Citizens Show Healthy Skepticism on Healthcare Tax

On Tuesday, a crowd of Manatee County citizens showed up to oppose a special-election referendum on a half-cent sales tax to fund indigent care programs. Manatee County Administrator Ed Hunzeker warned commissioners at the start of the meeting that it would likely be seen as a trust issue. He was right. Many residents don't trust his administration, or the board, to put what's best for the community in front of special interests. The rushed and unspecific nature of Thursday's proceedings did nothing to change that.

The BOCC's 2013 track record has been one of haste and artifice, in which issues have tended to be raised quietly, vetted privately and decided quickly – regardless of whether the stated concerns of dissenting board members and/or concerned citizens have been addressed. In the very first meeting of the year, an unadvertised motion to authorize board chair Larry Bustle to negotiate extending county administrator Ed Hunzeker's contract – despite the fact that the associated costs would be deeply impacted by Hunzeker having enrolled in the state's DROP program – was made and passed during the commissioners' comments portion at the end of the meeting.

Despite strong public backlash, two dissenting commissioners and negotiations which were not conducted in accordance with Florida sunshine statutes, the board rammed the new contract through without informing the public, or even board members for that matter, as to what the decision would ultimately cost taxpayers. County media releases and Commissioner Bustle's public explanation at the meeting papered over the true costs, deliberately making them seem much more benign than they actually were. No public discussions, no testing the market, no waiting to see what time would bring (Hunzeker wasn't due to retire for a year and a half and had nearly two years left on his old contract).

Next, with the administration's blessing, the board set about quickly passing a series of motions favoring phosphate giant Mosaic, who is suddenly in a big hurry to quickly see to it that their Manatee County mining operations are permitted well into the future, and that the preferred status the mining company has long enjoyed in terms of mitigating the wetland areas they destroy (typically 20 percent of what is required by developers) is “codified,” rather than just mutually understood. Again plenty of public concern, again plenty of commissioner skepticism, followed by a collective plea asking why rush into this? Yet again they plowed it through.

So when the county then pivots once more, rapidly rolling out a plan to spend hundreds of thousands of dollars on a special election for a referendum on increasing the sales tax in order to fund a series of indigent health care programs – with its typical lack of specificity and just 90 days for the litany of unanswered questions as to its practicality, timing and oversight to be answered – it's no surprise that citizens are again asking them to cool their heels.

We are at this very moment experiencing the most massive expansion of government health care in history – much of it focused on the very issue of indigent care. Billions are being spent on expanding access to Medicaid in order to provide more funding for the same people that programs funded by the proposed sales tax would cover. The common thread of dissent at Tuesday's meeting was a product of bewilderment as to why in the world a local government would attempt to simultaneously fund a parallel initiative, when the much larger federal one is about to begin and the funding source for the current local programs will not expire for two years?

Over and again we were told that time was of the essence; that they couldn't tie the sales tax to property tax cuts in the upcoming budget unless they were able to get citizen approval before July. After all, this was just a “diversification of revenues” switching out one source (property tax) for another (sales tax) in order to “spread the pain.” Waiting to piggy back off another ballot wouldn't work. There was no time to gather more information – and after all what more did you need, the fund is running out and this is the only way to replace it.

Rubbish. The county has known the state of the corpus for years. Rather than propose this idea back before the November ballot or spend the time having a frank, open and ongoing discussion with the community on what sort of programs it wanted to fund, what they would cost, and what was the best way to fund such initiatives over the long term, they instead opted to parade the existing model through one workshop and then put it to a vote. Now the community has a mere 90 days to understand what it has, what it wants, and what kind of deal it's been getting, and can expect going forward, in exchange for its significant investment.

Don't get me wrong, I support providing indigent care. Hell, I support universal health care through either a single payer system or a government model like the VA, and such initiatives are often funded in other developed nations by an increased sales tax. It's a progressive idea. But I have a lot of questions about a countywide plan to tax purchases and then pay for programs, the centerpiece of which has been a for-profit hospital. Tuesday's meeting yielded precious few answers.

The primary strength of Medicaid and Medicare is their ability to contain costs by collecting troves of data (which they mandate providers collect) that they can then use to ensure that only reasonable costs are being charged by setting a take it or leave it reimbursement rate. And despite the constant complaints by ever-profitable hospital companies that the rates are too low, I don't know of one who's chose the leave it option.

As for the urgency of the calendar, there is nothing which dictates that a tax would need to be implemented this year. If we've got two years left on the corpus, that's fine. Let it run out, as was intended. If that's how long we need to responsibly vet and debate a prudent long-term proposal, so be it. If you can manage to tie it in with next year's millage rates, or even the one after, that's fine as well. But tying the two together seems like a dangling carrot in order to encourage voters to get over their apprehensions.

As for spreading the pain, that's just more malarkey. The idea that only property owners contribute to the tax base is nonsensical. I've never met a landlord who pays their units' taxes out of the kindness of their hearts, without figuring it as an expense in their investment. No, they pass it on to their tenants through the price of rent, as you'd expect them to.

Yes, this is indeed a trust issue and not just because we've been sold the Chicken Little song and dance on every scam from the Patriot Act to the Iraq War, to the bank bailouts. It's hard to imagine that another rushed and rammed through initiative on this level is for the good of the community, if only because past experience with this board suggests that's unlikely to be the case.

I think voters will trust their nose on this one and decide it doesn't pass the smell test. Two years of funding in the corpus provides the perfect opportunity to allow the expansion of Medicaid to play out. There's no need to rush headlong into anything. As a wise man once said, discretion is the better part of valor.

Dennis Maley's column appears every Thursday and Sunday in The Bradenton Times. He can be reached at dennis.maley@thebradentontimes.com. Click here to visit his column archive. You can also follow Dennis on Facebook. Sign up for a free email subscription and get The Bradenton Times' Thursday Weekly Recap and Sunday Edition delivered to your email box each week at no cost.