As the county commissioners determine how to best meet local community healthcare needs (“County, LMAS May Split,” October 29), they have a timely opportunity to reduce the local taxpayer burden.

Home health services and hospice care are benefits of the Medicare system; Americans pay the Medicare tax throughout their working years in order to receive these benefits in retirement. That’s Tax #1.

American taxpayers also pay federal taxes that support the Medicaid system, which provides healthcare and other services to individuals who meet the Medicaid income threshold. That’s Tax #2.

All certified home healthcare providers bill Medicare or Medicaid for providing these much-needed services, but health departments also rely on local taxpayers, through the county, to financially support them. That’s Tax #3 – and it’s an entirely avoidable tax.

Taxpayers foot the bill three times when county-supported health departments provide home healthcare and hospice services. This is an example of the type of duplication of services that drives up our national healthcare costs and our local taxes.

There was a time when local government needed to provide home healthcare services, because no other organization was available in many rural communities. Today, nonprofit, nongovernmental organizations provide quality home health care to Mackinac County residents without that third layer of local taxpayer support. Taxpayers are relieved of additional taxation, and counties avoid unnecessary liability.

Clearly, the impact on the community is not just financial. The failure of the health department to assess the condition of patients after a 60-day episode of care is primarily a clinical quality issue – the health department did not provide adequate care to its home healthcare patients. This is the heart of the problem.

The secondary issue—the fact that the health department billed Medicare for assessments they did not provide – will result in Mackinac County taxpayers paying back to Medicare an estimated $300,000 to $400,000 in a time when we have dwindling revenues for basic community services.

Now is an opportune time for the county commissioners to envision and create a vital but lean health department that does not duplicate services available from the private sector. They have an opportunity to begin from scratch with a new, less costly structure that does not reward those who have breached both patient and public trust.

As taxpayers, we deserve no less.
Patricia Serwach
Moran