By Lisa ZahnerVERO BEACH — Congressman Bill Posey toured the Indian River County Health Department today and was so impressed by operations and the services being provided that he said he feels the department and other publicly funded clinics are the solution to healthcare for the masses of uninsured Americans.
“It’s a well-run, well-operated facility and it’s fulfilling an important need in the community,” he said.
The tour was part of a month-long series of events Posey is hosting and taking part in throughout his district. Many of these events are focused on health care, as it is in the forefront of many constituents’ minds and factions on both sides are hot about the issue.
“What we try and grapple with — and so much of the debate going on today and one of the reasons we came here today — is that we’ve got 40 million people who are uninsured,” he said. “I am pretty much heartwarmed to see what’s there for the uninsured because of their inability to pay for it.” Posey referred to some of the information being communicated to highlight the urgency of the uninsured problem, which cost the Indian River Medical Center and the Indian River County Hospital District nearly $11.4 million in the past 10 months for hospital and emergency room care for the County’s uninsured. He feels the information being spread is misleading.
“They make it sound like people without health insurance are not getting any care and that they all end up in the emergency room,” Posey said of Congressional Democrats who are working on three or more versions of a health care reform bill.
The Indian River County Health Department, between its main location and the Gifford satellite office, is slated to see 70,000 patients in 2009 and 65 percent of those do not have health insurance. Administrator Miranda Swanson said the number of cases has increased slightly from last year, and that the number of dental patients has gone up 28 percent.
When asked what kind of outreach her department does to let people know about services, Swanson responded: “We really haven’t had a problem with being under-utilized.”
In fact, the Health Department has faced budget cuts the past few years from all directions but has managed to not lay off staff and to maintain the same level of care for the County’s indigent and working poor. About 84 percent of the clinic visitors earn less than 150 percent of the Federal poverty line income. That income would be about $16,000 for an individual or $33,000 for a family of four. The department has had to prioritize certain services, such as dental, to make sure children are cared for first, but there is still a clinic for emergency adult dental services two mornings per week.
The Health Department charges on a sliding scale based on ability to pay for general medical services, and the staff also helps patients obtain and complete paperwork to qualify for programs such as Women, Infants and Children (WIC), Medicaid and Kidcare. If patients are in need of prescription drugs, the staff will also help them navigate the morass of private drug discount programs available through pharmaceutical companies.
“The stories that we hear from our clients are that they didn’t know what they could do if we weren’t here,” Swanson said. “We are a safety net for health care.”
In explaining why the Health Department sees such demand for service, Swanson said 24 percent of Indian River County residents — and roughly 20 percent of Floridians — are uninsured. The health department is able to serve those patients at a per-visit cost of $90 to $100, which includes labwork and prescriptions, where private physicians would charge about $160 for the same visit, not including labwork and prescriptions.
Registered Nurse Linda Wandell, nursing supervisor of the adult health program, said the health department is seeing its regular clientele of chronically uninsured people, plus a whole new crop of patients.
“We’re seeing a lot of new patients, new to the area or new to the health department, people who have never been without health insurance before, people who have moved here and are looking for work,” she said. “We’re also seeing people who are sicker and coming right out of the hospital and do not have coverage for follow-up care. We see people right after open-heart surgery, stent placements, strokes and brittle diabetics who need care.”
On the topic of uninsured people, Posey said he believed a great number of them could afford insurance, but choose not to be covered.
“They would rather have a new plasma TV than to pay the price for health care,” he said.
Posey said he feels that 80 percent of the people in America have health care and health insurance that they are happy with and he wants to preserve that, while trying to beef up funding for facilities like the health department, which struggle to provide care for the other 20 percent on very slim budgets. He said he was very concerned about preserving the parts of the healthcare system and the parts of private health insurance that do work. He considers facilities like the health department to be a part of the solution for the uninsured that would be preferable to the “public option” or working toward any universal health care. However, the health department can only provide basic care and its clients usually forego preventative care and wind up going to the doctor or the emergency room with serious illnesses. Clients only have access to specialists through a volunteer program called “We Care” where local physicians donate services, or by showing up in the emergency room. This causes people to wait until conditions are acute, which ends up costing the taxpayers more in bad debt at the hospital than if those patients could see a specialist to treat and head off a problem. Enrolling people in a public option could provide more people access to specialists, but the potential perils of such a program would outweigh the benefits, Posey says.
Later in the day, Posey met with about 30 consituents at the Richardson Center during his case work office hours and several of them, including a delegation from the Visiting Nurse Association, came to talk about health care. Apparently, certain patients’ access to home health care may be limited in at least one version of the reform bills being drafted in Congress.
The congressman will take part in a roundtable discussion on health care on August 25 and will host at least one town hall meeting on health care on September 2 in Brevard County, with an Indian River County event possibly in the works for that same week before Congress reconvenes on September 8.
