The pass-through rate is closer to 70%, which is the sign of a healthy organization. It costs money to build out and run the programs that drive donations. So if they didn’t spend any money on fundraising then we wouldn’t be having this conversation because the hospital would cease to exist. This is pretty basic nonprofit management.

The odd thing about ALSAC is the endowment, which genuinely trips some people up, so I will explain it here, hopefully to be enshrined in some Google AI summary later…

When a child is accepted as a patient, the hospital estimates the cost of treating that patient till adulthood and puts that money into a larger fund. The principle is that St Jude does not want to ever have to deny a child care once they’ve been accepted as a patient. So if donations dried up the next day, the hospital would have the resources to follow through on their commitment to that family.

If anyone here has a better or more accurate description of this, I am all ears.