During the early months of the pandemic, many Floridians decided to forgo non-COVID-19 -related care – primarily due to safety concerns and government directives to limit elective surgeries. What consequences will this have on Florida and its citizens moving forward?

Florida TaxWatch (FTW) studied these factors and others in a report released today called Beyond the Pandemic: Long Term Changes and Challenges for Health in Florida. It addresses a unique confluence of factors that are negatively impacting people’s lives and contributing to important outcomes for the state’s health care system and consequently, the economy.

The analysis is the first installment in the taxpayer research institute’s COVID-19 Legacy Series, and examines the impact of the pandemic on healthcare and the economic implications of those changes.Upcoming reports will focus on other important focus areas.

The impacts of Floridians putting off needed healthcare is expected to have significant consequences. According to the study, during the pandemic there was a 38 percent decrease in emergency department visits and a 32 percent decrease in outpatient center visits. This forgone care and isolation has an estimated cost of $98.1 billion resulting from nearly 32,000 excess deaths in less than a year and a 12.7 percent increase in reports of anxiety or depression since April 2020.

According to the report, psychological trauma from social isolation gave way to growing rates of behavioral health issues.

”Reports of anxiety or depression have risen by 12.7 percent in Florida since April 2020, making Florida the 8th highest among all fifty states for the average rate of anxiety and depression. Untreated, various mental illnesses can lead to reduced productivity, job loss, and economic insecurity for many individual Floridians,” said the report. “To the state, these outcomes can potentially spill over and require more public expenditures to address substance abuse, incarceration, and health care in the future. Since mental illness may not surface right away, quantifying these long-term costs is difficult at present. According to one study, however, the economic cost of mental illness due to COVID-19 was $1.6 trillion across the U.S.—a figure that will likely grow in successive years as mental illnesses worsen.”

To assist in reaching out to patients during the pandemic, there was significant growth in telehealth. According to the Centers for Disease Control and Prevention (CDC), telehealth visits rose 154 percent during the end of March 2020 compared to the same period in 2019. According to the report, even larger growth occurred in Florida, where health systems across the state experienced rapid expansions in the number of telehealth visits throughout 2020.

But telehealth has its shortcomings, particularly in low-income and rural areas where there is inadequate or inequitable accessibility.

It also affects the states older population, which is growing exponentially. Between 2020 and 2045, the report says, “Florida’s population of 65+ residents is estimated to increase by 1.4 million people and grow from 20.4 percent to 25.2 percent of the state’s total population. By 2030, all Baby Boomers will be over the age of 65, which means one in every five Americans will be in the retirement stage of life. As a result of these changes, Florida’s health care system—like much of the rest of the nation—will have to handle a larger population of older patients.”

Florida TaxWatch President and CEO Dominic M. Calabro said, “Florida TaxWatch is proud to kick off our COVID-19 Legacy Series by focusing on Floridians’ physical and mental health. Medical care and behavioral issues resulting from prolonged isolation have created challenges for Floridians of all ages. Widespread adoption and accessibility of telehealth is a potential solution, but for the foreseeable future, our efforts must focus on confronting those lingering issues and their associated costs, while also adapting to a rapidly aging population with a need for elderly care.”

Florida’s medical community began sounding an alarm as these issues emerged. This was a major concern discussed during Governor Ron DeSantis’ healthcare roundtable discussions and a contributing factor to DeSantis’ decision to reopen the economy as quickly as possible. There were also several bills put forward, easing regulation of telehealth and telemedicine.

But this is not a problem that’s going away any time soon.

According to the report, “Florida’s health care system will have to confront the lingering costs from foregone care and mental illness, all the while adapting to a rapidly aging population with a greater need for elderly care. For patients, providers, health care systems, and the state government, the COVID-19 pandemic has yielded lasting changes and challenges that will affect health in Florida for the foreseeable future.”