You'll probably recall the 'hospital tax' that was removed from the state budget during the extended negotiations between the Republican Assembly and the Democrat Senate. This was a contrivance that would've added a tax on hospital care with the ultimate result being that of receiving more than that amount in federal Medicaid funds. The state would then use these federal dollars to increase the reimbursement levels on Medicaid patients (which would've increased the taxes again,too).
The largest hospitals in Southeast Wisconsin were in favor of this contrivance since they would benefit most having the largest Medicaid populations. The Wisconsin Hospital Association (WHA) originally opposed this contrivance but later changed its position to one of favoring the tax. I suspect they were forced into that changed position since the largest hospitals, which wanted this tax, are also the largest payers of WHA association dues.
The smaller out-state hospitals were simply overpowered in this internal WHA debate. They were never going to see much, if anything, from the tax contrivance since they treat far fewer Medicaid patients than do the hospitals in the major metropolitan areas.
Medicaid reimbursements in Wisconsin were last increased some twelve years ago, and the hospitals say they now receive only $0.48 of every dollar billed. The portion they 'write off' actually ends up as part of the fees being charged to non-Medicaid patients in subsequent years. These write offs ultimately increase the cost of health care and, therefore, health care insurance for all those who still have that benefit.
Against this backdrop, why would anyone oppose the hospital tax?
Us taxpayers are paying the cost of Medicaid already. If this forced 'cost-shifting' from Medicaid to the private citizens (taxpayers, incidentally) had not been made necessary by poor government planning and higher than affordable medical care rates, the problem would not have happened.
The tax dollars to be collected would flow into general tax funds and, while they might be 'earmarked' for hospitals today, there is no guarantee that our lawmakers won't ultimately raid this 'hen house' for something even more attractive to them in the future.
Us taxpayers, by the way, also have paid the taxes to the federal government that would be used to fund this contrivance.
California's Governor Schwarzenegger came up with a similar scheme earlier this year, and that would've caused taxpayers in all other states to pay some $12 Billion annually to cover the cost of 'universal health insurance' in California. The 'Terminator' could've terminated some of us taxpayers with that grand approach.
Then, of course, there is the old saw that basically says we're stupid if we don't get ours, too. That seems to make sense except that, in reality, it never seems to work that way for Wisconsin. Remember that our population growth isn't keeping up with that of California, for example. We have far fewer members in the House of Representatives than does California. That translates into things such as milk prices being better in California than in Wisconsin, for example. It also means that California will get more federal money per capita than Wisconsin. That is simply the way it works.
As our taxes continue to increase, and as our ranking as a 'tax hell' continues to grow, employers will not see Wisconsin as a desirable place to do business; that will cause employment to suffer; that will cause Wisconsin to need to increase taxes even more; and, more and more people will leave Wisconsin or never come to Wisconsin in the first place.
These schemes simply work to our detriment, even though they sound like a 'great deal'. There are no 'great deals' that flow from taxes. We are always the ones that pay the taxes...and there is never enough tax money to do all the good that needs doing.
This contrivance also promises to cause health insurance premiums to increase...which will cause fewer employers to find the money with which to pay, thus causing them to drop that benefit. That could actually increase the number of Medicaid patients, too.
Sounds like a 'great deal' to me!
The answer to the Medicaid reimbursement problem is to increase the reimbursement fees with existing Medicaid funds instead of creating yet other ways to spend those same Medicaid funds that are already admittedly in too short supply.
