In this era of tight public funds afflicting virtually every state in the nation, there is one revenue source that has been all but neglected in the public debate: the subsidy of “not for profit” private hospitals by exemption from sales and property taxes being the typical form. This has been reexamined by the remarkable Illinois supreme court decision in the Provena Covenant case: the Court ruled that the Provena hospital group failed to meet the charitable health care provision required to enjoy the property ands sales tax freedom they had enjoyed.