Manatee County Moves Forward to Remedy Indigent Healthcare Costs

BRADENTON -- At Tuesday's BOCC Health Care Funding workshop, commissioners voted 5-2 to move toward a voter referendum to determine whether a half-cent sales tax could be levied to cover the cost of health care for the indigent, the uninsured and underinsured in Manatee County. The item will be added to the March 12 commission meeting.

The Manatee County Health Care Alliance (MCHCA) is made up of many specialist and health care providers. Their goal is to introduce a new paradigm in the way the county treats, implements and pays for the health care that is supplied to those who can't afford it.

The county provided three options, A: do nothing; B: increase property tax; and C: introduce a half-cent sales surtax, if approved by the public in a referendum vote. Studies show C could produce the needed funding and the commission ultimately went with that option. 

Currently, when someone falls ill and can't afford to see a doctor, they go to the emergency room at the hospital. This costs the taxpayers many times the amount it would if the patient went to see a doctor in their office or at a clinic. This path also prevented the patient from getting the needed help until the problem was in an advanced stage, which also contributed to higher cost.

Many things contributed to this inefficient and flawed practice. When the county sold its ownership of Manatee Memorial, interest rates were double digits and the county created a fund for the incoming revenue. It was thought that the fund would be self-sustained for 20 years. 

That period expired many years ago, and surprisingly, the funds kept in step with the payouts for the county's indigent care. But today, interest rates are only a fraction of what is needed to sustain the cost, and the fund is overburdened, projected to hit the red sometime in 2015.

As the different stakeholders presented their findings to the commission, one theme played over and over: Pay now or pay later -- and later multiplied the cost many times over. 

Donna J. Peterson, Senior Vice President and Dean of the College of Public Health at the University of South Florida, has been assisting MCHCA by providing the knowledge, expertise and latest research, that only an institution like USF can produce. "Florida is the healthiest state in the nation," said Peterson, "and I believe Manatee could be the healthiest county." 

Peterson demonstrated how prior practices left most health care providers' priorities backwards. She used a pyramid example that demonstrated behavior being the most important factor. She said, "everybody wants to be healthy" adding, "prevention and primary care are most important." 

Kevin Dilallo, CEO of Manatee Memorial, who oversees 1,300 employees at two hospitals said, "I write off $20 million a month. We can't continue to do that." Dilallo added, "What we have at One-Stop is a good working model. Five days the free clinic has medical students, and everyday a doctor spends five hours seeing patients in the three examination rooms ... the One-Stop plan saves a lot of money." 

All but the two freshman commissioners (Benac and Baugh) were engaged and inspired by the progress MCHCA had obtained to date. It had been two years of workshops pounding out stats and studies, and members of MCHCA were now ready to move forward with their plan.

Baugh repeatedly stated she was disappointed in what she was shown, saying, "I thought I would see a presentation with a Powerpoint and a plan. I don't see any plan."

Benac agreed, saying she came from a planning career where you had things "figured out and knew what was going on." Benac added, "I think we all have a responsibility to take care of ourselves. I don't want my dollars just being thrown at the issue. How do we know until we see a plan?"

The other commissioners seemed perplexed by their new counterparts' nonplussed response. After much ado, Commissioner Gallen made the motion to go forward. Commissioner Chappie seconded the motion and it passed 5 to 2, Benac and Baugh dissenting.