The issue of state-financed health care for a long time has been one of the most problematic in the United States. The system of hospital taxing districts was introduced to solve the problem of healthcare funding for indigent layers of the population. While the people in need should be provided free healthcare services, the mechanism of tax support for public and non-profit hospitals should be reconsidered.
Aiming to ensure reasonable burden on America taxpayers Florida’s Governor Rick Scott, known for his opposition to Obamacare heath reform, in his Executive Order of March 2011 established a Special Commission to examine the system of Florida’s hospital districts funded by the taxpayers. The Commission was to prepare the report with the arguments for reasonable cuts of tax reliefs for dependent not-to-profit hospitals. Scott noted that it was crucial for his administration to ensure “a higher degree of predictability and fairness” eliminating “inefficiency, higher cost, or irrational business practices” (1). In the report of the Commission, it was stated that of 34 active special hospitals districts 26 were independent and eight dependent ones; 16 districts had the authority to levy taxes and receive healthcare funding (“Report of the Commission…” 8). The Commission emphasized that hospitals often failed to reevaluate funding received from tax incomes and acted inconsistently (“Report of the Commission…” 3). It was recommended to follow the principle “money follows the patient” allocating tax funds to hospitals; all the hospitals could be assessed by the Public Medical Assistance Trust Fund before receiving funding. Moreover, all the hospitals were to establish tax-allocating boards with no hospital staff among their members (“Report of the Commission…” 4-5).
The recommendations of the Committee seem to be reasonable and justified. Every year more and more people require medical care and healthcare expenditures continue to rise from year to year, increasing the burden of the state, which is already facing the problems of massive debt and insufficient GDP growth. During the years 2011-2013, the US expenditures on healthcare comprised 17% of GDP, the 2nd greatest result in the world after Tuvalu (The World Bank). The recent demographic trends show that elderly and indigent people will be the key challenge for the health care system due to the population aging and unemployment problems. It is estimated that every fifth citizen in the USA will be elderly by 2030 (Burton and Ludwig 749). There is no doubt that the state should take care of those in need providing at least basic free medical aid. But very often the key problem are those not-to-profit hospitals who act unfairly and can spend the money of taxpayers inappropriately. Too often the ultimate aim of providing health care services to the indigent people had been overshadowed by the sought of hospital taxing districts to compete with non-tax supported healthcare establishments (Florida Tax Watch 7). Perhaps, some other scheme could work; the state, for instance, could provide public hospitals centrally, without giving them the right to dispose of the tax reductions.
On the other hand, current tax support ensures the indigent people at least the minimum level of assurance in that they would receive necessary treatment. Ill practices of some hospitals are mainly exclusions. And required level of self-governance can better ensure fair tax funds distribution. Moreover, pressure on public hospitals can aggravate the already critical situation connected with the lack of qualified medical personnel (Anderson par. 30).
Overall, it can be seen that the problem with district taxing support in Florida should be solved as soon as possible. The system has to be improved so that excessive healthcare spending is reduced and hospitals’ ill practices curbed. But at the same time, the state should not forget about its indigent citizens.
References
Anderson, Amy. The Impact of the Affordable Care Act on the Health Care Workforce. 2014. Web.
Burton, Marti, and Linda J. May Ludwig. Fundamentals of Nursing Care: Concepts, Connections & Skills. Philadelphia, PA: F.A. Davis, 2011. Print.
Florida Tax Watch. Florida’s Fragmented Hospital Taxing District System in Need of Reexamination. 2009. Web.
Report of the Commission on Review of Taxpayer Funded Hospital Districts 2011. Web.
Scott, Rick. Executive Order Number 11-63 (Creation of Commission on Review of Taxpayer Funded Hospital Districts. 2011. Web.
The World Bank. n.d. World Health Care Expenditures. n.d. Web.