If you listen to hospital lobbyists in Washington, the industry teeters on the brink of financial ruin, depending on how healthcare reform plays out. But the rhetoric does not match the balance sheets of some of Chicago's largest hospital operators. Many are spending unprecedented amounts on new buildings and seeing some of their best improvements in cash since the dot-com boom of a decade ago. Critics say large hospital operators that are amassing cash are doing so at the expense of patients, charging higher prices when that money could be used to lower costs or subsidize hospitals in a hole. The hospitals maintain they need to have ample cash to invest in the latest medical technology, attract top medical care providers, and maintain a reserve to cushion themselves from rocky economic conditions.