JaCo Translational Medicine Sales Tax

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aknowledgeableperson
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Re: World-class research institute could come to Kansas City

Post by aknowledgeableperson »

The medical research will benefit the entire country.
That is the end result. While the research is being done the county has the benefit.
I don't have a vote and if I did I don't know how I would vote at this time. I can see this as seed money used to attract more research to the county. Some have talked about UMKC bumping up its research efforts. Stowers has its thing going. There is that proposed research park in the Bannister area.
At this point the main problem I have with it is how it was rushed through the JaCo legislature without an extended period of time for the public to absorb its merits or its drawbacks.
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chaglang
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Re: World-class research institute could come to Kansas City

Post by chaglang »

Any concern that the Missouri Legislature does something completely predictable and passes a bunch of bills that cripple medical research in the state?
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Re: World-class research institute could come to Kansas City

Post by earthling »

chaglang wrote:Any concern that the Missouri Legislature does something completely predictable and passes a bunch of bills that cripple medical research in the state?
^That wouldn't surprise me. KC is better off growing the significant animal research industry it already has rather than human research. Human research is far more riskier, takes longer to pass things through, lots of compliance issues, more expensive - certainly not something to be applying local public funds to, especially a general sales tax. I'm all for locally pursuing human research but keep those things private and go after Fed grants. Is OK to aid them with TIF to get basic infrastructure going, but not annually fund salaries with local sales tax. Is baffling anyone would propose a sales tax for this.

P&L and Sprint Center were far less risky city investments than what is being proposed. At least that aid applied mostly to the physical buildings delivered, improved a dilapidated area and it was lower risk to anticipate they would encourage additional eco dev, which they clearly did.
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Re: World-class research institute could come to Kansas City

Post by pash »

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FangKC
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Re: World-class research institute could come to Kansas City

Post by FangKC »

I think the architect of the Children's Mercy Hospital expansion wings was going for childlike whimsy. :D
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Re: World-class research institute could come to Kansas City

Post by KCMax »

Just saw the first commercial against this from "Citizens for Responsible Research" attacking the salary of the Children's Mercy CEO.
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Re: World-class research institute could come to Kansas City

Post by FangKC »

That's the wrong approach to take. CEOs of hospital systems make big salaries. It's a complex job that requires a lot of experience, and salaries have to be competitive to attract and retain management.

If you oppose the tax, the approach to take is the concern over the overall sales tax in KCMO in Jackson County going too high (compared to neighboring cities), that it's the wrong priority among many right now, and whether it is the role of city residents to pay for medical research projects, and not the private sector and the federal or state government. Another tact would be whether this tax would create more economic activity than investing in mass transit, creating a city fund to demolish or repair vacant houses, or funding new residential projects on vacant lots to create higher density in the city.
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Re: World-class research institute could come to Kansas City

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FangKC
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Re: World-class research institute could come to Kansas City

Post by FangKC »

Let me start out by saying that I have worked in the health care industry for most of my professional life. I've worked in state government for a Medicaid program--which was the first statewide managed care program in the USA. I've worked for a noted academic physician at a very large medical center in NYC that practiced medicine, did surgery, research, wrote books, and taught medical students, as well as patented surgical devices. I've worked for the largest non-profit hospital system in the country, as well as a Top 10 medical school.

Not-for-profit medical centers may have a lot of revenue, but that doesn't mean they have a lot of profit. And any profits they do make must be put back into the institution, and/or improving patient care.

Not-for-profit medical centers operate under a lot of scrutiny from state and federal governments. Those that do research and educate students as well (like KU for example) have to be very transparent how they budget money, and the fundraising, research, and teaching parts of the equation have to be kept separate from the hospital operating budget.

For example, if you are a staff physician who also teaches at the medical school, and does research, you are often paid from three separate sources. You get a faculty salary for teaching, and probably compensation for doing research that is funded separately by fundraising or getting grants from some source like the NIH, other federal sources, the state, pharmaceutical companies, or some private foundation. There is a lot of scrutiny on the research funding side.

This physician might also get paid from a faculty practice for seeing patients. Payments for seeing patients are also scrutinized and overseen by Medicare and Medicaid--often through direct contracting or review of claims.

Medical centers are also overseen through the authority of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) which accredits hospitals and reviews practices and patient safety--among other things. There is also the Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS), which directly affects hospital policy and practices via federal and state law, contracts, and rules and procedures for reimbursement and patient care. On top of that is the General Accounting Office which reviews these organizations who oversee medical centers and academic health care institutions.

Medical centers, hospitals, and research labs are among the most regulated and scrutinized entities in the USA.

That said, the amount of compensation that CEOs of medical centers and research institutions is high because it's market driven. Good administrators are in demand because non-profit hospitals and medical centers operate on very small financial margins. Places like Truman Medical Center and St. Luke's are different than hospitals operated for profit by entities like Hospital Corporation of America (HCA). One big example is the issue of uncompensated care that non-profit medical centers must pay for out of their operating budgets.

It's a very specialized skill to operate a medical center on small margins and still provide a high level of quality health care to anyone that walks in the door. In addition to managing the hospital side, CEOs and administrators also have to have skills in fundraising and capital project management (for adding services, building new buildings, etc.). They have to make a lot of tough decisions, and the ones they make can have big consequences. It's also a very stressful job with a high burnout rate.

This is why administrators are paid so highly, because even non-profits have to compete in the market for the best talent. Being a medical center administrator is a thankless job.

Physicians at academic medical centers are also highly paid because they are often the best and most experienced physicians around. Not only do they practice medicine, they teach and do research, publish, etc. It's a quite different skill set than being a physician in a private practice or a community hospital, or just being a salaried staff physician at a large medical center. These physicians are also in high demand, and have a lot of choices in the market about where they will work and apply their skills. Even though they are highly paid, many of them could make even more money running a private practice and/or working for a pharmaceutical company doing research. Many of them work for large academic medical center solely because they like teaching, doing research, and seeing patients.

These physicians constantly get offers from the private sector to leave academic medical centers, but many of them stay because they are dedicated to serving these institutions.

That all said, I do question using public sales tax revenue to fund the research component in the way that is being proposed. I don't think it's the responsibility of Jackson County residents to use tax revenue to fund research. I think there are other ways to do this.

And the medical centers won't necessarily reap huge profits from the research per se. It depends how it is all set up, and the devil is in the details.

However, there are many institutions around the country and world that have set up public/private partnerships to conduct translational research. Turning knowledge into profits. This is not necessarily a bad thing. Whole local economies can spring up when you combine research into useful products. A lot of good things have come out of federal research and institutions like NASA, that were developed for one purpose, and then other useful purposes were marketed later. The Internet started as a federal project.

If something like this was created with institutions like UMKC, Truman Medical Center, Children's Mercy Hospital, and St. Lukes doing research that was funding through grants and direct contributions from the private sector, it could create a research-to-market economy where companies would take raw research and further develop it into useful things. It's like mapping the human genome, and the making the research available to the private sector to further develop medicines and treatments. It would create jobs and all kinds of revenue locally. I'm not opposed to that.

I just think Jackson county taxpayers shouldn't be responsible for raising the funds to do it. I also thing the proponents of this proposal have done a really bad job at explaining how the tax money would be spent, accounted for, and separated from the budgets of all the institutions involved. Are there firewalls set up, for example, in the funding mechanism that prevent cost-shifting from the tax revenue to increase salaries for administrators and physicians, or pay for other unrelated medical center costs? Would this firewall also prevent public money from being siphoned off to the private sector as a "cash cow" for whatever they want to do with it?

The other question is what authority would be responsible for allocating the funding for research projects? There are just a lot of questions that have not be raised or answered to my satisfaction, and that's why I will vote no on the proposal.
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Re: World-class research institute could come to Kansas City

Post by FangKC »

Yael said tonight on Ruckus that local foundations (The Kansas City Foundation, Hall Foundation, Kauffman Foundation, Stowers Foundation) could donate 1 percent of their funds annually to this cause and raise $36 million.

Under his premise, 2 percent would raise $72 million. That doesn't even count what Cerner and other local companies could put in. His point is that the money for this endeavor could be raised by private donations and money from local foundations. That is the point of foundations, and they do have to give away a percentage of their money each year anyway.
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Re: World-class research institute could come to Kansas City

Post by KCMax »

League of Women Voters has come out against this.
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Re: World-class research institute could come to Kansas City

Post by loftguy »

harbinger911 wrote:
KCMax wrote:League of Women Voters has come out against this.
they can jus git they progressive pale white asses back in tha kitchen where they belong

Yes, this is exactly why I frequent this forum.
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grovester
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Re: World-class research institute could come to Kansas City

Post by grovester »

I really hope this doesn't pass.

http://www.kcconfidential.com/2013/09/2 ... more-15027

Excellent point about what the Kansas side has actually produced.
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Re: World-class research institute could come to Kansas City

Post by KCMax »

The campaign against the tax is being funded by former KC Star editor Jim Fitzpatrick and uncreatively named Sprinfield-based personal injury attorney, Brad Bradshaw.
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Re: World-class research institute could come to Kansas City

Post by KCMax »

Mayor Sly James and other Jackson County mayors will not endorse the tax

http://www.kansascity.com/2013/10/16/45 ... dorse.html
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JaCo Translational Medicine Sales Tax

Post by DaveKCMO »

http://www.kansascity.com/2013/10/16/45 ... dorse.html

http://www.kansascity.com/2013/10/12/45 ... wrong.html

election is nov. 5. ballot language now EXCLUDES the 20% payback originally touted as a direct benefit to jackson county voters.

chamber fail.
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Re: JaCo Translational Medicine Sales Tax

Post by lock+load »

I hope this goes down in flames. Very disappointed in the county for even putting it on the ballot. This is not something that should be funded by sales tax revenue.
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Re: JaCo Translational Medicine Sales Tax

Post by KCMax »

I can't seem to merge the threads for some reason, but there is an existing thread:

http://forum.kcrag.com/viewtopic.php?f=1&t=19133
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grovester
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Re: JaCo Translational Medicine Sales Tax

Post by grovester »

Money grab. I wouldn't be surprised if it was exactly so that transit and/or other progressive initiatives don't have any room in the future.
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Re: JaCo Translational Medicine Sales Tax

Post by DaveKCMO »

KCMax wrote:I can't seem to merge the threads for some reason, but there is an existing thread:

http://forum.kcrag.com/viewtopic.php?f=1&t=19133
merged.
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