When states get a golden goose, they usually feed it to the lions

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John O'Connor
John O'Connor

As my dear mother used to say, it's a rare cloud that doesn't offer some kind of silver lining.

For quite some time, many states have been insisting they're too broke to pay nursing homes and other service providers in a timely way. But thanks to years of layoffs, service reductions, and the apparent demise of the Great Recession — plus a recent infusion of unusually generous tax revenues — many states have made a pleasant surprise. There's suddenly a lot of extra money slogging around in their coffers.

Nice silver lining! So cash-starved nursing homes can now look forward to quicker, better payments, right? Not so fast.

For if the past is any indication, most states will find some way to slaughter this golden goose. Or have we forgotten how well most invested their tobacco-company windfalls?

Sadly, giving people who control state spending new money is not so different than giving teenage boys whiskey and car keys. You just know things are not going to turn out well.

This all-too-predictable result has less to do with the personality flaws of state leaders than political convenience.

Three inescapable realities for most state-level officials are these: There is never enough money to go around, powerful friends need to be taken care of, and the next election  — and its war-chest demands — is quickly approaching. So whenever unexpected largess does happen to land in state coffers, it usually gets sopped up quicker than you can say, “What just happened?”

And unless you happen to be an extremely well-connected nursing home operator, the odds that you will see a noticeable chunk of the new windfall are not terribly good.

That doesn't mean there won't be sincere but meaningless debate about what's best to do. Some will insist that it be used to pay off debt. Others will demand it be used to enhance insufficient infrastructure and other services. Still others will call for a blended approach.

Those outcomes may or may not happen. But if the proven track record in most states continues to hold, here's what we can look forward to: Those with the most political leverage will call the shots and reap the greatest rewards.

For in some ways, state capitals are not so different than the jungles of Africa. In both places, the lions always eat first.

John O'Connor is McKnight's Editorial Director.

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Daily Editors' Notes

McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.


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