Florida House Speaker José Oliva goes after health care costs

TALLAHASSEE — To hear Speaker José Oliva tell it, January 2020 is the start of a new decade, a new legislative session and a new crusade against entrenched lobbyist interests.

But, opening his second and final legislative session Tuesday, the termed-out Miami Lakes Republican returned to familiar themes from his legislative career: hammering a message of fiscal restraint and a crackdown on university spending, as well as assailing his favorite targets in the “hospital-industrial complex” for ballooning healthcare costs.

“Spending is not caring, solving is caring,” he said repeatedly in his speech, just shy of 20 minutes. “If spending was the answer we would already have solved the problem.”

Oliva, like all legislative leaders before him, now faces the wane of his political clout in Tallahassee with his second and final session as the House’s leader before Rep. Chris Sprowls, R-Palm Harbor, takes over.

On Tuesday, Oliva seemed eager to start writing the outline of that political legacy: He praised his fellow lawmakers for passing a bill last year to allow Florida to import prescription drugs from abroad, and called last year’s bills “transformational healthcare and education policy” setting an example for other state legislatures.

His agenda for the 2020 legislative session was in a similarly bombastic vein to the one he outlined in his opening speech last year, in which he warned healthcare spending to be a “five-alarm fire.”

He slammed “the great robber-barons” of hospitals, medical device manufacturers and pharmaceutical companies “financially assault[ing]” patients and consumers. He called ballooning medical bills “the single greatest threat to our solvency.”

“What do they propose as a solution? More funds, of course,” he told members in the flower-festooned chamber. “This industry gets state dollars, federal dollars and private payer dollars. We also extend them all manner of local tax breaks and it is not enough! It will never be enough. Until we have the courage to empower the patient and loosen the regulations which have allowed their empire-building it will never be enough.”

But Oliva, who has focused on healthcare almost single-mindedly during his time in the Legislature, remained mostly silent on other issues: affordable housing, hurricane preparedness, transportation.

Even on other leaders’ priorities — such as Gov. Ron DeSantis’ calls for more spending on the environment and to boost teacher pay — Oliva gave only a nod.

Oliva committed only to “a significant, equitable and sustainable proposal” that would focus on increasing wages for teachers but also wages “in other critical areas.” He added that the House will also “offer our support to his efforts” when it comes to environmental issues but went no further.

For the second year in a row, Oliva took aim at higher education, pointing a finger at colleges and universities for spending money in excess and contributing to America’s student debt crisis.

“As lawmakers and custodians of the public purse we are relentlessly urged for more,” he said. “An expenditure for a university is seen as a measure of caring, regardless of the future implications of such expenditure. “

While Oliva is hardly the first legislative leader to tackle healthcare reform as his signature issue, he may be among the most ambitious. He and other Republican leaders successfully pushed through a spate of long-desired party priorities, like repealing the state’s certificates of need system for hospitals last year.

Oliva spent the bulk of his speech Tuesday signaling his remaining healthcare priorities for his final term: from making changes at the state’s child welfare agency to expanding when and to what degree advanced nurse practitioners can care for patients.

He underscored the latter point even before his remarks, by tapping Doreen Cassarino, a nurse practitioner from Naples to serve as the House’s “doctor of the day” in the legislative tradition dating to the 1960s. Before DeSantis rose to address the joint Legislature, Oliva also acknowledged a group of about a dozen nurse practitioners invited to watch his speech from the House gallery above.

“It is high time we allow healthcare professionals to practice to the extent of their training,” he said.