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Who Won on Health Issues? The Usual

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The 2014 legislative session -- while ignoring the $51 billion offered from the federal government to insure the poor -- took up other substantial health issues.  Very few passed.

WUSF's All Things Considered host Craig Kopp has been wondering what all the talk about "trains" was about during the legislative session that ended last week. He talked with Health News Florida editor Carol Gentry.

Carol Gentry: It’s a fascinating concept. The idea is you have an engine and several cars on the train and you have different bills in each car. The idea is if you don’t like one of the bills but you’ve got to have one of the others, then you’re going to vote for the train.

So they put a bunch of bills together in terms of health care and said, well, let’s see if we can’t push them all together in one super-bill being pulled in this one big train.

Gentry: Right, the House did that this year, and the reason they did it is they had some real provocative bills that they knew the Senate wasn’t going to swallow and they wanted to mix them in with the ones that were the must-pass bills. And the ones that were so provocative, one of those was highly opposed, it was the number one kill bill for the Florida Medical Association.

Kopp: What was that?

Gentry: Nurse practitioners, giving them power to practice independently.

Kopp: So what was the result? Did the train make it to the station?

Gentry: Boy, I sure thought it was going to get there. And at the very last minute on Friday, Friday night, 10:30, it just didn’t make it. it was like it crashed at the last minute. And in fact, things were going back and forth from the House to the Senate so fast that I couldn’t keep up. I had a split screen watching and I couldn’t figure it out.

Kopp: So what were the casualties in this train wreck?

Gentry: Well, the nurse practitioner bill was one. Another one was setting up a legal structure to handle telemedicine. Another was the one about trauma centers. They had reached a compromise to let the 3 existing trauma centers that were declared no-nos by a judge stay, grandfather them in, but there would be a moratorium for a year while they studied the issue. But it was on the train. It crashed.

One of the bills that failed is a particular favorite of mine that I was really hoping would get passed because of the importance to public health. It’s a loophole in Florida law that governs clinics. It requires them to be licensed and inspected on a regular basis. Well, there’s a loophole in the law. If you don’t take insurance you don’t have to be licensed. So all these fly-by-night clinics just take cash or credit so they get around the whole state law.

Kopp: And that remains the way things work because that was part of this train.

Gentry: That’s right.

Kopp: Who was the biggest winner in this legislative session? Was it the health consumer?

Gentry: Oh lord have mercy, no. What a concept. No. In fact the biggest winner was the Florida Medical Association, I believe, because everything they wanted to kill, they killed.

Kopp: What’s the biggest thing you learned about the process?

Gentry: The biggest thing I learned, Craig, and after all these years I can’t believe I didn’t realize it, is that most of this stuff, the sponsors of the bills never had any hope of passage. I talked to Dr. Cary Pigman, who’s a representative from Sebring. He’s the one who was pushing the nurse practitioner bill. He was also behind the telemedicine bill. All the stuff that crashed and burned. I called him on the phone yesterday and I said, 'You must be devastated.'

"Oh golly, no!" he said. "I knew it wasn’t going to pass. I would have been happy if I could have gotten it heard in two committees."

Kopp: Carol Gentry of Health News Florida, thank you so much for your insights on this session. There’s another one coming next year.

Gentry: Yeah, they say, and I guess I’ll be there.