Who really benefits from Prop. 1?

A lot of people have asked me what I think of Proposition 1, the plan on the ballot being pushed by the Border Health PAC that would establish a new Hidalgo County Healthcare taxing district.

I have interviewed a lot of the players – both pro and con – and I have covered several forums and debates on Prop. 1 and here is my take on the issue.

The reason this is on the ballot, again – after the voters turned it down two years ago – is to benefit the private, for-profit hospitals, and DHR (Doctors Hospital at Renaissance) in particular. This is a big boys’ game – game of manipulation of the system to benefit the rich and powerful. The wealthy who wield a great deal of influence in this county, and who stand to profit immensely have called upon our elected representatives – State Rep. Bobby Guerra and Sen. Juan “Chuy” Hinojosa – to craft the legislation to put this back on the ballot again, requiring just 50 signatures to do so.

They are being very “smart” about it. They lowered the tax cap of the new taxing entity from 75 cents to 25 cents, to make the issue more palatable to the voters.  They know the voters don’t want to subsidize for-profit hospitals with tax dollars, and would never approve a “hospital district” tax that benefits only the hospitals by reimbursing their write-offs. (They call this “uncompensated care.”) So, they included “indigent care” in the bill to pull at the heartstrings of those who want to help the poor and needy regardless of the tax consequences.

So, what do I think about this proposal?

I think we need to vote this healthcare district down again and send our legislators back to Austin with a mandate that says:

1. We will not support for-profit hospitals with our hard-earned tax dollars. Take that out of the bill.

2. Agreements have already been signed (Memorandums of Understanding) by the county and the four largest cities in the county to provide the funding that the medical school was otherwise lacking. We don’t need to create a new tax and a new taxing body bureaucracy to provide that funding. Take the medical school funding out of the bill.

3. What remains is funding for indigent care and for the health clinics that serve low-income families. The county leadership has failed us as well as the indigent and poor that this bill proposes to help. They need to do a needs analysis and come up with a plan. This county needs to assess and quantify the needs and come up with a specific proposal of how those needs can be met. This plan should include better utilization of the non-profit clinics and should assess where more funding can have the greatest impact. Don’t just throw money at the problem and hope it works.

They also need to address the very real concern that any expansion of healthcare services for the poor will be abused by people from Reynosa coming across getting free medical care. The costs could skyrocket. As Mission Mayor Norberto “Beto” Salinas has said, we will be paying for the healthcare for all of Reynosa. We can’t afford that. What’s the plan to prevent that from happening? The very weak system in place now to “provide proof of residency” without any form of photo ID and no requirement of legal status is just not going to work.  

Generally speaking, non-profits are much better at stretching the dollar than governmental agencies. So, let’s give them more to work with. But not before we have a plan and not before those clinics submit proposals to show the taxpayer how those funds will be utilized and how many people will be served.

Note that while Prop. 1 is being touted by its proponents as a way to fund indigent care, the backroom deal that was made on how to divide up the $24 million the new eight-cent tax will produce has only half of the money earmarked for indigent care. The rest is pledged to the hospitals, the medical school, the clinics and $2.4 million for administration of the new county healthcare bureaucracy. And since none of this is specified in the legislation, there are no guarantees of how the money will be spent. That would be completely up to the unelected board of directors appointed by the same elected officials who have received millions of dollars in donations from the two PACs that have funded this rich man’s game of taxing the poor to benefit the rich.  

Those PACs – Border Health PAC and Healthy Hidalgo County PAC – are primarily funded by donations from the hospitals and doctors.

 These are the very people who stand to profit from the proposed healthcare district tax.  This isn’t about indigent care. As Mark Walker said in last week’s debate, that’s a smokescreen.