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Munroe's Options


Ocala, FL - 09/04/2011

Published in the Star Banner/ on Sunday, September 4, 2011 at 6:30 a.m.

Munroe's Options

The five-year debate over what to do about Munroe Regional Medical Center's financial future has been spirited at best, acrimonious at worst. The main point of contention is whether it is best to prop up Munroe through a new hospital tax or seek a "partnership" with an outside entity that would either lease or buy the 113-year-old public hospital and assume those fiscal worries.

For all the divisiveness the issue has engendered, however, there is agreement by all sides on some key points worth noting.

First, there is consensus that Munroe is indeed one of the nation's finest community hospitals, truly "a top 100 hospital." When compared with other hospitals around Florida and the U.S., Munroe ranks among the highest in quality of care and among the lowest in patient cost.

That brings us to the second point of broad agreement. Delivering the best care at the best price is strong evidence that the current contracted management, Munroe Regional Health Systems led by CEO Steve Purves, is doing a remarkable job at a time when other community safety-net hospitals are struggling to keep their doors open.

Finally, with rising health care costs, dwindling Medicare and Medicaid reimbursement rates — which account for almost three-fourths of Munroe's revenues — and critical capital improvement and expansion needs looming, the current business model is not sustainable, with red ink forecasts for as far as the budgetary eye can see.

And that is the sticking point. One side, led by a majority of Munroe's trustees and Purves, believe a tax is the best answer, arguing it would allow the proven high-quality, low-cost status quo to continue. On the other side is an ardent anti-tax faction, led by the County Commission and a minority of the trustees, who want to look at changing the management, and possibly even selling Munroe, before seeking tax support — even if it means sacrificing quality and cost-efficiency. It is an ideological standoff that has been escalating for the past three years.

This week, the trustees finally acquiesced and moved ahead with plans to explore the so-called "other options" available to Munroe. They voted to hire consultant Ponder & Co. to bring back offers from outside firms.

This was an overdue step that needed to be taken. Ponder indicated they will take about six months to complete their work, and then trustees will get a look at just what sort of options really exist.

Once those outside proposals are in hand, then the question will have to be asked: Do we, as a community, want to sacrifice the best health care at the best price for something less. It is hard to imagine a private outfit could come in and maintain what Munroe offers without cutting services or raising prices, or both, and still make a profit.

And that, once again, is the real question at the heart of the Munroe debate. What is more important to our community, having a top 100 hospital that offers access to all, regardless of socioeconomic status, or avoiding another tax no matter what?

We know what our answer would be, but until a full and open examination of all Munroe's options is done showing the various advantages and drawbacks of each, the debate will be unresolved.

For now, we have one of the best community hospitals in the land. Our greatest hope is that keeping it that way will be a priority, no matter what option is ultimately adopted.