The New York Times reported on Florida Governor Rick Scott's rejection of millions of dollars in federal grant money aimed at easing the burden of higher health care costs on Floridians. Scott, a former hospital CEO and health care profiteer, was made famous by his adamant and vocal campaign against the Health Care Reform Bill which he still refers to as Obamacare. Not alone in his position of power and stance against the new law, Gov. Scott joins Alaska, Oklahoma and Wisconsin Republican governors in refusing to accept or seek government assistance to the tune of hundreds of millions of dollars. However, Florida is different.
Of all the states, Florida has the fourth-highest unemployment rate, the second-highest rate of people without insurance and a $3.7 billion state budget gap. Given this dire situation, Scott has decided that it is more important to draw a line in the sand than to accept federal funding for a law he opposes. Florida is also unique in its demand for health care needs, with a significantly higher percentage of its population being retirement age compared to other states. Florida also has a high rate of insurance-less citizens (nearly 16% of the population is without insurance). According to the Florida Hospital Association, $788.9 billion was spent on hospitals alone last year.
Rick Scott's rejection of available funds for political purposes means that the costs that would have been otherwise covered will be spread to the citizens of Florida through higher insurance premiums and increased out of pocket expenses. There is no indication that the current cost of health care in Florida will ever reduce and there is every reason to believe that health care costs will continue to rise. This will continue the trend of the last 10 years where Floridians have seen premiums rise three times faster than wages. With crippling unemployment, a service-slashing budget and a governor who refuses to budge, it appears that the people have lost again.
This news comes at the same time as the announcement of Gov. Scott's plan to switch Florida's Medicaid program to a managed care system, a plan that has been submitted to the federal government for approval. This managed care system means private companies would be in control of providing plans and services to the elderly and the working-poor. St. Petersburg Times reporter Stephen Nohlgren explains that these plans, "often run by insurance companies, could make a profit if they treat clients for less cost." Adding, "Critics worry that managed care companies will make money off the backs of the poor by simply skimping on services ... in a decade-old pilot program to deliver home-based services - known as Nursing Home Diversion - managed care turned out to be way more expensive than comparable fee-for-service programs run by nonprofit agencies. In some cases, managed care companies spent only 70 to 80 percent of their stipends on patient care, keeping the rest for overhead and profit."
In another blow to consumers in Florida, Gov. Scott has also made it clear that he opposes the creation of health insurance exchanges. These exchanges are a central platform of the health care reform law along with the individual insurance mandate. While opposing the latter in court, Scott has refused to begin the process of setting up these exchanges. Intended to function like travel websites which compare different flights and hotels while clearly showing their corresponding costs, insurance exchanges are indented to help members of the public more easily choose their insurance plan rather than having it chosen for them by their employer or chosen based on a provider based marketing or advertising campaign. The refusal by the governor to set up these exchanges is political folly, as the federal government can come in and operate the exchange if the state has not made adequate progress in doing so by 2013. Still, Gov. Scott is quoted in the Times article as saying, "I'd rather nobody run it. I don't think there's any way the state can do it where it's good for health care policy."
By comparison, Scott's health care policy seeks to privatize Medicaid and to keep the established system of for-profit hospitals and insurance companies - a system that made him millions. However, the for-profit institutions fall behind in health care outcomes compared to their nonprofit competitors. The reason? Nonprofit health care companies and hospitals are judged and supported based on outcomes, and therefore it is their primary goal. For-profit companies, however, depend on shareholder or owner return on investment, mandating a focus on cost savings that are not necessarily linked to good outcomes. Gov. Scott's political position is based on his own allegiance, not to the citizens of Florida, but to the money that can be made from their ailments.
Photo: Health care workers and others protest at the Capitol giving Gov. Rick Scott a pink slip for his job performance, April 7, in Tallahassee, Fla. (Steve Cannon/AP)