Larry Metz’s Crusade Against Medical Care for the Poor
Regular readers of the Leesburg Daily Commercial will be familiar with the efforts of Larry Metz (R-Yalaha) to dismantle the special hospital taxing district that adds a whopping one mil to the Lake County property tax rate. Revenue from this tax, which amounts to one dollar per thousand paid, or a tenth of a penny per dollar, helps Florida Hospital Waterman (FHW) and Leesburg Regional Medical Center (LRMC) defray the cost of caring for people who are uninsured or under-insured. The heavily-loaded phrase that is being bandied about is “indigent care,” since in practice many of those helped by this program lack the financial means to purchase health insurance or are on Medicaid, which does not always cover the full cost of their care. These are precisely the kind of people that a compassionate society ought to care about, but – as we prepare to celebrate the birth of Jesus – there is no room at Metz’s inn for compassion.
Diagnosing the Sickness of Larry Metz
We shall not waste too much time rehashing the basic facts of the case. The Daily Commercial can do that, but unfortunately that’s about all it will do. Telling us that Metz’s draft bill reforming the hospital district has received a stamp of approval from local Republican worthies is all well and good, but the real story here – the one we’re not being told – is why on earth our elected representatives are attempting to divert funds away from indigent care when we live in a country with 50 million uninsured people. Why, when the State of Florida has just slashed its Medicaid budget (by $510 million for fiscal 2012), is Metz so opposed to a minuscule tax helping to cover Medicaid shortfalls? Is Metz so cheap, so mean-spirited, so utterly bereft of Christian compassion, that he begrudges these needy people one thousandth of a dollar? Does he derive sadistic pleasure from placing his boot on their throats once he’s kicked them to the ground? And, more to the point, why isn’t the whole of Lake County asking these same questions? Why isn’t the Daily Commercial featuring Metz in its “Hits and Misses” column – as a resounding miss?
To be fair, the Daily Commercial lent support to the hospital tax in an editorial on November 4th, which concluded with the rather weak line, “if it ain’t broke, don’t fix it.” But Metz’s crusade requires a much firmer riposte, and the paper’s reporting on this issue has been far too deferential. Today, although we are treated to a few perfunctory lines mentioning the hospital’s take on the situation, the views of the governed are mere murmurs against the thunderous declamations of our illustrious decision-makers. The maximum extent of “debate” to which we are allowed to be privy is the disclosure that State Senator Alan Hays (R-Umatilla) – a retired dentist, for those who don’t know – objected to Metz’s draft bill on the grounds that it would add an unnecessary layer of bureaucracy. Bureaucracy? Say it ain’t so, Larry! If there’s one thing worse than a one mil tax, it’s Big Government interference! Thus, the only “debate” that matters in the People’s Republic of Lake County is the internal discussion among the good ‘ole boys (and gals) of the G.O.P. about the best way to adhere to Republican Party orthodoxy. But for the actual citizenry, this intramural hair-splitting is insultingly beside the point (although it is amusing to note that Hays has found a convenient way to distance himself from Metz’s madness).
So, what’s it really all about? It seems painfully obvious that Larry Metz is simply attempting to burnish his street cred with the excessively influential Tea Party movement. Not only is he opposing a tax – that dirty little word that bespeaks all manner of evils – he is laying claim to the Revolutionary slogan of “no taxation without representation,” opposing a revenue district that seems to be lacking in democratic legitimacy. (The courts, however, have upheld its legality.) Even his bizarre obsession with ensuring that none of these funds fill the Medicaid shortfall could be cast by Metz as an expression of fealty to high democratic ideals. After all, if the people of the great state of Florida, speaking (clearly, as always) through their duly elected representatives, have decreed that Medicaid shall be cut, then, so help me God, it shall be cut, and the will of the people shall not be subverted by even a thousandth of a dollar. Oh, Larry! I tremble upon beholding the nobility of your cause!
If we want to get serious about accountability and transparency in our society, let’s take our cue from another story in today’s Daily Commercial – the ongoing effort by several state Attorneys General to hold the big banks accountable for fraudulent mortgage practices. In a state with one of the highest foreclosure rates in the country, many local voters would take a keen interest in such an effort – especially those who no longer pay property taxes because they lost their homes in a financial collapse caused primarily by unregulated high finance run amok. Perhaps those large numbers are mathematically intimidating to Larry Metz, and he feels less intellectually insecure dealing with just $10 million. Or could it be that he understands numbers just fine, and the ones that speak most loudly to him are those on campaign checks from people who don’t have to worry about losing everything if they get sick.
For the larger point here, of course, is that the Republican Party’s full-frontal assault on the poor amounts to nothing more nor less than a class war. Cut their services; deny them medical care; stigmatize them with labels like “indigent care”; root out any forms of compassion toward them by denigrating such acts as socialism (and certainly not as Christian); ignore their contributions to society; expose them to pollutants by repealing “burdensome” regulations; make it harder for them to vote… it’s all of a piece. And remember, folks, class war is only un-American when it’s waged against the rich.
Prognosis: Same Cost, Different Payers
There is a fascinating sub-plot here that deserves far more attention than it will receive from the Leesburg Daily Commercial or the ridiculously Republican North Lake Outpost. Metz’s anti-tax fervor, reflecting as it does his own passion to secure re-election by courting the Tea Party, actually threatens the bottom lines of local medical companies. At first sight, this looks like an awkward clash of right-wing priorities, with the Tea Party’s mania actually trumping the G.O.P.’s love for black ink. But then we recall that both FHW and LRMC are not-for-profit organizations, and all the complaints about a lack of accountability start to make more sense. When was the last time we heard a Republican complain about lack of accountability in the profit-taking (sorry, profit-making) health insurance industry, staffed as it is by anonymous bean-counters who make decisions every day that deny health benefits to people who need them? (Some might even call them death panels….) No, there’s never an accountability issue when profits are being made and shares can be traded, for the market will hold the company accountable and provide all the supervision that is necessary. Markets are utterly infallible; they can be completely trusted at all times. (No wonder people of faith feel at home in the G.O.P.) If FHW and LRMC were for-profit enterprises, I’m not at all sure we’d be having this discussion.
That footnote aside, there is a great irony here in strict policy terms. Even if Metz’s crusade ends up succeeding – and in this climate it very well might – there is no way that FHW or LRMC are going to deny emergency care to the uninsured. Somebody, somewhere, is going to end up eating the costs that were previously covered by the hospital tax revenue. Will the hospitals simply shrug their shoulders and resign themselves to another unavoidable cost of doing business, or will they look for ways to pass that additional cost on to paying consumers of medical services? The latter option seems most likely, in which case the few dollars that property tax payers thank Larry Metz for saving them will simply migrate to the medical bills that they (and their insurance companies) have to pay. You can’t make costs disappear; all you can do is reallocate them to different economic actors. What Larry Metz needs to explain to the people of Lake County – and what the Daily Commercial should be demanding to know – is where all those fractions of pennies will ultimately pile up. And the Tea Partiers might want to ask themselves the same question (although they are probably not capable of drilling down that far beneath the surface).
I hope I speak for many Lake County residents when I say that I have absolutely no problem with one mil of my property tax dollars being used by local hospitals, and I’m not going to lose any sleep over the extent to which the district board may or may not lack transparency. But I do have a problem with a portion of the state revenue raised from various other taxes and fees that I pay ending up in the paycheck of narrow-minded, ambitious fools like Larry Metz. Perhaps it’s time to get out the calculator and see precisely what fraction of my sales tax dollar ends up supporting him.