Address Manatee County's indigent medical costs with another surtax vote

April 24, 2014 


Ambulances pack the emergency room parking area at Manatee Memorial Hospital. Health care executive Kevin DiLallo has suggested making another effort to pass a surtax to pay for health care for the poor in Manatee County.GRANT JEFFERIES/Bradenton Herald


Manatee Healthcare System's chief executive officer has pitched a solution to Manatee County's dilemma with reimbursing the medical community for administering health care to the poor. But are Manatee County voters willing to approve a sales tax increase after rejecting the idea last summer?

Should the county commission entertain CEO Kevin DiLallo's proposal and place the surtax on the November ballot, officials can ill afford a repeat of the June 2013 failure.

This time, should this be placed on the ballot, the county must come up with concrete and detailed plans for the expenditure of the tax monies and mount an aggressive information campaign throughout the community.

Taxpayers want accountability and assurances that the surtax is being spent wisely. Last year, the county's hazy campaign stirred discontent and distrust.

Manatee County's current fund dedicated to reimbursing medical providers for treating indigent patients will be depleted next year. That costly burden will then be borne by Manatee Memorial Hospital, Blake Medical Center and Lakewood Ranch Medical Center, which already write off a tremendous amount on indigent health care.

A solution is imperative -- and a property tax increase is highly unlikely, especially in an election year.

As we've opined repeatedly in the past, a half-cent sales tax increase -- raising the rate from 6.5 percent to 7 percent -- is a reasonable solution.

Sarasota, Pinellas and Hillsborough counties have 7 percent sales tax rates, so the argument that Manatee County would be at an economic disadvantage by approving a surtax does not hold water.

Hillsborough spends special sales tax monies on a comprehensive managed care program for residents with limited income and assets who do not qualify for other health care coverage, including Medicare and Medicaid.

Hillsborough HealthCare contains strict enrollment eligibility requirements, and members have co-payments for certain services, including prescriptions.

That might be a model for Manatee County. Or some other definitive plan that voters can judge before committing to a tax increase.

The county dedicated the money from the 1984 sale of then publicly owned Manatee Memorial Hospital to indigent health care, and the fund lasted 30 years before soaring costs depleted the account.

Now Manatee County must come up with a way to move forward, The issue cannot be ignored.

As DiLallo stated in Herald reporter Sara Kennedy's article Wednesday, "We should be proactive by trying to solve the problem before it becomes a problem."

A sense of urgency -- but not panic -- should be the order of the day.

County Commissioner Michael Gallen pinpointed our concerns in Kennedy's report:

"I feel we have to have a holistic plan in place for preventative care -- not focused primarily on emergency room care -- because we need something more efficient and effective in our health care system."

Again, Manatee County and the medical community should examine Hillsborough HealthCare and other county programs that deal with indigent medical care, steering patients away from expensive emergency room care.

While Manatee County commissioners might be hesitant about placing a surtax on the November ballot, they surely must come up with some plan to fund health care for the poor.

Another surtax referendum, under different circumstances than last year, merits a vote.

As stated here in March, the community must unite behind a comprehensive and lasting solution.

Any resulting strategy must be explained properly and fully to voters through visits to civic organizations, neighborhood associations and other public outreach well in advance of a vote.

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