Blue-state blues

“Your president has done it again,” said my patient, who always likes to tease me when she comes for a visit. My patient was born in another country and came to the United States many years ago after she married an American who was working abroad.

“Oh, he’s my president, is he? I thought he was your president.”

“Noooo. He is not my president!” she said in her delightfully accented English. “He is the president of you rich doctors. That is why you are happy that the new tax law passed. So, you can be richer.”\

“Well, I do like someone who wants me to be richer,” I replied, “but I don’t believe it is going to work out the way you think. Maryland is a high-tax state, and most of my city and state property and income tax will no longer be deductible.” (My income tax rate in Maryland exceeds by almost 60% that of the adjoining state where my patient lives.)

By comparison, of course, the states of Alaska, Florida, Nevada, New Hampshire, South Dakota, Tennessee, Texas, Washington, and Wyoming have no income tax.

So, this year, I gathered all the little pieces of paper that come my way showing what I earned toiling as a medical school professor, along with the interest and dividends from savings and investments and the chest of gold doubloons presented each year to the chief medical editor of Ophthalmology Times. I sent all this to my accountant, whose years of training as a CPA have caused him to actually be able to understand the rules in those IRS documents.

And I waited for the bad news. And bad news it was. As I had shared with my patient, the inability to deduct my state and local taxes (SALT) resulted in an increased overall tax bill, as I was required to pay taxes to the federal government on money I paid to my state and city in my Maryland taxes. At home, the news was accepted stoically.

“No new shoes for you kids this year,” I had to tell my two daughters, who fought back their tears. “No Christian Louboutins, no Manolo Blahniks, no nothing. We are tightening our belts around here. “And no more filet mignon!” I told my son. “From now on, you’ll eat New York strip steak and you’ll like it!”

Then it occurred to me

Rather than just being victims, we ophthalmologists residing in the so-called blue states (because they tend to have state legislatures and governor’s offices dominated by a political party that uses the color blue in its logo) can solve our fiscal challenges by appealing to the kindness and generosity of our red-state brothers and sisters (especially those in Alaska, Florida, Nevada, New Hampshire, South Dakota, Tennessee, Texas, Washington, and Wyoming). We could task the American Academy of Ophthalmology in the great state of California (about as blue as they come) to assess a modest tax on the red-state ophthalmologists and send those dollars to its blue members who are now sitting at home staring at the paperwork from their accountants and trying to come to terms with their new reality.

Or more simply, we can have red-state eye doctors send their checks, money orders, bitcoins, and doubloons to yours truly. Rest assured, these funds will be used to ensure that the children of blue-state ophthalmologists everywhere (or at least three in Maryland) will have luxury items and the finer cuts of beef.

Here’s a chance for red-state ophthalmologists to show that their reputation for selflessness is richly well deserved. So, what say you, Red Staters?

Disclosures:

Peter J. McDonnell, MD
E: pmcdonn1@jhmi.edu; P: 443/287-1511
Dr. McDonnell is the director of the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, and chief medical editor of Ophthalmology Times.