South Florida Hospital News
Monday August 19, 2019

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March 2007 - Volume 3 - Issue 9




Business Muse - Reflections on the Business of Healthcare Delivery

An Inspired Initiative

Recently I heard that organized medicine is launching an initiative in the Florida legislature to help both doctors and those less fortunate among us.

For years the poor among us have suffered from lack of access to the same care as those with "good" insurance or the ability to pay. We have even added one more layer and hurdle referred to as "boutique care". If we keep moving in this direction the inequality of services will grow greater and greater.

Medicare helped the elderly population, as well as some non-seniors with disabilities, to afford access to most medical services. It is far from perfect. Ask any Medicare recipient about nursing homes and long term care. Or point to the attempt at pharmacy coverage which was long in coming and mixed in results, but it came.

The main reason the government makes an attempt at helping the elderly is because, after all, they worked and gave a share of their pay to the Medicare fund. The operative condition is that the recipients gave to the system. The other and equally as important point is they vote: Usually in large numbers and are not afraid to "kick the bums out". They even have organized under banners such as the AARP.

The poor have no such structure. There is no organization such as the AAPP (American Association of Poor Persons) who advocates for them. They for the most part do not or cannot work or if they do the pecuniary reward for their labors is miniscule. As a group they feel disenfranchised and I believe do not vote in any significant numbers or more importantly as a block. The result is that they are in the unenviable political position of no voice and no influence.

Politicians are working people just like most of us. Most try to accomplish what they believe to be the right result. They go to work, do their job and bring home a paycheck. They utilize this income to support their families, send their kids to school and save for their own old age. The money and time donated to their election (read re-election) help them keep their job and keep supporting their families, and increase their personal power increasing the weight of the stance they take. The influence of groups and their votes accomplishes the same purpose as money and time donated. With limited time and resources politicians need to choose their fights. Your support keeps them in office and working and they most often reciprocate by advocating your position.

The system works, except for the disadvantaged among us. To be sure there are the noble among the political crowd that push for the poor. I applaud them, for without their efforts the disadvantaged would be totally disenfranchised. Allow me to paraphrase Alexis De Tocqueville’s words when he wrote in his famous commentary "Democracy in America": That even more than freedom, Americans believe in the principle of equality. That in America all Americans believe that they should be treated equally. Those noble politicians embody this belief. It is for the rest of us to step up on occasion and help move things along.

This brings me back to the initiative that organized medicine is going to present to the legislature and champion. It is true that the initiative will help their members, as well as those that are not members (but should be). The initiative that they have decided to champion is to have the legislature empower the state to institute the pay scale used by Medicare to replace that currently used by Medicaid.

For those doctors, and others, who currently accept Medicaid it will provide a large help. These practitioners are losing money if not cutting it to the bone to provide much needed services. But it hopefully will do more by enticing other providers who do not currently accept Medicaid to start doing so and increase their pool of available patients while delivering much needed care. It would help them, yes, but more importantly it would help those without influence or a voice gain greater access to the healthcare services available to other citizens. That access will also eventually result in savings to the system by the increase use of the office practice setting for care and thereby decreasing the more costly use of ER visits and excessive hospital admissions from lack of regular care. It is a win-win for healthcare equality.

Write a letter or email to your elected officials in Tallahassee to support this upcoming action. Let them know this is important to you. Let them know that those of us with higher education and the ability to make a decent living want them to help remove some of the layers and barriers to those among us who are disadvantaged. Providing care is still a business and we need to help them understand that to deliver that care one needs to cover one’s costs. Tell them that helping the provider ensures providers in place to deliver healthcare to all our citizens. And while you are at it, have pre-printed letters urging the same for your patients and staff to sign. They too have influence and voice if you help them use it.

Being poor is a matter of circumstance. Not all can or chose to chase the American dream, but that doesn’t mean as it relates to their need for healthcare that they should be stuck with an American nightmare.

PHC solicits and appreciates questions of a business nature relating to the health services industry to address in future columns. Please address your questions to PHC Practice Development Advisors at or fax (561) 799-4092.
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