People helping people

Tuesday, May 7, 2019

It is a treasure. Valuable to this larger community and well worth the effort to keep our Hillcrest Nursing Home open and financially healthy. That is the aim of a group of citizens, all volunteers, that has regularly been gathering to make plans for action, political action, here and now.

You see the Nebraska Legislature is in session and it is our State Senators who have the responsibility to allocate revenue generated by taxes. State-levied income and sales taxes. Two medical insurance programs are in play, Medicare and Medicaid, which are Federal programs but are administered primarily by the states.

At the moment the Medicaid program is the rub as the plethora of rules governing care of patients enrolled in Medicaid dictate the care that each is to receive. Medicine and wages plus benefits for those providing the care being the major expense. We are talking some thirty-three different levels of care each with their appropriate price tag. The problem is that at present the state does not pay adequately to cover those expenses by the neighborhood of some $30 to $50 a day less than the cost of providing that directed care. It can’t go on.

Now if you have paid attention to the machinations of State Government during the current legislative session you will note that Governor Rickets has been pressing cutting expenses in order to lessen the burden to property owners paying real estate taxes. We know that our schools are supported by taxes on real property. In the present farm economy, all too many property owners are land rich and income poor. Tough times and real estate taxes are at present a terrible burden.

The Legislature has proposed upping the state sales tax with the increased funds passed out to reduce local property taxes. The Governor isn’t happy holding the realistic opinion that in the future the sales tax will remain at that higher level and real estate taxes will again creep back up. The answer, of course, is to cut expenses but governing bodies tend to find that hard, impossible, to do.

Now the way it works in our system is that the legislature sets the tax rates and allocates the funds generated to the many entities that depend on that revenue to operate. It is then the responsibility of the executive branch, Gov. Rickets and crew, to spend those funds. Gov. Rickets mantra is cut taxes wherever possible.

Actually, the Legislature has been allocating enough revenue to support the Medicare and Medicaid programs. It is the responsibility of HHS, part of Gov. Rickets team, to allocate those funds. Unfortunately, at present, they don’t cover the expenses required by their Medicaid rules and send part of what should go to Medicaid to other of their programs.

Isn’t politics fun? Still, it is the way we have chosen to do the business of state government. Somehow spending other people’s money doesn’t get the same attention that each of us conduct our own personal affairs.

So the local group of us citizens meet and make plans of how to influence our state legislators at the moment. The group led by business lady Jacque Riener, incidentally a member of the Hillcrest Foundation, set up a public meeting last week to inform the public of the problem at hand. Thankfully it was well attended. That is why you have been asked to send letters and emails to appeal to our State Senators to allocate adequate funds to our Medicaid and Medicare needs. Inform the public by whatever means possible because it is we the taxpayers who vote for our representatives to conduct the state’s business for us.

The Hillcrest Board of Directors has hired a management firm the past several years to conduct business as efficiently as possible. You may know that Hillcrest employees, those that actually do the wonderful work of caring for our beloved friends and relatives who are the patients there, do not themselves receive medical care as a benefit. Each has to pay for their own medical insurance plan or not. Then under the rules of Obamacare Hillcrest, the employer has to pay a huge fine, in the neighborhood of $200,000 annually for not paying for their employee’s medical needs. Still in the big picture, it is more economical to pay the fine instead of covering the medical insurance of the employees. Nobody says that it is fair! Unfortunately, it is just how Hillcrest management is forced to do business.

At the present time, Hillcrest management has made the decision to up the rate that private pay residents have to pay to help cover the losses generated by inadequate reimbursement of Medicaid patients. That is not fair either. Unfair but necessary.

Yes, you or I may well be the next patient to become a resident at Hillcrest. Grannie Annie and I buy “long term care insurance” to avoid the trap that is currently Medicaid. Think about it.

That is how I saw it.

Dick Trail

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