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More is needed to help Pasco's needy with health care

Health care for the needy just got more accessible in west Pasco. Unless, of course, the patient needs to see a specialist, then getting in to see a doctor remains problematic.

The conflicting diagnosis is courtesy of the same symptom — the national economic recession. We'll start with the positive. The federal economic stimulus program includes a $1.2 million, two-year grant to Premier Community HealthCare Group of Dade City to open and staff a new clinic for low- and moderate-income residents in west Pasco. Premier has said previously that half of its 12,000 Dade City patients have no insurance. The rest are covered by Medicaid or other insurance.

There is no doubt about the demand. Three years ago, as the effort to expand Premier's reach to the west side began, officials estimated 70,000 county residents lacked health insurance. Likewise, treating uninsured or underinsured patients in hospital emergency rooms in Pasco cost $26 million in 2003, a 200 percent increase over the start of the decade.

The aim of the new Premier clinic is to treat people before they reach emergency rooms. It holds down health care cost increases, which, in turn, should help control insurance premiums. A byproduct will be less-crowded emergency rooms that can fill to capacity during snowbird season. It is a welcome federal investment to help Pasco's vulnerable population. Unfortunately, the clinic is a treatment, not a cure.

As the unemployment rate increases, so, too, does demand for free or low-cost health care. Premier has no specialists on staff and must refer people needing cardiology, orthopedic or other care to physicians not on their payroll. Therein lies a significant obstacle to treating the needy in Pasco County. Some specialists are shy about volunteering charity care because of liability concerns and because they are not accorded the same remuneration considerations that Premier provides to its primary care physicians.

The Health Department is encouraging doctors to volunteer under its auspices, which would grant them sovereign immunity courtesy of the state of Florida. Payment, however, remains problematic. In the past, Pasco County's Human Services Department helped cover the cost of the specialized treatments and diagnostic tests, but its resources are now stretched by increasing demand at a time the county government is seeking to cut costs. Premier said it refers about 25 patients each month to the county for assistance.

The county human services budget includes $7.6 million, but more than $6.6 million is tied up in state mandates for Medicaid hospitalization, nursing home and health care responsibilities. After personnel costs, the remainder covers general assistance for the needy: rent, food, shelter, utilities, medical care, prescription drugs and indigent burials. Combined, the county cut those accounts by $120,000 in the current budget, while increasing money set aside for hospitalization expenses by $33,000.

Demand exceeded supply just four months into the fiscal year. Last week, the county said it had exhausted the $34,000 fund to pay for specialized physicians to treat needy patients. The county likely can tweak its accounts to cover some of the unanticipated demand, but it simply means another area of welfare spending could get shortchanged. It is not an ideal solution.

Providing better health care access for the needy will require a holistic approach. More specialists must be willing to do volunteer work; local hospitals, including the for-profits, should assume a role in funding another Premier clinic to be built in Hudson; and the public must consider a greater responsibility for helping to finance indigent care for a growing population in need.

More is needed to help Pasco's needy with health care 03/07/09 [Last modified: Saturday, March 7, 2009 11:56am]
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