BRADENTON – Manatee County has been blanketed with signs, direct mail and other advertisements promoting the half-cent sales tax referendum, which goes before voters on June 18. So far, virtually all of the campaigning traces back to a group called Healthy Manatee, which has come under fire for incorrectly advertising that a vote for the sales tax is a vote for property tax cuts. Little was known of the group prior to yesterday's release of their first campaign finance report.

Of the nearly $170,000 raised by the group in just six weeks, much can be traced back to individuals and groups associated with Manatee Memorial Hospital and its parent company, King of Prussia, PA-based Universal Health Services (UHS) – interests that would seem to have the most to gain financially from the referendum's passage.

Currently, Manatee Memorial and its doctors receive millions of dollars in payments from the county each year for services provided to indigent residents. The money comes from a corpus that was created with proceeds from the county's sale of the hospital in 1984. The fund is projected to expire in 2015, and the terms of the agreement specifically states that the use of proceeds to provide for indigent care would not be construed to create an obligation for the county to provide or pay such care beyond what is required by state law.

Simply put, once the corpus expires, the county is under no obligation to provide payment for indigent care to Manatee Memorial or any other hospital in the area, including Lakewood Ranch Medical Center – another UHS entity, who also receives payments from the county under the current arrangement. The hospitals themselves are only required to provide such care as a term of accepting Medicare payments.

County administrator Ed Hunzeker has said that if the referendum passes, the county will continue to fund indigent care at its current levels, which would clearly be a favorable outcome for UHS, a for-profit company that ranked 339 on the 2012 Fortune 500. That same year, UHS Chairman and CEO Alan Miller took in just under $12 million in total compensation.

UHS is a $6 billion-plus company that operates hospitals and medical centers in 37 states, as well as Puerto Rico and  the U.S. Virgin Islands. It posted a profit of $119.8 million for first-quarter 2013, and two weeks ago saw its stock hit a 52-week high of $68.79 per share. Many Manatee County citizens have expressed outrage at making nonobligatory payments to such a profitable private-sector company.

In an effort to maintain the status quo, Universal and related interests have funneled big bucks into the Healthy Manatee PC, a group run by Manatee Memorial board member and former Manatee County Commissioner Pat Glass. “UHS of Delaware Inc.” is listed as having made three contributions to the group, totaling $75,000. Another $10,000 is listed as having come from Manatee Memorial “medical staff.”

Blake Hospital, who also receives indigent care funding from the county, has contributed $5,000. A $75,000 contribution was made by a political action committee called “HCA West Florida Division Good Government,” a group to whom Blake has donated $50,000 since 2010. The rest of the money is made up of individual contributions from physicians, healthcare executives and other local professionals, most of whom work for or with Manatee Memorial or one of the other groups. Click here to view the group's campaign contributors.

Currently, the county spends just over $24 million on healthcare-related expenses, about $15 million of which comes from its general fund. The other $9 million which it says will be in shortfall if the half-penny does not pass, is, ironically, nearly the exact same amount paid to hospitals and hospital-based physicians to offset their costs for indigent care. Meanwhile, only around $600,000 (or about 2.5 percent of total spending) goes to treatments at walk in clinics, where such care is delivered at its greatest value for taxpayers.

If the half-penny referendum passes, Hunzeker says that it would generate about $23 million a year, covering most of the county's healthcare expenses. Because only $1-2 million would be needed from the general fund, he says that the county commission could then vote to reduce property taxes by a correlated amount. But even by the county's own estimates, that would be a wash for the average homeowner, who'd be paying about as much in additional sales taxes as they would be saving in property taxes. Meanwhile, for-profit hospitals would still be taking the biggest chunk out of taxpayer-funded healthcare, while continuing to deliver the worst value because of the high costs of emergency room treatment. As major property tax payers who don't really pay much in the way of sales tax, such a plan would be doubly lucrative for those corporations. 

Hunzeker and company have said that there would be a focus on getting indigents away from the ER and funneling them toward cheaper means of care. However, the county hasn't done a very good job at explaining exactly how that would be achieved in any meaningful way, especially if Manatee Memorial and other hospitals can be assured that they will continue to be paid taxpayer money for treating them in their highly-profitable ER's. It's clear why those interests would be motivated to fund an entity like Healthy Manatee. Whether Manatee County taxpayers are interested in funding the status quo remains to be seen.

related:

Muddling Manatee's Healthcare Sales Tax Issue