BRADENTON – Manatee County Administrator Ed Hunzeker warned county commissioners at the start of Tuesday's meeting that his proposal to implement a half-cent sales tax for indigent care funding might be seen by citizens as an issue of trust, and that they might see the board as "guilty by association" with other irresponsible government bodies. Whether it was trust or genuine dislike of policy, citizens certainly weren't impressed with the idea, which nonetheless passed 4-3.
Though the idea received support from people like former county commissioner Pat Glass, sitting Holmes Beach City Commissioner David Zaccagnino and health care workers from groups involved with providing the care, citizen comments overwhelmingly urged the commission to hit the brakes on the idea of moving quickly toward a new tax, especially with so little time and information.
Sandy Marshall, 2nd Vice president of the Manatee Federation of Community Associations, was disappointed that the federation was not involved after it had played a vital role in the sale of the hospital. Marshall admonished the board for not finding a working model for keeping the corpus alive, saying that he'd found an out of state program which was doing just that and shared it with the board, who had no interest in adopting it.
"You're being asked to do too much, too soon, and with to little information," saids Marshall. "It's wrong to do it that way."
Marshall also had concerns over the lack of both time and information.
"I don't know where this information is going through the community," said Marshall, who noted that the federation had not received anything. "The referendum would be three months away. How are you going to get the information out to the citizens. There's a little group here that's working to decide how this works. I hope from here on out, they involve the public more."
Don Browning agreed. "I think we just need a lot more before we make a decision on this. We need information."
Longtime government watchdog Bill Wheeler also questioned the board's haste and suggested there were better ways they could manage to provide care.
Dick Hunt said, "It's putting the cart before the horse to start a program when you're saying that the state and federal government are in flux on what to do in terms of funding indigent care."
Chairman of the Manatee Republican Party Kathleen King also spoke against the plan. "Should taxpayers be asked to raise their own taxes to pay for increased reimbursements to providers?" asked King. "Did Manatee Memorial make a profit last year? We keep hearing about how much money they supposedly lost, but what did they make?" King said that some of the members were in favor of Obamacare and that it seemed hypocritical if they would support this plan while not even waiting to see if the Medicaid expansion works. Ultimately, King said she couldn't see taxing citizens to "subsidize for profit companies."
Steve Vernon of the Manatee County Tea Party said his group vehemently opposed the idea of a referendum. "This is a significant deviation without sufficient limits or oversights," said Vernon. "It's a financial commitment.
Vernon listed multiple areas with which he took issue.
"The mission statement emphasizes prevention - education, screening workshops, early intervention," said Vernon. "Prevention by definition is boundless. Also eligibility: earning up to 200 percent of the federal poverty level? Why do we think that double what the federal government considers poor, we should think of as poor? This plan has big government written all over it. Mr. Hunzeker said the people don't trust the government to do a good job. He's right. Empirical evidence tells us that the government cannot run anything right."
Another speaker said his big fears were related to accountability. He said he was attracted to the idea of reducing real estate taxes, but noted that only five Florida counties have implemented such a tax.
"62 counties have decided that it's not a good thing to do," he told commissioners. "Right now there's no evidence. As a county, spending a quarter billion dollars over 10 years when we don't know the outcome?" He said that we're not auditing now and that the biggest thing missing in the industry – competitive bidding – isn't even addressed. "We're committing to this without any accountability for getting the best value for our money." He argued that evidence showed preventative care doesn't reduce costs, but actually raises them because of false positive and additional tests and procedures, while the real benefit has to come from human behavioral choices which seldom happen.
Sarah Cohen wondered why children were included when the state's Kidcare program already covered children without healthcare.
Indigent health care has already raised eligibility from 135 to 200 percent of the federal poverty guidelines. Under that guideline, which would continue in the new plan, a family of four making less than $47,100 would be eligible. According to census data, the median household income is $48,181. Despite the opposition, the commission voted 4-3 to pass the motion to put the sales tax on a special ballot this June.