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Let’s imagine your annual earnings are $200,000. Sounds pretty good, right? We’ll not so fast. Let’s also assume that your debts—mortgage, car loans, student loans, etc.—equal $1.6 million. Interest on those loans costs you $120,000 per year. You have some assets thanks to your old granddad, mainly in the form of property, but the buildings are old and a sale doesn’t leave much after the lawyers and taxes are paid. Nevertheless, you’ll have to sell at least some of them even if you’ll lose the rent they bring.

Of course, you also have your ongoing costs–water, gas, electricity, food–so you can’t afford to hire help and you can’t afford to paint the house. And here’s the really bad news: your earnings are decreasing. A decent portion of your past work came from the federal government, and new regulations have meant a pay cut for you. Your customers are also receiving less government support, so few can continue to afford your services. And if your earnings drop much more, you want be able to afford living expenses and pay loan interest.

If this situation were real and not imagined, what would you do? Would you paint the house? Could you eat out? Would you sleep at night?

Well, the numbers included in the situation outlined above are proportional to what’s on the Community Health Systems balance sheet. CHS gives guidance for its earnings, on low side, of $1.8 billion and CHS pays approximately $1 billion in interest on $14.7 billion of debt. This leaves just $800 million to cover its costs: repairs, painting, heat, light, electricity, and–of course–the help. Earnings in the hospital industry are said to be down because of fewer procedures and fewer admissions, which is more of a problem for some than others. But if earnings drop much more, can CHS pay down its loans?

CHS’s challenges are somewhat hard to fathom given the size of the numbers, but imagine if it were a household. The problem would be the same presented in Proverbs 22:7: the borrower is servant to the lender.