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Florida Health Insurance News

Polk County Florida:

Prepare for a comprehensive answer if you ask Nancy Thompson why affordable, accessible health care is important.

The Frostproof resident goes beyond the dollar cost for patients, hospitals and employers to address the emotional and financial disruption that ensue when people lack access to health insurance or can't afford what their companies offer.

"We have lot of people in the work force who are one illness, one toothache, one day without child care, away from not having a job," said Thompson, chairwoman of a citizens committee that monitors how Polk County spends its half-cent indigent-care sales tax. "They're attached to the work force, but not very well."

The Citizens Oversight Committee that Thompson leads, whose members are appointed by the Polk County Commission, advises commissioners on spending sales tax dollars and multiple other issues involving health care for the poor and uninsured.

Thompson, 49, said the committee has accomplished a lot but that this year will be crucial in moving beyond some of the delays. Along with getting clinics under way, she said, the committee needs to keep looking at which services the Polk HealthCare Plan offers and whether they should be expanded. "I personally don't like stockpiling any money in that fund beyond what would be a normal reserve," she said. "It was approved by the citizens for a specific purpose, and we need to spend it for that purpose." But people need to remember the committee is an oversight and advisory board, Thompson said. The County Commission has the final word. She spoke to The Ledger about health care for the uninsured and the committee's role in monitoring that care.

Q. How would you describe what Polk County is doing with its Polk HealthCare Plan and other health programs funded with sales-tax money?

A. This is not a welfare program. This is a working program. The biggest impact here is going to be on the working poor.

Q. Can you elaborate on what the committee's role is?

A. To assist in the review and development of the budget every year for the plan, to review and advise on things like rate structure, (health care) provider relations and payments, what those are, how they're done. Are we actually outreaching and enrolling all the people we had hoped to?

Q. What else is involved?

A. To look at issues like the clinic issue. Should we be in the clinic business? Should we contract? Do we need clinics? To analyze health care needs and accessibility by the various regions of Polk County, the zip codes, and then advise according to that. How we improve our market penetration.

Q. How is your relationship with the County Commission?

A. The County Commission has been very trustful of us. They know when we've done our homework, that we are not going to come to them with a recommendation until we're sure that we've looked at all the different options and angles and pros and cons. The county manager and county commissioners really have used this group the way I think the ordinance intended.

(County officials) and I met with them to discuss the clinic issue. We did eventually issue a request for proposals and authorize staff to negotiate with Central Florida Health Care for clinics.

Q. Why the delay in getting primary care clinics up and running?

A. It's not a delay in their world. That's just the process. (But) I can certainly understand why the PEACE (Polk Ecumenical Action Council for Empowerment) people are like, "OK, you told us a year ago we were going to have clinics. Here it is a year later. Where are they?"

Q. Are local employers concerned about care for the uninsured and underinsured?

A. I can't speak for them. If they're not, they should be. And I think most proactive employers understand the issue.

Q. Why it is vital in Florida?

A. In Florida in general, and in Polk County specifically, 80 percent to 85 percent of all jobs are with small businesses that are the least likely or the least able to provide health coverage for their employees.

Q. What percentage of Polk's residents is uninsured?

A. About 60 percent of the working people don't have (coverage) or don't have access to health insurance. It's no wonder the write-offs to the hospitals are as big as they are.

Q. And how does that affect working people and their employers?

A. If you're working every day, and you don't have or can't afford health insurance and you get sick, then you immediately go into a downward spiral. You can't even imagine if you don't have health insurance how your lifestyle is going to go downhill.

Q. And for employers?

A. The more people we can have in programs that pay for their health care and give them a safety net, then the better off our economy is going to be because they're at work every day.

Q. What will stop employers from referring someone to the plan instead of providing insurance?

A. Well, nothing. Depending on what side of the fence you're on, is that a good thing or a bad thing?

Q. What do you think?

A. If I'm Joe's Plumbing Shop and I have three employees and I can't afford to buy them health care coverage, but they've got kids and they need it and I send them here and their income is such that they qualify, I don't know that that's such a bad thing. I think the fear is that companies will use this instead of paying their own resources to provide coverage.

Q. Are you worried about that?

A. I don't see it as a problem. Corporate welfare is what I think some people would consider it. But every one of those folks pays sales tax and that's how the program is funded.

Q. What are your priorities right now?

A. To see us get the clinics on-line, whatever it takes to do that. I would like to see us re-examine the menu of services. There are, as there are with almost any insurance plan, some exclusions. And as the plan has grown and we have more money, do we want to revisit those exclusions and see whether we can include some of the treatments that we've not been able to do in the past?

Q. What happens with the clinics now that Central Florida Health Care made the successful bid?

A. It's just a matter of being able to negotiate the terms. We can't just hand Central Florida the money and say "There, go open a clinic." It has to be in return for health services they will deliver to our clientele.

Q. Where will the clinics be?

A. We approved the first two for Lakeland and Winter Haven. The original goal was to have five (in more than two cities) in five years. Clearly, we're not going to get there at this rate.

Q. Will it take as long each time?

A. You would think, once that blueprint was laid, it could just be replicated four more times.

Q. What is your impression of Central Florida Health Care?

A. I'm a huge fan of theirs.

Q. Have you been there?

A. I went there (the first time) because I got strep throat. They provide a lot of valuable service to a whole lot of people for relatively little money. My vision is to pick that up only bigger and nicer ... in Lakeland and Winter Haven and Bartow and all the other places we've talked about where you have a mix of people being seen and served. These are not Polk Health Care Plan-only clinics. Other people will be served there and be seen there. My vision for the clinics is that they become a vibrant part of the whole medical community.

Q. Do you want to see Florida or the nation establish universal health care?

A. We need universal health care of some kind ... We're a long ways from getting there because we as consumers want it cheaper but we don't want it any less accessible than what we currently have.

Q. Is there anything more you'd like to add that we haven't covered?

A. When the plan only had $3 million, the goal was to keep people out because you didn't have enough to serve everybody who needed it. Now the goal is to get people in, everybody who needs it. And with a purpose of helping them become self-sufficient.

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