Every now and then Beacon Hill does something that surprises even me, who has come to
expect only the ridiculous, the venal, and the dumb from that source.
Yes, I admit I was astonished to learn about the nursing home and prescription drug taxes
that are presently being considered in the House and Senate budget conference
We have a nursing home shortage, with more threatening to close, and drug costs are
very high. So our legislature's solution is to tax the nursing homes and add a tax to the
prescriptions? This made no sense, even politically: Politicians don't usually try to see how
much they can upset senior citizens.
So I decided to look for the real agenda and report back to you.
It turns out that the prescription drug thing is fairly typical: To the political brain, people
who pay for their own prescriptions or have insurance, are "rich;" so someone must make
them pay more for medicine to help those who can't afford prescriptions.
I will pause here to remind you that in Pennsylvania, a commonwealth with a much lower
tax burden than ours, prescription drugs for the elderly cost only $6 each and are
subsidized by the state lottery. Here in Massachusetts, we have other priorities: A pork
bill passed recently that, among other things, renovates a government golf course in
Part of the nursing home tax carries with it the typical redistributionist ideology too -- an
assumption that any old, sick, dying person who can pay for himself can darn well pay
more to help subsidize someone else's care; while the state subsidizes -- pork bill again --
passive recreation trails and swamp cleanups.
Personally, I think we taxpayers should get our recreation by actively chasing the
politicians who voted for these things down a passive recreation trail and into a swamp.
This column is too short for a complete explanation of the nursing home tax, but here's
nuts in a nutshell:
There will be a really big Medicaid crisis as more of us, followed by the baby boomers,
live longer. So instead of facing up to this fact, legislators merrily increase benefits and
People who have no assets rely on state taxpayers to fund their care with Medicaid, and
the federal government reimburses the state for half the cost. The state doesn't make
paying its Medicaid bills a priority, so nursing homes often have a cash flow problem; but
even without that, it costs more to care for elderly and disabled patients than the facilities
get when the state's check finally arrives.
Seniors who saved for their old age and did not spend down their assets before entering a
nursing home pay their own way in both private and mixed private/Medicaid facilities;
they are not on taxpayer assistance. So of course the federal government doesn't
reimburse the state for their care.
The majority in the Massachusetts House (The roll call was 107 for the tax, 43 against.)
and Senate (Which is too cowardly to have a roll call.) decided to tax all nursing homes,
whether or not they have Medicaid patients, for each privately-paid and Medicaid bed
they have filled. The state then gives the Medicaid nursing homes nearly twice what they
pay in the form of increased Medicaid rates, and then waits for the feds to return half to
the state. The feds are dumb enough to do this -- though it should be noted that they are
starting to see through this cute scamming of federal taxpayers and in some states, are
now demanding much of the money back. I would think they would also be looking to
indict the schemers, but so far none of this is against the law.
It is also legal to get rid of your hard-earned money several years before entering the
nursing home either by taking a world tour or giving it to your kids for a nice vacation
after your funeral. Certain kinds of lawyers specialize in helping you set things up so the
taxpayers are stuck with the costs of your care -- until the whole system crashes and you
become a bedless patient. You then hope your kids set aside some of your money to put
the addition on their house for you and pay for some nursing assistance.
So there it is. Encourage private-payers onto public assistance in order to get more
money from the federal government, and hang the national debt. With the Big Dig,
Massachusetts gets more money from Washington than it sends, so the whole
commonwealth is on welfare anyhow.
The good news: Not only taxpayers, but seniors and the media seem to be unimpressed
with this latest Beacon Hill scheme. These two new taxes may be dropped by
embarrassed legislators, but if they aren't, Gov. "No new taxes" Jane Swift should veto
this, the dumbest idea to come out of Boston this year.