TellUs Emails

We also received several emails about our Community Healthcare Discussions.


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"Good job, thanks for the chance to participate. It seems obvious the common theme in my groups was the need for the expansion of Medicaid funding to cover the over 1.2 million Floridians who fall into the coverage gap (Kaiser Foundation data), many of whom represent working individuals and families. If the county did nothing and this gap issue was resolved it would go a long way to addressing the local health needs. There should be no confusion on the part of our government leaders that this needs to happen and every effort to support the necessary Medicaid changes should be made. This is a health care issue that has been politicized. There are many reasons to support the expansion of Medicaid funding to benefit individuals, families, hospitals, health care providers, and the economy.

There should absolutely be a county plan and needs assessment maintained and up dated on a periodic basis just as part of good government responsibility. This does not imply the county should or shouldn't provide direct services or funding, it would merely be an understanding of how well the needs of our citizens were being met or not and if any further efforts or advocacy were necessary.

A serious problem exists that I did not hear during group discussion which is the total lack of affordable dental health care. The One-stop Center helps for some individuals but is insignificant with respect to the need throughout the community. This is a very tough problem to address but the need is very real and exists on a broad basis. Many people in this community are getting little or no dental care even with health coverage. This would be a tremendous goal, to reach for: affordable, accessible dental care in this county. I am certain a needs assessment would clearly establish this problem. I think the county has a leadership responsibility in this area or more.

Thanks again for getting the community involved."

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"It bothers me that the county government seems bent on a tax increase to fund more government largesse towards the citizens of Manatee county.
Plus, some are wanting to increase this even for people who are covered and already more than capable to handle their own heath care.
Based on the past performance of County Government,  no audit or accountability has ever been implemented in the past program….so therefore we the citizens don’t ever know---what reimbursements to health care facilities have been?---how many people were served?  How much were they charged?  At cost?  Very doubtful. 

It also fosters the “corporate cronyism” that has been going on.

Some of the ideas being proposed by the health care workers at the meeting last week were so open ended and nebulous that they would become a bottomless pit to fund, much less account for.

We have got to stop this government in every corner mentality (and overlap with state and federal programs).  It creates a spirit of dependency.  People who are dependent on government for every area of life are not free.
Government bureaucrats are inherently poor auditors and managers of money.  The more of their earnings citizens keep, the more it inspires a continuation of enterprise and  job creation.  The more the government interferes with that process, and in such ---inefficient ways----kills that spirit.  It ”kills the goose that lays the golden eggs” in the first place.   
 
A government big enough to give you everything you want is big enough to take away everything you have.”

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  • people only need health insurance when they don't have a job - so the solution is JOBS
    • historically every time government shrank - prosperity grew
    • lower the taxes in Manatee County and it will encourage economic growth
  • The people who don't earn enough or are un-employed have
    • Medicaid
    • Medicare
    • Obamacare
    • others  
  • If the above are NOT doing their job, the question is why?
    • Is corporate welfare the solution? - which is socialism
    • Is "chrony capitalism" the solution? - which happens to be socialisn
  • If the problem is mis-management of the fund then solve THAT problem.

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The problem with healthcare is that we have deferred to socialism.
The solution is not MORE socialism!

 

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County Commissioners need to better manage spending of the taxpayers money.  The voters of Manatee County do not need any higher taxes especially since the County has spent the principle of funds that was intended to remain principle.  I don't want to hear about low interest rates because we all know that interest rates will not remain as low as they have been and will recover.

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I am against a new tax of Manatee County citizens for health care.  I have many reasons for this.  First, there has been no accountability or auditing of the funds used for this in the past.  Second, the plans for use of any future money are vague and there is no provision for accountability. These services can be provided for by Manatee County Rural Health Services, Medicaid and the AFA.  Let us put our efforts into developing personal responsibility and bolstering our charities as a means of last resort for the indigent.  Socialized medicine is inefficient and encourages dependence on the government. 

 

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Dear Sir/Madam
 
First let me Thank You for the orderly forum you created last night, as a way of hearing from all parties in this discussion.  It is not an easy issue to deal with for our community.  The federal government and essentially the rest of the nation is grappling with these issues with no comprehensive solutions.  There are, however, little wins that are occurring in little known places and we need to aggregate some of their solutions and adapt them to our needs here in Manatee county.
 
Below are a few of my observations that may give a direction to solutions for us ALL. 
 

  1. Develop ways to more effectively spend county funds, by implementing ways to minimize hospital ER usage and testing costs, as an examples.
  2. Rather than just continuing the existing way of dealing with indigent care, develop a new plan from the ground up with input from all the representative citizens in the county, not just the financial stakeholders.
  3. Introduce a data system like a Deerwalk to evaluate our pockets of successful outcomes and cost effective providers.  This will be a powerful tool for the county to evaluate its SPEND and address the financial concerns of many. 
  4. Consider privatizing much of the county spend on indigent care and reevaluate its effectiveness on a periodic basis, like every 3 years.  Do a test market on its effectiveness before committing full support.  This concept should be utilized for most modifications vs. just dumping millions on the problem.  This can be done on an interim basis while alternate funding can be realized for a more comprehensive solution.
  5. The county should NOT be in the business of providing healthcare, but merely shepherding its delivery.  Currently, it is only throwing $ at a perceived problem without any accountability.  Develop a way to allow innovation to spring up, then watch it flourish.  Be in the business of developing a climate for this innovation, through Mini contracts, tax incentives, seed monies to organizations that demonstrate fresh thoughtful solutions. In exchange for county support, they give back in some meaningful way.
  6. Develop a comprehensive community healthcare plan.  Who says the indigents are the only problem the community? What about drug and alcohol addiction and mental health.  You have left the propensity of the county to look like second class citizens.  The plan should include all persons, including our healthcare professionals.  The only way we can be in the top 10 counties is to make certain we attract the finest providers available. Continue programs like the intern program at Manatee Memorial, as well as other great programs currently in place.  Demand all hospitals achieve and maintain A status as part of any comprehensive plan.   Develop new innovative ways to bring “the best and brightest” here to Manatee county.

Best regards,  

 

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I am taxed more than enough, and am driven by conscience and faith to contribute consistently to my church, who in turn supports needy individuals.  This arrangement has satisfied millions of indigents for hundreds of years and has been found FAR more accountable and honest than governmental bureaucracies!  The people of Manatee County have spoken to this issue before, leaving me perplexed as to why it is resurfacing. Could there be some nefarious profit to be found within its bounds, particularly in light of the absence of accountability already exercised by this County Commission.
 
ENOUGH!  Get on with the people’s business and leave charity to those most effectively able to carry it out, absent of pocket-lining politicians and crooked health care cronies. This is stuff best left to the professional thieves in Washington and not to rank amateurs elected (or NOT) by local citizens aware of their circumstances.  With so many other opportunities in our county to research and perhaps make improvements, I find it amazing you insist on plowing again this infertile field, already resoundingly rejected by those who elect you!  It causes me to question either your collective intelligence OR perhaps your honesty; either case being very disturbing.
 
I implore you to put this egregious proposition to rest and move on to a more effective and responsive governance for Manatee County!

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I noticed that at two of the tables I sat at last night there were comments from participants that the comments they had made were not properly written on the large comment sheets that were suppose to be accurately covering all comments. Had these gentlemen not noticed that, then there would have been no record of their timely comments.
 
With that said, I’d like to comment that I was there to learn more about this healthcare issue. In doing so I felt that the whole story of healthcare was not actually clear. New to this topic I asked why the county was in a situation of needing more money because: “I thought”, I commented, “that there had been a very sufficient amount of money available for this type of healthcare since Manatee Memorial had been sold for a very high figure.” Answers to this were to the effect that this sale occurred long time ago, that the economy has worsened and jobs are few, that the money was no longer getting the interest income that it once had but the most unbelievable answer was that ‘it didn’t make any difference why the money no longer there! The problem is that there is no money for the indigent!” My reply was that I believed it DID matter because “where did the money go and under whose authority and how long did it take to go through the millions of dollars?” One person’s answer was 30 years. Another person’s answer was 5 years. Which was it? And should we not be sure that steps are in place to not let money go easily before the tax payers have to pay out huge sums? Many of the tax payers in Manatee County do NOT have the means of paying out one more penny and there are those who do have the means but “in this economy” (the phrase used to identify the problems with the indigent person) there are those who are having to pay special care to what they DO have.
 
So it appears to me that there is a little of the “From each according to his ability, to each according to his need” that I learned in my high school class, Americanism vs. Communism. I don’t think that’s what this great country is all about, do you?
 
I’m all about helping people in need and do. I do this through donations to groups or organizations or church. After the first night’s round table discussions I talked to the Rural Health administrator and got his business card. I will be putting aside a small amount to donate to Rural Health – it won’t be much but I will feel good about it. And I will encourage others to do the same.
 
I definitely believe that things will be ‘okay’ for everyone who needs help with their needs for health care. Maybe the hospitals can work on cutting their costs so that their bottom line looks more positive but asking tax payers to pull more money from their pockets to subsidize the hospital is just asking too much. Furthermore, our local government demanding this is NOT acceptable and blatantly FORCEFUL. In addition to that, our local government wanted this so badly that there was a special and costly election last summer to raise our sales tax. It failed to pass by something like 61% against and 39% for and yet … our county leaders are still trying to get their way. I just don’t ‘get it’. It is evident that the people of this county don’t want the responsibility of providing this healthcare to people that we don’t genuinely know even need it – is it possible that they want something that they don’t want to work for themselves? There was a question at the first roundtable meeting asking who exactly needed this indigent healthcare … were any of the needy illegally in this country? What is the answer to that question since there was no verbal documentation that night to answer that question? Somewhere along this road of America we’ve got to stop letting the government grow and grow and let it be returned to the people – the people who are legally suppose to be here one way or another. The American people have always helped each other by WILL not by FORCE.

 

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Kindly accept the following input that I did not hear mentioned in the summaries by the 7 group leaders at the end of the work session last evening.  I am listing the ideas (opinions / suggestions) under 3 categories.
 
A. THE ROLE OF MANATEE COUNTY GOVERNMENT in healthcare:
 
1. Thomas Paine said that “Government, even in its best state, is but a necessary evil – in its worst state, an intolerable one.”  I agree.
2. Thus, the less government the better.
3. Thus, getting Manatee County government more involved in healthcare is not good – or necessary.
4. The more government does – or tries to do – for citizens, the less they tend to do for themselves.
5. There is no legal requirement for the county to fund indigent care.
6. Concern (compassion, charity) for those in need is good, but how it is implemented is important.
7. Forced charity (by means of taxes) is not really charity at all.  It’s simply a form of re-distributing wealth.  True charity is voluntary, not mandatory.
8. Recipients of true charity are more grateful, and givers are more glad and fulfilled.
9. The most efficient and effective care for the needy is done by individuals (friends, fellow workers, neighbors, fellow church members) and places of worship (churches and synagogues).  They are best equipped to determine and decide who are the TRULY NEEDY.
10. Government programs are inherently wasteful, inefficient, ineffective, & bureaucratic in providing & monitoring services – e.g., the USPS and the VA and the depletion of Social Security funds!
11. The hospitals failed to do a good job with the money already given them. Why give more?  Why “throw good money after bad”?  Instead of using just a portion of the interest from the 1994 Agreement, they were given – and used – much of the principal.
12. Moreover, the  hospitals and the country have not provided evidence of how the money was used.
a. How many people were serviced
b. What services were performed
c. What the services cost (per hour or per procedure)
d. What the recipients were charged
e. What criteria the hospitals used to decide who should get free medical attention
f. What proof hospitals demanded that the recipients were truly needy / desperate
 
B. SUGGESTED SOURCES FOR MONEY to pay for healthcare for the truly needy
1. The truly needy can already get necessary care through Federal programs (eg, Obamacare & Medicaid) or local aid (Manatee Cty Rural Health Services) and charities – without the Corpus Health Care Plan
2. Hospitals should consider cuts in costs, salaries, and profits.
3. Hospital executives should consider making more charitable contributions to non-profit agencies.
4. Churches, synagogues, and other charities may get more involved, caring for their own needy members first, of course.
5. Informed, concerned citizens probably best know needy AND deserving individuals personally.
 
C. CRITERIA FOR DETERMINING ELIGIBILITY for healthcare assistance
1. WISDOM – Many people are needy due to their own stupidity and selfishness – e.g., men & women who have too many children, buy too many things, pay too much for things, and/or don’t budget. As the bumper sticker puts it, “If you can’t feed ‘em, don’t breed ‘em.”
2. MISAPPROPRIATION OF FUNDS – Many who get government handouts for the necessities of life use the money / coupons / etc. for alcohol, cigarettes, junk food, the lottery, and other gambling.
3. LIFESTYLE – Many people get free treatment and medications but then – unsupervised – go out and do the same things that brought them illness, injury, or incapacity in the first place.
4. LEGALITY – Illegal people (by definition) are NOT Americans & thus are disqualified for assistance.

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We understand that yesterday Mr. Hunzeker proposed this year's County Budget.  Although we don't know the exact amount that will remain in the "Corpus" after the Agreement with the Hospitals expires in September of this year, the attached "Health Care Analysis 2013" prepared by the County indicates the projected  Balance of Funds at Fiscal Year End 2013 of $16,578,632.  
We want the Agreement with the Hospitals to expire in September 2014 with no renewals, no extensions, no re-negotiations and no new agreement.  If there is no new contract after September, then the $16,578,632 (or whatever the balance turns out to be) will be available for other Health Care needs.  

We propose the entire remaining balance of the Corpus shall be put into a "Trust" type account to be used solely for the payment of "ARMOR" which is listed on this attached Analysis as "Prison Health Services".  

We believe this is the most prudent use of the Corpus funds going forward, primarily since ARMOR is a mandatory expenditure by law.  This will then free up the budgeted $5,700,000 for ARMOR coming from the General Fund and allow the Sheriff's Office to get their personnel needs of 8 Deputies and 4 Correctional Deputies satisfied along with taking care of some of the badly needed salary increases.  

As you know, we believe that the County spends huge amounts of money on many discretionary items which are not even remotely related to the proper Constitutional role of County Government.  However, police protection is not only a legitimate role of Government, but protection of Manatee County citizens is the first and highest duty of the Commissioners.   Please give this proposal immediate and serious consideration.  Thank you.

 

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1.  I have heard that Manatee County government is operating with a deficit,  i.e. spending more money than what is available each year.  If this is true, why would the county commission want to spend $196,000 for a study and a plan for providing healthcare to needy residents?  And if they like the study and plan, spend $9 million each year to provide such healthcare.  My bottom line on this is:  if excess revenue (i.e. over and above spending) is not available, you are foolish to spend money you don’t have.  By borrowing money you are putting the taxpayers at risk if the loan can not be paid back.  It has been in the news lately that some local governments are  going bankrupt, i.e. Detroit is already there, and Chicago is almost there.  Please be FISCALLY RESPONSIBLE and protect Manatee County’s money just as if it was your own money.
 
2.  Inherently government does not operate as efficiently as private enterprise.  The reason is that private enterprise needs to make a profit in order to survive, whereas government has no such incentive.  If needy residents can not obtain healthcare, then appeal to the private sector to step up to provide the service.  I guarantee you that the private sector will find a way to do it for less than $9 million per year, or they won’t do it at all.
 
Thank you for this opportunity to express my concerns about Manatee County government being in the healthcare business.

 

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I would like to express my opinion on the possibility of addition healthcare for Manatee county.
 
1. We HAVE healthcare for our citizens in the county. We do not need additional care provided by Manatee county.
 
2. There DOES need to be accountability concerning care, patients and costs. By all that I have heard, there are too many who have :learned to" cheat the system" and the public should not have to pay for that abuse.
 
3. There does need to be accountability concerning care, patients and costs. By all I have heard and read there are TOO many who have learned to "cheat the system" and the public should not have to pay for that abuse.
 
4. Let the hospital contracts run out
 
5. Have some definitive rules as to whom get free  healthcare, not like the people shown on TV who had gotten 6 to 10 FREE phones...free always seems to be abused.
 
6.The approach should not be "we can't let people die" No one wants that, but these businesses like clinics, hospitals, urgent care CAN provide care to those who qualify...but be SURE the qualifications are honest. ( I know this is almost impossible )
 
7. Charities will generally help, and need to have a system in place to check out the truth of the requests.
 
8. We are seeing costs for everything going up... do not saddle taxpayers with additional taxes.
 
I appreciate the opportunity to express my thoughts on this sensitive issue, I hope that the combined comments from the public prove to be helpful.

 

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From what I understand about the forced health care issue is :  The
Hospitals raided the Health care fund (aka "the Corpus") and depleted the
Corpus to almost zero when, the original 1994 Agreement was negotiated and  agreed by all parties that the Corpus would last forever because only a  portion the interest earned was suppose to be given to the Hospitals, never  the Principal. The Corpus at it's highest had approximately $80 million in  Principal which the Hospitals brought down to almost nothing and now want  more money.   The Hospitals didn't have to account for anything to get  millions from the County every year. There was no accountability. I don't  know how many people were serviced, what services the Hospitals performed,  what prices they charged for each of those services or even how many were  Illegals. How do you pay for the services to the Indigents after the Fund  runs out of money? That is the hospitals problem. I speak with the 61% that  defeated funding the Corpus last year.

We have Affordable Care Act, MEDICAID, and charities - why must I be forced  to pay for medical care for others.

Residents don't want their taxes raised, they proved that last year by a 61%  margin against Special Interest Groups big money campaigns. Also,Why give  for profit health care providers millions of tax payer money when they  misspent and depleted the health care fund before it should have been.  Let  the current Agreement with the Hospitals expire on it's due date in 2014 --  no extensions, no renewals. End the Corpus in 2014.

 

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I don't understand the hospital employees packing the meetings. What sort of
community input can be gleamed from paid hospital employees packing the
meetings with their obvious agenda to spend our money to keep their
positions. Were they paid to attend or just strongly encouraged to attend.

Medicaid & Obamacare will take care of the truly poor so why double the
eligibility?  Why include ILLEGALS? There is no legal requirement for the
county to fund indigent care.

 

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From http://www.cdc.gov/nchs/data/nhis/earlyrelease/emergency_room_use_january-june_2011.pdf

Released
5/2012
Emergency Room Use Among Adults:
Early Release of Estimates From the National Health Interview Survey

1 Significantly differs from private insurance, p 0.05.
2 Significantly differs from public coverage, p 0.05

NOTES: Estimates for 2011 are based on data collected from January through
June. Data are based on household interviews of a sample of the civilian
noninstitutionalized population.
SOURCE: CDC/NCHS, National Health Interview Survey, Family Core and
Sample Adult Supplemental components.
From January through June 2011, among adults aged 18–64 whose last
hospital visit in the past 12 months did not result in hospital admission:
• An estimated 79.7% of adults visited the emergency room for reasons reflecting lack of access to other providers, which is not going to change. As well I have heard those with medicaid state they were not going to go to Rural Health and spend their day waiting to be seen,they also get the prescriptions filled at the hospital and Rural Health expects them to pay, they also say they are not ever paying a medical bill. See the problem that has been created by government?