Guest view: Proposed tax could harm specialty surgical centers

In his budget address, Gov. Tom Wolf stated to applause, “This proposal asks for no new taxes. Not one dime. Not one penny.” Yet, as the General Assembly combs through the governor’s proposal, we find that there are, in fact, tax increases.

One specific tax being proposed by the administration is a “double tax” on ambulatory surgical centers (ASCs) like the ones in my district.

ASCs are convenient health care facilities run by physicians that provide same-day surgical and diagnostic care for focused care needs, such as eye surgeries, colonoscopies, spine and joint procedures, and more. There are 234 Medicare-certified ASCs in Pennsylvania.

The governor expects to take $12.5 million from these innovative surgical centers, which is income they would otherwise put toward the incredible services they provide at lower costs to patients. ASCs already pay income, sales and property taxes, as opposed to general hospitals, which do not pay these same taxes.

The governor is correct when he says there are no “new” taxes in his proposal, as he tried and was unsuccessful in getting this ASC tax passed through the General Assembly last year. It is my hope that the House Republican Caucus, along with the Pennsylvania Medical Society and other medical-service advocates, will prove once more that this tax would be detrimental to Pennsylvania surgery patients.

First, this tax would cause ASCs to be unable to afford state-of-the-art equipment. Such equipment allows them to have higher productivity and healthier patients, but under this tax plan, this customer care might no longer be possible.

Another advantage of surgical centers is that their nurse-to-patient ratios are generally lower than at general hospitals. These nurses are trained in one or a few specialized surgical procedures. This system ensures that patients receive the best care possible with the same nurses caring for them throughout their treatment.

Smaller facilities also help surgical hospitals protect patients from spreading infections among each other. This large reduction in nosocomial infections is critical in a surgical environment.

Not only are patients better cared for at ASCs, but they face lower costs at these centers than they do at general hospitals. Medicaid patients face 50 percent lower costs and patients with commercial insurance plans pay as low as 25 percent the costs of a hospital-based visit.

In addition to saving patients money, these practitioners also save Medicare $2.3 billion a year on just the 120 most-common procedures that Medicare patients receive, according to UC Berkeley.

UC Berkeley noted in a recent study that in 2015, Pennsylvania ASCs saved Medicare $32.6 million on cataract procedures, $1.3 million on upper GI procedures and $6.9 million on cystoscopy procedures.

If the Wolf administration’s tax proposal were to be enacted, the Pennsylvania Ambulatory Surgery Association, along with a coalition of state medical societies, warn that up to 25 percent of these centers may need to close – pushing thousands of patients into costly general hospitals and forcing centers to withdraw from Medicaid.

This is the very problem that ASCs were attempting to solve.

This ASC tax would be a blow to competition and innovation in health care. By tying the invisible hand of the free market in health care with burdensome taxes, we get less health and less care.

Another tax on these ASCs would not only cost the state Medicaid system, it may even cost lives.

I urge my colleagues in the Pennsylvania House and Senate to vote against this proposal and I urge Gov. Wolf to visit an ASC like West Shore Endoscopy in Cumberland County to learn about the progress that is being made by these entrepreneurial physicians and nurses.

As I meet with physicians and patients in my district, such as those at West Shore Endoscopy, I have been amazed at the benefits of their innovative approach.

We all can relate to the phrase, “Surgery is only minor if it happens to someone else.”

Nobody wants to be told they need surgery and they especially do not want an unpleasant surgery experience.

Thanks to ASCs, thousands of Pennsylvanians have been given a convenient and quality outpatient experience with positive outcomes and speedy recovery in the comfort of their own homes. A double tax on these centers would not only be devastating to the many hardworking physicians in our commonwealth but their patients as well.

For the sake of the health and wellness of our commonwealth, I hope my colleagues in Harrisburg listen to our physicians and their patients and reject this tax.

State Rep. Greg Rothman (R) represents the 87th House District, which is in Cumberland County.

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