Commentary by Andy Caldwell
of (COLAB)
For the
past several years, the State of
County
staff have estimated that some $8 million worth of medical care provided by
local providers is not reimbursed each
year. The laws of our nation, being what they are, require hospitals to
treat patients regardless of their ability to pay. Some of the costs
associated with this unfunded mandate are passed onto patients with
insurance. Some of the costs are picked up by our government. The
rest of the costs, the estimated $8 million in our county, are written off as a
loss by hospitals and doctors. County staff saw the trauma center funding
issue as an opportunity to suggest a new property tax be considered to raise
the money necessary to reimburse local care providers.
Of
course, some people feel that the burden to take care of the poor should not
fall on property owners alone, but should be borne by society as a whole.
Thus, the idea of a sales tax was also considered. The problem with a
sales tax is that it can only be raised in minimum increments of a quarter of a
percent. A minimum quarter percent hike would raise at least $15 million
per year, more than what is necessary to reimburse the care providers.
Staff suggests that the extra money could be used to either help fund a North
County Jail or alternatively, used to purchase and preserve open space.
Either way, raising property taxes or sales taxes requires
approval from two-thirds of the voters, and there is not a lot of confidence that such a measure would
pass. Why? Well, nobody can argue that hospitals and doctors have a
right to be reimbursed, but there is obviously more to the story! Walk
into
My take
on all this is that staff should have addressed the $1.6 million dollar trauma
center issue, which is not going to be hard to solve, and leave the $8 million
problem to the State and the Feds. There is no way that local taxpayers, who can barely afford the cost of health care for
their own families, can afford to subsidize the costs of the uninsured in our
community as well. Because of unfunded mandates, there is not
enough discretionary revenue available to local government to handle this
enormous problem. Neither should our local medical providers be forced to
pay for this unfunded mandate. The State and Federal government must take
responsibility for the fact that the social safety net they mandated local
communities to provide is bursting at the seams. They must either provide
the money to care for the poor, or relieve local governments and health care
providers of the legal obligation to do so.
Andy
Caldwell is the Executive Director of COLAB and a 39 year resident of the