Manatee County's indigent health care crisis not disappearing

November 24, 2013 

Manatee County's health-care dilemma on paying for uninsured indigent patients did not disappear with the implementation of the Patient Protection and Affordable Care Act. While Florida refuses to adopt an expansion of Medicaid benefits to poor working residents under ACA, those people still have health issues and still seek medical care while lacking health care insurance.

Manatee County taxpayers will be footing that bill soon, one way or another. Doctors cannot be expected to provide free care. But that's what the county is facing now with news that the $1 million budget to pay physicians for treatment of uninsured patients will be spent by the end of December -- just three months into the fiscal year.

The county's health care trust fund, stocked with millions of dollars from the 1984 sale of the then publicly-owner Manatee Memorial Hospital, will be exhausted in two years.

A little more than $9 million has been budgeted for the county's three big hospitals in a three-year agreement signed in 2011 -- mostly to pay for expensive emergency room care. But that contract only allows $1 million for payments to physicians.

A vibrant health care community is vital to the county's economic wellbeing and future. We can't chase doctors away by refusing to pay for their services. Nobody works for free.

This issue has been on the front page of Manatee County's medical, political and economic development community for many years with no resolution in sight still.

In 2008, a county task force charged with coming up with a solution proposed a half-cent sales tax increase after several dozen meetings, but county commissioners instead opted to continue draining the trust fund -- essentially kicking the can down the road in abject political weakness.

This June, that sales-tax idea came back to voters on a referendum that lost. The county failed to aggressively promote the referendum and the reasoning behind the tax -- even with the promise of a reduction in property taxes.

But that's long past now, and the county still faces this quandary of paying for indigent health care. How should this happen?

It will be a wrestling match for county commissioners. Since a sales tax is out of the question, how will the county pay this multimillion bill in the future?

Over the past few years, the county has executed a major staff and expenditure downsizing during the recession.

As county Administrator Ed Hunzeker has stated, all the "low-hanging fruit" been eliminated.

What's next? Do we reduce the public safety budget? Heaven forbid a cut in that most essential service. Are the options, then, quality-of-life programs -- parks and libraries? Both are important to economic development just as health care and public safety.

At this point, the only other alternative is an increase in property taxes. In an election year, is that even plausible for commissioners to pass?

Voters and taxpayers must soon come to a decision about the future of indigent health care. This has been more than five years in the making. Community leaders foresaw this.

We cannot continue to delay a definitive solution to this.

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