By James Call
http://stream.publicbroadcasting.net/production/mp3/wfsu/local-wfsu-957242.mp3
Tallahassee, FL – Patients, health care advocates and providers packed into a Senate meeting room Friday to testify about the Legislature's plan to revamp the state Medicaid program. James Call reports Florida lawmakers are looking to cut a billion dollars from the healthcare plan for the poor, elderly and catastrophically sick.
The Governor and leaders in the House and Senate agree it is time to make changes in Medicaid. Almost three million Floridians receive medicine and other services through the state/federal partnership. This year's budget is 20 million dollars and left alone it could grow by 10 percent for next year. Lawmakers want to curb costs because it is the biggest component of the state budget. Senate President Mike Haridopolos.
"Last year, I thought Dean Cannon did an outstanding job. It came to us a little late last year but it is a good product. And we just couldn't get their on Medicaid and we have put out our thoughts on Medicaid but this is something I know that is passionate to myself and more importantly to Speaker Cannon and it is something that we are going to work on over the next 60 odd days to try to get it right because it is such a pressing budget matter."
The Senate is working a plan that would move most patients into managed care plans like health maintenance organizations. Such coverage would have to meet minimum standards and covers basics but extras such as dental and some mental health services may be eliminated.
"Excuse me, I'm very passionate about this because I see treatment works."
Ken Pomerance is the co-founder of a social network site for people in recovery. A former junkie who has been sober since 1982, he told Senators it is in the state's financial interest to pay for programs treating drug and alcohol addictions.
"Uh, I have no dog in this fight. My business has nothing to do with treatment but I know that I see people every single day battling this disease. We're not bad people getting good we're sick people getting well. And I see the treatment works and from a business standpoint, and I am a businessman, treatment makes sense."
Fortyone citizens signed in to testify but because of the number wanting to speak they were limited to less than two minutes. Dana Fogelsong says she was an overachiever pursuing her dreams when mental illness struck her in high school. She traveled from her Fort Myers' home to tell Senators she is a living example of Florida's investment in community mental health services. She begins graduate school in the fall.
"A future I would not have without getting the help I needed from community mental health. I ask you to support funding for mental health. My peers, though struggling with their illness, had childhood dreams too. They are worth the investment. I'm worth the investment. Thank you".
The state provides Medicaid services through arrangements with more than 80 thousand vendors from large hospitals to specialized service providers to small town pharmacies. Senators say billions of dollars could be saved by privatizing much of the operation.
"That is not an efficient way to serve Medicaid patients."
Kim Cadenhead owns a pharmacy in Cantonment, a Pensacola suburb. She said privatizing delivery of prescription drugs will lead to Mail Order subscriptions and a host of problems.
"The Medicaid population is a unique population. I have people who walk into my store daily [saying] I want my bedtime pill. I want my red pill. And they depend on me and their families. I have better relationships with my Medicaid patients because I know them better [and] because I hear from them more frequently. They have more questions, they call more. I know them by name."
Some groups that provide services to other populations support privatization. The Brain Injury Association said it would lower costs. Linda Stamford's daughter's life was derailed by an accident. She told senators the former restaurant manager didn't talk for two years, didn't smile for longer than that. And no one gave her any hope until she had contact with the Association.
"Hadn't it been for the brain injury association supporting me and my inability to even know what was going on, explaining it to me being there to hold my hand to strengthen my back and tell me what to expect from my daughter I don't know if I would have made it through to help her out."
Senator Joe Negron has been listening to testimony like this since he co-chaired a House committee on Medicaid reform five years ago. Now, as chairman of the senate health and human services budget subcommittee, he's leading the Senate's reform efforts.
"Well the challenge is to bring in a private sector approach to Medicaid while at the same time enhancing quality and access. And I think you heard with the South Florida Mental Hospital there was agreement by members of both parties that that particular facility has dramatically improved once it was turned over to the private sector. I've visited that facility myself on two occasions. And there may be other facilities where, due to the mix of patients, there it may not be the best model. So I think those are the decisions that we're weighing."
Negron says he is ready to start talking to the House about reconciling what he calls minor difference between the two proposals. Budget analysts from the two chambers are evaluating the impact of the proposed changes. Any savings lawmakers are able to squeeze out of the health care plan most likely will go towards closing an estimated four-billion dollar budget shortfall.