Guidelines for Healthcare Reform in Florida

Introduction

The existing structure of Health care in Florida has proved to be incapable of meeting the health care needs of the Floridians. This paper is especially focused towards those Floridians who are not able to afford Health care services and reliant primarily on Medicaid services. In reaction to growing fiscal problems or political decisions, a number of states took advantage of changes in federal laws or pursued waivers that permitted them greater flexibility to curb costs, increase beneficiary cost-sharing, and/or reform the Medicaid delivery system. These changes have given states greater flexibility in tailoring their Medicaid programs toward a so-called consumer directed model. Florida was provided a Medicaid waiver where enrollees in some counties would be required to select from a variety of private insurance plans offering different provider networks, benefits, and cost-sharing levels. During the 7-month demonstration period, enrollees were informed that they would have to select an insurance plan or one would be provided for them. Plans are required to provide the minimum Medicaid benefit package, but can vary the extent of services by amount, duration, and scope, such as limits on prescription drug coverage. Although this model allowed Medicaid beneficiaries greater choice in health coverage, a survey of participants in 2 counties shows that many enrollees did not realize they had been shifted to a private plan and had difficulties understanding plan information. Given the vulnerable nature of the Medicaid population, such misunderstandings may lead to difficulties accessing appropriate care, and some evidence shows that Florida's Medicaid access problems are worsening since implementation of the reform effort.

Some enrollees have reported problems finding a plan that included their doctors in the network. In addition, many doctors have reported dissatisfaction with the program, with 47% describing the reform effort as making the Medicaid program worse (compared with 8% reporting that it had improved the program. Florida physicians also reported issues with the increased administrative burden as well as low reimbursement rates. Many physicians also expressed that the ease of authorizations for needed services had worsened since reform was enacted (Alker, p.56). In order to meet the needs of the Floridian natives, government should adapt effective strategies to solve the issue and reform the existing health care structure in Florida. For achieving this purpose, Measures have to be taken both at the executive, as well as legislative branches of government.

Thesis Statement

The purpose of this study is to propose viable solutions or guidelines that can aid in resolving the matter of Floridians having to choose between rent, food and medicine.

Discussion & Analysis

Medicaid continues to be an enormous part of states' budgets, and when combined with the Medicare program, makes up 4% of the nation's gross domestic product. Medicaid offers essential health care services to weak populations, such as people with low-income, unprivileged and disabled, but similar to the entire health care system, Medicaid must be reformed to emphasize primary and preventive care (Engel, pp. 87-95). Some of this is occurring now, as states like Vermont experiment with ...