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BOCC Finally Has it Right on Health Care:


At least one Manatee County Commissioner came to Tuesday's meeting fully prepared to stroke a $200,000 taxpayer check to fund a somewhat incoherent plan to “study” indigent health care options, now that the county has basically sat on its hands for the past year since it tried to sneak through a poorly-conceived health care sales tax in an effort to maintain an inefficient status quo. Fortunately, at least a majority of the rest had the sense not to follow Commissioner Bustle down that road.

One after another, commissioners echoed various sentiments conceding the fact that attempting an expensive, mid-year special election in which the message was, to put it mildly, muddled, had not left them in the taxpayers' collective favor on the issue.

Commissioners Baugh, DiSabatino and Gallen were ardently opposed to moving forward with any kind of vote on Tuesday, echoing members of the public who had chastised the board for moving so quickly on such a vague and expensive gamble.

Commissioners Chappie and Benac looked to be closer to the fence, but sensing the lack of support, seemed to temper any enthusiasm they might have had going in. Commissioner Whitmore, an avid proponent of the failed tax, who is facing a re-election challenge in November, was clear that she did not want to move toward another run at a sales tax referendum, as Manatee Memorial CEO Kevin DiLallo recently asked of the board.

You can't blame Whitmore for not wanting yet another reminder that she led the charge on spending hundreds of thousands of dollars on the failed special election to be sitting on the same ballot while she's asking voters to send her back to the dais for four more years – especially when she's already dealing with the fallout surrounding the county's failed No-Kill policy that she'd championed and the associated scandal at the Napier Animal Sanctuary.

Commissioner Benac seemed to notice which way the wind was blowing, but still used the item as a chance to vent a misguided rant about “Obamacare” having been supposed to solve the issue, without seeming to grasp that it was her party's refusal at the state level to accept $51 million in federal funding to expand Medicaid that has compounded the challenge of treating indigents.

For her part, Whitmore did seem to finally get that and wondered if maybe they shouldn't be lobbying the state legislature to accept that long-ago offered funding. Considering the legislature's annual session came to an end last week, it seems she's a little late to the party. One has to wonder why she and her fellow board members hadn't been beating that drum way back when, before the corpus was on its last legs, but I guess everyone gets more open-minded during election season.

Whitmore also finally acknowledged that the county has no obligation whatsoever to reimburse private hospitals for treating indigents, something the administration was dishonest about in the run-up to the referendum. This was something she said she'd “finally” asked. Again, it would have been nice had commissioners been this interested in the facts before they lost their credibility on the issue by trying to pull a bait and switch property tax reduction, sales tax hike in a mid-year election when many residents weren't even in town.

Meanwhile, Commissioner Bustle echoed County Administrator Ed Hunzeker's latest the sky is falling argument, warning that it isn't so much about indigent care as keeping doctors in Manatee. If we don't pay them to treat indigents, they'll simply close up shop and move to someplace that treats doctors better, or so we are told. I find that hard to believe. Where there are wealth-inhabited tropical paradises (and world-class golf courses by the score), there are doctors.

This is a truism backed by the fact that our area (Bradenton-Sarasota-North Port) was recently named the most favorable spot in the entire United States for an MD to hang their shingle. Considering that the top five is rounded out with places like Des Moines, Iowa; St. Joseph, Missouri and Lacrosse, Wisconsin, I hardly think the sawbones are going to be packing up and leaving paradise anytime soon.

At the end of the day, we've only got a couple of choices. Maintain the status quo in which we back our proverbial Brinks truck up to local hospitals and dump money on them each year by raising property taxes; or find a way to more efficiently hold the line by improving our delivery model with the $15 million in non-corpus dollars we currently spend, while letting the hospitals eat the rest.

If a company that pays their top five executives more than $20 million a year and whose profits have nearly doubled in the last five years (Universal Health Services, which owns both Manatee Memorial and Lakewood Ranch Medical Center) decides it can't get by without accepting Medicare and its associated strings, like stabilizing any emergency case that presents regardless of means to pay, I suspect others will be ready and willing to fill that market vacuum without having their business model socialized. That's called capitalism, which – last I checked – Republicans were in favor of.

I remember Commissioner Michael Gallen asking last year that we spend the money we were about to waste on a special election by instead hiring outside consultants to help us determine how we might improve our current inefficiencies and direct the indigent to the least expensive means of treatment available. There was zero interest in improving the system back then, probably because the $23 million projected from the sales tax could have kept lining pockets in the status quo.

That's why taxpayers – especially those who don't directly benefit from the current system – have a hard time believing that a study paid for by the county, but administered by the chamber of commerce, would produce an outcome that recommended anything other than a way to maintain it. Commissioners ultimately voted to defer the item until next month, though I'm sure that the real lobbying has only just begun.

Here's a suggestion: change the agenda item to a vote on whether to spend no more than half of that amount directly hiring credible outside consultants to study how to best fund indigent care within the specific parameters that it has to be done. Do this study using no more than the $15 million that currently comes from the general fund. Of course, you won't get the answer your friends are looking for, but you might restore a little of that precious credibility which seems so hard to come by these days.

Dennis Maley's column appears every Thursday and Sunday in The Bradenton Times. He can be reached at dennis.maley@thebradentontimes.com. Click here to visit his column archive. Click here to go to his bio page. You can also follow Dennis on Facebook.


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