I Told You So.

But did anybody listen? Nooooooooooooooooo.

And so it begins: Vermont Governor Peter Shumlin has proposed a budget for the new year. Gov. Shumlin is a “Big-D” Demorat but one who won’t raise taxes. Gov. Shumlin’s budget increases the provider tax on Vermont’s hospitals by $17.4 million.

A “provider tax” ain’t a real tax, right?

The gov says this increase will simply “maximize the draw down” of matching Federal Medicaid dollars to help fill the State’s budget shortfall. It will tax hospitals, physicians, Home Health Agencies, and pretty much any other healthcare providers. Probably even WalMart because they (used to be able to) sell prescriptions for $4 which makes them a provider.

“Hey, Dick! I get my scrips from Wally now,” Raul Garcia told me. “Did you know that some of the stores charge me sales tax on them some of the time. Some don’t.” Mr. Garcia is North Puffin’s best known hypochondriac and was our most respected grant writer until that little trouble with the Feds. He ended up serving 18 months of a four year sentence for fraud after he used the $4 million he “borrowed” from a major pharmaceutical company as the matching funds for an $8 million corporate gene splicing study at North Puffin College of Veterinary Medicine. The Pharma got their “investment” back when the grant came in. It wasn’t the first time. Even so, he says he has not yet determined which phase of the Moon determines the sales tax boondoggle.

Back on point. Northwestern Medical Center is a small, friendly, not-for-profit, hospital in St. Albans, Vermont. In the interest of full disclosure, I served on the Board of Incorporators for NMC for more than a decade. This regional, primary care facility offers a broad range of high-tech medical equipment and services to the area.

For that one local hospital’s privately insured patients, the added tax means sharing an increase of $350,000 in tax expense alone in the coming year. Yeppers, ObamaCare is gonna reduce the cost of medicine.

And Gov. Shumlin is right at the forefront of that reduction. Newspeak. Word.

No small town hospital is more vital to the community and none is better liked. NMC has earned national Avatar awards for the last three years for patient satisfaction but that’s just part of the story. They sponsor local events like the ArTrain and the Summer Sounds concert series. They field teams for the United Way. And 600 of our friends and neighbors work there.

The original St. Albans Hospital was built in 1883. It has grown and morphed from two hospitals into one that now cares for 1,900 inpatients each year. The E.R. sees over 28,000 emergency patients and 7,000 people already walk in to the new Walk-In Clinic in Georgia each year. 400 babies arrive via storks at the Family Birth Center. That all adds up to more than $129 million of patient care each year.

Gov. Shumlin “proposes to increase the tax assessed on hospitals by $17.4 million from 2011. This increase will be used to draw down Federal funds to help address the State budget shortfall,” NMC Chief Executive Officer Jill Bowen told the St. Albans Messenger. “However, the State no longer returns the provider tax to the hospitals in full after it has secured the matching funds.”

In case you missed it, the State of Vermont told the Feds they took in beaucoup bucks as matching funds to increase the “grant” money funneled back to the state. Then the State of Vermont gave most of those beaucoup bucks back to the hospitals.

“Hey, Dick?” Raoul Garcia said. “Isn’t that what I went to jail for?”

2 thoughts on “I Told You So.

  1. It’s worth noting that, like so many hospitals, NMC gets reimbursed about 57¢ for each dollar billed. Their actual income is around $73.5 million of that $129 million worth of service. The medical staff and employees earn nearly $38 million.

    Catamount Health is Vermont’s health “insurance” program for uninsured residents of the state. Signed into law by Gov. Jim Douglas (R-VT), it’s been around about 5 years. Gov. Shumlin’s proposed new budget will eliminate Catamount Health and transfers those covered into the Vermont Health Access Plan known here as VHAP; it is Vermont’s version of Medicaid.

    Naturally, VHAP reimbursement is less than Catamount Health. $14 million less when added up across payments to Vermont’s hospitals and physicians. Like so many liberal programs it doesn’t actually save any money. It simply forces the hospitals and physicians to provide the care but to shift the uncovered portion of the cost onto the fewer and fewer privately insured patients.

    And guess what happens next year.

    Yeppers. According to Gov. Shumlin there will be no, zero, nada privately insured patients. Everyone in Vermont will be on VHAP.

    Oh, yay.


    Despite the storm, the Administration still plans to hold its first public hearing about Gov. Shumlin’s single-payer system on Vermont CCTV around the state tonight. (SNOW DAY: Burlington CCTV and Channel 17 Studios tweeted they are closed today.)

    I guess the Administration hopes to say no one offered negative comments.

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