Sunday, May 26, 2024
Hawaii Daily News Read

Current Articles | Archives

Monday, July 25, 2022
Letters to the Editor July, 2022
By Letters to the Editor @ 8:24 PM :: 1463 Views

How Hawaii GE Tax Squeezes Private Practice Doctors

Dear Editor,    July 25, 2022

1) Hawai’i is the ONLY state in the union that taxes Medicare, Medicaid, Champus (all federal programs), by charging GET tax on all private medical practices’ receipts.

Not a good look for the “Aloha State.” (Can you say government greed? I can.)

By federal Medicare law, all doctors are prohibited from passing that GE tax on Medicare on to their patients.

2) Hawaii's not-for-profit hospitals, such as Maui Memorial & Hilo Medical Center, don’t pay any GET tax even on the fees collected for their employee physicians. All private clinics and doctor practices DO pay GET, on ALL insurance fees, EXCEPT Medicare, and they attempt to pass it on to patients, clearly at some extra cost in the effort.

3) Hawai’i Medicare physicians payment schedule are near lowest in nation--50% less than Alaska. Then Hawai’i takes 4.7% GE Tax off the top. That’s a tax on the gross, not the net.

Now the federal Center for Medicare & Medicaid Services (CMS) is proposing a 4.33% cut for 2023, as we face 9% cost of living inflation at the same time.

Years ago, Sen. Dan Inouye & Alaska’s Sen. Stevenson reached a deal: Alaska got a 50% Medicare bump up. Forever.

We got a School of Pharmacy (Now the Dan Inouye School of Pharmacy. Yay! Not.)

4) Hawai’i has the highest cost of living in the nation. Now combine that with #3.

5) Doctors employed by the hospitals get higher Medicare rates than docs not so employed plus other bump ups and hospital bonuses for various things, including every COVID admission, ventilation, and death.

6) Hospital doctor employment contracts are tied to productivity, including in-house referrals.  They are dinged for outside referrals, a blatant prima facie federal Stark Law violation regarding referral for profit, which further cuts off private practices from patient access.

Hawaiʻi Physician Workforce Assessment Project Report (UH School of Medicine) for 2020, which was submitted to the Hawaiʻi State Legislature, estimated a Hawai’i shortage of over 1,000 doctors, and increasing steadily. 37.3% of Hawaii’s doctors are over age 60.

And folks wonder why they can’t find a doc, that the docs in private practice are aging, dying, leaving, retiring, quitting & giving up. They shouldn’t. As in any abusive relationship, eventually you end it.

Sincerely,

Edward Gutteling, MD

Member, Hawai’i Physician Shortage Crisis Taskforce

UH Hilo team physician, and one of the last marginalized, free-range, endangered orthopedic surgeons on the Big Island


Links

TEXT "follow HawaiiFreePress" to 40404

Register to Vote

2aHawaii

Aloha Pregnancy Care Center

AntiPlanner

Antonio Gramsci Reading List

A Place for Women in Waipio

Ballotpedia Hawaii

Broken Trust

Build More Hawaiian Homes Working Group

Christian Homeschoolers of Hawaii

Cliff Slater's Second Opinion

DVids Hawaii

FIRE

Fix Oahu!

Frontline: The Fixers

Genetic Literacy Project

Grassroot Institute

Habele.org

Hawaii Aquarium Fish Report

Hawaii Aviation Preservation Society

Hawaii Catholic TV

Hawaii Christian Coalition

Hawaii Cigar Association

Hawaii ConCon Info

Hawaii Debt Clock

Hawaii Defense Foundation

Hawaii Family Forum

Hawaii Farmers and Ranchers United

Hawaii Farmer's Daughter

Hawaii Federation of Republican Women

Hawaii History Blog

Hawaii Jihadi Trial

Hawaii Legal News

Hawaii Legal Short-Term Rental Alliance

Hawaii Matters

Hawaii Military History

Hawaii's Partnership for Appropriate & Compassionate Care

Hawaii Public Charter School Network

Hawaii Rifle Association

Hawaii Shippers Council

Hawaii Together

HiFiCo

Hiram Fong Papers

Homeschool Legal Defense Hawaii

Honolulu Navy League

Honolulu Traffic

House Minority Blog

Imua TMT

Inouye-Kwock, NYT 1992

Inside the Nature Conservancy

Inverse Condemnation

July 4 in Hawaii

Land and Power in Hawaii

Lessons in Firearm Education

Lingle Years

Managed Care Matters -- Hawaii

MentalIllnessPolicy.org

Missile Defense Advocacy

MIS Veterans Hawaii

NAMI Hawaii

Natatorium.org

National Parents Org Hawaii

NFIB Hawaii News

NRA-ILA Hawaii

Obookiah

OHA Lies

Opt Out Today

Patients Rights Council Hawaii

Practical Policy Institute of Hawaii

Pritchett Cartoons

Pro-GMO Hawaii

RailRipoff.com

Rental by Owner Awareness Assn

Research Institute for Hawaii USA

Rick Hamada Show

RJ Rummel

School Choice in Hawaii

SenatorFong.com

Talking Tax

Tax Foundation of Hawaii

The Real Hanabusa

Time Out Honolulu

Trustee Akina KWO Columns

Waagey.org

West Maui Taxpayers Association

What Natalie Thinks

Whole Life Hawaii