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Health Care Summit Tackles Insurance Issues

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By Carl  Orth | The Suncoast News

Published: November 29, 2008

NEW PORT RICHEY - Tell me where it hurts, Dr. Marc Yacht is asking the Pasco community.

The retired director of the Pasco County Health Department led a recent health-care summit attended by some 75 representatives from 40 local agencies. The focus of the summit was people without health insurance.

The turbulent economy is prompting more and more people with limited financial means to seek aid, Yacht commented.

"Resources are going to be difficult to come by," Yacht said in a telephone interview after the conference. As a result, agencies are trying to figure out ways to pool assets toward dispensing more effective help, he said.

"The list is long," Yacht said about attendees from all local hospitals, the health department, homeless coalitions, domestic violence shelters, Salvation Army and many other agencies.

Often, people without medical insurance utilize hospital emergency rooms almost as a substitute for a primary care doctor, Yacht observed.

"It jams the emergency rooms," Yacht said. "We need to try to find a medical home for people who need a primary care doctor."

"This looks at the larger picture" for people without medical insurance, Yacht said about the summit.

Indigent people are worried about paying the rent or electric bill when a medical crisis strikes, Yacht said. Perhaps a network of local agencies can point them to the place that can help. A person might qualify for aid through SSI, for instance, or be eligible for help to pay the utility bill.

The health summit ties in with the Primary Care Access Network project forged by state Sen. Mike Fasano, Yacht noted. A regional hurricane shelter in the works will double as a PCAN health care center.

Fasano, R-New Port Richey, gave the lunchtime keynote speech during the daylong conference. A snapshot of Florida's uninsured population is "quite eye opening," Fasano, now the Senate's president pro tempore, said in his remarks.

About 3.6 million of Florida's 18 million people do without medical insurance coverage, Fasano noted, adding, "Sadly, 548,000 of the uninsured are children."

More than 60 percent of the people without medical insurance are employed, Fasano underscored. "Even though they have jobs, health insurance has become too costly for them to purchase and they often make a little too much to qualify for Medicaid," Fasano said of these "working uninsured."

The state-managed Medicaid program, which is jointly funded by the state and federal governments, already consumes 20 percent of Florida's total budget, according to Fasano.

"Were it not for Medicaid, though, the issue of the uninsured would be even worse than it currently is." Fasano remarked. "Without Medicaid, more than half the women giving birth in Florida would be without a regular source of prenatal care."

In fact, Medicaid paid for almost 53 percent of all deliveries in Florida in 2006, Fasano said.

Under the existing health care system, emergency rooms often double as the primary health care provider for the uninsured, underinsured and those who have little or no access to primary care providers, according to Fasano. In fact, in 2007, 71 percent of the services delivered in emergency departments were classified as nonemergencies, he said.

Demographics play a role, since Florida has a higher percentage of older people who might wind up needing nursing home care, home health care and other specialized help, Fasano noted.

"Currently with the economy souring we are seeing Medicaid enrollment soar," Fasano remarked.

Among alternatives, Fasano recalled his legislation in 2007 to extend the hours to nights and weekends at existing PCAN clinics in Pasco and four other counties. Non-urgent ER visits have dropped by nearly one-third in areas with a PCAN clinic.

The pilot program in the five counties cost $3.5 million. The PCAN clinics reported more than half of the visits to the clinic during nights and weekends during a three-month period last year were by uninsured people. That meant 3,122 fewer visits to emergency rooms for routine care.

The new Cover Florida Health Care Access Program, which was championed by Gov. Charlie Crist, is another part of the puzzle, Fasano believes. Cover Florida partners with private insurance companies to foster competitive bidding on innovative health insurance products.

The Cover Florida plan will change the way those roughly 3.6 million uninsured Floridians perceive health care and their ability to prioritize their health needs by obtaining reasonably priced coverage, Fasano explained. Each health plan offers consumers two types of coverage options, one with catastrophic and hospital coverage, and one without.

For an average of $150 per month, Cover Florida benefits will include regular medical check-ups. Coverage typically might cover preventive services, screenings, office visits, outpatient and inpatient surgery, urgent care, prescription drugs, durable medical equipment and diabetic supplies.

In addition, Florida KidCare offers coverage for children, regardless of income. Parents who do not meet the income qualifications to receive the free or discounted KidCare services can now pay the full premium, which is still a great bargain at around $120 a month, Fasano said.

"We are optimistic that new products will be available to consumers by the first of next year and that this will bring us one step closer in addressing the needs of the uninsured," Fasano said in closing.

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