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Letter Timothy J. Michals, M.D. Re: Federal Funding for Pennsylvania Indigent Health Care.

March 18,1988

Timothy J. Michals, M.D.

8305 Seminole Street

Philadelphia, Pa. 19118

Re: Federal Funding for Pennsylvania Indigent Health Care.

Dear Tim,

The preliminary draft of the Lewin Report has just come over my desk, and there are many options in it which seem acceptable to Lewin which do not seem acceptable options to me, or I presume to you. However, that was fairly predictable, and we can do battle with it in due course. What bothered me in a different was was a small note in the principles the Council wants following in his option paper.

Some members of the Council regard it as axiomatic that maximum federal contributions should be sought. I violently disagree: federal contributions should be kept to a minimum if not avoided entirely.

Because of the composition of the US Congress, Pennsylvania is a loser, every time there is a recycling of federal tax money back to the states. The last time I saw the figures, Pennsylvania taxpayers paid about $1.20 for every dollar returned to the state in programs. There are states which only pay 80 cents for each dollar returned to them. It is understandable that such under contributing states would favor federalization of any and all programs, but it is not at all in the interest of Pennsylvania to do so. The real dynamic is that state governments hate to raise taxes, even when it is more expensive to have the federal government levy taxes for the same program. What's good for the politicians is therefore not good for the state as a whole, and must get public attention to be prevented.

As a matter of fact, there is a second good reason to oppose federalizing anything which states can do for themselves. The federal government can print money to cover its debts, while the states can't. Federal deficits are inflationary, state deficits are merely painful for state officials.

If you find these arguments persuasive, perhaps you could voice them in the Council?

Sincerely yours,

George Ross Fisher, M.D.

Originally published: Tuesday, November 06, 2018; most-recently modified: Thursday, May 23, 2019