TALLAHASSEE — When Richard Corcoran was sworn in as speaker of the Florida House in November, he laid out his vision for health care.
"Let us show Washington, D.C., and the rest of the country how well the people would benefit from a free-market, consumer-driven health care system," said Corcoran, R-Land O'Lakes.
On Thursday, the Florida House took steps toward the future Corcoran wants, passing two components of a free-market health agenda the chamber has pushed in recent years:
• HB 161 gives people and employers the option to negotiate and contract directly with a doctor for primary care services. It passed 107-6.
• HB 145 allows surgical centers to keep patients for a full 24 hours and creates new recovery centers that can care for them 72 hours after surgery. It passed by a 79-34 vote, as most Democrats rose to oppose the bill.
Direct primary care will "make our health care system stronger," said Rep. Mike Miller, R-Winter Park, who sponsored the legislation last year and helped push HB 161 this year. Agreements with doctors aren't insurance and don't qualify as a health plan under Obamacare, but lawmakers believe it will increase access to preventive care.
Recovery centers are more controversial.
Supporters of HB 145 argue that surgical centers save money for generally healthy people and that recovery centers will allow them to mend in a safe environment at a lower cost, assuming there are no complications. All this helps people who face high deductibles on their health insurance plans, said Rep. Paul Renner, R-Palm Coast, who sponsored the bill.
"(It) is a real victory for patients," he said. "It increases their access to care and also lowers the cost."
Opponents argued that new options for surgery and recovery will make it harder for hospitals to survive. Hospitals rely on private insurance to help cover losses from Medicaid, which pays less, and charity care for patients who can't afford to pay at all.
"Recovery care centers cherry pick private pay patients," said House Democratic Leader Janet Cruz of Tampa. "It's not fair."
She also has safety concerns and said hospitals are better equipped for emergencies. Democrats tried to change the bill Wednesday to require doctors be on site 24 hours a day at recovery care centers and to force them to contribute to a state Medicaid fund.
Renner said patients with complications are still likely to go to hospitals, and he said he doesn't think hospitals will be harmed.
The issue is not likely to pass in the Senate, where the recovery care centers were taken out of similar legislation, though lawmakers left in language allowing surgical centers to hold patients for 24 hours.
"It's just not ready for prime time," said Sen. Dana Young, R-Tampa, the chairwoman of the Health Policy Committee. "There's just too many questions."
A point of agreement between Cruz and Renner: Changes to health care look a lot like what the Legislature has done in education as it passes policies that increasingly benefit charter schools.
"It's all an attempt to privatize," Cruz said. "It started with the schools, went to the prisons, and now the villains are the doctors and the hospitals."
Renner sees that same push in a more positive light: "It's putting people in the right place at the right price and making sure we're customizing care. The same thing we're doing in education with school choice, we're trying to do in health care."
Contact Michael Auslen at [email protected] Follow @MichaelAuslen.