Vital reforms

Everyone needs to be concerned about the spiraling cost of the Medicaid program and its effects on the budgets of the state of Florida and the country. Every tax-paying business and individual is impacted by the rapidly rising costs of such an expensive government program.

Medicaid is the government program that pays for health care for the poor, serving mostly pregnant women, children, the frail elderly and the disabled whose incomes fall below a certain level. Florida’s Medicaid budget is $14 billion this year, and is predicted to rise to $17 billion next year. The program has grown by 88 percent since 1988 and is expected to account for 60 percent of the entire state budget by 2015.

In response to this impending budget crisis, Gov. Jeb Bush proposed a dramatic overhaul and restructuring of Medicaid. Businesses and individuals, whether they are health care-related or not, need to pay close attention to the upcoming debate and communicate their support of the governor’s efforts to restrain the growth of the program while improving health care and expanding health care choices for the more than 2 million Floridians who depend on Medicaid.

The governor’s plan is designed to empower Medicaid patients to have more control over their own health care. The plan would transform Medicaid from a system of direct government-regulated payments to health care providers for services into one that would pay HMOs, provider service networks and other managed-care networks to develop benefits plans for specific Medicaid recipients. The governor believes that allowing managed-care companies to compete for Medicaid patients will increase access to care and improve the quality of care while holding down costs.

Medicaid patients would be empowered by being able, for the first time, to choose among companies and benefits plans competing for their business. Counselors would be available to help patients choose a health care plan that best fits their needs.

Patients would also be able to opt out of selecting one of the Medicaid plans and use their state-paid premium to shop for plans on the open market.

Another innovation would allow patients to earn enhanced benefits through flexible spending accounts by making healthy lifestyle choices such as not smoking. The enhanced benefits would enable patients to purchase increased coverage for more services.

Many health care systems already have networks in place that could be adapted to the new Medicaid. The North Broward Hospital District, for example, has an integrated delivery network that provides a variety of medical services, such as discounted drug prices and experienced case managers.

Prior to the 2005 legislative session, the governor’s Medicaid proposals and alternatives proposed by others will be the subject of joint hearings around the state by the Florida Senate and House Select Committees on Medicaid Reform. Sen. Lisa Carlton (R-Sarasota) is chair of the Senate committee and Sen. Jeffery Atwater (R-Palm Beach) is vice chair. On the House committee, Rep. Joe Negron (R-Stuart) and Rep. Holly Benson (R-Pensacola) are co-chairs.

Besides Sen. Atwater, members from Broward and Palm Beach counties include Sen. Walter “Skip” Campbell (D-Fort Lauderdale), Sen. Mandy Dawson (D-Fort Lauderdale), Sen. Ron Klein (D-Boca Raton) and Rep. Eleanor Sobel (D-Hollywood).

The Florida Chamber of Commerce commended the governor for addressing the Medicaid issue and added that “health care costs are growing at a rate that is making it extremely difficult for employers and individuals to find affordable options.”

The Medicaid program affects health care costs and access to quality care for everyone. All business leaders and individuals need to monitor this issue closely and tell their senators and representatives to support this important and necessary Medicaid reform initiative.

William R. Scherer Jr. is managing partner of Conrad & Scherer, which specializes in health care law and complex commercial litigation. Reach him at [email protected] or (954) 462-5500.

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