Back in March, county commissioners started making noises about asking for a piece of the taxes collected by two hospital districts that cover Lake.
Last week, they did it.
Commissioners asked for $145,165 total from the two, and the letters warned that the county expects to ask for another $248,751 from both by the time the fiscal year ends in October.
The county, by law, must pay for the 11th through the 45th day that a patient on Medicaid spends in the hospital. The first 10 days are paid by the state. The current request for the tax district money is to cover that cost.
The amount is a measly 2.3 percent of the nearly $18 million that the two districts collect annually and hand out among the three hospitals in the county. The hospitals spend it any way they want.
A state law says that a hospital district shall help with the cost of care for the poor by giving a share of that money to the county if asked. However, this is the first time commissioners have asked.
The districts are howling in protest, as expected. They say they provide far more care for indigent people than they are reimbursed for, and this would chip even more cruelly into their bottom line.
The hospitals can claim that they provide care for the poor, but the truth is that the money goes into their bank accounts and there's no tracking its specific use. In other words, there are no charges from specific patients that are posted against a specific fund containing the tax money.
That's why it is hard to listen to their whining. These hospitals all are not-for-profit. They exist for one reason: to serve the community. Unless this miniscule request would push hospital books into the red and somehow endanger their existence, it's hard to credit their objections as valid.
Each hospital has a different rate that is calculated on a variety of factors, including what types of services are offered and what it costs to offer them. The reimbursement rate for Leesburg Regional Medical Center, for example, is $853.16 a day; for Florida Hospital Waterman, it's $803.29. If a patient with a complicated case must be sent to Orlando Regional Medical Center, the cost tops $1,000 a day.
County employees get the name of each Medicaid patient and the amount being billed, and they verify that the person actually is a resident of Lake and a Medicaid recipient.
That's a far better system of accountability than the hospitals offer.
From the hospital point of view, the county's request represents just the proverbial nose of the camel under the flap of the tent. If commissioners get this little bit, perhaps they'll ask for more, hospitals reason.
And they're probably right.
The county also is required to pay $55 a month for each Medicaid patient in a nursing home, and there are 700 to 800 in such facilities at any given time. That's an additional half a million dollars the county may decide at some time to go after.
And then there is the 12 percent decrease in the amount the state is sending the county to pay Medicaid bills, commission Chairwoman Jennifer Hill said.
That has to come from somewhere.
So it's hard to say whether a bigger chunk of the tax money might be on the table eventually.
So far, there's been no response to the request from the districts, and that's significant because this law never has been tried in the past in Lake, county officials have said.
Taxing-district officials, who are closely aligned with the folks who run the hospitals, ought to fork over the cash quietly.
It's the best deal for taxpayers. Treatment of the poor is guaranteed, and the accountability is solid.
Granted, it is not the best deal for the hospitals.
But taxes shouldn't exist to help hospitals. They should be collected for the benefit of the people in the community.
Lritchie@tribune.com Her blog is online at http://www.orlandosentinel.com/laurenonlakeCopyright © 2015, Los Angeles Times