MANATEE -- A polite but passionate "listening session" attracted nearly 100 people Wednesday to discuss how the county should solve health care dilemmas when funds for the poor run out next year.
The Manatee County Commission workshop kicked off a 10-day "citizen engagement process" to help officials make decisions about whether -- and if so, how -- to pay for indigent care once the county health care fund is exhausted.
Among the topics at Palmetto's Bradenton Area Convention Center:
Whether government should be providing health care at all?
If so, how to ensure taxpayer dollars are spent efficiently?
How many people in Manatee County are unable to get health care?
There was plenty of debate about why it's so hard to know what a medical procedure costs, and whether prevention programs work to curb costs.
Dr. Eric Folkens, who operates urgent care clinics in Bradenton and Lakewood Ranch and two in Sarasota, said: "We could save everybody so much money" by negotiating contracts with the county to keep people out of expensive hospital emergency rooms.
"Everybody knows what we charge," he said, noting his clinics list the price of each procedure online and in plain view of patients.
Access to care is a big issue because so few doctors will see poor Medicaid patients whose bills are paid for by a state-federal program, said several participants.
Dr. Celestino Palomino, who takes patients regardless of ability to pay, said he was "overwhelmed" with the needy.
"About 25 percent of my patients in the hospital are indigent," he said.
Steve Vernon, former president of Tea Party Manatee, said extremely important stakeholders in the discussion are never included in the discussion: Taxpayers.
"They're never represented. It's always special interests," he said.
Several participants discussed why Manatee County Rural Health Services Inc., a nonprofit that operates clinics across the county for indigent and insured patients, cannot handle all who need care.
One reason is people may get primary care at such places but still have no access to specialists for more serious conditions. Manatee County lacks adequate dental care for the needy, said Adell Erozer, executive director for Turning Points, which operates a busy free clinic at Bradenton's Galvano One Stop Center.
"I've had people who just needed a tooth pulled" face life-threatening situations because they couldn't find a dentist," said Erozer.
Such people were not among those gathered to discuss the health care system, said Luz Corcuera, program director for the Healthy Start Coalition of Manatee County Inc.
"We need to go out to them," she said. "It's a great discussion, a great start, but unfortunately not everyone is here."
County commissioners deferred a decision earlier this month, pending public discussion, on a funding agreement with the Manatee Chamber Foundation for a health care system analysis and plan development to be conducted by the University of South Florida College of Public Health.
Manatee officials should contract directly for development of a health care plan for the community, rather than through the Manatee Chamber Foundation Inc., chamber leaders said in a letter to the Bradenton Herald.
A proposal that the chamber foundation, a nonprofit affiliated with the chamber, should be a contracted party in conjunction with the University of South Florida for development of a plan "is not the best approach," it said.
"We suggest that the county consider contracting directly with USF's College of Public Health, knowing that USF's proposed process calls for significant public engagement opportunities and stakeholder input," said the letter signed by Rae Dowling, chairman of the board of the Manatee Chamber of Commerce, and Chris Pennewill, president of the Manatee Chamber Foundation.
A second health care workshop session is slated for 6 p.m. Tuesday at the Bradenton Area Convention Center, 1 Haben Blvd,, Palmetto.
Sara Kennedy, Herald reporter, can be reached at 941-745-7031. Follow her on Twitter @sarawrites.