Throughout our nation's history, hospitals were built to meet the needs of our communities. Often, the reason for starting a hospital was tragedy - the tragedy of death or disability because of the lack of health care services.

In all cases, churches or local governments were the sponsors of hospitals because, more often than not, they required subsidies to stay open. Over the years, however, the number of county hospitals dwindled and care for the needy fell to the remaining not-for-profit hospitals.Then the hospital environment became even more complex. Insurance companies and the government became involved in the funding of health care. Investors found they could make a profit by opening and running hospitals.

Given these changes, it is difficult for many people to sort out the reasons why not-for-profit hospitals should continue to receive the exemption from property tax they have always had.

Federal law recognizes the charitability and tax-exempt status of not-for-profit hospitals, as do the law of most states. In Utah, all counties but Salt Lake County have continued to grant tax exemptions to not-for-profit hospitals. Only Salt Lake County is currently grappling with the issue.

Why single out not-for-profit hospitals for taxation? After all, other charitable institutions - churches, schools, museums - are not taxed, and rightly so.

Intermountain Health Care's not-for-profit hospitals have always acted in a charitable way. They have always provided medical care to those in need regardless of their ability to pay and they continue to do so. Businesses couldn't and shouldn't be expected to do that.

I should point, out, however, that not-for-profit hospitals do expect those who can pay for medical services to do so. Our hospitals must attempt to recover payment for services they provide so they can stay open to provide health care to all who need it.

The advent of the property tax challenge and greater public review of the role of not-for-profit hospitals has led those hospitals owned by Intermountain Health Care to tell the public about their charitable mission.

Signs are now located in IHC hospitals to inform patients that financial assistance is available if they are in need. That same message is included in IHC publications.

And, the already substantial charitable contributions of IHC hospitals, including Alta View and Cottonwood, were increased. Both hospitals recently opened outreach clinics for the underserved. These clinics, which operate on a free or ability-to-pay basis, follow in the successful footsteps of the Central City Community Health Clinic operated by LDS Hospital in downtown Salt Lake City.

More than 4,800 people, many of whom otherwise would have no health care, have been served by the Central City Clinic since it opened a year ago.

Cottonwood and Alta View operate these clinics in addition to providing millions of dollars in other gifts to the community annually. These gifts include free care to the needy, volunteer and community service including education and research, donations and grants, and the difference between what hospital services actually cost and the amount Medicare and Medicaid reimburse the hospitals.

When you add that all up, Alta View provides more than $1 million a year in gifts to the community, while the total for Cottonwood tops $3 million. In contrast, Salt Lake County's tax assessment for Alta View is about $185,000, for Cottonwood about $456,000.

The case for exempting not-for-profit hospitals from property taxes is black and white:

- Not-for-profit hospitals were created not to make profits, but to meet human needs.

- Not-for-profit hospitals provides care to people regardless of their ability to pay.

- All revenue a not-for-profit hospital receives from patients is used for the benefit of the hospital and therefore the community.

- In all cases, these not-for-profit hospital's free care to the needy exceeds its property tax bill.

All Utahns benefit from not-for-profit hospitals serving our state. Our not-for-profit hospitals belong to us all and deserve our support.

(Nathan C. Tanner served as Chairman of McKay-Dee Hospital Center board for 12 years and is director of Board and Community Relations of Intermountain Health Care.)