Property taxes going up? The 340B Program might be partly responsible (opens in new tab)

I don't know man?

The issue is that, most of the time, "incredibly dense cities" are not the places where this is hitting the hardest. It's the smaller towns where the impact of hospital rollups hits hardest on the property tax rolls.

Problem is, of course, that if we don't get one of the hospitals in, say, Houston, to put a facility in, say, Nacogdoches, on its books; then that facility may go away entirely. In which case you'd have issues in the market with inequity of access for the very populations who may need that access most. (Elderly and poor.) But if you do allow it, well, you have issues with property tax rises.

So local leaders are put in a position of having to weigh the value of having a hospital or clinic be available locally, against any potential decrease in property tax revenues. Now you hope they get that cost-benefit analysis correct, but there's no guarantee.

But churches? Yeah. Not so much.

In my metro area it irks me to see the churches with large empty parking lots empty most of the week. We have a housing shortage and they seem to have no little incentive to convert their parking to more productive use.

I agree, the whole ruse that these 501s meaningfully does charitable work for our communities is laughable and their tax exemption should be revoked, at least with regard to land taxes.

The idea is that we give up the land tax revenues in exchange for the services the non-profit provides. (And of course the government does not decide which services are useful or not, the people do.)

One thing I might agree with is land tax for non-profits that charge fees for services, as opposed to those who work off of donations. I think that would fix the issue without destroying non-profits.

Yes. And then after many years, the appreciated land is sold for a profit.

Do you think a government should be able to seize property under eminent domain if they believe that selling it to a third party to commercially develop would lead to higher tax revenue?

Or property taxes should be eliminated because they are subject to abuse, and instead sales tax should be the primary source of income for all governments.

Hi, I wrote this article and largely agree with you. 340B is important and without it many hospitals likely wouldn't survive. However, it's pretty evident at this point that 340B has expanded beyond its original intent.

For example, Northwestern University (in the middle of downtown Chicago) got itself reclassified as a rural hospital in order to participate in the program.

Moreover, it's grown extremely rapidly over the past ~5 years, and the gravity of the program is starting to create bizarre second-order effects like the one outlined.

My intent with this article is just to highlight some of those effects, not to advocate for eliminating 340B.

Also, not bankrolled by pharma, just a researcher for Turquoise Health (a healthtech startup). I get to dig around in their data and publish occasionally, but editorial control / opinions are my own.

It's incredible how far we'll bend over backwards as a country to avoid single payer healthcare. It's especially ironic that the most common argument against it is "taxes" when ...the outcome here is higher taxes.

> it will kill many hospitals in underserved communities.

At some point it makes more sense to move every person from their remote hamlet than to create a hundreds different programs and exceptions to deliver broadband, groceries, and healthcare there. Many of these towns are leftover from when farming was 100x more labor intensive or industry had to be located next to a river.

Where's the money for local services supposed to come from?

Why should you be allowed to monopolize a piece of finite and scarce resource, land, for free?

Since you think it's a scam, surely you support 100% capital gains taxes on homes? Since old people getting rich off of an unproductive asset, blocking supply to "preserve neighborhood character", and inflating the price of their artificially-scarce goods would be more of a scam?

There's nothing wrong with retirees being forced to sell and downsize. You don't need a family-sized home when you live alone. Property tax is the least unfair tax of them all.

Yes you should not be able to own something you had no hand in creating, such as the earth beneath your feet or the productivity of that earth created by your community.

Totally absurd to think that you should!

>There's nothing funnier than a lot of people taking some absurd principles for granted when they make no sense at all, property taxes being one of them.

>Make it make sense

The cops/judges/prisons/schools/military/etc that maintain a mostly peaceful and ordered society that prevents someone else from walking onto your property and throwing you out costs money, and costs more money every year. The more land you have, the more it costs, since more time, materials, and energy have to be spent moving around all of that surface area you have "own". Surface area is the costliest thing people consume.

Tax on the improvements on the land, as well as earned income tax are the absurd principles.

Universities are just as bad or worse on this front. They will buy up properties with no plan simply because they have the cash to throw around and don't have to pay tax.

Although they key thing here is that it's not just that effect, but emergent unintended consequences. In the article, it describes how non profit healthcare institutions have an incentive to buy for profit clinics, because (alongside the other incentives), when they do so, the real estate becomes tax exempt because now it's owned by a non profit, even if the work being performed stays the same.

Only if you keep the things those taxes were paying for. I have no public roads anywhere near me, ~no police, no fire service, no public utilities, basically no county services -- maybe it is not for everybody but once I experienced it I would never go back to having these public services. I basically pay a pittance for the local school and that is it. Once property taxes are eliminated the other voters can push to not have their taxes raised and just shitcan what property taxes were paying for.

reducing or removing property taxes for legitimate historic properties seems like a good thing to me. I don't want every community to look like a slightly randomized version of every other community. Historic stuff is interesting. If we can encourage it to stay interesting and not get torn down to build a TGI fridays that sounds like a good thing to me. How much did your crusade to tax local historic structures save the average taxpayer? How many of those places will be lost?

It's interesting, that's good enough for me.

The largest landowner in the USA is the Mormon church and it has two or more senators in its pocket to prevent that ever happening.

Scientology (a family-destroying cult that brutally harassed the IRS into granting it recognition as a religion) is the perfect example, funneling huge sums into buying up real estate that then sits empty and generates no tax revenue. The center of Clearwater, FL is close to being a ghost town because of this.