Palm Beach Post readers had many questions for Gov. Rick Scott, who visited The Palm Beach Post editorial board today.
A large number of the questions concerned health care, difficulty accessing it and difficulty paying for it.
I asked Scott several of your questions.
Marcia Wagshol, who owns Cormat Tax & Accounting Services in Lake Worth, asked: “As a small business owner, I pay at least 40 percent more in health care premiums than larger companies. In fact, I would like to hire an additional employee, but can’t afford it because I am paying $2,000 per month for our family of four for a very basic plan with high deductibles and copays. The Affordable Healthcare Act will lower my health care premiums through competitive health care exchanges. So why are you and the state of Florida fighting against implementing it?”
Scott answered by explaining one of his guiding principles: The state should never accept money for programs that create dependency and aren’t sustainable over the long-term, he said.
Scott has turned away tens of millions of dollars in federal grants and has told state agencies not to prepare to open an insurance exchange in 2014 for individuals and small businesses.
He’s refused over $37 million that would have helped pay to keep disabled seniors in their homes and out of nursing homes by paying for support services.
And he’s turned away money for monitoring insurance companies.
Why? Scott said he’s convinced the state’s court challenge against the Patient Protection and Affordable Care Act will prevail at the U.S. Supreme Court.
“It’s not the law of the land,” Scott said. “I don’t believe it will ever be the law of the land.”
And if the Supreme Court upholds the law next year? Scott said Florida will be ready.
“If it’s the law of the land, of course” Florida will implement it, he said. “If it’s the law of the land we will be ready.”
Where will the money come from? The budget, he said.
But he won’t like it.
“Obamacare overpromises, it overpays providers, and it rations care,” he said. “This act is going to cause the cost of health care to go up; it’s going to ration care, and the state obligations for Medicaid will kill jobs.”
Post editorial board member Rhonda Swan asked Scott to acknowledge that health care now is already rationed. Scott wouldn’t bite.
People have a choice to buy insurance, and they have a choice which plans to buy, he said. In other words, if you didn’t pay for a certain type of coverage, you can’t claim your care is being rationed when you aren’t given that coverage.
In a similar vein, another reader, Michael Ross, asked: “Besides the ‘must buy’ mandate, which parts of the health care law do you want to repeal first:
- The part where I cannot be denied coverage because of a pre-existing condition;
- The part where my sons can be covered under my insurance while they are between college and grad school;
- The no-cost cancer screening for my wife and my sister;
- Or the part that saves my 90-year-old mom money by closing the ‘doughnut hole?’”
Scott’s answer? There may be a few nice elements of the law, but they don’t make up for its flaws.
“In any bill there are some things that look good,” Scott said. “But in the end, it’s going to ration care.”
I asked Scott whether Florida has a back-up, state-based health reform plan, should the Affordable Care Act be overturned by the U.S. Supreme Court, so that people like Marcia Wagshol have a chance at negotiating on an even footing with large employers when they go to buy coverage.
He offered general principles, but no sign of a concrete plan.
First, he said, people need to know what health care costs. Pricing needs to be transparent.
Second, he said, not elaborating, there needs to be more competition. (I would read that as support for making insurance something you can buy across state lines.)
Third, he said, “It would be better for individuals to own their own policies, so they can buy what they want and keep their coverage if they change jobs.” That would eliminate the pre-existing condition problem, he said.
Federal tax credits and other ideas would require changes in federal law, he added.
Finally, I asked this question:
A National Institute for Healthcare Management Foundation study out this week finds that the prices hospitals charge to private insurers are 30 to 50 percent higher when the hospital is in a market controlled by one hospital group. Scott, of course, was co-founder of HCA, which ignited the consolidation of the hospital industry and was laser focused on monopolizing regional market share to increase earnings.
Last winter Scott convened the Florida Commission on Review of Taxpayer Funded Hospital Districts. The commission appears to be poised to recommend privatizing Florida’s public hospitals. Given Scott’s stated goal of keeping Floridians’ cost of living down, I asked if he didn’t think he risked increasing what the state and businesses pay for health care if he requires public hospitals to be sold to major chains?
Scott’s eyes flashed at the mention of hospital consolidation and rising costs. He said the hospital district review commission would issue its report on Dec. 1.
“We’ll see what recommendations they make,” he said.
A large number of the questions concerned health care, difficulty accessing it and difficulty paying for it.
I asked Scott several of your questions.
Marcia Wagshol, who owns Cormat Tax & Accounting Services in Lake Worth, asked: “As a small business owner, I pay at least 40 percent more in health care premiums than larger companies. In fact, I would like to hire an additional employee, but can’t afford it because I am paying $2,000 per month for our family of four for a very basic plan with high deductibles and copays. The Affordable Healthcare Act will lower my health care premiums through competitive health care exchanges. So why are you and the state of Florida fighting against implementing it?”
Scott answered by explaining one of his guiding principles: The state should never accept money for programs that create dependency and aren’t sustainable over the long-term, he said.
Scott has turned away tens of millions of dollars in federal grants and has told state agencies not to prepare to open an insurance exchange in 2014 for individuals and small businesses.
He’s refused over $37 million that would have helped pay to keep disabled seniors in their homes and out of nursing homes by paying for support services.
And he’s turned away money for monitoring insurance companies.
Why? Scott said he’s convinced the state’s court challenge against the Patient Protection and Affordable Care Act will prevail at the U.S. Supreme Court.
“It’s not the law of the land,” Scott said. “I don’t believe it will ever be the law of the land.”
And if the Supreme Court upholds the law next year? Scott said Florida will be ready.
“If it’s the law of the land, of course” Florida will implement it, he said. “If it’s the law of the land we will be ready.”
Where will the money come from? The budget, he said.
But he won’t like it.
“Obamacare overpromises, it overpays providers, and it rations care,” he said. “This act is going to cause the cost of health care to go up; it’s going to ration care, and the state obligations for Medicaid will kill jobs.”
Post editorial board member Rhonda Swan asked Scott to acknowledge that health care now is already rationed. Scott wouldn’t bite.
People have a choice to buy insurance, and they have a choice which plans to buy, he said. In other words, if you didn’t pay for a certain type of coverage, you can’t claim your care is being rationed when you aren’t given that coverage.
In a similar vein, another reader, Michael Ross, asked: “Besides the ‘must buy’ mandate, which parts of the health care law do you want to repeal first:
- The part where I cannot be denied coverage because of a pre-existing condition;
- The part where my sons can be covered under my insurance while they are between college and grad school;
- The no-cost cancer screening for my wife and my sister;
- Or the part that saves my 90-year-old mom money by closing the ‘doughnut hole?’”
Scott’s answer? There may be a few nice elements of the law, but they don’t make up for its flaws.
“In any bill there are some things that look good,” Scott said. “But in the end, it’s going to ration care.”
I asked Scott whether Florida has a back-up, state-based health reform plan, should the Affordable Care Act be overturned by the U.S. Supreme Court, so that people like Marcia Wagshol have a chance at negotiating on an even footing with large employers when they go to buy coverage.
He offered general principles, but no sign of a concrete plan.
First, he said, people need to know what health care costs. Pricing needs to be transparent.
Second, he said, not elaborating, there needs to be more competition. (I would read that as support for making insurance something you can buy across state lines.)
Third, he said, “It would be better for individuals to own their own policies, so they can buy what they want and keep their coverage if they change jobs.” That would eliminate the pre-existing condition problem, he said.
Federal tax credits and other ideas would require changes in federal law, he added.
Finally, I asked this question:
A National Institute for Healthcare Management Foundation study out this week finds that the prices hospitals charge to private insurers are 30 to 50 percent higher when the hospital is in a market controlled by one hospital group. Scott, of course, was co-founder of HCA, which ignited the consolidation of the hospital industry and was laser focused on monopolizing regional market share to increase earnings.
Last winter Scott convened the Florida Commission on Review of Taxpayer Funded Hospital Districts. The commission appears to be poised to recommend privatizing Florida’s public hospitals. Given Scott’s stated goal of keeping Floridians’ cost of living down, I asked if he didn’t think he risked increasing what the state and businesses pay for health care if he requires public hospitals to be sold to major chains?
Scott’s eyes flashed at the mention of hospital consolidation and rising costs. He said the hospital district review commission would issue its report on Dec. 1.
“We’ll see what recommendations they make,” he said.
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