Health care cuts reconsidered

About 19,000 poor and low-income people have come to depend on the 10-year-old health care program.

By KATHRYN WEXLER

© St. Petersburg Times,
published September 7, 2001

TAMPA -- Frank Valdez fell off a porch step in January and tore his rotator cuff. Valdez, a 55-year-old substitute teacher who earns $250 on a good week, underwent surgery and therapy thanks to the county's indigent health care program.

Eddy Marteli, a carpenter for more than 40 years, landed in the emergency room last year with two aneurysms and a blood clot behind his eye. The county picked up the tab under its catastrophic plan for the working poor.

"If not for this plan, I probably wouldn't be here," said Marteli, 56.

Both men showed up along with several dozen other people, some holding signs, at a public hearing before Hillsborough County commissioners Thursday evening to urge them not to roll back the county's 10-year-old health care plan.

The indigent health care fund will fall short by $5.3-million next year when costs to run the program exceed projected sales tax revenues, according to the Hillsborough County Health Advisory Board, a group of health care professionals and concerned citizens. And in fiscal year 2003, the fund is expected to fall short by $9.3-million.

In anticipation of the shortfall, the commission voted last month to cut $4-million from the programs, reduce administrative costs and shift costs for some programs unrelated to indigents out of that fund. They also slashed $2.2-million from the General Assistance Fund, a program that helps with utilities, rent or food for poor people struggling with sudden illness whose bills threaten to render them homeless.

But commissioners were alarmed enough by what they heard Thursday night that they voted to revisit their cuts during the next public hearing Sept. 20, when they make their final budget votes.

Unless commissioners find funding elsewhere, some of Hillsborough County's poorest residents will be denied access to certain medical services or bounced entirely from the program.

"This is not acceptable," said Rita Dale, 55, who has lung cancer. "Not to us, not to the working poor, not to the sick."

About 19,000 poor and low-income people are enrolled in the plan, which uses 12 primary care clinics, five hospitals and 600 physicians.

The plan has served as a national model for its funding and breadth. It has saved the county an estimated $100-million in emergency medical bills for people who otherwise couldn't afford to see doctors before their conditions become dire and more expensive.

The county's indigent health care plan was created in 1991 and funded with an annual $26-million in property taxes and a half-cent sales tax. By 1997, the fund was so flush, commissioners eliminated the property tax supplement and cut the sales tax to a quarter-cent.

But by November 2000, the fund was getting low. By a previous agreement, the sales tax will return to a half-cent again next month, but that won't be enough.

"By every measure, this plan is a phenomenal success story," Sherry Dorsey of the Health Advisory Board said as she urged, "Don't cut it."

The commission already voted last month to slash the $3.2-million catastrophic program by $2-million each of the next two years. That fund entitles people to partake of the county's indigent health care plan if a sudden dire illness threatens to wipe them out financially. For a single individual, poverty is assumed below an annual income of $8,590. For a family of four, it is $17,650.

"It was just heart-wrenching to watch you do that," said Cindy Miller of the University of South Florida Dialysis Center. Her clinic's 10 patients on the county's plan are all in jeopardy now that commissioners restricted the catastrophic program eligibility.

A confluence of factors make the future of the fund especially alarming, according to a coalition formed to preserve the county health care plan. Prescription costs have soared in recent years. A sluggish economy could threaten the sales tax revenues.

Even worse, the working poor could get poorer as jobs dry up and they become even more vulnerable when sudden illness strikes, said members of the Hillsborough Healthcare Coalition, a group of 30 representatives from such groups as St. Joseph's Hospital, the Tampa Chamber of Commerce, the Hillsborough County Health Department and the Florida Coalition for Optimal Health and Aging.

In addition to the cuts in the catastrophic program, commissioners last month chopped $1.1-million annually for the next two years from the $4.5-million General Assistance Fund. That will disqualify about 700 families, according to the county's Health and Social Services Department.

- Kathryn Wexler can be reached at (813) 226-3383.

© 2006 • All Rights Reserved • St. Petersburg Times
490 First Avenue South • St. Petersburg, FL 33701 • 727-893-8111

Contact the Times | Privacy Policy
Standard of Accuracy | Terms, Conditions & Copyright