County’s Healthcare Plan Red Flags Then and Now Jan 6, 1999 Item F3 beds for criminals – Storms, Hart, Easterling, Norman…voted unanimously to drain funds from Indigent Healthcare

April 12, 2000 – Workshop Budget Process/Tampa General Mr. Kleman submitted copies of TriBrook Consultant’s report and County’s 12 point request. –Item 1 was to increase contract amount for more than $3.5 million with TGH as per request from the Commissioners. –How would the County pay for this? –Did anyone pay attention to this red flag?

Loss of U. S. Health Coverage in 2001 Due to Increased Unemployment January & February 197,200 March & April 358,700 May & June 131,750 July & August 430,950 SUB TOTAL BEFORE ,118,600 September & October 589,050 November & December 504,900 TOTAL 2,212,550 Analyst Predict Continued Increase through 2002 Bureau of Labor Statistics, U.S. Department of Labor

Bush’s Budget will cut $10 million from the infectious disease control program * H.M.O.'s have either pulled out of Medicare or sharply raised co- payments, causing thousands of retirees to lose benefits Bush’s budget cuts $57 million for programs for chronic disease prevention like Diabetes* Bush Cut by 86% the Community Access Program for public hospitals, clinics and providers for people without insurance** W hat are the Dangers faced in 2002 ? * NY Times, Feb.2002 **Washington Post, Jan. 2001

Medicare reimbursements to physicians decreased 5.4% on Jan. 1 Physicians have warned if not reverse they may cut back Medicare services or exit the program altogether Bush’s budget NO funding increases for Ryan White CARE Act and for the AIDS Drug Continuation Program – Florida is about to run out of money for ADAP. Who will pay the cost of life saving drugs? Dangers faced in 2002 Kaiser Health Report, 2/2002 & CDC News Update 2/2002

President’ Bush’s budget recommends cutting money for vaccines for children Will the County cover this new cost? 63% of uninsured, roughly 4.7 million Americans-have incomes at or below 200% of poverty, or about $35,000/ year for a family of four There is no current proposal to assist working families in that income range Dangers faced in 2002 Community Tracking Study Physician Surveys

Florida Rated One of the Worst in Providing Health Care For Uninsured A study by the National Survey of America’s Families looked at 13 states; identified their safety nets for the uninsured as public hospitals, community health centers, local clinics & some primary care physicians. Bush’s Florida & Bush’s Texas have the most vulnerable safety nets because they have the highest adult uninsurance rates, relatively high commercial managed care penetration and a high percentage of for- profit hospitals.

Commissioners, will you ignore the red flags again and make our Public Health System worse? Commissioners, will you heed the warnings and improve our Public Health System? OR