State Politics

Florida House moves forward with its own free-market healthcare ideas

Dr, Kanna Posina, left works with Dr. Nirat Beohar, the director of Mount Sinai’s cardiac catheterization lab and structural heart disease program, on a practice procedure on pretend patient, David Patlak, during an emergency drill in July 2015.
Dr, Kanna Posina, left works with Dr. Nirat Beohar, the director of Mount Sinai’s cardiac catheterization lab and structural heart disease program, on a practice procedure on pretend patient, David Patlak, during an emergency drill in July 2015. emichot@miamiherald.com

After knocking down a plan to expand Medicaid last summer, the Florida House is now pushing its own ideas for healthcare reform.

And the proposals are starting to make headway.

Three bills forming the first wave of reforms were approved Thursday in the inaugural meeting of a special House committee focused on healthcare costs. Together, they would loosen some regulations on healthcare in Florida.

Supporters believe they would cut costs and help low-income patients access care. But critics say they will discourage doctors and hospitals from serving low-income communities.

The bills that won committee approval Thursday would:

▪ Eliminate certificates of need, a license for opening and expanding hospitals. The state approves new beds based on the demand in an area to reduce competition where there are already sufficient hospitals serving patients.

▪ Let people negotiate and pay doctors directly for some services, cutting out insurance companies for routine procedures like office visits and vaccinations.

▪ Create facilities outside of hospitals where patients can recover for up to 72 hours after surgery and extend the time patients can spend at surgical centers.

“The goal of this committee is to bring a holistic view and a holistic solution to the problems that are currently ailing our healthcare system,” said Rep. Jose Oliva, R-Miami Lakes, who chairs the House Select Committee on Affordable Health Care Access. “So what you will find are solutions that, while presented individually, are meant as an overall solution, and things that can truly affect the cost and the access to healthcare.”

Among the proposals, gutting certificates of need is perhaps most controversial.

So-called CON programs were set up in the 1970s to prevent hospitals from having overlapping services in the same area.

Rep. Chris Sprowls, R-Palm Harbor, says they haven’t worked and that the lack of competition between hospitals discourages efficient, low-cost care. Fourteen other states do not require CON.

“If you have a neighbor across the street who does great work and provides quality care and uses innovation to give patients access to quality,” Sprowls said, “you’re going to want to do the same thing because you don’t want patients to go across the street.”

But Democrats — who voted down the bill — argued that some communities, particularly those in low-income, inner-city and rural areas would not have nearby hospitals if not for CON.

“I understand that right now we’re trying to reform our healthcare system,” said Rep. Alan Williams, D-Tallahassee. “But when you do this, you potentially open up Pandora’s box, where you have these hospitals popping up on top of each other. What will prevent that from happening?”

Speaker Steve Crisafulli, R-Merritt Island, created the special panel to consider a series of reform ideas, starting with the three it approved Monday. Oliva said they will be looking at other proposals as well, including a price transparency measure.

Gov. Rick Scott has unveiled his own reform plan forcing hospitals to publish the costs of their services. His Commission on Health Care and Hospital Funding is currently considering a letter of endorsement for the proposed bill.

Critics, including fellow Republicans in the Legislature, say the House’s reforms won’t do enough to help poor Floridians afford healthcare.

“If you don’t have insurance, it doesn’t matter how many innovative programs you make,” Senate President Andy Gardiner, R-Orlando, said last month. “You still don’t have access.”

Oliva’s not convinced.

“What competition does is that it significantly drives down the cost of any good or service,” he said. “If you look at a flat-panel TV that was introduced 20 years ago, they were $5,000. Today you can pick them up for a couple hundred, in spite of inflation and everything else, because when there’s a real ability to compete, prices go down and usually quality goes up.”

Contact Michael Auslen at mauslen@tampabay.com. Follow @MichaelAuslen.

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