Health care reform, Franklin County style

During this sticky summer weather in Washington, politicians are dealing with a sticky challenge. Senators and congressmen have before them the monumental task of reforming the nation’s health care system.

Drug companies have promised to return $80 billion in cost savings over the next 10 years to Medicare recipients. Hospitals have upped the ante, and pledged to give back $155 billion.

President Obama is pushing hard to deliver on a promise he made during the campaign, to bring coverage to 46 million uninsured Americans and to rein in expanding heath care costs, the single largest stumbling block to the nation’s economic growth.

Republicans are balking at Democrats’ plans for universal coverage, decrying a public insurance option as an enormously expensive step that will limit patient choice and stifle private enterprise.

There’s plenty of options on the table - whether they be single-payer, tort reform, tax breaks, trigger plans, co-op plans, you name it - and they’re complicated. But, most importantly, the sheer vastness of the challenge is out of the hands of ordinary American citizens who don’t sit in the hallowed halls of Congress or in the board rooms of huge pharmaceutical giants or hospital chains.

Ordinary people who live in faraway big cities and small towns, in places like Franklin County, who deal every day with the simple challenge of keeping themselves and their loved ones healthy.

They go to the doctor when they need to, and when they can afford it, and they follow his or her instructions as best they can. If they have medical insurance, they rely on it like a life preserver in a treacherous sea. If they don’t have coverage, they go somewhere they can afford the charges. Sometimes all they can afford are no charges at all.

And who pays the difference, between what they can afford and the true cost of health care? The taxpayer, people who live in faraway big cities and small towns across the nation, in places like Franklin County.

With this backdrop in mind, it is important for county commissioners to remember some basic principles as they approach the upcoming July 21 afternoon workshop on health care delivery in Carrabelle.

This is not a vast challenge, like massive nationwide health care reform, that is out of everyone’s hands. This is a challenge squarely on the shoulders of this county’s elected officials, those five commissioners elected to spend wisely each and every nickel of taxpayers’ money. And on those constitutional officers who have an obligation to provide constructive advice when it comes to gathering, collecting and spending those dollars.

This is a challenge squarely on the plate of this county’s appointed health leaders, those who run the health department and the Weems Memorial Hospital system, whether it’s preventive care, medical treatment or emergency response.

This is a challenge squarely on the charts of this county’s medical professionals, who deliver the services we all depend on, to keep us and our loved ones healthy.

We’re all in this together, which is why it’s crucial we embrace common assumptions when it comes to finding answers for funding health care for Carrabelle and the eastern end of the county.

Over the last five years the county has been able to dig its way out of a troubling health care crisis of its own, by putting Weems and the ambulance service on solid financial footing with the help of a one-cent sales tax. No one threw up their hands and said “let the hospital die,” or let EmergyStat’s sudden departure destroy the ambulance service. Everyone pitched in, reached into their pockets, and put the ship on an even keel.

The deck of that ship that serves Carrabelle is blessed to have several able health care providers meeting the community’s health care needs. Dana Whaley, an advanced registered nurse practitioner at the county health department’s annex, is a valuable primary care asset, just as are Dr. Nancy Chorba and Dr. Timothy West at Weems Clinic East.

From all indications, patients like these health care options available in the Carrabelle area, and that is how it should be. If both offices were just another example of private-sector health care providers successfully meeting patients’ need, then all would be fine and this editorial could end right here with a giant sigh of relief.

But such is not entirely the case. Both the health department practice and Weems Clinic East are heavily dependent on public-sector taxpayer support for survival.  The Carrabelle annex’s primary care practice offers a sliding scale for patients who can’t otherwise afford to see a medical professional. Plus taxpayer money, by way of a county subsidy to the state-funded health department, is what keeps that afloat.

In the case of Weems Clinic East, county sales taxes enable that facility to break even and provide the care patients depend on. And on the horizon is a million-dollar project to build an Urgent Care Clinic in Carrabelle, based on a promise made in order to secure passage of that very sales tax.

With this in mind, we believe it is important county commissioners, health care officials and medical providers give careful consideration to Clerk of Courts Marcia Johnson’s outspoken call for a cost-effective solution to Carrabelle’s health care needs. No one wants to deny Carrabelle the medical care it needs and deserves. The commissioners on the eastern end of the county are right to defend that care.

But there are serious questions about taxpayer dollars. In this time of deep recession, does it still make sense to hand over a million dollars to contractors to build a brand-new urgent care center, when a retrofit of the existing annex may work as well for less money? Especially since further shrinkage of state dollars to the health department will only free up more available space at the annex, and even threaten to close it altogether?

Does it make sense for taxpayers to continue to subsidize two medical practices in Carrabelle, when a reasonable collaboration between Weems and the health department could result in more expanded and cost-effective care for everyone?

Does it make sense for Weems and the health department to continue to conflict over scarce health care dollars? Isn’t it reasonable to expect that the two publicly-supported health care entities will work together even more closely as a united force to meet the county’s medical needs, from Alligator Point to Apalachicola?

We don’t have all the answers; no one does. It’s going to take everyone working hard to hash this out. And both the health department and Weems are to be congratulated for their success in delivering care.

But we believe that this success has come because of a willingness by taxpayers to pony up the funds needed to cover costs. These taxpayers must be listened to when it comes time to reach a cost-effective conclusion.

            Commissioner Noah Lockley was right when he said “Some of these issues can be worked out but we have to sit down and negotiate.” Now is the time. We need health care reform, Franklin County style.