Since publication of our paper, “Lack of Transparency for New Mexico’s
Not-For-Profit Hospitals Cost Taxpayers Dearly,” we have engaged in an extensive dialogue with various representatives of UNM Hospital. They have brought to our attention some concerns relating to the paper. This document is intended to offer a critique/correction of errors within the paper and clarify the issues presented within. It is also designed to offer an update on public meetings that have been planned to discuss the proposed expansion.
1) UNMH is not a not-for-profit hospital; rather UNMH is a government-owned and-operated facility. This is true and, although UNMH does have a not-for-profit fundraising arm, it is technically a government-owned entity. This actually worsens some of the issues with UNMH potentially moving into new areas of care (taxpayer-funded institution competing with a for-profit, tax-paying institution) outlined in our paper.
UNMH is funded in part through a Mil Levy that is voted upon by the citizens of Bernalillo County every 8 years, with the last vote being in 2008
2) In the RGF paper on UNMH, concerns were raised over the types of treatments to be offered at the new facility and why taxpayers should be asked to fund care targeted at non-indigent and non-native populations.
UNMH responded that it “distinguishes between emergent and elective care. Emergent is defined as immediate threat to life or limb if care is not provided quickly. Elective care, which might be better defined as scheduled, is defined as all other care. Cancer patients are treated as elective care patients because their care needs are urgent, but not emergent.”
While the distinction is welcome, RGF remains concerned that UNMH will be using taxpayer dollars to compete with existing, tax-paying, for-profit hospitals. More information on the specifics of this new project and how it will serve the Hospital’s existing mission (as opposed to expanding it) is needed. Some third-party analysis may be needed in this area.
3) RGF expressed a great deal of concern about transparency and the new UNMH wing.
UNMH responds that UNM Hospital is a part of the University of New Mexico and is a governmental organization. It is subject to the New Mexico Opens Meeting Act and the New Mexico Inspection of Public Records Act. It posts its financial information and its Board agendas and minutes on its Hospital web site. Combined with voter approval of bond measures and regular updates to Bernalillo County Commission, UNMH states that transparency has been adequate
RGF responds that while meetings have indeed been public and in keeping with New Mexico law, there is a need for additional public input from various stakeholders throughout the Albuquerque area and the state as a whole prior to making such a large investment.
This project may ultimately be deemed necessary or it may be modified somewhat in order to address the concerns of RGF and others in the community. Before we invest $146 million taxpayer dollars in the construction of a new hospital wing (not to mention annual operating expenses), we need to have a more thorough discussion.
According to this document from UNMH, the Hospital has agreed to hold a series of meetings at which the public will be provided additional information and given the opportunity to offer input. The schedule and locations of those meetings are as follows:
Oct. 2, 6–7:30 p.m. Indian Pueblo Cultural Center
2401 12th Street NW, Chaco I and II
Oct. 3, 6–7:30 p.m. Jewish Community Center
5520 Wyoming Blvd. NE, Auditorium A
Oct. 4, 6–7:30 p.m. – Alamosa Community Center
6900 Gonzales Rd SW, Room A
We are encouraged by UNMH’s willingness to hold these hearings. It is our hope that the community will turn out both to receive information on this project and to be allowed to ask questions and express their own concerns.
If you don't read the great reporting over at New Mexico Watchdog, you should. Recently, our watchdog, Scarantino, reported that a local member of the New Mexico House of Representatives, Miguel Garcia, has been reimbursed for some unusual "campaign expenditures" and dubious travel expenses to and from Santa Fe. KRQE Channel 13 picked up the story and did a great in-depth interview with Jim on last night's 10pm broadcast.
The Rio Grande Foundation primarily focuses on economic and education issues, but government transparency and accountability are integral to our efforts as well. Yesterday, I was interviewed by Channel 4, KOB TV regarding efforts to preserve the integrity of elections and a study that claims mass-disenfranchisement will result from well-intended efforts to ensure the accuracy of voter rolls.
Check out the report below:
The show “Seinfeld” was said to be “the show about nothing.” In terms of the federal election, this election cycle might be called the campaign about nothing. The issue being avoided on a bi-partisan basis by most of the candidates of both major parties is our nation’s precarious fiscal condition driven by out-of-control spending.
Look through the websites and public pronouncements of the Republican and Democratic presidential candidates (Gary Johnson being the exception), New Mexico’s senate candidates, and even those running for the House of Representatives. You will find plenty of platitudes and talk of “cutting waste.” You will, among Democrats, at least, find plenty of willingness to raise taxes on “the wealthy.” Republicans, on the other hand, will talk about overturning “ObamaCare,” but you find few specific ideas for dramatically-reducing the $1.3 trillion annual federal deficit.
HHS Secretary Kathleen Sebelius recently sat down with the folks at Channel 13 KRQE to discuss the massive expansion of Medicaid on the part of the states that is strongly encouraged under ObamaCare. The Secretary of course supports the expansion and we at the Rio Grande Foundation oppose it. View the story below:
Mark Mix, president of the National Right to Work Legal Defense Foundation was in Albuquerque on Wednesday, September 12 to discuss Right to Work Laws and how such a law might benefit New Mexico. Mark spent a great deal of time working on the issue in New Mexico and has some great anecdotes to tell throughout his speech. Lt. Gov. John Sanchez attended and spoke on the importance of Right to Work as well. Plus, see this report from Rob Nikolewski of Capitol Report New Mexico on the protesters.
(Albuquerque) New Mexico subsidizes hospitals, specifically UNMH, through both a tax exemption and outright tax dollar expenditures of nearly $100 million annually.
While such subsidies might be reasonable were they narrowly-targeted at indigent care and the needy, but a planned $146 million expansion currently under consideration for UNMH would not be targeted at indigent care, rather it is designed to attract middle and upper-income patients to a taxpayer subsidized facility. Worse, due to a lack of transparency at UNMH, no one knows where this money will come from.
As Scott Moody and Wendy Warcholik, Ph.D, the authors of the new Rio Grande Foundation report, “Lack of Transparency for New Mexico’s Not-For-Profit Hospitals Cost Taxpayers Dearly,” economic theory predicts this type of behavior by not-for-profit hospitals since the tax exemptions and subsidies encourage “vertical integration…” As a consequence, for-profit health care providers are “crowded-out” of the marketplace by not-for-profit health care providers.
Moody and Warcholik argue that policymakers need to be vigilant about the potential for not-for-profit hospitals to creep into for-profit medical services through the aggressive use of their tax-exempt status and note that over time, this tax advantage will result in an over-population of not-for-profits which is bad for the economy and state and local coffers.
In the short-term, policymakers should put a stop to this and other questionable expansions of New Mexico’s fast-growing, taxpayer-subsidized hospital network. In the longer run, New Mexico policymakers should consider ways to prevent such hospitals from growing beyond their original intent.
One possible solution put forth by Moody and Warcholik is a piece of legislation considered by the New Hampshire legislature during 2012. The bill, (HB 1482), would have limited tax exempt activities to a hospital’s main campus. This would at least give local governments the final say on expansions of such tax-exempt facilities in their communities.
In the longer-term, Moody and Warcholik argue that New Mexico policymakers might want to consider tying indigent health care expenditures to the individual patient as opposed to funding institutions themselves.
On August 22nd, Paul Gessing, president of the Rio Grande Foundation, Dr. Deane Waldman, a pediatric cardiologist at UNMH and an adjunct scholar at Rio Grande Foundation, and former US Rep. Bill Redmond, appeared on a panel discussion to discuss the health care law known as "ObamaCare."
The event was hosted by Libre Initiative and the panel is introduced by Michael Barrera of Libre.