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Debates ignore big health issues

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By Jim Saunders
10/26/2010 © Health News Florida
 

Florida's next governor will face overhauling the $20 billion Medicaid program. He or she will lead a state where nearly 4 million people lack health insurance.

But you would barely know Florida has health-care issues if you watched a nationally televised gubernatorial debate Monday --- or two earlier debates this month.

Like the proverbial elephant in the room, the state's daunting health-care problems were virtually ignored by Republican Rick Scott, Democrat Alex Sink and the moderators --- whose questions Monday ranged from illegal immigration to NPR's firing of commentator Juan Williams because of controversial remarks about Muslims.

Scott and Sink brought up health care, but it was the stuff of he-said-she-said television ads. Scott blasted federal health reform and repeatedly tried to link Sink to President Obama.

"It's horrible for patients, it's horrible for taxpayers, it's horrible for business people,'' Scott said of the federal law passed in March by congressional Democrats.

Sink, meanwhile, spent most of her health-related bullets attacking Scott for his leadership of the Columbia/HCA hospital chain in the 1990s. After he stepped down as chief executive officer, the company paid $1.7 billion in fines because of Medicare fraud.

"You've spent a lifetime reinventing the truth, Rick,'' Sink said at one point.

The only substantive mention of Medicaid came when Sink said she would curb fraud to help deal with the state's massive budget problems.

"We've got $3 billion in Medicaid fraud in the system,'' Sink said. "We've got to get to work cutting that Medicaid fraud.''

But the Medicaid focus didn't last long, with the debate quickly veering into a back-and-forth about building a high-speed rail system.

Monday's debate, televised by CNN, came little more than a week before the Nov. 2 election. It largely followed the lead of two debates earlier this month in ignoring health-care problems. An exception came during an Oct. 8 debate televised by the Spanish-language Univision, when Scott and Sink were asked about the state's high rate of uninsured people.

Scott responded to the question by saying it's important to get people jobs so they can afford health insurance. He also touted a plan for reducing insurance costs.

"You need a choice. You need more competition. You need your own health-care policy,'' Scott said, according to a St. Petersburg Times transcript of the debate. "You reward people for taking care of themselves. That will drive health-care costs down.''

But Sink fired back that many people have jobs but can't afford insurance because of the high premiums.

"It's a crisis. It's the biggest problem I hear from small businesses,'' Sink said, according to the transcript. "You are out of touch with reality and the way Floridians are living here.''

Granted, it is difficult to talk about the complex problems of fixing Medicaid or reducing the number of uninsured people during an hour-long debate. But health care --- particularly Medicaid --- promises to be one of the most-vexing problems for the next governor.

Already, the incoming Senate president and incoming House speaker have said a top priority will be overhauling Medicaid to help control costs. That overhaul likely will involve a controversial move to enroll more Medicaid beneficiaries in managed-care plans.

Scott has backed moving toward more managed care --- or even a more far-reaching idea of giving vouchers to Medicaid recipients so they can buy health insurance. Sink's campaign has said she favors slowing down and holding public discussions before deciding whether to put more beneficiaries in HMOs and other managed-care plans.

The debate Monday, however, reinforced one major difference between the candidates on a health-related issue: abortion.

When asked, Scott said he would support limits modeled after a new Nebraska law, which bans most abortions after a fetus reaches 20 weeks. Sink said she would not support such a proposal and favors keeping in place Florida's current abortion laws.

Capital Bureau Chief Jim Saunders can be reached at 850-228-0963 or by e-mail at jim.saunders@healthnewsflorida.org.