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Column | Howard Troxler

Governor should sign doctor bill, veto water bill

Hey, who do you like in a fight between the doctors and the insurance companies?

The fight is about a bill passed by our Legislature this year. It makes it easier for patients choosing doctors outside their insurance company's "network."

The way it works now, when you choose an "out-of-network" doctor, most insurance companies send the check to you. You're responsible for paying your doctor yourself.

This brings us to Senate Bill 1122. It says that you can instruct your insurance company to send its check directly to any out-of-network doctor you choose.

Doctors really like this idea.

They say if they get paid directly, they can spend less time chasing down checks sent to patients who don't pay, or don't even understand that they're supposed to pay.

"They sometimes think it's a reimbursement for something else," says Lynn Takacs, a spokeswoman for the Florida Medical Association. "Sometimes they just spend it."

In one case that doctors love to cite, a patient hired a cardiologist — then bought a car with the insurance money.

Hey, I can relate to the idea of patients being confused. I'm as smart as the next guy (maybe), but I don't have a clue as to what my insurance statements mean.

Some insurance companies, most notably BlueCross BlueShield of Florida, hate this bill. They want Gov. Charlie Crist to veto it.

Here is their argument:

There is a good reason to have these networks. They hold down costs, because doctors agree to charge only a certain amount. In return, doctors get a stream of "customers," so to speak.

But if a doctor is going to get the same paycheck automatically anyway without joining, it lessens the incentive and weakens the network. In the long run, costs go up.

Besides, opponents warn, the out-of-network doctor can charge more than the insurance company pays, and the patient is on the hook for the balance. More patients will have out-of-pocket expenses.

The Consumer Federation of the Southeast wants a veto. So does the state employee union.

Still, I'm leanin' toward the doctors. Mostly we're just talking about sending the check to a different address — the claims that there will be increased costs are speculative. There is still plenty of incentive for doctors to stay in networks.

On top of that, the bill automatically repeals itself in two years if the state finds that costs have increased. If I were the governor, I'd sign it.

• • •

On the other hand, I wouldn't just veto SB 2080 — first I'd jump up on the desk, stomp up and down on the bill, crumple it up and set it on fire. Then I'd veto it.

This bill represents the Legislature at its worst — an innocent bill promoting "Florida friendly" landscaping, amended at the last minute for a different purpose.

The amendment hands over the power to issue state permits — for water use and for wetlands destruction — to the executive directors of the state's five water districts.

Hey, I don't even like the state's appointed water boards. But at least they meet in the sunshine and have public input.

Audubon of Florida calls it "the worst bill of the session."

Veto material? Sure. The worst? Nah. As Yoda assured Obi-Wan Kenobi in The Empire Strikes Back: "There is another." But that's a topic for another day.

Governor should sign doctor bill, veto water bill 05/20/09 [Last modified: Monday, May 25, 2009 4:56pm]
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