Health Care “Crisis” A Political Creation

If the Kathy Castor master political plan succeeds, she will leave her Hillsborough County District 1 Commission seat in November of 2006 and assume the District 11 congressional one being vacated by Jim Davis soon after the holidays. The early money for the safe Democratic seat is on Castor to make the seamless segue to Congress.

But that is then; this is now. Castor, 38, still chairs the Hillsborough Environmental Protection Commission; she still fights the good fight on behalf of lobbyist disclosures; and she still seems way too normal to be part of any group that also includes Brian Blair and Ronda Storms.

Additionally, Castor sees a loose end that she doesn’t want unraveling on her watch. She would like to correct the record for anyone who thinks the county’s indigent health care program – funded by a half-cent sales tax — is in “crisis.” Or that it’s in need of an emergency-room fiscal operation.

“The plan has worked well,” Castor points out. “The county has done a good job negotiating reimbursement rates.” Indeed, the program is generally accorded plaudits for its managed-care approach and emphasis on preventive care.

The award-winning plan for the working poor, which was created in 1991, needs a scalpel – not a sledgehammer — says Castor, as it confronts a $6 million deficit on a $98 million budget. Treatment, emphasizes Castor, need not include service cuts. Nor are “enrollment gimmicks,” such as three felonious strikes or smokers butt out, any kind of viable prescription.

“I am concerned that our original goal of thoughtful improvement of the Health Care Plan has been mischaracterized as a need for radical restructuring due to a crisis,” noted Castor in a recent memo to fellow commissioner Mark Sharpe. Sharpe is chairing the 12-member Hillsborough County HealthCare Program Study Committee.

“I don’t know what you get by feuding or attacking,” she notes in a subsequent interview – in obvious reference to the unseemly Brian Blair-Pat Bean contretemps over privatization. “You really don’t see that between the professional staffers.”

What she would like to see is more of a focus on “intelligent disease management, low-cost pharmacies and a stable cash flow over the long term.”

Speaking of cash, the county is expected to save as much as $5 million next year as Medicare seniors avail themselves of prescription drug coverage from the federal plan. Moreover, removing part of Hillsborough’s Medicaid budget from the indigent plan would be a saving of some $10 million.

Privatization, however, “makes no sense,” underscores Castor.

While she’s not likely to juxtapose Blair as the Commission’s “Killer C,” Castor has drawn a line in the health care ring against any privatization “scheme” that could “possibly reward an industry for political support,” she wrote in the Sharpe memo.

“This push has everything to do with private companies attempting to raid our Trust Fund for their own profit,” added Castor, “and, thus, diminish the quality health care we provide to our residents. Please do not allow this to happen!”

Not every county-level issue translates well into a congressional campaign. But health care certainly does – and “privatization” has its own political resonance.The campaign – whether for lowest cost pharmaceutical pricing or Congress – is on.

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