Medicaid Archives - Page 6 of 31 - Florida Politics

Debbie Wasserman Schultz calls Jeb Bush comment’s on phasing out Medicare a “massive blunder”

Democrats such as DNC Chair Debbie Wasserman Schultz are seizing on comments that Jeb Bush made Wednesday night regarding Medicare.

Speaking at an Americans for Prosperity event in New Hampshire, Bush said brought up the government run health care program for seniors by first blasting television ads back in 2012 featuring a Paul Ryan-look-a-like pushing an elderly person off the cliff in a wheelchair. That ad was in reference to the Ryan budget that called for fading Medicare out and instead make it into a voucher system.

“I think we need to be vigilant about this and persuade people that our, when your volunteers go door to door, and they talk to people, people understand this,” Bush said. “They know, and I think a lot of people recognize that we need to make sure we fulfill the commitment to people that have already received the benefits, that are receiving the benefits,” Bush said. “But that we need to figure out a way to phase out this program for others and move to a new system that allows them to have something – because they’re not going to have anything.”

“This is such a massive blunder on Jeb Bush’s part,” Democratic National Committee Chairwoman Debbie Wasserman Schultz said Thursday afternoon on a conference call. “I was outraged, but not surprised, given what I know about Jeb Bush,” she added.

“Once again, Jeb Bush has shown he just doesn’t get it when it comes to the issues that matter to middle-class families and not surprisingly, to seniors,” Wasserman Schultz continued. “Maybe Jeb Bush can afford to get by without Medicare – I’m sure the Koch Brothers would be fine too – but millions of Americans count on Medicare when they retire for access to quality affordable health care.”

Americans for Prosperity is a group funded by the Koch Brothers, a leading nemesis for Democrats nationwide.

Bush is by no means the only Republican who think Medicare is headed towards insolvency. Marco Rubio and Chris Christie have also talked about major Medicare reforms on the campaign trail. Democrats reject that theory, however, and are citing a Trustees report on the program released yesterday that shows that the system is fiscally secure through 2030.

“I’m sick and tired of Republicans who say that the only way to save Medicare is to destroy it,” Wasserman Schultz sneered.

“Jeb Bush just must be living in a Charles Dickens novel,” quipped Rich Fiesta, Executive Director of the Alliance for Retired Americans. “His behavior over the last few months towards working people and retirees has been nothing short of outrageous, if not myopic.” Fiesta brought up another recent Bush comment that Democrats seized up – his comment that Americans needed to work longer hours.

Democratic Party presidential hopeful Bernie Sanders also weighed in on the Bush comment.

“It is an indication of how far right-wing the Republican Party has become when its ‘moderate’ candidate, Jeb Bush, at a forum sponsored by the billionaire Koch brothers, is now talking about phasing out Medicare. This follows Bush’s statement that we should raise the retirement age for Social Security,” Sanders said.

All three Democrats referred to the fact that Bush’s statement comes just a week before the 50th anniversary of the creation of both Medicare and Medicaid, programs that went into effect on July 30, 1965.
The Kaiser Family Foundation recently reported that in a recent poll, by two-to-one margins, people of all political persuasions favor preserving Medicare in its current form, as opposed to replacing it with vouchers or other forms of premium support.

Gary Stein: Needle exchange is the one-buck no-brainer

Florida is not an early adapter. Most of the time, our state takes a “wait-and-see” attitude regarding nearly any health policy, social program or economic strategy that has been attempted by another state’s legislature. In some cases, no amount of positive data on a successful program is enough to convince our leadership to move in the path of innovation, regardless of the possibility of lives or money saved.

One such innovative program has saved at least hundreds of thousands of lives, millions of dollars and is older than CDs, cellphones, home computers, Katy Perry and Flo Rida, but you won’t see a statewide needle-exchange program in Florida.

It’s not for lack of trying. Bills proposing needle-exchange programs (NEPs) have been attempted for the past three years, but never got to the governor’s desk. In 2013, HB 735 (Pafford) died in the Judiciary Committee and SB 808 (Margolis) got to the Senate floor, but died on the calendar awaiting a vote.

After that session, Democrat Rep. Mark Pafford of West Palm Beach filed again, but HB 491 died in Messages at the Senate after passing the House Floor and SB 408 (Braynon) died along with it. In 2015, HB 475 (Edwards) died in Government Operations Subcommittee while SB 1040 (Braynon) died on the Senate floor calendar while the House called a premature end of session.

The real question, though, is how many Floridians have died since needle exchange programs first came to the U.S. in the 1980s?

The bills floundered, but it was not for lack of bipartisan support. After the 2013 session, Republican Health Policy Chair Aaron Bean of Fernandina Beach told the media, “We had it, we researched it. It doesn’t sound like a conservative idea — at first, but it is backed by the Florida Medical Association and would be 100 percent funded with private money, and that combination sold me.”

It may not have appeared conservative to Sen. Bean at first glance, but the concept has had conservative support from the beginning. The very first national needle-exchange program was championed by the highly conservative U.K. Prime Minister Margaret Thatcher. She looked at the data and decided the program was necessary to prevent an HIV epidemic among British addicts. In England, only 1 percent of addicts contracted HIV since the program started. Addicts in the U.S. have fared much, much worse.

Especially in Florida.

Today, there are more than 90,000 needle-drugs users, 19 percent with HIV and at least 23,000 with Hepatitis-C. Considering the lifetime healthcare cost of more than $600,000 for HIV patients and $300,000 for those with Hep-C, the burden on the state is tremendous, since street addicts rarely have health insurance and often seek treatment in emergency rooms or in Medicaid-based clinics.

Add the problem of reduced Low Income Pool funding this year and additional reductions on the horizon, and it’s not too hard to see a crisis coming to the state budget and to hospitals caring for indigent addicts.

Florida, because of its inaction, has 30 years of data and success rates across  the country and around the world to verify that needle-exchange programs work as legislators take yet another year to make a decision to start one. There are 35 states with NEPs, and they exist in one form or another in almost every country in Europe, Australia and New Zealand. They know that avoiding hundreds of thousands of dollars in health-care costs by offering a $1 syringe is a no-brainer.

Almost any question or concern can be answered by the data. For those who think that offering clean needles facilitates heroin use, there is no data that an addict ever stopped using drugs because of dirty syringes. The choice of whether or not to use while tempting HIV or Hep-C infection doesn’t seem to come up to addicts. According to a 2012 report by the Florida Department of Health’s Bureau of HIV/AIDS, 29 percent said they reuse the needles from their last injection, and 64 percent reported they had used a needle previously used by someone else.

There are even statistics about unexpected consequences. A report from the American Journal of Public Health in 2000 took notice that some states with NEP’s saw a reduction in crime.

This week, TIME magazine, a long-time conservative publication, published an article called, “Needle-Exchange Programs Could Prevent HIV Outbreaks, Experts Say.”

In 1990, I was working alongside HRS in South Florida trying to control the HIV epidemic. The idea of a needle-exchange program was batted about and then forgotten, while some activist groups actually went so far as to distribute the syringes in communities in Miami-Dade and risk arrest to save fellow Floridians. Maybe 2016 will be the year that Florida’s Legislature wakes up and smells the rationale behind the compassion of a needle-exchange program and the ability to save lives and health-care money before another year of suffering and death occurs.

It’s an idea whose time came many years ago, but it’s never too late to save lives.

Gary Stein MPH, a native Detroiter, worked for the Centers for Disease Control, landed in the Tampa Bay area to work for the State Tobacco program and is now a policy consultant, a health advocate and activist and blogger for Huffington Post. He has also been the executive director for Health Equity and Accountable Care and the Policy Director for FAAST, Inc. Column courtesy of Context Florida.

Aaron Bean and Mia Jones: “Let’s find the win-win on Medicaid expansion”

They may be on opposite sides of the aisle in Tallahassee, but State Senator Aaron Bean (R-Fernandina Beach) and State Representative Mia Jones (D-Jacksonville) say they’re on the same page when it comes to figuring out a health care funding solution for Florida the next time the Legislature meets.

“We’ve got to figure out a way to go forward,” said Bean, the Senate Health Policy Chief, during an appearance on WJCT’s First Coast Connect

After meeting in special session (because the regular session ended early in a meltdown over health care funding) lawmakers adjourned for the year without expanding Medicaid to provide health insurance for about 800,000 low-income Floridians.

However, federal funds for the Low Income Pool (LIP) that funds hospital indigent care, are expected to decline by another $400 million next year, upping the ante for an eventual fix.

“The price tag will continue to go up,” said Jones, ranking member of the House Health and Human Services Committee. “We have an opportunity for us to sit down and say, now is the time. We need to recognize that we aren’t sitting around with pots of money that are overflowing to the point that we don’t need the dollars from the federal government. Let’s come to the table again, with a true heart of saying we are going to walk away with a win-win. Unless they are willing to do that, we will end up in the same predicament we were in before.”

By “they,” Jones was ostensibly referring to the Florida House, which was not on board with Bean and the Senate’s Medicaid expansion bill known as FHIX. It had job and education requirements, and would have extended health insurance to low-income working participants for as little as $25 a month. Only four Republicans in the House voted in favor of the measure.

Bean, who had floated the idea of a joint health care committee going into the 2016 session, says until pressure mounts on House legislators, movement on the issue will be challenging. “I don’t see a change. The players are going to remain largely intact. Next year the price goes up as we wean off federal funds, it’s going to cost us three-quarters of a billion next year and the following year it’s all up to us. Maybe if the numbers change and every time we put state dollars in the pot that’s less money we can spend on projects like education or roads. The numbers will get bigger and the pressure will ratchet up, so we’ve got to come up with an idea,” he said.

Jones saluted Bean for his work on the issue, and he returned the favor, lauding her epic seven-hour debate on the House floor during the Medicaid fight.

“It was not Republican Senator Bean and Democratic Representative Jones on opposite sides, we stood together,” Jones said.

Health care agency closes three Medicaid offices

 Three Medicaid field offices  are closing June 30.

The Agency for Health Care Administration is closing regional offices in Panama City, Alachua and West Palm. Combined, they have been processing fee for service claims, among other things, for 37 counties across the state.

Medicaid providers who normally send fee for service claims to those field offices will use on of two other existing offices. Claims that are sent sent to the  Panama City office must be sent to the Pensacola office, instead. Claims that normally are sent to Alachua or West Palm now must be sent to the office in Tampa.

The offices are being closed as part of staff reductions under the new budget that goes into effect July 1. The Legislature reduced 81 positions from the agency, leaving it with 1,563 positions for the upcoming year.

Twenty-six people, earning a combined $1.12 million in salary and benefits, will lose their jobs with the closure of two field offices, budget documents show. The agency closed three offices. The reductions are being made because of restructuring under the statewide Medicaid mandatory managed care program.

Rick Scott’s veto list puts friends, foes in sharp relief

Gov. Rick Scott denied giving consideration to his friends — or retaliating against his enemies — as he threw out more than $460 million allocated by lawmakers in this year’s budget.

“Absolutely not,” Scott told reporters Tuesday morning after the day’s Cabinet meeting concluded.

But a close look at what was axed and what was not tells a different story.

While lawmakers, state agencies and lobbyists wade through the governor’s hundreds of individual line-item vetoes, they would do well to keep a scorecard of who’s in and who’s out with Scott in mind.

A straightforward, if well-worn example: $15 million for a new University of Central Florida downtown campus was nixed while a similar a project of similar size and scope — $17 million for a new downtown medical campus at University of South Florida — was not.

Scott said the decision was made on procedural grounds, not political ones.

“That’s simple: One went through the Board of Governors process and one didn’t,” the governor said.

An inquiry to the governor’s office elicited the same basis for his decision: The project “circumvented the BOG’s campus approval process,” spokeswoman Jeri Bustamante said on Scott’s behalf.

Such concerns, though, seemed to have little bearing on the governor’s disposition in general.

“There are so many inconsistencies in the ways those things are applied,” Sen. Jack Latvala said to the Tampa Bay Times on Tuesday afternoon.

“They don’t even know what he asked for before,” Latvala said in an interview in which he said outright that Scott has “declared war on the Legislature” with the veto list.

Non-legislative actors felt the sting of Scott’s veto pen as well.

One thing the governor has approved before, funding for a Florida Catastrophic Storm Risk Management Center at Florida State University in Tallahassee, was summarily vetoed.

Was it the process, largely the same as in the past years when the non-controversial item has been fully funded, or was it antipathy towards the item’s primary supporter — CFO Jeff Atwater — who has vocally criticized the governor’s handling of former top cop Gerald Bailey‘s exit?

Agriculture Commissioner Adam Putnam, who along with Atwater is on the Florida Cabinet, saw a priority of his fall to Scott’s veto pen: $1.6 million to give the state’s 606 Forest Service firefighters each a $2,000 a year pay raise. Putnam, too, questioned Bailey’s departure.

Senate President Andy Gardiner, who supported the University of Central Florida funding, criticized the governor for his actions. Gardiner, at odds with Scott most of the Legislative Session after the governor reversed his position on a Medicaid expansion, contended in a statement that Scott’s vetoes were politically motivated.

Scott vetoed $9.5 million for the Florida Association of Free and Charitable Clinics and another $3 million for Florida State University Rural Primary Care Clinic.

“The Governor refused to support the Senate’s efforts to help the working poor in our state purchase private health insurance, yet vetoed nearly $10 million in funding for free and charitable clinics, again depriving these families of the chance for proactive primary care and pushing more and more Floridians without health insurance towards hospital emergency rooms when they are at their sickest and most vulnerable. He also vetoed funding for primary care residency programs and faculty to train physicians who work in rural and underserved areas,” Gardiner wrote in a news release.

“While I respect the Governor’s authority to veto various lines within our budget, his clear disregard for the public policy merits of many legislative initiatives underscores that today’s veto list is more about politics than sound fiscal policy. It is unfortunate that the messaging strategy needed to achieve the Governor’s political agenda comes at the expense of the most vulnerable people in our state.”

Budget signed, LIP deal formalized (sort of), health care done for now

Just hours after Gov. Rick Scott quietly signed a state spending plan into effect, the federal government gave Florida a long-awaited “agreement in principle” letter that all but formalizes an agreement between Florida and the federal government on hospital funding for the next year.

The coveted agreement, which the state had hoped to secure in April so the Legislature could draft a budget before the end of the 2015 regular legislative session, lays out a two-year agreement that expires in June 2017, which is when the underlying Medicaid 1115 waiver that makes Low Income Pool possible expires. The waiver also allows Florida to operate its mandatory statewide Medicaid managed program statewide.

The two-page letter was sent to Deputy Medicaid Secretary Justin Senior and is signed by Centers for Medicare and Medicaid Services Acting Director Vikki Wachino. CMS and Florida have been working closely to reach final agreement on Low Income Pool funding.

Meanwhile, the budget put an additional $400 million recurring general revenue into hospital rates and directs $1 billion in Low Income Pool dollars to a variety of hospitals based on a plan hammered out between the House and Senate.

Jan Gorrie, managing partner of the Tampa office of Ballard Partners and a lobbyist for large urban hospitals around the state, said the “high five” from the federal government and the signing of the budget is good news for Florida hospitals.

However, CMS also indicated next year LIP will be further ratcheted back. “So our work is cut out for us. No rest for the weary,” she said, noting that the Legislature returns to Tallahassee in about two months to begin a round of meetings in preparation of next year’s Session, which starts in January.

And even before the start of the January session Florida will be working on what a new Low Income Pool distribution model for 2016-17 looks like. Wachino’s letter makes clear that the the $1 billion Low Income Pool money in fiscal year 2015-16 will be distributed as outlined in the General Appropriations Act, but that the $608 million for the following year will be distributed based on the volume of provider uncompensated care and in accordance with a new distribution formula.

The letter notes that Florida will have to submit a new formula to the federal government by October 31 and that CMS will work with Florida to approve the new distribution method before December 31, 2015.

“Florida may not claim federal financial participation for LIP payments [in 2016-17] until a new methodology is approved by the federal government,” the letter notes.

6_23_15 Lettter to Florida

Jac Wilder VerSteeg: Jeb Bush’s view of religion knocks off some commandments

I have to believe Jeb Bush when he says he wouldn’t let his priest – or even the pope – dictate his economic policy. In fact, if you take Jeb’s recent statements about religion seriously, an obvious conclusion is that Jeb doesn’t take his religion seriously.

I hope Im not going to get castigated for saying this by my priest back home,Jeb said, but I dont get economic policy from my bishops or my cardinals or my pope.”  He continued, I think religion ought to be about making us better as people, less about things [that] end up getting into the political realm.

With that statement which Jeb uttered in an attempt to sidestep Pope Francisencyclical on climate change Jeb has created a conundrum. We have to identify things that can be categorized as making us better as peoplebut that are not so important that they would be getting us into the political realm.

The first thing to notice is that Congress and state legislatures routinely deal both in criminal and civil statutes with things such as murder, theft, perjury and marriage.

Right away, at least four of the Ten Commandments are in trouble. Dont kill, dont steal, dont bear false witness and dont commit adultery.

Sorry, priests, rabbis and pastors, we dont want to hear your thoughts on those topics any more. Too political.

Its true that some commandments that used to be enforced by the state already have fallen or are falling by the wayside. We dont still put people in the stocks for missing services on the Sabbath, though a dwindling few blue laws remain in effect. Presumably Jeb-gagged priests can continue to preach about such things. But, and this is part of the head-scratcher Bush has posed, those things could not have dropped out of the political realm without some politicians deciding to remove them from statutes.

But leave that catch-22 alone for time being. Try instead to imagine the kinds of things that Jeb thinks would be appropriate for religious leaders to concern themselves with. Get back to that sliding scale with Making us better as peopleon one end and Getting us into the political realmon the other. You can move the slider along the Making us better as peoplerange only until it moves into the Getting us into the political realmon the other. Then you have to stop, Mr. Minister, and abandon the issue to politicians.

However, Im having trouble thinking of an issue that makes us better as people that doesnt quickly get into the political realm in some fashion or other.

Could he be talking about I dont know eating right and exercising? Oh, wait. Hasnt Congress had regular fights about which farm products can be purchased for low-cost school lunches? Hasnt the Florida Legislature mandated periods of physical activity for school children?

Perhaps religious leaders should just talk about the redeeming value of prayer. Certainly prayer never has become a political issue. Oh, wait

What about, love your neighbor as yourself? That sounds just a little too much like what all those sore-loser Florida senators were saying when they castigated House members for failing to expand Medicaid even as they preserved special health insurance for themselves.

Like it or not, nearly everything that is important to religion also is important to politicians. Jebs view seems to be that once politicians pick up a subject, religious leaders have to drop it.

How incredibly secular of him. I guess there is only one thing for religious people to do: Pray Jeb doesnt get elected.

Jac Wilder VerSteeg is a columnist for The South Florida Sun Sentinel, former deputy editorial page editor for The Palm Beach Post and former editor of Context Florida. 

Jac Wilder VerSteeg: Jeb Bush’s view of religion knocks off some commandments

I have to believe Jeb Bush when he says he wouldn’t let his priest – or even the pope – dictate his economic policy. In fact, if you take Jeb’s recent statements about religion seriously, an obvious conclusion is that Jeb doesn’t take his religion seriously.

I hope Im not going to get castigated for saying this by my priest back home,Jeb said, but I dont get economic policy from my bishops or my cardinals or my pope.”  He continued, I think religion ought to be about making us better as people, less about things [that] end up getting into the political realm.

With that statement which Jeb uttered in an attempt to sidestep Pope Francisencyclical on climate change Jeb has created a conundrum. We have to identify things that can be categorized as making us better as peoplebut that are not so important that they would be getting us into the political realm.

The first thing to notice is that Congress and state legislatures routinely deal both in criminal and civil statutes with things such as murder, theft, perjury and marriage.

Right away, at least four of the Ten Commandments are in trouble. Dont kill, dont steal, dont bear false witness and dont commit adultery.

Sorry, priests, rabbis and pastors, we dont want to hear your thoughts on those topics any more. Too political.

Its true that some commandments that used to be enforced by the state already have fallen or are falling by the wayside. We dont still put people in the stocks for missing services on the Sabbath, though a dwindling few blue laws remain in effect. Presumably Jeb-gagged priests can continue to preach about such things. But, and this is part of the head-scratcher Bush has posed, those things could not have dropped out of the political realm without some politicians deciding to remove them from statutes.

But leave that catch-22 alone for time being. Try instead to imagine the kinds of things that Jeb thinks would be appropriate for religious leaders to concern themselves with. Get back to that sliding scale with Making us better as peopleon one end and Getting us into the political realmon the other. You can move the slider along the Making us better as peoplerange only until it moves into the Getting us into the political realmon the other. Then you have to stop, Mr. Minister, and abandon the issue to politicians.

However, Im having trouble thinking of an issue that makes us better as people that doesnt quickly get into the political realm in some fashion or other.

Could he be talking about I dont know eating right and exercising? Oh, wait. Hasnt Congress had regular fights about which farm products can be purchased for low-cost school lunches? Hasnt the Florida Legislature mandated periods of physical activity for school children?

Perhaps religious leaders should just talk about the redeeming value of prayer. Certainly prayer never has become a political issue. Oh, wait

What about, love your neighbor as yourself? That sounds just a little too much like what all those sore-loser Florida senators were saying when they castigated House members for failing to expand Medicaid even as they preserved special health insurance for themselves.

Like it or not, nearly everything that is important to religion also is important to politicians. Jebs view seems to be that once politicians pick up a subject, religious leaders have to drop it.

How incredibly secular of him. I guess there is only one thing for religious people to do: Pray Jeb doesnt get elected.

Jac Wilder VerSteeg is a columnist for The South Florida Sun Sentinel, former deputy editorial page editor for The Palm Beach Post and former editor of Context Florida. Column courtesy of Context Florida.

Lawmakers aimed to build a veto-proof health care budget

Florida’s legislative leaders are trying to make the health care financing decisions they made during the June Special Session veto-proof.

The Florida House and Senate were at odds throughout the 2015 Regular Legislative Session on health care spending and policy. Indeed, the inability to agree on how much additional Medicaid funding to include in the budget was the reason the chamber’s didn’t pass a spending plan on time.

But that was then and this is now. House and Senate leaders not only agreed to $400 million in recurring general revenue dollars for hospital funding, they appear to have agreed to a strategy to buffer their hard-won compromise from a potential veto from Gov. Rick Scott who during the regular Session made clear that he did not support back-filling the loss of any Low Income Pool funding with general revenue.

The Senate’s chief budget writer, Sen. Tom Lee, told reporters that the agreement to Low Income Pool funding was one of the “linchpins” that was able to bridge the House and Senate into working again on the 2015-16 budget.

“Since that was a huge priority to the Senate, and we understand that not everyone supports putting general revenue into back-filling LIP, we wanted to make sure that the critical pieces of that were part of this agreement that brought us together didn’t get unraveled after when we left here for session,” Lee said.

“We have had a priority to continue to stabilize the health care system while we look for long-term solutions. And in the interim we just think it would do irreparable harm to the system to allow the executive branch to go in and unravel that transaction that took place in the legislative process. We tried to do as much as we could to keep that agreement together.”

To that end, buried in the mounds of paper that House and Senate budget chiefs agreed upon was language that stated the two chambers agreed to reference a 53-page document in the General Appropriations Act as well as proviso called the Medicaid Hospital Funding Programs. It is the 53-page Low Income Pool offer the House made to the Senate.

Incorporating the document by reference means that there will be no dollar amount listed by the appropriation. Scott can veto an appropriation in a substantive bill without vetoing the underlying policy. Without a dollar amount, the governor would have to veto the entire bill to eliminate the spending.

The chambers agreed to put language in the conforming bill that notes whether any portion of the General Appropriations Act is unconstitutional then “all other provisions or applications of this act invalid” and that “the entire act shall be deemed to never have become law.”

Though included in the conforming bill, which, is permanent law, the chambers agreed to repeal the language effective July 2016.

Lee said the House knew that hospital funding and stabilizing the health care environment in the aftermath of the loss of $1 billion in Low Income Pool funding was a priority for the Senate. As such, Lee said the House was “accommodating” when it came to including the comfort language throughout the bills.

Matt Hudson, chief writer for the House health care budget, said the language was put in the bills at the behest of the Senate but may unnecessary.

“I think at the end of the day the governor is going to be very pleased with the work we have.”

Marc Yacht: Universal health care access must come to U.S.

The Florida House’s rejection of Medicaid expansion money affects more than just the poor. A recent Tampa Bay Times editorial outlined 25 reasons to accept the federal money.

Because of House members’ rejection, 800,000 low-income Floridians are now shut out of health care coverage. Many working poor who now pay high premiums for Obamacare face high deductibles. One rightly questions the value of insurance without protective subsidies.

Significant numbers of uninsured will continue to use Florida emergency rooms. That pressures insurance premiums and health care costs to rise. A fully insured population would break the cycle of escalating health care costs.

By refusing the expansion money Florida lost $700 million in 2016, and billions more down the road. That loss ripples outward to affect healthcare providers, pharmacies, medical equipment suppliers, the business community and all Florida residents.

Arguments against accepting the money are disingenuous at best and relate solely to the ideological hatred of President Barack Obama. Many who support that bias work against their own interests. The opportunity for comprehensive care will be lost to hard-working families. Federal taxes paid by Florida residents are then sacrificed to Obamacare-friendly states.

In all fairness, Medicaid offers second-tier discounted coverage. Many doctors reject it.  However, it does open the door to a full range of services including primary care, specialty care, and hospitalizations.

Free clinics rarely offer comprehensive services. Placing the Medicaid insured into managed-care models further reduces the options for care because those insurers profit by limiting patient care. That conflict of interest has defined the managed-care model. Also, doctor scorecards unfairly flag physicians for statistically driven increased patient costs. The health care management model can determine what services a doctor may perform.  Yet the physician remains responsible for outcomes.

In spite of all the emphasis on healthcare cost containment, the U.S. significantly exceeds per capita healthcare costs worldwide. Wise efforts should be directed at reducing administrative costs that can consume 20 percent or more of the health care dollar. Such costs result from the fragmentation of insurers, complex billing practices and onerous oversight.

A valid argument exists that Obamacare is too expensive to provide universal coverage. Yet those same critics block every effort to reduce healthcare administrative costs. Naysayers protect not only highly profitable insurers but also protect provider profiteering. And, of course, the uninsured place further pressure on costs.

Whenever the circular arguments vis-à-vis the outrageous costs of health care occur, rarely is there any movement to effectively address excessive charges, administrative costs and fragmentation. Those remain off the table.

That brings up the “Medicare for All” model with administrative costs under 5 percent. Every provider would save significantly because of the simplicity of the coverage. It’s criminal to allow the profiteering to continue while criticizing the lack of resources to provide universal health care to Americans.

Universal coverage would allow all Americans access to needed preventive and episodic care. Chronic conditions would be addressed and no one would have to delay needed care for fear of cost.

We stand alone from wealthy nations that have successfully provided universal health coverage for decades. Those nations surpass us in the overall health and well-being within their countries. Such political confusion regarding affordable healthcare for every American is unforgivable.

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

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