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Don't Say 'Medicaid' Around Gaetz

DonGaetz2.jpg
State Impact, NPR

Florida Senate President Don Gaetz, who doesn't think it's sappy to speak of "public service" and would go the second mile for a kid or a veteran or an elder, doesn't want to talk about Medicaid.

Even though he spent much of his adult life as a health-care executive - he's been a hospital administrator, and founded a hospice - he seems to despise the joint state-federal health program for the poor. He gets grumpy when the subject of Medicaid comes up.

Unfortunately for the Senate president, the subject comes up a lot, since Medicaid comprises a third of the budget and is currently being overhauled.

In an interview with Health News Florida last week, Gaetz brushed off concerns of “safety-net” hospitals over the state’s new Medicaid funding formula. Neither did he want to talk about Florida’s refusal to expand Medicaid under the Affordable Care Act, nor the resulting loss to the state of billions of dollars that could have been spent to cover the poor.

Medicaid, he said, is “metastatic,” a cancer eating away at the state budget. No one likes Medicaid, he said, not patients, not doctors, not taxpayers. End of story.

Health News Florida Editor Carol Gentry learned this and more in a half-hour interview with the Senate president in his Capitol office on March 3, the day before the launch of the 2014 legislative session. Highlights of the interview have been condensed:
 

CG: Do you  think this is just not going to be the session of health care,  that the day of health care came and went last year?

DG: I don’t know that anybody has made a claim that this would be the session of health care, but we have a very active health care agenda.

CG: The scope of practice bill, (giving more authority and) independent practice to nurse practitioners.  Do you have an opinion about it?

DG: I do. The answer here is not to change the standard of care and redefine who a doctor is.   I believe that we have it wrong in Florida in this sense: We graduate a lot of medical students; we don’t have enough residency slots; we send those students out of state to do their residencies, and then we import doctors. And then we have a physician shortage. I wonder why.

CG: What about medical residency slots, is there going to be any movement on that?

DG: I hope so. I placed in the budget last year a substantial increase in medical residency slots. Unfortunately, the governor vetoed it. …But now the governor is proposing more medical residency slots in his budget, and I’m very pleased about that.

Secondly, the Florida GI Bill  will allow military doctors who are in good standing with the military and good standing with the medical profession to immediately be able to begin practicing in Florida instead of going through hoops and scoops and delays upon their leaving the military.

(Editor's note: The Florida GI Bill has passed both the House and Senate and is expected to be signed into law by Gov. Rick Scott. Coverage has focused on education issues for veterans, but it also offers quicker licensure for military physicians.)

CG: When people come to talk to you about the Medicaid expansion as a religious issue, you know,  Matthew :25, “...the least of these my brethren you’ve done it for me,” that whole thing, what do you say?

(Editor’s note: At a "Moral Monday" rally in the Capitol that day, ministers had called on the Legislature to pass a version of Medicaid expansion because, they said, caring for the poor is something Christians should do.)

DG: In my study of the Synoptic Gospels, when I was getting my religion degree, I don’t remember Jesus saying a single thing about Medicaid expansion.

CG: I think you know that doesn’t really get to the heart of the issue.

DG: To suggest that it is somehow immoral or unethical not to expand Medicaid, I think, is presumptive, undocumented and  bad theology.

I think people of good will can disagree about public  policy issues, but the House of Representatives  took the position they did not want to expand Medicaid, and to by inference suggest they are unethical or lack some sort religious conviction, I think, would be scurrilous.

CG: There was a story on hospital funding, it said hospital districts, where taxpayers  are coughing up money to support their indigent care hospitals, some of that money is being spent in other districts. What is your reaction to that? What are you going to do?

DG: The rest of the state of Florida has ponied up $200-to-$300 million a year for some of those hospitals in South Florida, so I think that notion that money gets moved from one part of the state to another part is probably as old as the appropriations process.

CG: Okay, so they’re mistaken?

DG: They’re grievously mistaken. They’re grossly mistaken. Having once been a hospital administrator, let me tell you when hospital administrators get together and begin wringing their hands about this sort of thing, hyperbole doesn’t even begin to explain it.