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Column

Let's do better for our uninsured neighbors

By C.T. BOWEN
Published January 22, 2006


Scott Pittman envisions the day 20 years into the future when east and west Pasco are united as one. Or, using his analogy, when the railroad lines meet in the center.

The preacher turned professional hospital administrator didn't complete what would have been the obvious sentiment.

It can be a train ride or it can be a train wreck.

Pittman is chief executive officer of Florida Hospital Zephyrhills. The hospital on the hill, formerly known as East Pasco Medical Center, is driving the public debate about how to provide medical care to uninsured Pasco residents. The goal is to avoid the train wreck that could accompany the public's continued reliance on emergency rooms for basic medical care.

Friday, the hospital culled together about 30 people from state and county government, hospitals and health care agencies to begin the task of forging the track.

They heard about Orange County where the train wrecked in 1999 when Princeton Hospital, serving a poor population, closed its emergency room. Its former uninsured clientele spilled into the county's other hospitals and the stress on the health care system became the genesis of a community partnership known as PCAN or Primary Care Access Network. Last year, it served 57,000 new patients, all of them without medical insurance.

Hillsborough County acted in 1991. Its County Commission approved a half-cent on the dollar increase in its sales tax to pay for indigent health care. Polk County voters approved a similar tax in 2004.

The initial focus in Pasco has been on a sales tax increase, too, though nothing is final. Still, asking Pasco voters to approve a second tax increase in less than three years requires a leap of faith that would give Robbie Knievel the jitters. The Penny for Pasco increasing the tax from six to seven cents on the dollar became effective Jan. 1, 2005. It pays for schools, roads, preserved land and public safety equipment.

Following the Orange County model here means developing a network of clinics to augment the work of the Good Samaritan Clinic in New Port Richey and Premiere Community HealthCare Group in Dade City. Good Samaritan, which sees only the uninsured, had 5,000 patient visits last year. About half of the 12,000 patients at Premiere have no insurance.

Orange County government provides $12-million to the PCAN consortium annually, the same amount the county spent on indigent health care pre-1999, said administrator Margaret Brennan. A three-year federal grant of approximately $2.4-million helped other initial costs.

Pasco County's 2005-06 budget for indigent medical care includes this notation on page 10-3:

"This fund has been exhausted during fiscal year 2005."

The proceeds from the sale of the two public hospitals in the early 1980s are gone. Pasco County has no $12-million starting point.

Treating uninsured or underinsured patients in hospital emergency rooms in Pasco cost $26-million in 2003, a more than 200 percent increase from three years earlier. But, that kind of data won't resonate with the public, particularly with three of the five hospitals in Pasco owned by the for-profit chain HCA.

Treating people in clinics before they reach the emergency room cuts health care costs or at least holds down increases, and, in turn, should help control the cost of insurance. Still, some skeptics might look at it as a bailout for Bill Frist's stock portfolio.

Whatever system is developed requires a funding source and a strong sales pitch to the public or to Pasco County commissioners who have the authority to simply restore indigent health care as a line item in the budget and pay for it with property taxes.

There are plenty of colloquialisms to describe the uninsured population which may be as high as 70,000 in Pasco County.

Uninsured.

Self-payers.

Working poor.

Needy.

Here's a better one: neighbor.

It's that kind of statistic that advocates for a revamped health-delivery system should emphasize.

If the estimates are accurate, more than one of every six Pasco residents lacks health insurance coverage.

Figure you know them, if you're not one of them yourself.

Reach C.T. Bowen at bowen@sptimes.com or at 727 869-6239.

[Last modified January 22, 2006, 01:02:19]


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