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Healthcare

HEALTH INSURANCE: A Hurdle and a Stumbling Block

Almost 3 million Floridians under age 65 do not have health insurance. The state is hoping to ease the problem this year as the 2004 Affordable Healthcare for Floridians Act goes into effect. One component involves rolling out health savings accounts (HSAs), which combine a savings account with a high-deductible health insurance policy. The idea is that the high-deductible policy will be less costly for both employers and employees, while the savings account provides tax benefits.

Also on the state's fast track is a high-risk insurance pool for Floridians with severe medical problems such as Lou Gehrig's disease and brain and spinal injuries. "It's supposed to be a safety net in the purest form," says Karen Bender, an actuary with Mercer Oliver Wyman who presented her finding to the board of the state-sponsored group on the issue. Floridians unable to obtain medical insurance would pay anywhere from one and a half to three times the price of a standard premium.

A stumbling block for healthcare is the spiraling cost of Medicaid, the state-federal program that primarily serves low-income children and senior citizens. Gov. Jeb Bush is expected to push for reform. Medicaid will cost Florida about $14 billion this fiscal year and is projected to almost quadruple to $52 billion in 2015 if nothing is done. "The cost is not sustainable," says Jerry Senne, president and CEO of Health First Health Plans in Brevard County and chairman of the Florida Association of Health Plans.

2005 Forecast: What healthcare issues will be worth watching in 2005? "The biggest one is healthcare inflation and then the price of medicine and malpractice insurance," says Jerry Senne, chairman of the Florida Association of Health Plans. Senne sees "continued healthcare inflation at a lower rate than 2004, which was approximately 11%, but at double the overall rate of inflation."
HOSPITALS: Manpower and Money

The November passage of Amendment 8, known as the "three strikes you are out" amendment, will hinder the already difficult staffing of Florida's hospital trauma centers, says Ralph Glatfelter, senior vice president of the Florida Hospital Association. Florida trauma centers, which are still reeling from Gov. Jeb Bush's veto of $21 million in dedicated state funding, are facing the dual challenges of finding a stable funding source to support a statewide system and recruiting and retaining specialists, particularly neurosurgeons.

Along with trauma center operations, hospitals are looking for ways to mitigate the cost of indigent and unreimbursed care, which the FHA says costs $2 billion a year. "I think there is enough money in the healthcare system. We just have to use it efficiently," says Glatfelter.

2005 Forecast: "We're encouraged, but we're not naive" concerning state trauma center funding, says John Hillenmeyer, president and CEO of Orlando Regional Healthcare, a private non-profit that operates seven hospitals and one of the six Level 1 trauma centers in the state. "Clearly they are not going to raise taxes," he says of Florida legislators, warning, "If there's not some funding relief, I think you are going to see trauma centers close."
PHARMACEUTICALS: North of the Border

Six months after Florida seniors began sorting through the pros and cons of the Medicare drug cards, Floridians of all ages are demanding more affordable prescription drugs.

Much of the discussion centers on Canada. "Importing drugs from Canada, we think, is part of the solution," says Jeff Johnson, advocacy manager for AARP Florida.

Unlike a handful of states that have quietly helped residents get drugs from Canadian suppliers, the Florida Department of Health in 2004 shut down a dozen unlicensed pharmacies with names like Canada Direct and Buy Canadian Discount Drugs. This year, however, there's likely to be pressure on lawmakers in Tallahassee and Washington to pave the way for Canadian imports.

2005 Forecast: Although the importation of drugs from Canada is primarily a federal issue, it will likely also be on the front burner in Tallahassee in 2005, says Miami Democratic Rep. Yolly Roberson, who will sponsor legislation that allows Florida licensed pharmacists to sell scripts from Canada. Roberson concedes that in 2004 she could not round up enough support for her bill. "This year is a different story," she says, adding, "I'm hopeful that something will be done."