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Dickinson County Healthcare System in Iron Mountain, Mich., will lay off employees as it prepares to implement its restructuring plan, Becker's Hospital Review reported. Interim CEO Jeanne Goche said that a lot of natural attrition has occurred at the organization, and layoffs will "probably be a dozen or less." The organization has reportedly seen losses of about $21 million over three years. It motioned to begin filing for chapter 11 bankruptcy in September, but it ended up not needing to file. Through the first quarter of 2019, the system showed financial improvement, recording an operating gain of nearly $750,000 through the first quarter of 2019, according to the Iron Mountain (Mich.) Daily News. Read more. 

For more on hospital and health care insolvencies, be sure to pick up a copy of the ABI Health Care Insolvency Manual, Third Edition from the ABI Bookstore. 

The Social Security program’s costs will exceed its income in 2020 for the first time since 1982, forcing the program to dip into its nearly $3 trillion trust fund to cover benefits, the Wall Street Journal reported. The shortfall comes two years later than projected last year — when the program was expected to dip into the fund, but ended up in the black. But by 2035, those reserves will be depleted and Social Security will no longer be able to pay its full scheduled benefits, according to the latest annual report by the trustees of Social Security and Medicare released yesterday. “Both Social Security and Medicare face long-term financing shortfalls under currently scheduled benefits and financing,” the trustees wrote, urging lawmakers to take action sooner rather than later to give policy makers enough time to phase in changes and shore up the programs.

Three Mississippi hospitals, their physician practices and a Tennessee parent company are filing for bankruptcy, citing more than $70 million in debts, the Associated Press reported. Health of Knoxville, Tenn., filed for chapter 11 bankruptcy reorganization in Nashville, Tenn., on Monday. Curae, a nonprofit company, owns Gilmore Memorial Hospital in Amory and Panola Medical Center in Batesville, while it leases Northwest Mississippi Regional Medical Center in Clarksdale. Curae’s Russellville Hospital in northwest Alabama is not seeking bankruptcy. The company plans to keep operating the Mississippi hospitals until it can sell them, CEO Stephen Clapp said in court papers. The company has 1,245 employees, who will continue to be paid during the bankruptcy proceedings, Clapp said. Clapp added that past revenue and profits were high enough when bought the hospitals in 2017 to pay off the money the company borrowed. But he said that revenue declined and the hospitals faced higher-than-expected costs for electronic health records. He said that the company saw a cash crunch, with vendors demanding payment for lagging bills, which sparked the bankruptcy filing. Read more. 

Don't miss the "Stayin’ Alive . . . Debt Restructuring for Critical Access Hospitals" abiLIVE webinar on May 1 sponsored by the ABI Health Care Committee. Register for FREE. 

For more on hospital and health care insolvencies, be sure to pick up a copy of the ABI Health Care Insolvency Manual, Third Edition from the ABI Bookstore. 

The gap between payments to hospitals by Medicare and by private health insurers for the same medical services may prove the biggest obstacle for advocates of “Medicare for all,” a government-run system, according to a New York Times commentary. If Medicare for all abolished private insurance and reduced rates to Medicare levels — at least 40 percent lower, by one estimate — there would most likely be significant changes throughout the healthcare industry, which makes up 18 percent of the nation’s economy and is one of the nation’s largest employers. Some hospitals, especially struggling rural centers, would close virtually overnight, according to policy experts. Others, they say, would try to offset the steep cuts by laying off hundreds of thousands of workers and abandoning lower-paying services like mental health. The prospect of such violent upheaval for existing institutions has begun to stiffen opposition to Medicare for all proposals and to rattle health care stocks. Some officials caution that hospitals providing care should not be penalized in an overhaul.

Unlike a majority of the fourteen hospitals with ties to Empower, Hillsboro (Kansas) Community Hospital will not be grouped into an Empower bankruptcy, but will continue progressing in its own bankruptcy case, the Hillsboro Free Press reported. The hospital declared bankruptcy on March 13 and has been moving forward in the case. But, according to a press release issued by the lawyers for the hospital, on April 4, CAH Acquisition Company #5, the company under Empower that previously ran HCH, had attorneys file a motion in the U.S. Bankruptcy Court for the Eastern District of North Carolina, Greenville Division, to have the Hillsboro Community Hospital bankruptcy case transferred from Kansas to North Carolina. The City of Hillsboro, along with the Bank of Hays, and other parties involved in the Hillsboro Community Hospital bankruptcy case, worked together to file a joint objection to the requested transfer to North Carolina. They also sent witnesses and attorneys to North Carolina to appear at the expedited hearing on April 10 to help argue against the transfer request. Bankruptcy Judge Joseph N. Callaway in North Carolina denied the request to transfer the bankruptcy case to North Carolina. This means that the bankruptcy case will remain under the jurisdiction of the U.S. Bankruptcy Court for the District of Kansas, Wichita Division. Read more. 

For more on hospital and health care insolvencies, be sure to pick up a copy of the ABI Health Care Insolvency Manual, Third Edition from the ABI Bookstore. 

• A New, 4 Percent Employee Payroll Tax: Sanders would impose another 4 percent payroll tax on employees, which he calls an “income-based premium paid by employees.” According to Sen. Sanders’ estimates, this increases taxes on American families and individuals by $3.9 trillion.
• A New, 7 Percent Employer Payroll Tax: Sanders would impose another 7 percent payroll tax on employers, which he calls an “income-based premium paid by employers.” This is a $3.5 trillion tax increase over 10 years.
• 70 Percent Top Tax Bracket for Ordinary Income and Capital Gains Income: This would give America the highest income tax rate in the world. A top 70 percent rate for ordinary income and capital gains income above $10 million will raise $51.4 billion over a decade. After accounting for macroeconomic effects, the proposal would actually cost the government $63.5 billion because the proposal suppresses investment and economic growth.
• Wealth Tax: Sanders proposes an annual wealth tax of 1 percent kicking in above $21 million in assets. Sanders estimates the proposal will increase taxes by $1.3 trillion over 10 years.
• Bank Tax: Sanders proposes a tax on financial institutions totaling $800 billion over ten years.

A survey released yesterday by Gallup and the nonprofit West Health found that Americans borrowed an estimated $88 billion over the last year to pay for health care, the New York Times reported. The survey also found that one in four Americans have skipped treatment because of the cost, and that nearly half fear bankruptcy in the event of a health emergency. There was a partisan divide when respondents were asked whether they believed that the American health care system is among the best in the world: Among Republicans, 67 percent of respondents said they believed so; that number was 38 percent among Democrats. But Democrats and Republicans had similar responses about putting off medical treatment. Asked if they had deferred treatment because of the cost, 27 percent of Democrats said they had, compared with 21 percent of Republicans and 30 percent of independents.