Frequently asked questions about the community health care plan

Frequently asked questions about the community health care plan

In the September issue of the Tortoise, Bill Phelan outlined some of the pertinent questions concerning the half-cent sales tax referendum that will be on the November ballot. That tax would fund an insurance program for county residents who are without access to health care. This is part two of the FAQs; please click here http://www.apalacheetortoise.com/archive/healthcare.shtml to read the first part of the FAQs.

Analyis by Bill Phelan

Why do we need a sales tax or a comprehensive health care plan? What’s the matter with the present system of two clinics -- Bond Clinic and Neighborhood Health Services – and the Capital Medical Society’s “We Care” program of donated services by medical specialists?

According to a recent study by Mercer, an outside consultant, the two clinics are operating at or beyond capacity, yet the number of uninsured people in the county keeps rising. Waiting time for appointments and for walk-ins is excessive, and the physicians and other providers are overloaded. Continuity of care and preventive care can be improved.

The “We Care” program of donated specialty physician care has been so overwhelmed with referrals that in 2005, they were forced to declare a 90-day moratorium for new referrals. Capital Medical Society President John Mahoney, M.D., has stated that, “donated care cannot meet the demand for essential health care for the medically indigent in our community.”

Treatment of mental illness and treatment of dental disease are hard to get in this community if one is uninsured. For example, Neighborhood Health Services, the only source of outpatient mental health care for low-income people without insurance, had an 18-month waiting list in July for mental health care.

The new plan promises a great emphasis on continuity of care because patients would see the same providers regularly. It also emphasizes preventive care such as screening for cancer and cardiovascular disease.

Several medical studies have shown that people who lack health insurance are more likely to die before their time. Women with breast cancer, for example, are almost 50 percent more likely to die from their disease if they have no health insurance. Why? Their cancer is often found in an advanced stage since the women could not afford screening mammograms and physical exams. The new plan will enable low income uninsured people to find and treat their dangerous medical conditions before the heart attack, stroke or cancer leaves them disabled or dying.

Should I drop my own health insurance?

You would probably be better off keeping your current plan. There is a waiting period of up to one year for people to get into the new plan if they drop or are dropped by their private or employer-sponsored insurance plan. Further, the benefits of the new plan probably are leaner than in your current plan.

Who will be eligible for the proposed plan?

Leon County residents who do not have public or private coverage for their health care, and whose income is at or less than 200 percent of the federal poverty level will be eligible.

When will the comprehensive health care plan be in its final, detailed form?

The county has adopted the Mercer consultant’s report as the outline for the plan. It includes: patient eligibility criteria, projected enrollment and costs, provider rates of payment, covered and excluded benefits, and standards of accountability. The county staff and community leaders are developing accountability provisions and are further defining eligibility and benefits. If the referendum passes in November, an administrative services organization will be hired by the county to further develop and administer the plan using guidelines developed by the county.

Are there “unanswered questions” about the community health care plan?

The Chamber of Commerce, the two hospitals’ administrators, the Capital Medical Society and other physicians and business people were working with county staff to improve the plan before and after it was adopted by the county commissioners. This group had been discussing health care in the community for several years as part of the county’s advisory board, which then recommended that the county commissioners adopt the Mercer plan as the basis for the new health care plan.

All of the questions from these community leaders have been answered by county staff. If there are “unanswered questions,” about the plan, they have not yet been asked. The county staff remains available to answer any questions.

How are other Florida counties dealing with health care for the uninsured?

Hillsborough County’s health care plan is 15 years old, and is funded by a sales tax like the one that Leon is considering. Their program is seen as very successful by most analysts, and, according to U.S. Health and Human Services Secretary Michael Leavitt, this type of plan is “substantially more efficient” than the Medicaid program for the nation’s poor.

Polk County’s plan is younger, but is also similar to Leon’s, and seems to be successful so far in getting medical care to people who have no insurance.

Alachua County (Gainesville) has an even newer plan, and is having some difficulty getting started, having enrolled less than 200 people so far.

Gadsden County’s commissioners unanimously adopted a similar health care plan in July, and the referendum will be on the ballot in November. This plan has wide community support and no organized opposition.

Leon County’s staff has been studying these various programs and is learning from the positive and negative experiences of these counties in developing our plan.

Will the higher sales tax hurt our local businesses?

Tallahassee is the business, cultural and population hub of the Big Bend. People in surrounding counties and in South Georgia come to Tallahassee to work, to be entertained, and to shop. This will not change because of a half cent sales tax increase. People will still come here to work, because the jobs are here--we have a very low unemployment rate. People will still come here to shop, because most of the stores in the region are here.

Since most of the shoppers in the region live in Leon County, they are not going to go elsewhere to avoid a sales tax increase. If you are buying a $500 refrigerator, would you drive to Thomasville, or even Quincy, to save $2.50 on increased sales tax? The cost of gas alone would keep you shopping here.

Customers, workers and jobs will not leave Leon County on the basis of a half-cent sales tax increase. Further, local businesses, especially those whose employees currently have no health insurance, will benefit from a healthier work force as a result of the plan. Workers also will spend less time waiting in emergency rooms when they can go to their medical home for more appropriate treatment.

Bill Phelan is recording secretary for the Tallahassee Equality Action Ministry, an organization of more than 19 diverse faith-based groups that work together to address concerns affecting low-income people.