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Options limited for those without health insurance

By ANDREW SKERRITT
Published January 24, 2006

When officials from Pasco County met with local health administrators for a health care summit late last week, it was clear that the problem wasn't manufactured.

Too many families just can't afford health insurance. And too many of those families end up in the emergency room whenever they get sick.

Addressing this issue is clearly a public policy priority. It's something that elected officials need to care about. Unfortunately, that day in the room, only one Pasco County commissioner, Ann Hildebrand, could be there to listen.

In an election year, voters need to hear elected officials talk about issues that matter, not the symbolic issues that drive special interest voters to the polls. And providing quality health care for those who can't afford it is one issue that matters.

Early in the debate, some fiscal conservatives rejected the idea of a half cent or quarter cent sales tax to pay for indigent care. They said that's what Medicaid is designed to do. Unfortunately, they haven't looked at the numbers.

Not everyone qualifies for Medicaid. Statewide, about 10 percent, or about 1.9-million people, are eligible - about 40,000 in Pasco. That's not getting the job done. There are 70,000 uninsured in Pasco.

"A lot of poor people make too much for Medicaid," said Dorothy Knight, president and chief executive officer of the Premier Community Healthcare Group, which runs a federally financed health care clinic in and around Dade City and Zephyrhills.

Early indications are that Pasco is a long way away from being able to come up with anything rivaling Orange County's Primary Care Access Network, which last year treated about 57,000 patients who have no insurance.

In the interim much of the primary care load will be borne by clinics such as the federally funded Premier Community health care centers. Premier operates three sites. We need more.

Knight says her organization is looking to expand. Over the next six months, it hopes to provide primary care until 11 p.m. Monday through Friday and noon to 8 p.m. Saturday.

Minor medical emergencies have a way of happening after dark. Those kinds of hours accommodate working people who don't get paid when they take time off to see a doctor.

"We are the model for health care," Knight said. That center, which provides care to everyone with or without insurance, has been around for 27 years. The time for similar clinics in Pasco is long overdue.

Knight's dream scenario?

To open two or three federally financed community health care clinics on the west side of Pasco County.

It costs about $700,000 to open and run a community health center. Given that the five hospitals in Pasco County provided $26-million in uncompensated care in 2003, the cost of opening a center is money worth spending.

Unfortunately, the federal fiscal realities aren't on the side of helping the uninsured. Thanks largely to the mounting federal deficit, tax cuts, Hurricane Katrina, the war in Iraq and other factors, no grants are available to open new facilities this year, Knight said.

That's too bad. Not only are such facilities needed in Pasco, but also in Citrus County, where officials are looking to find money for a community health center, according to Citrus health department administrator Marybeth Nayfield.

In Citrus, the 16,724 uninsured residents don't have many options for health care. They usually go to the health department clinics in either Crystal River, Inverness or Lecanto. Unfortunately, too many of them end up in the emergency room at Citrus County Memorial, Nayfield said.

Who pays for all that uncompensated care? Taxpayers do.

But there is good news for the more than 26,000 uninsured residents of Hernando County. A community health center is opening in Brooksville this spring, according to health and human services director Jean Rags. But in a county where indigent care cost taxpayers about $2.9-million a year, it's only a drop in the bucket.

But it's a start.

--Andrew Skerritt can be reached at 813 909-4602 or toll-free at 1-800-333-7505, ext. 4602. His e-mail address is askerritt@sptimes.com

[Last modified January 24, 2006, 00:55:20]