Medicaid Archives - Page 4 of 31 - Florida Politics

Dominic M. Calabro: Allow professionals and technology to provide affordable health care for Floridians

Florida TaxWatch has been a leader in making sure Florida residents have access to affordable health care options, saving millions of dollars and countless lives.

Lawmakers are considering two TaxWatch recommendations to eliminate barriers to 21st century solutions to help Floridians enjoy longer, healthier lives.

One change would reduce the limits on “telehealth” — the use of technology to expand access to all Floridians. More and more health care providers are offering everything from routine visits to critical post-operative check-ups via computers, telephones, and smartphone apps.

Allowing Floridians to get world-class medical care can avoid costly visits to the doctor or hospital while saving time and money. Critical follow-up care for more severe health issues is more easily accessed via telehealth, promoting quicker recoveries and avoiding expensive hospital and emergency room visits.

And telehealth allows Floridians in every corner of the state to have better access to all types of primary and specialty health care regardless of their proximity to doctors and hospitals.

Telehealth options promote incredible savings by providing immediate help and avoiding costly emergencies later. Just a simple 1 percent reduction in Medicaid costs would save Florida taxpayers more than $220 million. And a 1 percent reduction in hospitalizations would save Florida families and businesses more than $1.2 billion annually.

The second TaxWatch proposal lawmakers are considering is expanding the scope of practice for the state’s 15,000 advanced registered nurse practitioners. Freed from short-sighted legal barriers, ARNPs could provide up to 80 percent of the primary care needs for Florida patients. These nationally certified professionals have extensive training, and allowing them to provide efficient and thorough care for basic health care needs would provide quicker, more accessible pathways to health for all Floridians.

All 49 other states have taken steps to reduce restrictions on ARNP scope of practice. Allowing ARNPs in Florida the same freedom to serve would save Floridians up to $44 million per year in Medicaid costs alone and up to $339 million across the entire health care system by providing prompt care before small problems become more serious with costly visits to hospitals and specialists.

Floridians cannot afford to wait any longer for common sense improvements to the health care system. We applaud lawmakers for considering these simple yet critical changes to add value for the hard-working taxpayers and improving the physical, mental and fiscal health of our state.

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Dominic M. Calabro is the president and CEO of Florida TaxWatch, the state’s premier independent government watchdog group. Florida TaxWatch is committed to protecting taxpayers by keeping a watchdog’s eyes on our policymakers. Please click here to subscribe to our regular updates. Column courtesy of Context Florida.

Senate Health budget panel advances children’s Medicaid dental proposal

Despite some pushback from health insurance carriers, the Senate Health & Human Services Appropriations Committee approved a bill to reform children’s dental coverage by creating an independent program to administer it under the state’s Medicaid regime.

The bill, SB 994, is sponsored by newly minted Senate President-to-be Sen. Joe Negron. Negron said the state’s participation levels in the program is too low – “as low as in the mid-30s,” though insurers disputed that figure  – and that many states that have gone to a separate, independent program for children’s dental have seen more patients receiving treatment.

States such as Connecticut and others that have switched from a unified Medicaid dental program see participation rates of 80 percent or better.

Negron said Democratic- and Republican-leaning states are making the switch – including Louisiana, California, North Carolina, Colorado, Maryland, Massachusetts, and Tennessee in the past two years – and Florida would do well to follow their example.

The immediate fiscal cost for next year would be $450,000, for expert consulting on the proposal and five new positions at the Agency for Health Care Administration.

Negron said his bill lets the current five-year contract continue undisturbed and unabated; AHCA will conduct a study and report to the governor and Legislature; and if the Legislature fails to act by 2017, revert the program back to being an independent, carved-in program.

Audrey Brown, head of the Florida Association of Health Plans, objected to the latter provision.

“Florida’s health plans do not oppose a study of the effectiveness of pediatric dental services under statewide medical managed care as contemplated in the bill,” Brown said. “The plans know dental health is a key component of overall health.

“Our underlying issue with this bill is the way it is drafted. No matter what the study shows, the results don’t seem to matter,” said Brown, referring to the automatic carve-out clause in the bill if the Legislature does not act otherwise. “We ask that before a policy change is made, that the results of the study are evaluated and considered. Otherwise, the study is truly irrelevant.”

Negron said lawmakers certainly would consider the study of the $240 million dollar program.

“My view is, I would rather err on the side of being with the national trend. I’m confident that we’ll be up to that task,” Negron said in closing.

Florida counties “in crisis” without Medicaid expansion, League report says

In a series of broadsides at Gov. Rick Scott and the state’s House leadership, a panel of national health policy experts convened by the League of Women Voters of Florida has released a blistering report to the media outlining the Republican leadership’s decision not to expand Medicaid – in particular, its growing effect on Florida counties.

“The rational, reasonable, and responsible thing to do is to accept the federal funding,” said LWVF President Pamela Goodman during a conference call with reporters across the state.

That argument was buttressed by a deep dive into the impact of steep reductions in LIP (Low Income Pool) funding for Florida, traditionally the state’s major source of safety net funds.

The full complexity of the changes wrought by the Affordable Care Act are many, but in a nutshell, the basic principle of the law bends toward the idea that health insurance coverage is desirable over uncompensated care pools such as LIP. Florida’s LIP pool will be reduced 75 percent for fiscal year 2016-17.

That presents Tallahassee with a major problem in terms of the LIP dollars available, and how they will be allocated.

“The Legislature has two serious issues to deal with,” says Joan Alker, Executive Director of the Georgetown University Center for Children and Families.

“The overall cut, which is larger, as well as the way those funds will be distributed. The Legislature has a difficult situation on their hands. Expansion would be a far better financial deal for them.”

Picking up the baton was Miriam Harmatz, Senior Health Law Attorney with Florida Legal Services and co-author of the reports (a separate white paper deals with the effect of LIP reduction in Miami-Dade).

“We have about a million people in Florida who are eligible for federal coverage under the expansion funding,” Harmatz said. “That includes about 600,ooo people in the coverage gap. People who are below 100 percent of the poverty line. We are in a state who hasn’t accepted the funding so they have no path to affordable coverage. They are below the minimum for accepting subsidies in the federal marketplace.

“The issue of Medicaid financing particularly for hospitals is incredibly complicated, but it is landing in a very real way in our communities. Opponents of federal funding saying ‘No, thank you, we won’t accept those dollars to cover the uninsured,’ and this is the fourth year going into this now, and they’re also ignoring the hospitals needing this funding. That’s really all a diversion, and to date has allowed the Legislature to say ‘We’re not going to talk about this.’ But it’s going to be much harder for state leaders to ignore county leaders as people really understand what’s at stake, in terms of the economic implications.”

The bottom line: The report’s author’s argue that the 75 percent reduction of LIP funds in 2016-17 represents a $4.85 billion loss over five years. And that the loss of federal dollars translates into an $8 billion reduction in state GDP, 15,000 lost jobs, and an $8.25 billion loss in personal income.

Of course, this is an argument both the governor and the GOP-controlled Legislature dispute, saying Florida cannot afford to expand Medicaid long term.

What will tell the tale, the authors argue, is how much pain bubbles up in individual Florida counties during the next several years, and how much pressure that brings to bear. A recent death in Miami  that demonstrates that pain was referenced in the call.

“Until the Legislature deals with the problems of the uninsured, the ramifications will be felt locally,” said Harmatz.

Pam Bondi blasts GOP-backed bill on Medicaid

Attorney General Pam Bondi took a rare stance Wednesday, personally criticizing a Republican-backed measure because she said it would derail an ongoing lawsuit alleging Medicaid fraud.

Bondi, who usually remains out of many legislative battles, testified before a House panel that a bill sponsored by a Panama City Republican was a “desperate attempt” to help companies that provide laboratory testing for the state’s safety net health care program.

Bondi’s office joined a whistleblower lawsuit filed in Leon County that contends the companies overcharge the state.

The state’s top legal officer and former Tampa prosecutor said both Quest and Laboratory Corporation of America have overcharged taxpayers by “tens of millions.”

California previously reached settlements with the two companies that totaled nearly $300 million. She said the legislation would give the companies an “open checkbook” to “raid” the multibillion dollar Medicaid program.

“In my five years I have never seen anything like this happen,” Bondi said. “This is an end run, desperate attempt in a potentially multimillion dollar case … It is highly inappropriate.”

Michael Huey, a Tallahassee lawyer and lobbyist representing Laboratory Corporation of America, told the House panel that Bondi’s criticism were not based on “facts.” He said his clients have won some of the legal skirmishes surrounding the dispute but that the lawsuit is still going on.

Court records show that a circuit judge last year rejected a request to dismiss the lawsuit.

State Rep. Jay Trumbull said he filed the measure (HB 421) in an effort to define billing practices that are at the center of the ongoing lawsuit.

Trumbull said there “too much ambiguity” with the current terms used by the state. He also maintained that he filed the legislation after conducting research about the issue on his own and was not asked by lobbyists representing the testing companies to file the bill.

Some Republicans on the House Health Innovation Subcommittee asked Bondi whether she would be willing to support changes to the bill. Bondi said no, because she said the legislation would create a bad precedent.

“It needs to die here right now,” Bondi said.

After Bondi testified, the House committee delayed a vote on the bill. State Rep. Kenneth Roberson, who chairs the panel, said he wasn’t sure if the bill would be considered at the next meeting.

Reprinted with permission of The Associated Press.

Rich Templin: The great Florida surplus myth

Once again, the media is abuzz and many in the Florida Legislature are absolutely giddy at the prospect of what they call a budget surplus this year.

State fiscal analysts are predicting a surplus of about $635 million and the Governor’s Office, using a bit of fuzzy math that no one outside of his administration can understand, is projecting excess revenues of $1.3 billion.

While Senate President Andy Gardiner and Senate budget chief Sen. Tom Lee have been cautious at best, Gov. Rick Scott and Florida House leaders have been spraining their arms patting themselves on the back for their good fiscal stewardship and salivating over the tax cuts they hope to hand out like candy during an election year.

Scott has rolled out a $1 billion tax-cut package and he and his minions have been campaigning across the state, in the Capitol and anywhere else they can find a microphone, to get it passed in the Legislature.

All of the logos and printed materials look just like Scott’s last “Let’s Keep Working” election campaign leading many to believe that this is less about smart fiscal policy and more about the next U.S. Senate race.

The tax-cut package has several big ticket components including the permanent elimination of the corporate income tax for manufacturing and retail corporations (which costs $779 million each year), the permanent elimination of sales taxes paid on manufacturing equipment and machinery (which costs $76.9 million each year) and a 1 percent reduction on commercial property leases (which costs $339 million per year).

There are also temporary sales tax holidays that would cost about $75 million per year, but these have really become sales gimmicks for the big retailers and save working families very little money. So in short, as usual, Scott wants big tax cuts for big business while average taxpayers get pennies.

So how much is the surplus? $635 million? $1.3 billion? In reality…there is no surplus.

Webster’s Dictionary defines surplus as “an amount that is more than the amount that is needed.” It is true that the state has more money on hand than last year, but is it more than the amount needed? Not even close.

Average teacher salaries in Florida, adjusted for inflation, have fallen 6.5 percent. Florida had the fewest state employees per 10,000 in population than any state in 2013, almost half of the average number of employees in all the states.

Florida has not expanded Medicaid to uninsured Floridians earning less than 138 percent of the federal poverty level. Nearly 600,000 working Floridians would obtain health coverage if Medicaid were expanded.

Florida ranks 47th among the states in the percentage of uninsured children – 11 percent. That means that about 445,000 Florida children are without health coverage.

These are just a few examples of our poor record of funding critical social services, a record that is keeping Florida at or near the bottom in just about every indicator of a strong and vibrant state. We also have huge challenges with poor infrastructure and inadequate resources for environmental protection.

Working families need meaningful investments from state government to help get them back to work, not sales tax holidays that put pennies in their pockets while exploding the profits of Florida’s retailers.

Florida continues to suffer from a major revenue problem. We are home to the fourth wealthiest population in America but are cursed with the second most regressive tax system, meaning the middle class and working poor pay the bulk of the bills while the wealthy and big corporations reap all the benefits.

This so-called “surplus” and the haggling over what to do with it offers us an opportunity.

We can begin to discuss these issues once again as we work to close over $5 billion in corporate tax loopholes and exemptions so that Florida can begin to climb out of the hole created by 17 years of failed “trickle down” economic policies.

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Rich Templin, Ph.D., is the Legislative Director for the Florida AFL-CIO which represents approximately 500 local labor unions and labor councils, representing over 900,000 workers, retirees and their families in Florida. Column courtesy of Context Florida.

Tampa house Democrats blast Scott administration’s investigation into public hospitals

Florida Governor Rick Scott has been targeting the Florida public hospital industry for much of this year, after the Florida Hospital Association made a strong pitch for the Legislature to expand Medicaid under the Affordable Care Act, a push that failed for the third straight year in Tallahassee, and after the federal government announced deep cuts in hospital funding earlier this year

At a forum highlighting the upcoming Florida legislative session focusing on health care in Tampa on Wednesday, Tampa House Democrats Ed Narain and Janet Cruz blasted Scott’s efforts as being detrimental.

Narain is a freshman elected a year ago in the House District 61 which encompasses much of the urban corridors of Tampa. He bashed the Scott Administration for the Governor’s request earlier this year to order state health officials to audit more than 100 hospitals as part of his ongoing battle with those facilities, which the governor said was driving up Medicaid costs.

“And what have we found at this point?” asked Narain. “Absolutely nothing. So political theater is taking place in the state of Florida.”

Cruz, who also represents parts of Tampa, agreed, saying that the public hospitals are “under attack,” and said it reminded her of previous attacks on the public schools in Florida.

“Where they’re looking at this big pot of dollars and moving to voucher programs and charter schools,” she said. “They want to move away from the public hospitals that in my opinion serve the uninsured and the underinsured. The move is to privatize, and the hospitals are next.”

Earlier this year, the Governor created the Commission on Healthcare and Hospital Funding and directed it to examine the rate of return on tax dollars used for Medicaid. That panel was blasted as being biased, with only one of the nine appointees an actual physician (Gainesville microsurgeon Jason Rosenberg).

In September, Scott said he wanted to help Floridians to fight against unfair hospital prices by requiring hospitals to post their prices and average payments, along with their annual IRS reports, in an easily accessible location on their website.  He also proposed to create additional protections  by allowing the referral of any suspected hospital price gouging to the appropriate law enforcement agency or regulatory authority.

But he hasn’t had much help in acquiring a sponsor in the Legislature for such a proposal.

Although Cruz, Narain and Republican state house member Jamie Grant, the third member of the panel who participated in the Tampa Bay Healthcare Collaborative on Wednesday, all said that Medicaid expansion was dead for 2016, it didn’t stop the partisan attacks that have been part and parcel of the debate for years in Florida.

Among the House Republicans talking points in opposing Medicaid expansion has been their contention that the state’s existing Medicaid program already provides a safety net for low-income children, pregnant women, elderly and disabled people. Grant says Medicaid expansion would have come at expense of kids and the elderly.

“If the question is to provide health care to a larger population that overwhelmingly was made up of able bodied men who chose not to work and didn’t have children, and we were going to pay for it by taking health care from kids and the medically needy, that’s never, ever ever going to pass the Florida House,” Grant said.

Cruz immediately responded that she didn’t like speaking after Grant because “he’s so bright and so eloquent – but he’s wrong here.”

“Most of the Medicaid population is sick children and lots of very sick children,” Cruz said. It is a sad day in the state Legislature that we refuse to offer care to working families. …it’s an atrocity, and it’s wrong, and we have a budget surplus in a $76 billion budget. We still refuse to provide some kind of care for our working families. It’s just wrong, it’s wrong that we didn’t and we don’t expand healthcare coverage in Florida.”

“We have too many people in this state that, when they think of the doctor, they’re thinking of the ER,” added Narain.

Grant is director of national markets for CareSync, an app and website that allow people to store and control their medical records online. His background in health care was apparent as he expounded effortlessly on his opinions regarding various aspects of the industry.

He kicked off the conversation by boldly stating that the traditional fee-for-service model of paying for health care was on the way out, to be value-based-care. “Fee-for-service is going to die,” he said. “The days for performed service, get paid for that service a set amount is going away.”

Grant said that was a move led by the federal government, and Florida has nothing to do with that. He said what the Legislature could do to augment that would be to allow for more price transparency in health care. “There’s zero reason that a hospital or a health system should be getting data from AHCA (Florida Agency for Health Care Administration) that’s a year or two years old. It’s 2015, it’s about to 2016. It’s laughable.”

Dr. Marc J. Yacht: The elephants in the room

Underneath the candidate smears that are so much a part of local and national politics, there are a number of critical issues that leave both Republicans and Democrats too far apart. Party posturing aside there is substance to both sides of each concern but an inability for friendly if not effective bipartisan discussion.

The elephants in the room include the military, Social Security, Medicare, Medicaid, the Affordable Care Act, and welfare. Money and debt drive the imbroglio and getting to “yes” could be described as “Mission Impossible.” Opponents are so far apart on the issues that they have been reduced to personal attacks and filling the airways with misinformation.

The Republicans are right: The nation spends too much money and has outrageous debt. It is also true that Republican administrations bear much of the brunt of the debt. One has to be reminded of the man who caused rain and then ran around selling umbrellas. Political strategists often create self-fulfilling prophecies. Or live by the adage, if there is no problem, create one. The voters demand a good fight.

According to the National Priorities Project, in fiscal year 2015, the United States spent $1.11 trillion in discretionary spending. Military spending is projected to account for 54 percent of all federal discretionary spending, a total of $598.5 billion. Such spending includes all regular activities of the Department of Defense, war spending, nuclear weapons, international military assistance, and other Pentagon-related spending.

That’s a fat budget and weighs heavily on resources to meet so many other needs of the nation. Typically conservatives support the military budget while attempting to slash other programs that would address health care, human services, infrastructure needs, transportation, and veteran’s benefits.

Social Security and unemployment insurance account for $29.1 billion or a negligible 3 percent of the total $1.11 trillion and continue to be a frequent target of right-wing politicians and pundits. Although defined as entitlement programs, that label ignores contributions made by workers to help pay for this benefit.

Medicare and other health programs, in spite of all the raging against government health-care expenditures,  claims $66 billion or 6 percent of the budget. Americans pay a significant portion to receive those benefits.  Again, suggesting Medicare as an entitlement does not properly acknowledge those contributions.

Another target, public education, receives a mere 6 percent of discretionary spending yet is facing revenue cuts across the nation.

Arguments to end or compromise Medicare and Social Security continue. Military spending, however, needs to top the list at efforts for fiscal prudence.

Welfare expenditures approach $400 billion and legitimately represent a need for serious attention to streamline services to the needy.

If solutions to federal waste are truly the objective of Congress, tackling welfare and the military budget should be the appropriate target not minor costs associated with an array of useful federal programs.

The Democrats should defend the safety nets but must be receptive to suggestions that would make the programs more fiscally efficient. On the other hand, dialogue is needed to burst the bubble of military spending and allow those saved resources to meet a vast array of community needs.

The voters angry with the waste and gridlock are showing their disdain with both parties as no-party-affiliation registrations mount. The political paradigm is shifting and Democrats as well as Republicans need to respond, or they will ultimately give way to successful third-party candidates.

Marc Yacht M.D., M.P.H. is a retired physician living in Hudson, Florida. 

For more state and national commentary visit Context Florida.

Dr. Marc J. Yacht: The elephants in the room

Underneath the candidate smears that are so much a part of local and national politics, there are a number of critical issues that leave both Republicans and Democrats too far apart. Party posturing aside there is substance to both sides of each concern but an inability for friendly if not effective bipartisan discussion.

The elephants in the room include the military, Social Security, Medicare, Medicaid, the Affordable Care Act, and welfare. Money and debt drive the imbroglio and getting to “yes” could be described as “Mission Impossible.” Opponents are so far apart on the issues that they have been reduced to personal attacks and filling the airways with misinformation.

The Republicans are right: The nation spends too much money and has outrageous debt. It is also true that Republican administrations bear much of the brunt of the debt. One has to be reminded of the man who caused rain and then ran around selling umbrellas. Political strategists often create self-fulfilling prophecies. Or live by the adage, if there is no problem, create one. The voters demand a good fight.

According to the National Priorities Project, in fiscal year 2015, the United States spent $1.11 trillion in discretionary spending. Military spending is projected to account for 54 percent of all federal discretionary spending, a total of $598.5 billion. Such spending includes all regular activities of the Department of Defense, war spending, nuclear weapons, international military assistance, and other Pentagon-related spending.

That’s a fat budget and weighs heavily on resources to meet so many other needs of the nation. Typically conservatives support the military budget while attempting to slash other programs that would address health care, human services, infrastructure needs, transportation, and veteran’s benefits.

Social Security and unemployment insurance account for $29.1 billion or a negligible 3 percent of the total $1.11 trillion and continue to be a frequent target of right-wing politicians and pundits. Although defined as entitlement programs, that label ignores contributions made by workers to help pay for this benefit.

Medicare and other health programs, in spite of all the raging against government health-care expenditures,  claims $66 billion or 6 percent of the budget. Americans pay a significant portion to receive those benefits.  Again, suggesting Medicare as an entitlement does not properly acknowledge those contributions.

Another target, public education, receives a mere 6 percent of discretionary spending yet is facing revenue cuts across the nation.

Arguments to end or compromise Medicare and Social Security continue. Military spending, however, needs to top the list at efforts for fiscal prudence.

Welfare expenditures approach $400 billion and legitimately represent a need for serious attention to streamline services to the needy.

If solutions to federal waste are truly the objective of Congress, tackling welfare and the military budget should be the appropriate target not minor costs associated with an array of useful federal programs.

The Democrats should defend the safety nets but must be receptive to suggestions that would make the programs more fiscally efficient. On the other hand, dialogue is needed to burst the bubble of military spending and allow those saved resources to meet a vast array of community needs.

The voters angry with the waste and gridlock are showing their disdain with both parties as no-party-affiliation registrations mount. The political paradigm is shifting and Democrats as well as Republicans need to respond, or they will ultimately give way to successful third-party candidates.

Marc Yacht M.D., M.P.H. is a retired physician living in Hudson, Florida. Column courtesy of Context Florida.

Florida hospitals say they spent $1.5B in charity care

Florida hospitals paid for $1.5 billion in health costs for uninsured and underinsured patients last year.

The Florida Hospital Association released its annual report Wednesday, noting it provided inpatient care for 2.7 million people and treated 9.5 million patients in emergency rooms in 2014. Hospitals contributed a total of $4.2 billion in community benefits, including charity care. Hospitals also spent about $22.4 million to ensure they are prepared to for emergencies, including hurricanes or outbreaks such as Ebola.

Florida hospitals helped more than 39,000 individuals obtain health plan insurance through the Affordable Care Act or Medicaid.

The report comes as Gov. Rick Scott has repeatedly criticized hospitals, accusing them of price gouging patients and charging rates that are driving up Medicaid costs. He’s proposed legislation encouraging more transparency on hospital pricing, but it’ unclear if anyone will take up the bill.

Republished with permission of the Associated Press.

Sarah Maricle Ayers: Rick Scott should stay out of hospitals’ business

If you believe that smoking cures cancer and rainfall is a fix for flooding, then Gov. Rick Scott has some health care proposals for you.

Scott wants to foist a battery of new regulations onto about 129 hospitals across Florida in 2016 as a means of improving health care. He has proposed requiring them to publicize IRS reports, information regarding pricing and average payments received for products and services, and performance on quality measures, all in accordance with strict deadlines. Additionally, Scott has launched an online forum for patients to directly air complaints about medical bills and hospital experiences, which can, in turn, trigger third-party reviews by the state.

Scott’s official statement delineating these initiatives, released in September and naturally cloaked in populist favorites, like “fairness” and “transparency,” are purportedly aimed at cutting health care costs for consumers. Closer examination, though, reveals that their real consequences will do nothing of the sort, and will even further muddy the health-care waters for patients.

Scott says, “The best way to guard against unfairly high hospital costs being passed on to patients is to require hospitals to be fully transparent with their own costs and patient charges.” However, every minute associated with complying with each of these administrative requirements drives up hospital costs. Scott is essentially seeking to reduce costs with a plan that raises them, and enhance patient care with a plan that burdens staff with extra bureaucratic mandates.

Come again?

His website for medical bill complaints is designed to root out price-gouging, but is similarly ill-conceived. Scott’s news release tells patients they would be able to “refer complaints of price gouging at hospitals and surgical centers to the appropriate law enforcement agency or regulatory authority for investigation and potential prosecution.” However, outside of the 120 percent Medicaid cap, there are no legal price parameters on medical products and services. How can price-gouging be assessed or enforced when it has no definition?

And how can average consumers, reeling from medical emergencies and their accompanying hospital bills, be prepared to evaluate the going rate for liver transplants, spinal fusions, and hip replacements? Displeasure with prices is not the same thing as price-gouging.

In any circumstance, consumers are always inherently motivated to minimize financial obligations as much as possible, whether it’s for a cup of Starbucks or an appendectomy. Self-reporting from patients hardly constitutes a reliable basis for activating the potential legal consequences that Scott is dangling over hospitals.

Should we next ask convicts to weigh in on their own sentencing?

Given the legislative history of the past year, this disappointing attack on hospital business practices seems to be less about saving consumers and more about retaliation over Medicaid expansion differences. When Scott sprang onto Florida’s political scene in 2010, part of his unique appeal was the private sector prowess he possessed, having founded and managed Columbia/HCA, ironically the largest private health care company in the U.S. He represented the antidote to the incoming wave of intrusive Affordable Care Act provisions, and the pragmatism he espoused was a welcome contrast to the empty populist rhetoric of then-incumbent Charlie Crist.

Scott’s war on hospitals just adds to bureaucratic sludge and demonstrates that his steely conservative armor is losing its luster.

In order to genuinely advance consumer interests, Florida’s health care industry should do the opposite of Scott’s proposals and adopt the Direct Primary Care approach. This model consists of simple payment-for-treatment pricing, with zero government and third-party involvement. This is an emerging laissez faire approach that achieves true cost cutting.

For example, when the Surgery Center of Oklahoma adopted Direct Primary Care, the savings enabled by streamlining led to bills that are one-tenth to one-fifth of what competing facilities charge. Owner and anesthesiologist Dr. Keith Smith even posts his prices online, but does so voluntarily and in a spirit of free-market competition, not under the threat of a tax-payer funded, bureaucratic fist.

Transparency in pricing is good for consumers, but gubernatorial power should be used for the good of ensuring freely operating health markets, not imposing regulations. Competition can naturally spur upfront pricing for consumers, and do so without the costly layer of government interference. Scott would be well-advised to remember his hospital CEO perspective and dump these non-solutions.

Sarah Maricle Ayers has bachelor’s degree in economics from Florida State University, and an MBA from FSU. Her op-eds on economic issues have been published in Florida newspapers. 

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