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Legislature's hidden tax increase

by: kite

Sat Jun 18, 2011 at 08:43:09 AM EDT


Excellent story on NHPR yesterday about the state budget's impact on hospitals.  
Under a plan crafted by House budget writers, New Hampshire hospitals stand to lose $250 million dollars over the next two years. New analysis shows that if they lose these funds, all but four of the state's largest hospitals would suddenly plunge into the red.
The story reports that this huge fee increase is already causing many of the state's non-profit hospitals to consider closing urgent care facilities, or selling out to for-profit institutions.  

This budget tactic is disturbing on so many levels.  First, the sheer mendacity of Republican leadership regarding their so-called refusal to raise taxes, although not unexpected, is still appalling.  And this fee on hospitals violates an agreement going back to Republican governor Judd Gregg.

Worse, at the same time Republicans are saying the New Hampshire health care system is in good shape, they are about to tax it into changing beyond recognition:

Under a new analysis done by the New Hampshire Center for Public Policy Studies, if Wilhelmsen doesn't make any changes, his bottom line would suddenly plunge from a $5 million surplus to a $6 million dollar loss.
Just what we need when people are struggling financially: the closure of community health centers and the conversion of NH hospitals from non-profit to for-profit.  Good thing the state is working to implement the federal health care law.  Oh, wait... they're rescinding funds to implement that, too.

Mentioned very briefly in the story is the fact the obstetrics are expensive, making those facilities a frequent target of cuts.  The implications for the rural poor in the northern part of the state are left as an exercise for the reader.

budget writer Neal Kurk says hospital execs are crying wolf. "We're dealing with very large institutions. Only one of those in 2009 lost money. 12 of the 13 were doing very well, thank you
And yet, of all the large institutions the legislature could have taxed, they chose non-profit hospitals...

Well, at least we're lowering taxes on cigarettes.
 

kite :: Legislature's hidden tax increase
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Upside down priorities (0.00 / 0)

Thanks for making this so clear Kite.

Cheaper cigarettes to bolster the "NH advantage" -- that's more important than keeping non profit hospitals up and running.



Well, after all, (4.00 / 2)
they are non-profit, and that is socialism, you know.  If you're not doing it for profit, it is anti-American and communism, etc.  

A long and twisted story (0.00 / 0)
As I understand it, this comes out of Judd Gregg's Mediscam.

The idea was: the federal government would provide matching funds for some state spending on health care. So, the state set up a phony tax. The state imposed a tax of about $100M on hospitals - and then immediately used that $100M to fund health care support to those hospitals. The tax check from the hospital and the grant check to the hospital were actually written on the same day!  Then, the federal government match that $100M state "spending."

The hospitals worried that the state would some day a) stop writing grants, but b) continue collecting the tax.

The legislature just did exactly that.


How low do we expect them to go? (4.00 / 2)
So in this state the only state-supported health care is Medicaid (and we all know how much the state spends on that) and these DSH funds (which is really the hospital tax returned to the hospitals!)

If you can't afford insurance in this state, you're only recourse is to go to your care provider and ask for charity, a discount, a payment plan, whatever. The state itself DOES NOTHING to help support you in the insurance market. Our neighbors had Catamount (VT), Dirigo (ME), and Romneycare (MA) -- SOMETHING to help the uninsured. Each had varying degrees of success in their initial form. Most are now working to achieve systems that work fully AND bring down costs.

In NH there has never been any attempt to come up with public support for individuals or small business trying to get coverage. It has been left to the care providers to establish the state-wide Health Access Network, which set criteria (through an application process) for minimum discounts or free coverage for those uninsured. But that is not insurance!

And the number of uninsured had been increasing faster during the recession.

Now we're going to still tax, but then deny, these funds to the hospitals. Do we care what might happen to the quality of our health care --even for those who are insured -- if revenues are chopped to many of our regional non-profit hospitals?

I doubt we'll really control the cost of health care and maintain quality just by telling the care providers we gonna pay them less, much less.

We've had a quality health care delivery system here in NH, even though expensive from the insurance angle. But unilaterally cutting out state funds and dropping the cost curtailment onto the hospitals does not ensure future continued quality in our system. It just heaps more charity burden on the careproviders.

And then there's always the cost shifting...

JillSH



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