TALLAHASSEE -- A pair of Republican state legislators who are also doctors are pushing an alternate plan to reform health care that runs counter to the proposed overhaul laid out by party leaders.
State Reps. Julio Gonzalez, R-Venice, and Fred Costello, R-Ormond Beach, want to keep doctors in control of health care decisions and give individuals incentives to negotiate health care costs. They even want the state to run its own Medicaid program, cutting federal regulations out entirely.
The plan, laid out in a 29-page missive to a House panel Thursday, is an eight-year road map for where the two freshman lawmakers want the state to go. While some of it aligns with House leaders such as soon-to-be Speaker Richard Corcoran, R-Land O'Lakes, many of their ideas conflict with those of lawmakers who are influential in healthcare.
The goal, according to Gonzalez and Costello, is to cap the total cost of delivering health care at one-third of the state's budget. Medicaid totals $25.7 billion in the current state budget, about 32 percent of the total.
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There is a need for a "safety net," they say, but the system as a whole should be built on the idea of "individual ownership" of people's own health care.
Just three months ago, the Florida House voted down a plan to request federal Medicaid money as a way to fund private health insurance for needy Floridians. Gonzalez, an orthopedic surgeon, and Costello, a dentist, were in the 72-vote majority.
Instead of expanding Medicaid, they suggest the state create its own program to pay for needy Floridians' health care.
Under the plan, Florida would still use federal Medicaid dollars but would seek waivers for federal regulations.
"The states are in a much better position to decide how to allocate the funds to meet the particular needs of that state," Gonzalez said. "The cookie cutter plan from the federal government -- I think we've already demonstrated that does not work.
Their plan would let patients negotiate with doctors and hospitals to get the best price and for cost savings to be split between the state and the patient. Patients could also use tax credits as an incentive to use health savings accounts, limiting insurance companies' roles as negotiators.
This is one of the tougher ideas in the proposal, Gonzalez said, and it likely won't come to fruition for at least a few years when new leaders will control the House.
Much of Gonzalez's and Costello's proposal is intended to increase competition within the health care industry, which Corcoran championed last year as part of the House's refusal of a Medicaid expansion plan.