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Tanner Andrews

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Tanner Andrews

Medicaid is an interesting creature. A few years ago, the federal government offered to give a bunch more money to the states in order to expand availability. This meant more poor folks could have health care.

Florida hated that. Our attitude toward the less fortunate is slightly less generous than Ebenezer Scrooge. California once had state police at the border to beat or arrest the poor, where Florida kindly prefers prisons or workhouses.

So, in its less than infinite wisdom, the Legislature turned federal Medicaid money away. Legislators prefer to get the money from local taxpayers, so they assess each county.

Counties have one source of ready money: taxpayers. Volusia is lucky, having health care taxing districts to which it can pass along the cost. This has been the custom since time immemorial, or at least since 1991.

It is not as bad as it sounds. Sure, the state turns away federal money, and gouges residents. Local taxpayers get less health care for the poor, and pay more money for it. You expect nothing else in a one-party state.

Still, hospitals really do benefit from Medicaid. At the County Council meeting, counsel for Halifax explained. They receive more than $260 million in Medicaid payments, of which a little less than $40 million is profit.

Fish New Smyrna benefits to a lesser degree. They only receive about $30 million in Medicaid benefits.

But West Volusia taxpayers get nothing: They neither own nor oversee any hospitals, and they receive a grand total of zero Medicaid funds.

The statute allows counties to apportion the burden among their health care districts that receive Medicaid benefits. Halifax receives the overwhelming majority: $260 million of $290 million. And, while West Volusia does not receive any benefit, the county is pleased to share the burden.

Evidently, $40 million is not enough profit for Halifax. Add the extra “disproportionate share” money, yet still they want more.

The County Council was embarrassingly groomed by staff to avoid questions. No one said, “Show us on the wallet where he touched you.” No one probed how the extra disproportionate share money made them feel, either.

No one asked Halifax, “Is $40 million enough profit for you?” Instead, at their November meeting, the County Council critters showed us what they were groomed to think — load up a pickup with money from the west, drive to Halifax, unload, and party!

— Andrews is a DeLand-area attorney and a longtime government critic. For purposes of the column, he finds it convenient that there is so much government to criticize.


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