HMO disgust pours out

By SAUNDRA AMRHEIN

© St. Petersburg Times, published July 15, 2000

SPRING HILL -- As a mob of retirees screamed for answers, James Nico silently slid his wheelchair through the crowd.

A retired Georgia police officer, Nico was not here on his own behalf.

[Times photo: Kevin White] A crowd mills around Friday in the parking lot outside the Spring Hill Enrichment Center.

He came to the town hall meeting looking for a way to pay medical bills for his ailing in-laws once their Medicare HMO pulls out of Hernando County at year's end.

"Financially, there's no way we could do anything for them," Nico said, who has a damaged left kidney and hip bone from a bullet he took while off duty 16 years ago. "If something doesn't happen, we'll have to sell our house and leave the county."

Like the other 100 people in the parking lot outside the Spring Hill Enrichment Center on Friday afternoon, Nico was shut out.

The meeting, called by two agencies for the elderly, was intended to calm more than 9,000 Hernando County seniors told last month that the two remaining Medicare HMOs and their extensive prescription drug benefits were leaving town.

But the meeting merely served to incite an already angry crowd of more than 100 people in the parking lot and another 100 who were allowed inside.

Some seniors left the center and returned with signs of protest that read, "We suffer, no one listens," and, "We need action, not talk."

Other seniors began arguing in the parking lot about whether Republicans or Democrats were to blame for their plight with Medicare. Many stormed the door of the Enrichment Center and berated the volunteer on the other side of the glass for poor planning.

Those seniors who emerged from the center an hour later were just as angry, disappointed with what they considered a lecture on Medicare.

"We were hoping to find out which HMOs they were going to bring into the county to help the elderly," said Nico, who was locked out of the meeting.

He and his wife are the primary caregivers for her parents, who are recovering from several ailments, including a stroke, heart attack and diabetes.

Right now, Humana's Medicare HMO covers most of the costs for prescription drugs and doctor visits. But if forced back on traditional Medicare and its supplemental plans, they would be socked with up to $600 for both parents in monthly premiums and well more than $300 a month in medications for his mother-in-law alone.

Both Humana and AvMed Health Plan announced in June that they would withdraw their Medicare HMO plans from Hernando County at the end of the year because federal reimbursement rates for their services here are too low, causing them to lose money.

Medicare HMOs -- offering prescription drugs and other benefits not available through Medicare -- became popular in the 1990s as Congress sought an affordable alternative to Medicare.

But the Balanced Budget Act of 1997 sliced annual increases in reimbursements to Medicare HMOs to 2 percent, causing many HMOs to scale back dramatically.

If another Medicare HMO does not move into Hernando County after the new year, many seniors gathered Friday said they would have to choose between medication and food.

"They are taking everything away from us," said Frances Sosler of Spring Hill, who was locked out of the meeting. "They're going to have us all in the cemetery or the poorhouse."

Paul Cote was steaming that about not being able to get into the meeting.

"If someone was awake, they should have known better," Cote said. "There are 9,000 in Hernando County affected. That should be enough (of a clue)."

Jennifer Glymph, coordinator of outreach and wellness programs for Mid-Florida Area Agency on Aging, one of the co-sponsors of the meeting, said the groups had no idea the turnout would be so large.

In response, coordinators have planned another meeting for 2 p.m. on July 21 at the Hernando County Fairgrounds.

Those who got inside the center Friday wanted to know whether any Medicare HMOs would soon replace Humana and AvMed.

That's why Dr. Alfonzo Ruiz showed up.

With offices in Pasco and Hernando counties, he tried to calm the retirees in the parking lot by telling them that he and other doctors have been meeting with at least three insurance companies about bringing a Medicare HMO plan here by the end of the year.

"That's the only answer," he said. "We have five months to work together."

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