Residents anguished over HMOs leaving

A group warns politicians they won't let two HMO companies leave the county without a fight.

By ROBERT KING

© St. Petersburg Times, published August 6, 2000

SPRING HILL -- With nearly every politician in Hernando County on hand, a restless gathering of 600 Medicare HMO members held their own convention Friday night and threatened to toss the politicians out of every office between here and Washington.

Referring to themselves as "HMO refugees" on the verge of "genocide," the group lambasted Gov. Jeb Bush and Insurance Commissioner Bill Nelson.

They took pot shots at state Rep. David Russell and vowed to march on Tallahassee and Washington if that's what it takes to get their point across.

The spark behind their angst is the recent announcements by AvMed Health Plan and Humana that they will stop offering their Medicare HMO plans in Hernando County at year's end.

The HMOs say they can't make a profit in Hernando County. Since they are the only two companies with Medicare HMOs here, their nearly 10,000 members will have to find other insurance or return to traditional Medicare, which doesn't offer prescription drug coverage.

Cancer survivor Miriam Spitz fears that, come New Year's Day 2001, the supply of medication she needs to keep her alive will dry up if her Medicare HMO pulls out. "Life is precious," she said. "I do not intend for it to be taken from me because of greed."

Another cancer survivor, Diane Kujat,said she won't be able to afford her share of chemotherapy and radiation costs she'll have to pay if her HMO leaves and she has to go back to regular Medicare.

Their comments epitomized the purpose of the meeting, which was to rally the troops to action and to let the politicians know that -- with the elections around the corner -- they are prepared to carry a big stick into the voting booth.

Officially on hand to hear the message were U.S. Rep. Karen Thurman, D-Dunnellon, aides to U.S. Sen. Bob Graham and state Rep. Nancy Argenziano and county Commissioner Nancy Robinson.

But the auditorium turned into a magnet for those elected and those who want to be elected, even if their office has little to do with Medicare HMOs.

While Robinson was the County Commission's official representative, Commissioner Pat Novy joined her on the stage and spoke to the audience. The three remaining commissioners were among the crowd, as were sheriff's candidate Richard Nugent and County Commission candidates Diane Rowden, Betty Whitehouse and William Alonzo Merritt.

At the end, state House candidate Sabato Devito took one of the microphones to tell the crowd that the HMOs were taking their premiums and using them to fill the golden parachutes of their high-paid executives.

Devito came, he said in an interview, "for the same reason as everybody else: There's a crowd of people and it's an important issue." Medicare HMOs have come up at previous candidate forums, he said.

Other politicians -- Bush, Russell, Nelson, U.S. Sen. Connie Mack, state Sen. Ginny Brown-Waite and state Rep. Mike Fasano -- were invited, according to rally organizers, but did not show. Their absence was purposely made more conspicuous by a row of empty chairs with their names on them.

"I see a chair there for Florida Gov. Jeb Bush. Where the hell is he," said Rose Nardone, a member of Humana's Medicare HMO. "Watch out for us. And your brother better watch out too." The audience erupted in applause.

Bush felt the group's wrath because they said he should use power granted to him and other governors by the Balanced Budget Act of 1997 to order HMOs to cover every county in their states.

HMOs have said they can't afford to operate in every county because, in smaller counties, the federal government's reimbursements for their services isn't high enough to cover their costs and there aren't enough providers to create competitive pricing.

Port Richey physician Dr. John Batista took an open microphone Friday to support that idea. He said patients and doctors need to cut costs in ways that will preserve quality care but not drive HMOs into the ground, such as picking the least expensive of two hospitals.

Bush spokesman Justin Sayfie said Saturday that it is the federal reimbursement rates that are the problem and that it would be "unworkable" for the governor to force a private company to operate in every Florida county if it only wants to operate in a few.

"It's not difficult to see that such a proposal would lead HMO companies to decide not to provide coverage to any Florida counties at all," Sayfie said. He says that would mean fewer seniors with HMO coverage, not more.

That point is the same one that state Rep. David Russell tried to make two weeks ago to a similar gathering at the Hernando County Fairgrounds. But it is a point that some at Friday's rally referred to as an empty threat.

Roy Betts, a Spring Hill man who is a Humana Medicare HMO patient, is one of those who doesn't buy it and who doesn't think seniors should have to beg for good health coverage.

"I don't feel like begging right now," Betts told the audience. I think we ought to be out there and kick a little butt."

Thurman, who was warmly received, asked members of the audience to raise their hands if they have adult children or grandchildren living in other states. Probably 75 percent of the people raised their hands.

Thurman told the audience to get those relatives to write their members of Congress and to demand that they support a Medicare bill that Congress will take up when it returns after its summer break. Political support for the measure is building, Thurman said.

"I have never seen an issue move so fast," she said.

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