neave, eds., The Encyclopedia of Higher Education (Pergamon
Press, 1991).
PONPO Working Paper-149 "Charitable Associations," by Carl Milofsky
and Julie T. Elworth. In: Issues in the Care of Children with
Chronic Illness, (Nicholas Hobbs and James M. Perrin, eds.), San
Francisco - London: Jossey-Bass Publishers, 1985.
PONPO Working Paper-150 "Managers in Different Fields of Service:
Managerial Tasks and Management Training," by Paul J. DiMaggio.
In: Educating Managers of Nonprofit Organizations, (Michael
O'Neill and Dennis Young, eds.), New York: Praeger, 1988
PONPO Working Paper-151 "Configuration and Strategy Making in
Brazilian Universities," by Cynthia Hardy (April 1990). (51 pp.)
PONPO Working Paper-152 "Leadership and Strategy in Brazilian
Universities," by Cynthia Hardy (April 1990). (65 pp.)
PONPO Working Paper-153 "Cultures of Trusteeship in the United
States," by Peter Dobkin Hall (May 1990). (150 pp.)
PONPO Working Paper-154 "The Emergence of Nonprofit Legal Education
in New York: A Case Study" by James A. Wooten (May 1990). (53 pp.)
PONPO Working Paper-155 "Class Authority and Cultural
Entrepreneurship: The Problem of Chicago," by Paul J. DiMaggio (May
1990). (45 pp.)
PONPO Working Paper-156 "Managing Nonprofit Funding Relations: Case
Studies of Six Human Service Organizations," by Kirsten A.
Gronbjerg (August 1990). (60 pp.)
PONPO Working Paper-157 "Development as Grassroots Empowerment: An
Analytic Review of NGDO Programs in Lima, Peru," by Javier Diaz-
Albertini (September 1990). (87 pp.)
PONPO Working Paper-158 "The Possibility of Tax Incentives for
Landing to Charitable Organizations, If by Seth M. Hendon. In: Yale
Law & Policy Review, Vol. 8, No. 2, (1990). pp. 414-435 (36 pp.)
PONPO Working Paper-159 "How Alternative Ideas Become Institutions:
The Case of Feminist Collectives," by Rebecca L. Bordt (November
1990). (54 pp.)
Yale Program on Non-Profit Organizations
Working Papers Published between January 1, 1991 and July 1991
PONPO Working Paper-160 "Cultural Boundaries and Structural Change:
The Extension of the High-Culture Model to Theatre, Opera and the
Dance, by Paul J. DiMaggio (January 1991). (56 pp.)
PONPO Working Paper-161 "Nonprofit Hospitals and the For-Profit
Challenge," by Bradford H. Gray. In: Bulletin of the New York
Academy of Medicine (National Health Policy Seminar Issue: Toward
a Health Care Financing Strategy for the Nation) 66 (July-August
1990) : 366-374.
PONPO Working Paper-162 "Religious Participation, Religious
Diversity, and Social Conditions," by Judith R. Blau, Kenneth C.
Land and Glenn Deane (February 1991). (41 pp.)
PONPO Working Paper-163 "A Theory-Driven Framework for Evaluating
Youth Programs," by Miriam M. Wood (March 1991). (31 pp.)
PONPO Working Paper-164 "National Neighborhoods: Communal Class
Politics and the Rise of the National Neighborhood Movement,' " by
Albert Hunter (January 1991). (42 pp.)
PONPO Working Paper-165 "Strategic Planning In Organizations and
Environments: Non-Profit Human Services In Rural New England," by
James Tober (February 1991). (80 pp.)
PONPO Working Paper-166 "The Impact of Changes in the Tax Laws on
Private Elementary and Secondary Schools," by Hayden W. Smith (July
1991). (71 pp.)
PONPO Working Paper-167 "Examining Profit and Nonprofit Child Care:
An Odyssey of Quality and Auspices," by Sharon L. Kagan. In:
Journal of Social Issues, Vol. 47, No. 2, 1991. pp. 87-104.
Yale Program on Non-Profit Organizations
Seminars -- Spring and Fall 1990
January 16, 1990. Mark Schlesinger (JFK School, Harvard), "Ownership
Form and Organizational Performance: Property Rights in Organized
Professional Services in Health Care."
January 30, 1990. Wolfgang Seibel (University of Konstanz, West
Germany) "Successfully Failing Organizations: A Cross National
Perspective on the Third Sector as a Non-Problem Solver."
February 13, 1990. Peter Dobkin Hall (PONPO) "Cultures of
Trusteeship."
February 27, 1990. Vincent Mor (Brown University), "The Emergence of
Community-Based Nonprofits in Response to Aids."
March 13, 1990. Charles Tremper (National Law Center, George
Washington University), "Reconsidering Legal Liability for
Charitable Organizations and Volunteers."
March 27, 1990. Carl Milofsky (Sociology, Bucknell University), "The
Love Life of an Alternative School: The Oligarchy Problem in
Democratic Organizations."
April 10, 1990. Emmett Carson (Ford Foundation), "Black Philanthropy
and the Shape of Tomorrow's Nonprofit Sector."
April 24, 1990. Richard Frank (Johns Hopkins School of Public
Health), "Altruistic Motives in Nonprofit Hospitals and the Supply
of Charity Care."
May 8, 1990. Francie Ostrower (Sociology, Yale), "Why the Wealthy
Give: A Study of Elite Philanthropy in New York city."
September 18, 1990. Helmut K. Anheier (Rutgers & Johns Hopkins), "The
Nonprofit Sector in Comparative Perspective: The Johns Hopkins
Comparative Nonprofit Sector Project."
October 2, 1990. Bradford H. Gray (Public Health, Yale), "Cataract
Surgery vs. System Building: International Blindness Organizations
and the Dilemmas of Assistance in Less Developed Countries."
October 16, 1990. Richard Magat (The Foundation Center), "Which
Media, Which Messengers? Public and Scholarly Reporting on
Philanthropy and the Nonprofit Sector."
October 30, 1990. Julie Fisher (Consultant, Fisher & Peck
Associates), "Rethinking Political Development: The Growth of the
Third Sector in the Third World."
November 13, 1990. Teresa Odendahl (Author), "Charity Begins at Home:
The Giving of Elites."
November 27, 1990. Paul Schervish (Boston College), "Religion and
Philanthropy: The Spiritual Secret of Money."
December 11, 1990. Hayden W. Smith (PONPO), "Some Observations
Regarding Corporate Charitable Contributions as Reported on Federal
Tax Returns and the Impact of Changes in the Tax Laws."
Yale Program on Non-Profit Organizations
Seminars -- Spring 1991
January 22, 1991. Uri Yanay (PONPO and Hebrew University), "Securing
Personal Safety in the Community: Another Challenge to
Philanthropy and Voluntarism?"
February 5, 1991. Thomas R. Buckman (The Foundation Center),
"Foundations on Film."
February 19, 1991. Ivan Lansberg (Editor, Family Business Review),
"The Influence of Donor Families on Family Foundations."
March 5, 1991. Ellen Condliffe Lagemann (Columbia University), "The
Politics of Knowledge."
April 2, 1991. Paul DiMaggio (Sociology, Yale), "The Nationalization
of Nonprofit Enterprise in the Arts. "
April 16, 1991. John C. Lammers (U.C.L.A.) "What Do We Really Know
about the Impact of Boards on Nonprofit Hospital Performance?"
April 30, 1991. Sharon M. Oster (School of Organization and
Management, Yale) "Issues in the Management of Nonprofit
Organizations."
May 14, 1991. Carl Milofsky (Bucknell University) and Stephen D.
Blades (East Carolina University) "Accountability in Fundraising:
The Case of the Health Charities."
Yale Program on Non-Profit Organizations
JOHN D. ROCKEFELLER 3RD FELLOWS
SUMMER 1990
TERRY BOYCHUK is a doctoral candidate in sociology at Princeton.
With a general focus on comparative institutional cultures, his
research will examine the development of social insurance in Canada
and the United States following the second World War, with a
particular focus on health insurance systems.
EVE CHARFAUROS is a doctoral candidate in sociology at Yale.
Proceeding from a general interest in the institutional experience of
people of color, her research will examine the development of Third
College, a multiracial, multicultural experimental unit of the
University of California-San Diego, between 1970 and 1990.
PAUL GALATOWITSCH is a doctoral candidate in sociology at Yale.
Building on a concern about institutional responses to the AIDS
epidemic, he will be studying New Haven nonprofits dealing with
populations at-risk for HIV infection.
JENNIFER GUNN is a doctoral candidate in the history and sociology of
science at the University of Pennsylvania. She will be studying the
role of private philanthropy in the development of population policy
in the United States and abroad during the twentieth century.
DANIEL C. HUMPHREY is a doctoral candidate in education at Teachers'
College, Columbia University. With a general interest in the
problems of translating reforms originating on the national level
into local settings, his research will focus on the impact of Ford
Foundation education reform demonstration projects in New Haven
during the 1960s.
EVELYNE PAYEN is a doctoral candidate at in American history at Case
Western Reserve University. With a general focus on the comparative
development of the welfare state on both sides of the Atlantic, her
research will focus on the growth of federated voluntary associations
in Oakland, California in the period 1900-1930.
Yale Program on Non-Profit Organizations
JOHN D. ROCKEFELLER 3RD FELLOWS
SUMMER 1991
BROOKE JANE BARR is a doctoral candidate in American studies at Yale.
Her project will focus on the role of nonprofit organizations in
historic preservation and urban planning in New York since the second
World War.
RUTH HALPERIN is a doctoral candidate at the Yale Law School. Her
project will define, compare, and contrast religious and secular
systems of legal adjudication in the United States.
DONGYOUB (DON) SHIN is a doctoral candidate in organizational
behavior at Yale's School of Organization and Management. His project
will focus on the responses of Korean religious organizations to
democratization movements, 1970-1990.
LISA SULLIVAN is a doctoral candidate in sociology at Yale. Her
project will explore the contemporary status of voluntarism and
community service in New Haven's black community, with a particular
emphasis on its response to the AIDS crisis.
ANDREW WALSH is a doctoral candidate in the History of American
Civilization program at Harvard. His project will examine the growth
of the Protestant Establishment in Hartford in the late nineteenth
century.
NATALIE WEBB is a doctoral candidate in economics at Duke. She will
be studying patterns and motives underlying corporate giving in the
United States during the 1980s.
PROJECT ON RELIGIOUS INSTITUTIONS
Program on Non-Profit Organizations
Yale University
PROJECT SUMMARY
The Yale University Program on Non-Profit Organizations is
launching a three-year project on religious institutions as
nonprofit organizations. The purpose is to focus scholars on
important matters that have received insufficient study, generate
new research, and establish an institutional framework for
ongoing social research on religious institutions at Yale
University. This will be done by involving a group of scholars
and practitioners from Yale and elsewhere in a series of seminars
and conferences, commissioning papers, providing support for new
research endeavors, and dissemination in working paper and book
form for scholarly and nonscholarly audiences.
Religion plays an extraordinarily important role within the
nonprofit sector. Nearly half of Americans' giving and
volunteering is devoted to religious institutions, which comprise
almost half of all charitable tax-exempt entities. The
documented connection between people's involvement with a church
or synagogue and their charitable behavior is evidence of
churches' importance in linking the individual to the community.
However, religion has received relatively little attention as
the field of research on nonprofit organizations and philanthropy
has blossomed over the past decade or SO. To date, little effort
has been made to define the place and role of religious
organizations in the nonprofit sector or to understand what, if
anything, distinguishes religious and secular nonprofits. It is
the goal of this project to begin to fill this void in research.
We believe that a major new research initiative, building on
the concerns of nonprofits scholars and the Divinity School, can
profoundly affect the understanding of the role of religion
institutions by academic researchers and practitioners. The
involvement of the Department of Religious Studies, the Law
School, the School of Management, and other social science
departments has also been explored and is expected to add
significantly to the success of the project.
Religious nonprofits as organizations
Even though religion has received relatively little
attention within the nonprofits field, there is a basis on which
to build. Past work by religious scholars and sociologists of
religion have illuminated many important topics -- the structure
of belief systems, the sources and correlates of religious
beliefs, the role of the clergy, the history of churches and
denominations, statistical studies of church membership and
attendance. Within the nonprofits field, a paper on churches and
tax policy was among PONPO's first working papers; another may be
issued in 1990.
However, the organizational side of religious institutions
has been largely overlooked, both within the nonprofits research
community and among the sociologists of religion who have not
been connected with it. Moreover, until now, divinity schools,
seminaries, and religious studies programs have shown little
interest in empirical explorations of the organizational
dimensions of religious institutions. Nevertheless, churches and
other religious institutions are organizations, and, as such,
they share with other organizations a host of managerial,
financial, resource allocation, and governance problems. But how
do they deal with these problems? How do religious organizations
vary among themselves? What are their similarities and
differences with secular nonprofits?
In the delivery of services (health, education, welfare,
counseling), do religious and religiously-affiliated nonprofit
organizations share the same goals of secular nonprofits? Does
it make a difference that service delivery is but one goal of
religious organizations or that religious ideals lie behind the
service delivery? Can distinctions be drawn between the
pragmatic and instrumentalist style of secular philanthropy and
the orientations of religion and religious charity? Earlier
generations of philanthropists and churchmen have faced, but
never satisfactorily resolved this dilemma, which is often stated
in terms of mission versus money.
The importance of the topic has also been heightened by
recent events that make it increasingly clear that the place of
religious organizations in the larger framework of the charitable
tax-exempt universe can no longer be ignored. High visibility
problems, like the well-publicized scandals at Covenant House and
the television ministries, as well as the struggle for control of
the Lutheran Synod and the Southern Baptist Convention, underline
the extent to which insights about governance and management, so
extensively studied among secular nonprofits, could also be
usefully applied to religious organizations.
If secular scholars and practitioners have insights of
potential value to the religious nonprofits community, it is
equally true that the wisdom and experience of the latter may
illuminate the concerns of the former. Ninety percent of the
secular nonprofits currently in existence are less than 30 years
old; much organizational theory suggests that old organizations
have much to learn from new ones. On the other hand, older,
primarily religious, nonprofits which have been dealing with the
dilemmas of organizational maturation for many decades, may also
have important insights for resolving the tension between mission
and economic goal orientation that has bedeviled secular
nonprofits over the past two decades.
In sum, the churches and church-affiliated organizations
should be better understood not only because of their importance
2
but also to promote mutual learning between scholars and
practitioners in the secular nonprofits tradition and the
religious community.
The project
The objectives of Project on Religious Institutions are:
1) to convene interested scholars and practitioners to
define important issues;
2) to recruit mature scholars, research-oriented
practitioners, and graduate students in divinity,
religious studies, and the social sciences to explore
these questions in seminars and in commissioned
research;
3) to produce in published form the findings of these
scholars;
4) to create an enduring network of scholars, teachers,
practitioners, and students interested in religious
nonprofits, the interrelationship of religious and
secular nonprofit organizations, and regulatory
questions involving religious organizations;
5) to create at Yale a dialogue among the Divinity School,
the Department of Religious Studies, and the social
sciences.
Beginning: An advisory committee has been named to meet at the
beginning of each of the three phases of the study to provide
guidance. The distinguished Yale scholars who have agreed to
serve in this capacity are: Dean Tom Ogletree (Divinity School),
Kai Erikson (Sociology), Perry Dane (Law), Sharon Oster (School
of Management), Jon Butler (Religious Studies), and Jaroslav
Pelikan (History).
Phase One: The first phase of this project will be devoted to
identifying interested scholars and practitioners, convening them
to discuss potentially fruitful areas for research, and planning
further research. Activities in this phase (the 1990-1991
academic year) would include:
-- convening an invited group of up to 20 scholars and
practitioners from seminaries, religious studies
programs, and the social sciences to identify areas
of common concern. This group -- which would not be
limited to Yale people -- would meet as a bi-monthly
seminar/workshop;
-- commissioning a critical survey of the social science
literature bearing on religious organizations; the
purpose would be to summarize what is known, identify
gaps, and draw comparisons with other nonprofits;
-- recruiting a group of younger scholars -- graduate and
professional students with interests in the area --
3
through the seminar and through the John D. Rockefeller
3rd Graduate Summer Fellowship Program at PONPO.
-- providing modest funding for pertinent research projects;
-- recruiting a senior scholar to serve as a mentor and
convener for the implementation phase of the project
(the 1991-2 academic year) (We assume that this would
be a visiting scholar who would spend the year at
PONPO, although new faculty would also be a
possibility). This would be a person suitable for
teaching a seminar between the Divinity School and a
social science department such as sociology.
The structure of this phase follows procedures which PONPO
has used in the past. Rather than attempt to impose a "research
agenda" on researchers, it creates an open forum in which
concerns can be brought forward, discussed, and pursued.
Phase two: The second phase of the project (1991-92) will be
devoted to exploration of the questions and concerns raised in
the first phase. Activities in this phase would include:
-- a graduate seminar jointly sponsored by the Divinity
School, PONPO, and the social science department in
which the senior visiting scholar has an appointment.
-- the presentation of papers by scholars recruited in the
previous year to colleagues and interested members of
the public in the bi-monthly seminar/workshop;
-- the publication in working paper form of projects
undertaken in the previous year, and arranging for
other publications in scholarly and nonscholarly
articles and books. (PONPO Working Papers circulate
both within and beyond the university.)
-- continuing support for work by graduate and professional
students;
-- at the end of the second year, convening a group of
interested scholars and practitioners to evaluate the
progress of the project, to consider the adequacy of
questions and methods, and to suggest dimensions of the
concluding phase.
Phase three: The third phase (1992-93) will be used to carry on
research and writing projects that will have been initiated, to
consolidate the efforts of the previous two phases, and to
construct a basis for institutionalizing the work. In addition
to continuing dissemination activities and support for the
graduate seminar, the bi-monthly seminar/workshop, and research
projects, activities would include:
-- presentation of research at national meetings of
scholarly and professional associations;
-- producing an edited volume, which could perhaps be
published in the Yale Studies of Nonprofit
4
Organizations series by Oxford University Press;
-- a concluding conference to present major findings, to
evaluate the project, and to suggest future directions
for scholars and practitioners.
People: Key project leaders are Bradford H. Gray, PONPO's
director whose work on nonprofit hospitals has included
consultation with groups including the Catholic Health
Association; Thomas Ogletree, new Dean of the Divinity school,
who brings expertise in ethics and church organization to the
project; and Peter Dobkin Hall, senior scholar at PONPO who has
done pertinent historical work on the role of the church in
American cultural life, on trusteeship, and on the place of
religious institutions in the nonprofit sector. Day-to-day
management of the project will be the responsibility of Terry
Schmitt, a senior sociology graduate student who is also an
ordained and practicing minister.
5
Project on Religious Institutions
Program on Nonprofit Organizations
The following people have agreed to participate in the
Project's ongoing seminar. A brief introduction to their work is
included as part of this list.
1. Perry Dane, Associate Professor, Yale Law School. Author of
"Religious Exemptions Under the Free Exercise Clause: a
model of competing authorities, Yale Law Journal, (1980),
and is currently at work on "The Corporation Sole and the
Encounter of Law and Church."
2. Jim Davidson, Professor of Sociology, Purdue University.
Executive Director of the Society for the Scientific Study
of Religion, and author of Mobilizing Social Movement
Organizations: the formation, institutionalization, and
effectiveness of ecumenical urban ministries (1985).
3. Jay Demerath, Professor of Sociology, U. Massachusetts,
Amherst. Author of A Bridging of Faiths: religion and
politics in a New England city (forthcoming), and "The
Separation of Church and State: notes on a mythical past and
an uncertain future, Society (1984) (Rhys Williams, co-
author).
4. Jeffrey Hadden, Professor of Sociology, U. Virginia. Author
of The Gathering Storm in the Churches (1969),
Televangelism, Power, and Politics (with A. D. Shupe) (1988),
and editor (with A. D. Shupe) of the three volume study,
Religion and the Political Order.
5. Margaret Harris, Assistant Director, Centre for Voluntary
Organisation, and Lecturer in Social Administration, London
School of Economics. Author of "The Governing Body Role:
problems and perceptions in implementation," in Nonprofit
and Voluntary Sector Quarterly (vol. 18, no. 4, 1989) and
the monograph, "Organising Modern Synagogues: a case of
multiple models, " for Leo Baeck College, 1990.
6. Dean Hoge, Professor of Sociology, Catholic U. Author of
Division in the Protestant House: the basic reasons behind
intra-church conflicts (1976) and (with Jackson Carroll &
Francis Scheets) Patterns of Parish Leadership: cost and
effectiveness in four denominations (1988). Currently at
work on exploring institutional factors influencing giving
patterns among church members of different denominations.
7. Thomas Jeavons, Associate Director of Programs, Association of
American Colleges, and Adjunct Professor of Organizational
Behavior and Management, Seton Hall U. Author of "Giving,
Getting, Grace, and Greed; an historical and moral analysis
of religious fund raising," in Taking Fund Raising Seriously
(in press) Dissertation title: When the Bottom Line is
Faithfulness: towards a philosophy of management for
religious philanthropic organizations.
8. Christa Klein, Independent scholar. Current research for the
Lilly Endowment is in two areas: 1) seminary governance
structures, and 2) the changing shape of American
denominationalism.
9. Greg Krohn, Associate Professor of Economics, Bucknell U.
Author of "Religious Organizations and the Nonprofit Sector
in a Mixed Market Economy, (1988), ""An Economic Model of
Religious Congregations's Expenditures, (1989 Spring
Research forum working Papers), and "Economics Outside the
Garden of Eden,' in God, Goods, and the Common Good (1987)
10. David Nygren, Visiting Assistant Professor, Graduate School
of Management, Boston University, and Research Associate,
Center for Applied Social Science, Boston University.
Author of "The Catholic Diocese of Louisbourg: strategic
planning intervention, (with M. Monette) in Cases in
Organizational Development (1990), and "Contextual
Correlates of Religious Leadership: structure, climate, and
leader attitudes," (dissertation, 1988).
11. David Roozen, Professor of Religion and Society, and Director
of the Center for Social and Religious Research, Hartford
Seminary Foundation. Recent work includes, "The Unfolding
Story of Congregational Studies," (with Allison Stokes) in
Carriers of Faith: lessons from congregational studies
(forthcoming), and "Congregational Identities in the
Presbyterian Church," (with Jackson Carroll), Review of
Religious Research (vol. 31, no. 4, June, 1990).
12. Harry Stout, Professor of American Religious History, Yale U.
Author of A New England Congregation: First Church, New
Haven, 1638-1988 (with Catherine Brekus) (1991), and
"Declension, Gender, and the 'New Religious History, " (with
C. A. Brekus) in Beliefs and Behaviors (1991) Co-editor of
Dictionary of Christianity in America (1990)
13. David Swartz, Assistant Professor of Sociology, Wesleyan U.
Author of Culture and Domination: Pierre Bourdieu and
Contemporary Social Theory (forthcoming), and "Pierre
Bourdieu: culture, education, and social inequality," in
Education and Inequality: a reader (1990)
14. David Williams, Assistant Professor of Sociology and Public
Health, Yale U. Author of "Religion and Psychological
Distress in a Community Sample," (with D. Larson, R.
Buckler, R. Heckmann, and C. Pyle) Social Science and
Medicine (forthcoming), and "Socioeconomic Differentials in
Health: a review and redirection, " Social Psychology
Quarterly (vol. 53, 1990).
15. Jim Wood, Professor of Sociology, Director of Indiana U.
Project on Governance of Nonprofit Organizations, Indiana U.
Author of Leadership in Voluntary Organizations: the
controversy over social actions in Protestant churches
(1981), and "Alternatives to Religion in the Promotion of
Philanthropy," and "Liberal Protestant Social Action in a
Period of Decline," in Faith and Philanthropy (1990).
16. Charles Zech, Professor of Economics, Villanova U. Author
and presenter of "The Efficient Management of Resources in
the Private Nonprofit Sector: Roman Catholic Dioceses,"
Midwest Economics Association (April, 1991), and "The
Determinants of Contributions to a Nonprofit Organization:
the case of religious organizations, " (with Peter Zaleski)
Eastern Economic Association (March, 1991). Also with Peter
Zaleski: "The Optimal Size of a Religious Congregation,"
(working paper, 1991).
The New York Times
Book Review
April 28, 1991
Copyright 1 1991 The No
Medicine: What the Traffic Will Bear
limits of scientific knowledge itself.
seeking corporations were important as suppliers, but
THE PROFIT MOTIVE
The two most prominent objects of our collective
mostly stayed at the periphery of patient care: Two
AND PATIENT CARE
passion seem in some ways opposites: medicine and
precepts - "Doctor knows best" and "spend whatever
armaments. Health care and national defense each
it takes" - summarized, without much distortion, the
The Changing Accountability of Doctors and Hospitals.
claim huge shares of America's national income. Our
system's essential norms.
By Bradford H. Gray.
technological virtuosity in each is the envy of the world.
That changed. Research laboratories presented doc-
440 pp. Cambridge, Mass:
And there is one more similarity: both our military
tors with a steady parade of advances in medical ma-
Harvard University Press. $37.50.
system and our medical system rely, to a degree
chinery. Options for improving health and prolonging life
unmatched by those of other major nations, on private
exploded, posing ethical and economic challenges we are
organizations driven by the profit motive.
just beginning to engage. Medical specialization meant
By John D. Donahue
Bradford H. Gray is the director of the Program on
fragmented responsibility for patient care and, along
Nonprofit Organizations in the Institution for Social and
with an increasingly mobile population, has made medi-
MERICA is selective in its commitments. Causes
Policy Studies at Yale University. In "The Profit Mo-
cine more impersonal. Meanwhile, many local hospitals
A
that other nations find compelling - basic
tive and Patient Care," he has written a fine book that
closed or lost their independence. For-profit hospitals
schooling, economic competitiveness, the
examines the large and growing role of profit seeking in
grew from a curiosity to a medical mainstay in many
dreaded, dull infrastructure - leave many of
American health care. As recently as, the late 1960's,
communities. Nonprofit hospitals, struggling to survive
us cold. But where our will is engaged we stand ready to
Mr. Gray reminds us, the appetite for financial gain
in the new environment, remade themselves in the
that we accept as the main engine of our economy was a
consecrate nearly limitless talent and treasure, to
image of their corporate counterparts. Third-party pay-
secondary force in the health care system. Most hospi-
ment schemes interposed new institutions between doc-
scorn crass calculations of cost, to push out against the
tals were run by charities, or by local nonprofit groups.
tor and patient. And physicians faced powerful pres-
While physicians made good livings, and while the
sures to think and act less like professionals and more
John D. Donahue teaches at Harvard's Kennedy
selfless healer may have been more a television staple
like entrepreneurs. (To appreciate the speed of this
School of Government and is the author of The Privati-
than a real-life standard, nearly all doctors acknowl-
change, consider that the for-profit Hospital Corporation
zation Decision: Public Ends, Private Means."
edged duties beyond maximizing their incomes. Profit-
of America was started in 1968. In 1983, it ran one out of
8
April 28, 1991
every 14 hospitals in America,)
ciality and, stupefying detail - no mean feat in this
just that professional integrity is helpful, or that it
As health costs surged from less than 6 percent of
area. He struggles to avoid the technicalities that make
lubricates the workings of a fundamentally money-
national spending in 1965 to around twice that today, the
health care an insider's game (though here and there a
driven system, but that without it the system would
old system of accountability crumbled. That system
phrase like "retrospective review and payment denial
grind to a halt or collapse into costly chaos.
had assumed professionalism and public spirit; the new
is also commonly used in IPA-type HMO settings" does
No project so ambitious as this is without fault, and
system assumes commercialism and self-interest; and
slip in).
four stand out. While the tight weave of Mr. Gray's
sets the rules accordingly. We are living through what
arguments may have made the task seem forbidding to
Mr. Gray calls "an unplanned national experiment to
E finds that the profit motive is neither so
his editor, the book could have been cut by one-fifth or
see how much medical care can be managed through
corrosive as some critics warn nor so benignly
$0 without losing anything essential, and a shorter book
the use of incentives and review mechanisms" instead
efficient as enthusiasts advertise. The author
would have been more inviting to the bad audience
of professional integrity and peer oversight.
stresses that the norms that rule markets for
that this one deserves. Second, he pays disproportion-
Mr. Gray's approach is systematic, respectful of
snow tires, machine tools and frozen waffles can't be
ate attention to issues of private third-par y payment,
the evidence and relentlessly fair-minded. In one of the
transferred unamended to this industry, where custom-
at the expense of the public programs (Medicare and
many specific questions he examines (do for-profit
ers are poorly equipped to understand their own inter-
Medicaid) and policies (especially tax rules favoring
hospitals provide less free care for the poor than do
ests, where "needs" are matters of technical judgment,
employer-sponsored health care) that have shaped the
nonprofit hospitals?) he reviews nine major studies en
quality is hard to monitor, and someone other than the
system. Third, he could have both saved himself some
route to the answer (yes, but not as much less as one
immediate customer pays the bill.
effort and fortified his case by invoking some of the
might suppose). In chapter after closely reasoned,
The core conclusion of "The Profit Motive and
work by. economists (from Kenneth Arrow back to
meticulously documented chapter, Mr. Gray surveys
Patient Care" is at once simple and starkly challenging:
Adam Smith) on the incapacity of market forces to
the struggle between cost-control bureaucracies and
Because our repertory of "incentives and controls
manage, on their own, the intricate accommodations
physicians devoted to maintaining their prerogatives.
will continue to be imperfect for the foreseeable future,
involved in subtle undertakings like health care.
He helps us appreciate the stakes and the power of the
it remains essential that the health care system be
Fourth, Mr. Gray's writing style is frequently wooden.
varied forces at work, and makes us marvel that the
populated primarily by institutions and professionals
Yet "The Profit Motive and Patient Care" remains a
strains are accommodated as well as they are. Mr.
who are committed to doing right by the patient." There
diligent, deeply informed inquiry into a topic of unsur-
Gray steers safely (for the most part) between superfi-
is no substitute for honor, Mr. Gray concludes. It is not
passed importance.
Twentieth Century Fund
41 East 70 Street, New York. N.Y. 10021
(212) 535-4441
NEWS
FOR IMMEDIATE RELEASE
Contact: Laurie Ahlrich
212/535-4441
In the rapidly changing American health care system, "an ethos that emphasizes
trust, community service, professional autonomy, and devotion to the interest of
individual patients is being replaced by undisguised self-interest, commercialization,
competition, and the management of care by third parties," according to Bradford H.
Gray's Twentieth Century Fund Report, The Profit Motive and Patient Care: The
Changing Accountability of Doctors and Hospitals.
Gray, who is director of the Program on Nonprofit Organizations in Yale
University's Institution for Social and Policy Studies, and a professor in the Department
of Epidemiology and Public Health at the Yale School of Medicine, is concerned with
two factors that make the problem of accountability so difficult in medical care: the
vulnerability of the patient and the fact that the payer is not present when the
purchasing decision is made.
Focusing on these factors, he assesses the evolution--some would say
revolution--of health care since the 1960s. He examines in detail how the profit motive
has shaped the organization, the availability, and the adequacy of medical care in
America.
more more
The Twentieth and social Century Fund is a research foundation which undertakes timely. critical and analytical studies of
political institutions and issues. Nonprofit and nonpartisan, the Fund was founded in 1919 and endowed by major Edward economic. A Filene
Gray - Page Two
According to Gray, "with health care costs in the United States now
approaching $700 billion annually--about 12 percent of our gross national product--it is
not surprising that money is central to the changes that have swept health care." The
impact can be seen not only in the emergence of more explicitly for-profit health care
organizations, but also in the changes that have affected nonprofit hospitals, doctors,
and even third-party payers. The question is whether the shortcomings of the
American health care system are being mitigated or exacerbated by these sweeping
changes in which traditional forms of responsibility are being replaced with new
structures of accountability.
Although third-party payers' distrust of health care providers is an
understandable response to the developments that Gray documents, he nevertheless
cautions that "enthusiasm needs to be qualified and tempered" for the new
accountability methods that are being used by third-party payers, who are embracing
practice guidelines, monitoring patterns of care, and employing utilization review and
management. He warns that the atmosphere of distrust between payer and provider
can become "poisonous." And he argues that the "traditional conceptions of
professionalism and a patient-service orientation, in which professionals and
organizations that provide health care services define their role in terms of the patient's
needs and interests, not in terms of doing what third parties are willing to pay for,
continue to be essential."
more more more
Gray - Page Three
The Twentieth Century Fund, a bipartisan, not-for-profit research foundation that
supports analyses of critical domestic and international economic, political, and social
issues, has long been concerned with health care in America. It sponsored Bruce C.
Vladeck's Twentieth Century Fund Study, Unloving Care: The Nursing Home Tragedy
(Basic Books, 1980), and Dennis P. Andrulis's Twentieth Century Fund Paper, Crisis at
the Front Line: The Effects of AIDS on Public Hospitals (Priority Press, 1989), and is
currently supporting examinations of public policies for managing epidemics, changing
attitudes toward access to health care, and organ transplant policy.
The Profit Motive and Patient Care: The Changing Accountability of Doctors
and Hospitals is published by Harvard University Press.
# # #
5/6/91
E
b'
wx
Yale
ET
VERITAS
Weekly Bulletin & Calendar
Published by the Office of the Secretary
December 10-17, 1990
Vol. 19, No. 14
Inside
PONPO receives grants from Lilly Endowment
To fund research on religious institutions, trusteeship in nonprofit organizations
The Yale Program on Non-Profit Org-
the organization and operation of reli-
cution of new empirical studies. In addi-
anizations (PONPO) has been awarded
gious institutions or how they compare
tion, the grant includes funding to bring
two grants totalling $904,000 by Lilly
with each other and with other types of
a prominent scholar to Yale as a visiting
Endowment Inc. of Indianapolis, Indi-
nonprofit organizations, according to the
professor for the 1991-92 academic year.
ana, to undertake major research projects
researcher.
An advisory committee to help guide
focusing on religious institutions and on
"This major grant from Lilly Endow-
the project is being formed. It will
trusteeship in nonprofit organizations.
ment will enable us to examine the man-
include faculty from the Law School and
A grant of $778,000 will support a
agerial, financial and governance prob-
the School of Organization and Manage-
three-year program of activities to en-
lems that religious institutions share with
ment as well as from the departments of
hance understanding of the role of reli-
other nonprofit institutions," says Mr.
religious studies, American studies and
American premiere of "Bambu."
gion in society. The main focus will be on
Gray. "These concerns are of obvious
sociology. The Reverend Thomas W.
Page 9.
the organizational aspects of churches, a
importance to our understanding of the
Ogletree, dean of the Divinity School,
topic "that has been neglected by both
church's role in society."
will serve as chairman of the advisory
scholars who study religion and those
The project will also probe the organi-
committee - thus marking the first col-
who study nonprofit organizations,"
zational sources of such "high-visibility
laboration between PONPO and the
PHOTO BY MICHAEL MARSLAND
according to Bradford H. Gray, executive
problems as the much-publicized scan-
school.
director of PONPO. Designed to stimu-
dals at Covenant House and the televi-
The second project, funded by a
late scholarly work and communication
sion ministries, as well as the struggle for
$126,000 Lilly Endowment grant, focus-
across disciplinary lines, the project will
control of the Lutheran Synod and the
es on the nature of trusteeship in non-
approach the topic through symposia,
Southern Baptist Convention," say Mr.
profit organizations. "Nonprofits play a
empirical studies, scholarly papers and
Gray and PONPO scholar-in-residence
vital societal role in many fields, such as
seminars.
Peter Dobkin Hall in the proposal to the
health care, education, social services and
Nearly half of all giving and volunteer-
endowment.
foundations," says Mr. Hall, who will
ing in the United States is connected to
The project will involve both individu-
direct the project. "Yet we know too little
religious institutions and affiliated orga-
als from religious organizations and
about their governance and control.
nizations, says Mr. Gray, and Americans'
scholars from Yale and other institutions
"There is a large prescriptive literature
charitable and voluntary activities are
nationwidé. Activities will range from a
that talks about how boards of trustees
often linked with their involvement in a
research seminar to the preparation and
should work and should be organized,"
Groundbreaking at Science Hill.
church. But little is known about either
discussion of scholarly papers to the exe-
(Continued on page 3)
Page 12.
PONPO projects (Continued from page 1)
he notes. "This literature grows out of
ties for enhancing understanding of the
authors' reflections on their personal
governance of nonprofits.
experiences, but has little basis in system-
The Lilly Endowment grant will sup-
atic empirical studies. We believe that
port a one-year planning phase for what
void should be corrected."
is envisioned to be a much larger project,
The program will bring together a
says Mr. Gray.
group of scholars, practitioners and con-
Lilly Endowment, the nation's fourth
sultants in a series of meetings and writ-
largest private charitable foundation, has
ing projects to discuss the history and
a longstanding interest in education, reli-
evolution of trusteeship in different fields
gion and community development, with
of nonprofit activity; assess what is
a special emphasis on sustaining the leader-
known about the role and impact of
ship of nonprofit organizations.
trustees; and identify research opportuni-