Showing posts with label hospitals. Show all posts
Showing posts with label hospitals. Show all posts
Sunday, November 24, 2013
Friday, June 21, 2013
North Carolina's Shadowland Teat Squawkers
If you want to see the difficulty in trying to
implement tax reform and a decentralization of power, look at North
Carolina. I can’t even imagine trying
this at the national level. Every
special interest group is fighting tooth and nail to keep the status quo. If the states’ republicans aren’t successful
at beating back the teat squawkers, at least the exercise has been insightful.
What surprised me is how powerful nonprofit
organizations are in this state.
Hospitals, which have higher profit margins than Exxon, are complaining
about the loss of revenue because the General Assembly refused to expand
Medicaid. They are also bitching about
proposals that would eliminate exemptions from collecting sales taxes and subsequent
refunds. Yet, Carolina’s HealthCare
System’s CEO’s 2012 compensation was $4.7 million, which included bonuses over
$2 million. And this is a nonprofit?
Another band of teat squawkers that operate under
the radar are cities and townships. To
get a good idea of how involved the State is in funding everyday operations,
here is an excerpt from the Charlotte Observer:
In the Senate plan, the biggest hit
for the city in the tax bill would be the repeal of the privilege license tax
that cities impose on certain businesses. The loss of this levy would cost
between $17 million and $18 million a year when fully implemented.
The business privilege tax is levied
on all businesses, trades and professions operating inside Mecklenburg County.
The minimum tax is $50. The maximum is $10,000.
The city could also lose $15 million
per year if it loses refunds on sales taxes that it pays to the state, plus an
additional $10 million from the elimination of the local sales tax on food. The
lost revenue would be partially offset by an additional $11 million in revenues
from additional taxes that nonprofits such as hospitals would pay.
Berger spokeswoman Amy Auth said the
Senate’s tax reform plan incorporated feedback from people across the state,
including constituents, businesspeople, other legislators and the governor. In
particular, a vast majority said the state should not tax food, she said.
Local governments have other options
for raising money for local services and infrastructure, including impact fees,
water fees and other local taxes, Auth said. Governments could make up for lost
sales tax by reinstating the food tax, or they could reduce spending, she said.
As for privilege taxes, Auth called
them a disincentive for business to move to and create jobs in North Carolina
and noted municipalities will have five years to prepare for the change.
According to the League of
Municipalities analysis, Charlotte would lose the largest amount of revenue in
the state, but other communities would face steeper tax increases. The
Edgecombe County town of Leggett, for example, would need to raise property tax
bills by 849 percent to make up for $83,584 in lost revenue.
Among Charlotte-area communities,
Monroe would take a $2.2 million hit, Gastonia would lose about $2 million and
Mooresville would come up $1.1 million short.
Cities like Charlotte have been double
dipping. Besides imposing their own
taxes, they use the state to confiscate wealth from their citizens through taxing
services and items like food. They then get
the rebates, all the while scrubbing their hands of the dirty political
process. In the meantime, we have sprawling
unaccountable bureaucracies that perform duplicate, and without a doubt,
substandard service.
A famous Democrat once said all
politics is local. That’s the way taxation
should be as well. All forms of revenue
should be transparent and the politicians of that community held
accountable. But as we’ve seen, it’s
better to operate in the shadows.
Tuesday, June 11, 2013
N.C. Hospitals Throw Tantrum Over State Budget
You can hear the squeals all the way from
Raleigh. The free lunchers are throwing
tantrums throughout the state. So-called
“non-profit” organizations are screaming about reductions in state tax refunds,
and the possibility of actually having to collect taxes for services
rendered. One of the biggest non-profits in the state are
hospitals.
Carolinas HealthCare System CEO
Michael Tarwater warned Tuesday that state legislative proposals to tax
hospitals and decrease reimbursement could “disrupt the delicate balance that
exists between mission and margin.”
“It’s still pretty gloomy,” Tarwater
told board members at their quarterly meeting.
Tarwater, who leads the region’s
largest hospital system with $7 billion in revenues and about 40 hospitals
across the Carolinas, said he and his staff are monitoring state and federal
legislative proposals. Some of them “would have a very negative impact on what
we are able to do for our patients,” he said.
For example, under a bill
co-sponsored by N.C. State Sen. Bob Rucho (R-Matthews), nonprofit hospitals
would be required to pay sales taxes.
State and local governments now pay
more than $400 million in annual sales tax refunds to nonprofits, and most of
the money goes to hospitals. Under Rucho’s bill, sales tax refunds would be
capped at $100,000 per year starting in 2016.
We all know what N.C. hospitals’
mission is, and that is to procure outrageous profits. Everyone complains about Big Oil. Hell, they’re pikers compared to Big Hospital. Their profit margins double that of the integrated
oil and gas industry.I have a mission for anyone who’d like to take a challenge. Get a quote from a hospital on the cost of stitching a finger. Now that’s a mission!
And let’s disabuse ourselves that
these "non-profit" hospitals are concerned about the general welfare of our
citizens. They are just as concerned
about profit as any other business, and will use any means to help their bottom
line.
For years, the state hospital
industry had been accustomed to getting its way in Raleigh. With a squad of
lobbyists and generous donations to elected officials, it has long been one of
the most powerful interest groups in state politics.
Now it’s facing an array of
financial threats, including the rejection of expanded Medicaid funding by the
state legislature.
Leaders in both North Carolina and
South Carolina chose not to accept Medicaid expansion, which was intended to
provide health insurance to more low-income people as part of the Affordable
Care Act.
By rejecting the money, North
Carolina will deprive state hospitals of $440 million a year, the hospital
association estimated.
Tarwater added that cutbacks to
hospitals will make it harder for Carolinas HealthCare to give free care to
needy patients and to provide other “community benefits.”
The nonprofit system said it
provided $284 million in financial assistance and discounts to uninsured
patients last year.
And I'm sure they made it up it by overcharging the insured and those who paid cash. But even after the state rejected “free money” from the federal government, Carolinas HealthCare’s financials aren’t hurting. Hell, they’re expanding:
In other business at Tuesday’s
quarterly board meeting, Carolinas HealthCare reported first-quarter profits of
$160 million, a decrease from $229 million during the same period in 2012. Most
of the profit resulted from investment income of $130 million, which was down
from $169 million in last year’s first quarter.
The system also reported operating
income of $18 million from net operating revenue of $1.9 billion, compared to
the first quarter of 2012 when it had $37 million in operating income from $1.6
billion net operating revenue.
Chief Operating Officer Joe Piemont
blamed the decrease on “impacts of changes in funding,” such as Medicaid cuts
and the loss of county reimbursement for indigent care. “And our costs are not
going down.”
Still, Piemont called it “a solid
quarter.”
Capital expenditures for the system
totaled $185 million in the first quarter. That included the start of
construction on a behavioral health center in Davidson and a new rehabilitation
center at Carolinas Medical Center-NorthEast in Concord.
Saturday, April 20, 2013
Charlotte's Forgotten Health Care Legacy
I watched an
excellent documentary about the development of Charlotte’s health care
system. Most notable was the
establishment of hospitals by churches and citizens. Two major hospitals in our area can be traced
back to the activities of individuals and their parishes.
After the devastation of the War of Northern
Aggression, Jane Wilkes saw a need for nursing skills while tending to wounded
soldiers. She helped raise funds for St.
Peters Hospital and also for Good Samaritan Hospital, which was the first
privately funded all-negro facility in the state of North Carolina. She and her fellow citizens typified Alexis
de Tocqueville’s ideals of what it means to be an American. This kind of civic pride and participation lasted
until the mid-twentieth century when local governments began to take over the
hospitals.
You won’t find monuments or public buildings named
after Jane Wilkes in Charlotte. Those
kinds of accolades belong to rapacious politicians who raid the public
treasury. No, her legacy endures even
though most Charlotteans don’t remember her.
Source:
Subscribe to:
Posts (Atom)