Conference on Health Care Access 2003
A Report To The Membership
by Ron Pace, PA-C
President, FAPA

On January 17-18 I had the privilege of attending the “Conference on Health Care Access 2003” presented by the Health Professions Division of Nova Southeastern University in Ft. Lauderdale. The first day of the conference consisted of a Community Forum. The main panelists included:
Sen. Ron Klein, Democratic Leader, Florida Senate
Rep. Eleanor Sobel, Member, Florida House Health Care Committee
Sen. Campbell, Florida Senate
And three NSU faculty members

They were each given about ten minutes to make their presentation on their opinion of the state of access to health care in Florida and the issues facing us, and what they felt the solutions might be. It was then opened to the floor for questions. There were about 250 people present at that time. This included about 80 PA students from the freshman class, about 50 or so senior citizens, and other concerned people including physicians, pharmacists, health care administrators, PAs, and representatives of the major health care groups in Florida, and of course a very few lawyers.

The main questions centered on the malpractice crisis issue, cost of medications, health insurance plans, veteran’s problems, and special care programs provided by the state. There were some rather emotional pleas for help for various groups. And there was a rather testy confrontation over the malpractice issue between a hospital administrator and one of the legislators, a lawyer by trade, brought on by comments by the legislator, which most of the group appeared to feel was out of place. He and the hospital administrator left in less than a happy frame of mind shall we say. One fact I left remembering is that there are 108,000 drivers in Florida over the age of ninety. Think about that the next time you get behind the wheel.

The second day began with a plenary session with presentations on the same issues on a national basis. The major panelists included: Yank Coble, M.D., President, American Medical Association
Mary Alexander, J.D., M.P.H., President, Association of Trial Lawyers of America
William Novelli, Executive Director & CEO of the AARP
George Atkins, Managing Director, State Affairs, American Association of Health Plans

Each presented his views on the health care situation in America and related it to Florida. Some facts I remembered are that there are 46 million Americans with no insurance coverage at all. Sixty percent of Florida physicians are over 50 years of age, and forty percent are greater than 60 years of age, so the physician population in Florida is an aging one which is going to have a tremendous effect on access to health care in the next five to ten years especially. Each group representative seemed to blame one of the other groups for their part in the crisis. And no one had anything good to say about the insurance companies and their “greed” and mismanagement of funds and its’ role in the current crisis. Again, the tension between the lawyers and physicians was quite evident. The rhetoric was quite inflammatory at times. It was interesting to observe. There was no give and take, mostly just each giving it to the others.

The second part of the morning plenary session dealt with the same issues on a state perspective. The major panelists for this discussion included:
Joel Rose, D.O., President, FOMA
Howard Coker, President, Academy of Florida Trial Lawyers
Frank Sacco, J.D., CEO, Memorial Healthcare System
Bentley Lipscomb, Executive Director, AARP, Florida Chapter
Harry Spring, Director, Governmental Relations, Humana

This was more of the same as the initial panelists presented but just it centered more on Florida. Again there was a great deal of finger pointing and accusations about the cause of the problems. Each person pointing at the other, and most everyone pointing at the lawyers and the insurance companies as the major culprits in the issue. I did come away with a better understanding of the “caps” proposal and the differences in economic damages and those for pain and suffering. The big question was how the insurance companies could justify paying their top executives thirty million plus a year in salary and benefits and then raising the rates for malpractice. The insurance company representative just seemed to ignore that question.

The luncheon featured Sen. Jim King, President of the Florida Senate. He, the Governor, and Rep. Johnny Byrd, Speaker of the House, are probably the three most influential persons in Tallahassee this year. If President King does not want it to be heard in the Senate it will not be heard, and the same for Speaker Byrd in the House. And the Governor is of questionable influence at this time it seems. Sen. King looked like the stereotypical Southern politician, but if you listened closely, he is a sly fox and is obviously very bright, intelligent and knowledgeable on most of the issues. His was a very entertaining presentation. His key point was that there is going to be a 2-4 billion dollar budget deficit this year, and that is going to be the focus of the legislature, not the alleged malpractice issue. He indicated that a decision on this issue is not likely this year unless there is some major breakthrough in partisan politics. They may listen but they won’t pass any tort reform. This did not sit well with the physicians and many others in attendance. The pointed out on several occasions during the conference that it took a three and one half week strike by doctors in California to get legislation passed.

The afternoon sessions focused on malpractice, universal health care, care for the homeless and illegal aliens, the high cost of prescription drugs, and terrorism and weapons of mass destruction. I attended the medical malpractice issue session and the session on terrorism. The session on malpractice had some good materiel presented by Dr. Rose of FOMA and Dr. Palamara from the FMA. The lawyers did their best to counter their presentations. The lawyers indicated that the caps legislation in California has not stopped the rise in malpractice insurance rates or had a tremendous on lawsuits. Again there was a lot of tension in the room. I think next year we might see metal detectors at the doors.

The session on terrorism was very informative and frightening. It was presented by Dr. Robin McFee, and Charles Lewis, PA-C from Nova Southeastern University. Nova is the first medical school in the nation to require mandatory training in the medical aspects of bioterrorism, and hands on decontamination drills and training. I attended this because of my position in Occupational Health and our role in the pending smallpox vaccination program. They voiced some opinion on the recent Norwalk virus outbreaks aboard the cruise lines and how they were more than just coincidence but more likely some unknown group testing the feasibility of such an attack. They also talked about the feasibility of dirty nuclear bombs. It was a real thought provoking presentation.

During the breaks I was able to network with Dr. Rose of the FOMA and had a couple of nice conversations with him. He voiced his appreciation that FAPA had joined their coalition on the malpractice issue. I also spoke for a few minutes with Dr. Palamara from the FMA Board of Governors. He thanked me for my attendance and support at the lectures. He also voiced an unsolicited statement of support for PA affiliate membership in the FMA and stated he would work on that issue with his fellow Board members. I also managed to speak to Sen. Debbie Wasserman- Schutlz who was the event organizer and is on the faculty at Nova Southeastern University in addition to her Senate legislative position.

I think this was a valuable experience for me as President, and even more so as representing FAPA there. I believe we should continue to have Board members present at such conferences whenever we have the chance to put forth the FAPA name and presence. The exposure and knowledge gained was well worth the minimal expense involved.