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Six working-age Floridians die each day because they don’t have health insurance.

Without health insurance, they are less likely to receive care. An estimated 2,400 people died in Florida for lack of healthcare services in 2006.

Those were the facts that splashed across Florida newspapers and television screens in late March because Families USA had launched a media campaign. But the group had merely dredged up numbers that existed since 2002 in an effort to remind the public that covering the uninsured is a life and death issue.

The fact isn’t lost on Rep. Ed Homan (R-Tampa) who’s been watching budget committee hearings at the state rotunda in agony knowing full well that at this point, Florida’s healthcare system is only liable to get worse.

“I’m hurting,” said Homan from his office in Tallahassee. “They have a position called behind the eight ball. You don’t have a shot. You are boxed in. We can’t even cover our insured folks.”

Covering the uninsured has become a non-starter at Tallahassee with state budget cuts dominating the scene, Homan said. Lawmakers debated through April reductions worth between $5 and $6 billion on a $65 billion annual budget to begin in July.

The Senate proposed an overall $1.1 billion reduction in health and social services, while the House chose $800 million, including a program that serves more than 20,000 severe medically needy.

The bottom line to get the state out of this morass of diminishing tax revenues, Homan said: “The economy has got to turn around.”

Increasingly, the task of treating the uninsured gets passed to those closest to the ground – safety net clinics, local doctors and hospitals. In the patchwork system that’s become America’s healthcare service, local communities are left to figure out for themselves ways to evenly distribute the responsibility.

In many cases, it simply means doctors stepping up to volunteer. In Polk County, the medical society has amassed a list of 200 specialists willing to volunteer care for free. The list has grown by about 50 doctors in just the past four months, said Sandy Swanson, executive director of We Care of Polk County, a non-profit spin-off of the medical society, which manages the volunteer list and other services.

Similar “We Care” programs have sprouted up across Florida.

“Our physician community is becoming very aware of the need to provide free medical care,” Swanson said. “The problem is going to get worse, and the need is going to get greater and greater as our healthcare system deteriorates. It’s falling on the doctors to be compassionate and understand that they went into medicine to help people, but they’re seeing far more of their share that’s pro bono.”

As more doctors sign up for volunteer medicine, many of those same doctors are foregoing new Medicaid patients at the same time, Swanson said. That they’d rather volunteer their time than deal with Medicaid demonstrates doctors’ frustration with poor reimbursement rates and administrative headaches, she said.

“A lot of doctors who don’t take Medicaid say this is how they help society,” Swanson said.

In West Volusia County, outside Orlando, the local hospital authority changed the way it operates its two health clinics, which will result in saving money and treating more low-income patients. The clinics currently treat 10,000 uninsured patients a year, said Cheryl Lankford, chair of the hospital authority board.

“It’s the most positive move a community can make,” Lankford said. “We’re being proactive instead of reactive. It’s totally appropriate.”
The best value comes from keeping people out of the emergency department. “If someone doesn’t need minor or major surgery they shouldn’t be in the hospital,” she said.

By switching from the county health department as its provider to a private, non-profit group – Northeast Florida Health Services – the hospital authority will save $150,000 within the first six months and $500,000 a year by 2009, money that will go toward new facilities and more service.

While doctors and clinics step up to fill needs, physician groups register support for a nationalized health plan in America. According to a recent study in the Annals of Internal Medicine, 59 percent of physicians support a “national health plan,” 32 percent disagree and 8 percent are neutral. The survey involved 2,193 physicians across the U.S.

“It’s sad we have to rely on our doctors to provide care,” Swanson said. “But it’s in the kindness of their hearts that people are alive today who couldn’t get healthcare otherwise. If everybody does a little bit, we can accomplish a lot.”



May 2008

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