Set the record straight on the hospital assessment

    Dennis Elmaurer’s April 29 entry in the Milwaukee Business Blog ("Connect the Ugly Dots in the Hospital Assessment Scheme") contained numerous inaccuracies and omissions that warrant a response.

    As preface, by the end of this state biennium (June 30, 2009), it will have been over a decade since Wisconsin hospitals received a direct increase in what they are paid to care for Medicaid patients. In 2007, hospitals received, on average, 48 cents for every dollar they spent providing care to this population. In other words, 52 cents of every dollar of Medcaid cost (not charges) had to be collected from someone else. Last year, this meant roughly $600 million in unpaid government health care costs were shifted to every employer in Wisconsin.

    And it hasn’t mattered which party has been in control at the state capitol … paying for Medicaid/BadgerCare (eligibility for which has been expanded by both Republicans and Democrats) has not been a priority in Madison.

    So who picks up the tab for these growing programs? Wisconsin employers and Wisconsin families.
    Legislators from both sides of the aisle readily acknowledge this problem, but Medicaid cost shifting is largely unseen, inconspicuous among the various factors that comprise the cost of health care – so nothing gets done. 

    History clearly shows that the only way to break this cycle of inaction is to find another approach. Our Association, along with major Wisconsin business groups, believes the hospital assessment is a solution that can be a "win-win" for all of us.

    Here are a few more facts.

    Medicaid (and BadgerCare) is a state/federal partnership. A dollar put into the Medicaid program garners well over $1 in additional federal matching money. It’s the way the program works. And yes, as Mr. Elmaurer pointed out, that federal money comes from taxes we all pay. But today, those taxes we already pay are going to other states at astounding levels.

    Wisconsin now ranks 47th in the amount of OUR federal tax dollars coming back home.  Shall we strive for 50th and watch health care costs continue rising in the process? Shall we slash state funding for Medicaid/BadgerCare and send back to Washington the millions we already receive so even more Wisconsin tax dollars can go to other states?

    We don’t need to pay more in federal taxes. We need to do a better job of making the taxes we pay matter  … in Wisconsin. The hospital assessment is one way to do that.

    The hospital assessment will not be a tax on a patient’s bill, as claimed. If implemented, it will be an assessment on hospital gross revenues. The dollars generated will be placed into Medicaid and, like any money put into Medicaid, capture hundreds of millions in matching federal revenue. These dollars would in turn be used to increase hospital Medcaid/BadgerCare payments.

    The net result: hospitals will receive far more than they were assessed, a significant dent will be made in the hundreds of millions now being cost-shifted onto employers and the legislature will finally begin addressing a long-ignored problem that is contributing to our high health care costs.

    Lastly, we commend state and Milwaukee business leaders for supporting the assessment. The Wisconsin Manufacturers & Commerce (WMC) and the Metropolitan Milwaukee Association of Commerce (MMAC) are fighting for our fair share of federal dollars and lower health care costs. They deserve a "thank you" from taxpayers, not a misleading thrashing.

    Eric Borgerding is executive vice president of the Wisconsin Hospital Association.

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