Monday, October 15, 2018
Politics

Infighting, maneuvering doomed health bills in Tallahassee

TALLAHASSEE — Millions of Floridians have no health insurance. The state has nowhere near enough primary-care doctors. Highly trained nurses might be able to help, but they lack the authority. Hospitals are suing other hospitals, claiming their trauma centers don't even deserve to operate.

No one expected Medi­caid expansion to get a hearing in a Legislature dominated by Republicans seeking re-election, most of whom oppose the federal Affordable Care Act.

Yet even health care issues that might have seemed assured of success went nowhere this year. Blame it on political squabbles and failed power plays that managed to sink much in their wake.

Case in point: Senate President Don Gaetz tried to entice the House into helping doctors get around insurer restrictions on the drugs they prescribe. So he added his controversial idea to an under-the-radar insurance bill slated for easy passage — and torpedoed both.

Gaetz has no regrets. "It's never more than 10 months until the next session," he quipped in an interview this week.

That wasn't the only time a lawmaker derailed a bill by tying it to a less popular topic.

Many lawmakers wanted to make sure three HCA trauma centers in Pasco, Manatee and Marion counties will stay open, despite lawsuits from longer-established trauma centers. HCA even agreed to accept compromises its competitors wanted in order to protect the three centers.

But the plan failed when it morphed into a heavily freighted "train'' of unrelated health bills.

Mark Delegal, a lobbyist for nonprofit safety net hospitals such as Tampa General that had sued HCA, says he now finds himself in the unusual position of defending the for-profit hospital chain.

"At the end of the day, the group that tried to do it the old-fashioned way of working its issue and getting votes ended up being the victim of a cobbled-together health care package that had so much on it … it ended up not making it," Delegal said.

Gaetz said desperation created these trains, even though the danger was obvious.

"It was very difficult to get a clean health care bill out of either house," Gaetz, R-Niceville, said. "Because the special interests, as well as individual legislators, would sense that a bill might move so they all wanted to climb on. And as they climbed on they slowed the train down, and then started it up running in different directions so it couldn't move."

•••

Infighting between interest groups doomed some health bills.

The House wanted to tackle the doctor shortage by allowing nurse practitioners more leeway to work independently, and by allowing doctors to treat Florida patients over the phone or Internet.

The Florida Medical Association, with Senate support, blocked those ideas.

The House also wanted to let outpatient surgery centers keep patients for up to three days after an operation, arguing it could save money. But the Senate sided with hospitals to kill that idea.

Bruce Rueben, president of the Florida Hospital Association, said he and his colleagues could not let up for a moment in the hunt for amendments unfriendly to their cause.

"We had to follow it and be active right until the last second of session," he said.

•••

Most of the health care measures that fell apart this year likely will return.

Rep. Cary Pigman, R-Avon Park, a physician, has returned to his job working 12-hour shifts in the emergency room of a Highlands County hospital. He served as vice chairman of the House Select Committee on Health Care Workforce Innovation, which saw several of its priorities die late in the session.

"I was never delusional to think that we would get anything important in one year," Pigman said with a laugh. "That's just not the way it works."

Pigman said he will spend the next few months rethinking his arguments about independence for nurse practitioners and telemedicine now that he had a chance this year to hear from the opposition.

"I hope that now this session is over, the (Florida Medical Association) will be a little more reasonable and interactive so we can talk about these issues," he said.

Gaetz, who can serve for two more years under term limit rules, expressed similar optimism. He pointed to approval of legalizing a strain of medical marijuana as proof that some issues just need more patience than others.

"Even two years ago, could you have imagined one of the most conservative members of the Florida Legislature, Rep. Matt Gaetz, being the prime sponsor of legislation that would employ cannabis for medical purposes?" Gaetz said. "I couldn't, and I'm his father."

Contact Tia Mitchell at (850) 224-7263 or [email protected]

Comments
Candidates for Pinellas commission race pause to help with natural disasters

Candidates for Pinellas commission race pause to help with natural disasters

As Election Day nears, the candidates for Pinellas County Commission have shifted from campaigning to helping residents deal with the aftermath of natural disasters.Democrat Amy Kedron held a town hall meeting and helped draft policies for businesses...
Updated: 5 hours ago
Trump calls on blacks to ‘honor’ him with votes, then praises Confederate general Robert E. Lee

Trump calls on blacks to ‘honor’ him with votes, then praises Confederate general Robert E. Lee

LEBANON, Ohio - President Donald Trump praised the Confederate general Robert E. Lee whilst asking African-American voters to "honor us" by voting for him at an Ohio rally which included an unexpected and provocative monologue on America’s Civil War ...
Published: 10/13/18
Carlton: Playing politics when a hurricane’s coming? There oughta be a law

Carlton: Playing politics when a hurricane’s coming? There oughta be a law

Maybe Florida needs a new law. The Disaster Decency Bill, we could call it.Because given the current political divide wider than the Gulf of Mexico, we might need it to mandate what has long been a tradition of coming together in the face of disaster...
Published: 10/12/18
MSNBC's Katy Tur hosting live panel with USF students during 'Battleground College Tour'

MSNBC's Katy Tur hosting live panel with USF students during 'Battleground College Tour'

MSNBC's Katy Tur will speak to USF students during a live panel in front of USF's Marshall Student Center on Friday from 2 to 3 p.m.
Published: 10/12/18
Monica Lewinsky comes to Tampa on Monday to talk #MeToo, media scrutiny

Monica Lewinsky comes to Tampa on Monday to talk #MeToo, media scrutiny

TAMPA — Monica Lewinsky, an anti-bullying social activist best remembered as the White House intern whose affair nearly brought down a presidency, will be in Tampa on Monday to deliver the keynote address at the 17th annual Franci Golman Rudolph Scha...
Updated: 3 hours ago
Retired Tampa cop gunning for Hillsborough sheriff’s job touts outsider status

Retired Tampa cop gunning for Hillsborough sheriff’s job touts outsider status

One day this summer Gary Pruitt delivered a two-minute pitch to Plant City voters, describing what could change if he were picked to be Hillsborough County’s next sheriff. Among his promises: He would diversify the ranks. But the uniformed competitor...
Published: 10/11/18
Joe Henderson: It's getting easier getting to Tampa but try getting around once you're here

Joe Henderson: It's getting easier getting to Tampa but try getting around once you're here

If you haven’t been to Tampa International Airport in a while, do yourself a favor and go. The place is sleek, well organized, and has the look of an airport you might expect to see in some exotic city – which, I guess, we can say Tampa...
Published: 10/11/18
Carlton: Job one in Straz campaign to be Tampa’s mayor? Show up

Carlton: Job one in Straz campaign to be Tampa’s mayor? Show up

Tampa philanthropist and gazillionaire David Straz has gotten lots of deserved accolades for his acts of generosity over the years.His name graces the downtown performing arts center in lights and adorns the sign at a manatee hospital at Tampa’s zoo ...
Published: 10/10/18
Daniel Ruth: Whatever degree she may or may not have, mayor qualifies in chutzpah

Daniel Ruth: Whatever degree she may or may not have, mayor qualifies in chutzpah

Perhaps the tip-off Temple Terrace Mayor Mel Jurado's alleged doctoral degree was (ahem) about as worthless as a Venezuelan $1 bill was when she started pimping her dubious bona fides on her personalized license plate, "DRMEL." Really? Not....
Published: 10/10/18
What will $241 million get you? Lots of stuff, including a couple of fire stations you may have thought you already paid for

What will $241 million get you? Lots of stuff, including a couple of fire stations you may have thought you already paid for

Pasco County voters face four local referendums on the November ballot.
Published: 10/10/18