It now seems that the Florida legislature (i.e. the Florida House) is turning down the federal dollars that would greatly expand Medicaid in Florida. While I strongly disagree with turning away any money to expand medical coverage to Floridians, I do agree that their fear of expanding the Florida state budget is legitimate. The underlying problem (and point of complicity of the Florida legislature) is that the Florida Medicaid program is a mess.
The way that the system operates is cumbersome and expensive and often does not provide good care to the people that are covered. The Medically Needy Program (“Share of Cost”) is totally broken. These legislators that are turning down federal money have obviously never lacked access to healthcare.
They have never been turned away from an emergency room with a broken limb because it is not life threatening. They have never had to be treated in a free clinic where care while better than nothing is limited and sporadic. They have never been disabled and unable to get a doctor two years (waiting for their Medicare to begin) because most doctors in the State of Florida refuse to treat any patient on the Medically Needy Program. Otherwise they would not turn down a single dollar to increase access to healthcare for Floridians.
The only solution that this Florida Legislature has been able to come up with to fix Medicaid is to totally turn it over to private HMOs which would be another nightmare. A large percentage of Medicaid patients are already under these private HMOs. Many of these private companies are incompetent and the worst ones are totally fraudulent.
The medical providers in the state that actually accept Medicaid patients are providing the care and then having to beg and fight for their small Medicaid payments from these companies – often receiving nothing even though they are providing the care. Meanwhile, these companies are reaping profits from tax payer dollars designated to treat the sick of our state. And lest we forget, our Governor Scott presided over the largest federal Medicare fraud case to date.
Having him preside over this process is akin to putting the fox in charge of the hen house and at this point I am on his side as he is championing taking the money. Now that our legislators have turned down this money I would like to see them push to address the underlying problems with Medicaid program in Florida and to develop a system that provides quality, effective care and is cost effective. And ironically these two qualities (quality care and cost effective) are actually interdependent.
There needs to be an emphasis on primary care and outpatient treatment instead hospital emergency room care (which is expensive and for the most part ineffective). The Medically Needy Program needs to be totally scrapped and reworked. Then we as a state would be a much better position to accept federal dollars for Medicaid without fear of setting off an out of control expansion of our State budget.
As more and more Floridians are being locked out of even basic healthcare services there is a strong moral, ethical and economical imperative to address the underlying problems that are crippling our healthcare delivery system.
Catherine Price is a registered nurse who has worked as the clinical director at Parkview Medical Clinic in Haines City. She is also the former chair of the Polk County Health Care Alliance.