Just in the NICA time

Thank goodness we still have robust newspaper reporting. The Miami Herald and ProPublica recently wrote a series of stories about the State of Florida's abusive incompetent program to help children born with neurological damage.

Only because of the Miami Herald investigation uncovering the scandal, did the state legislature finally act.

The NICA program - birth-related Neurological Injury Compensation Association - was created by the state in 1988. Bob Martinez was governor and the Democrats were the majority party in Florida.

In the 1980s, doctors who delivered babies were suffering with what they thought incredibly high malpractice premiums. Hospitals didn't want to deliver babies because of the potential malpractice insurance.

In response, the state of Florida created its own insurance program - a government owned and operated program that dramatically reduced malpractice costs for doctors. Under the NICA law passed in 1988 and currently in force, parents of a brain-damaged child infant were prohibited from suing their doctors for malpractice.

In exchange, the state of Florida promised to take care of all medically necessary and reasonable care expenses for the entire lifetime of the brain-damaged child. The government of Florida-owned and operated insurance fund is paid for by doctors.

Obstetricians pay just $5,000 a year to be guaranteed immunity from these brain damage lawsuits. Other doctors in the state pay $250 a year. Every hospital pays $50 for every live birth.

In theory, this is a great outcome. Lower malpractice fees for doctors so we have more doctors and hospitals willing to perform delivering babies. A funded system to humanely handle the needs of these incredibly unfortunate infants.

But like many government programs which seek to displace private enterprise with a similar government program, this NICA program turned into a disaster.

The state NICA program has accumulated over $1.5 billion in assets while arbitrarily denying claims, using Google for its medical reference in making decisions; and not even have a parent's handbook that was current and could not clearly explain the rights of the child and the potential benefits.

And here's the kick in the pants on top of this already disgusting mess.

Although the state of Florida-owned NCIA fund is sitting on $1.5 billion, the state often sends people with brain-damaged infants first to Medicaid to take care of their needs. NICA often won't pay anything until the family can prove not only that Medicaid said no, but the family has exhausted all of the appeals process with Medicaid.

Why would the state of Florida put a family with a brain-damaged infant unnecessarily through the morass of Medicaid when there is $1.5 billion unspent in the bank for NICA to take care of the needs of the brain-damaged?

It's because the federal government pays for about 60.9% of all of Florida's Medicaid costs. Putting these unfortunate families through a financial and emotional Medicaid wringer to save the state of Florida insurance program money is disgusting.

To add even more obscenity to this program, Federal law requires Medicaid to be the payer of last resort, not NICA. It appears, the state of Florida regularly violated federal law to save a buck, while putting families of brain-damaged children through hell.

When this government embarrassment of a fund for brain-damaged children continues year after year for 33 years with no action by the state government, we have a right to be ashamed.

The state recently did an audit of the program and passed legislation to make major changes to NICA, but only because of the Miami Herald and ProPublica expose. The Miami Herald arrived just in the NICA time.

Think about this. The state decided private enterprise was not doing a good job with doctor's malpractice and a state-owned insurance business would be better. When it became clear the state is incompetent running an insurance business, instead of turning it back over to private enterprise, the Republican-led state of Florida doubled down on a state-run insurance monopoly.

When the government decides to boot out private enterprise and tells us they can do a better job for less money, can we believe them? Is this any way to treat children with brain damage caused at birth?

Share your thoughts.

David Dunn-Rankin is CEO of D-R Media, which owns the Highlands News-Sun and the Highlands Sun, as well as newspapers in Lake, Polk and Sumter counties. He can be reached at [email protected] .