|Ocala, FL -
September 29, 2011|
Published in Ocala Star-Banner on Thursday, September 29, 2011 at 6:30 a.m.
It would seem now that the question of Munroe Regional Medical Center's management lease is settled, the hospital's board of trustees could get down to business addressing the real issue at hand in earnest — that is, the community hospital's long-term fiscal viability.
Lamentably, that is unlikely given the tenor of the public comments at Monday night's hospital board meeting, especially those directed at the Marion County Commission. Politics still is casting an obstructive, potentially destructive pall over this important discussion.
The task of fixing Munroe's financial picture is difficult enough because Munroe has a customer base that is three-quarters Medicare- and Medicaid-insured patients. Not only does the hospital receive far less in reimbursement for those patients' care than it gets for privately insured patients, but the reimbursement rates for both programs are both unpredictable and declining.
Adding to the difficulty is Munroe's growing need for capital improvements, from new patient rooms to upgraded equipment and state-of-the-art technology. But nothing has muddled the five-year-old discussion about Munroe more than the political chasm over whether the hospital's trustees should seek public tax support. The divisiveness that question has created has done more to slow identifying a definitive course of action than any of the actuarial or management factors that come into play.
So far, the County Commission, which appoints Munroe's governing trustees, has driven the discussion by making it clear time and again that it would not consider a tax until all other options were examined and rejected. A trustee majority, meanwhile, has remained convinced that maintaining the status quo through new tax support is the best for the hospital and the community.
At Monday night's meeting, residents chastised the commission for refusing to consider the tax. Some went even further, accusing commissioners of trying to orchestrate the sale of Munroe to private interests, no matter the impact on the community. With two trustee seats about to come up for reappointment, they noted, the commission is positioned to stack the trustee board with anti-tax, and in their view, anti-Munroe members. County Commission Chairman Stan McClain went so far as to basically concede to the Star-Banner in Wednesday's edition that that is a possibility. We would hope the commissioners would not implement such heavy-handedness when it comes to one of our most respected and beloved community assets.
We have urged the trustees to examine all the options available to them regarding Munroe's future. We still believe keeping Munroe a community hospital like it is today is the best route, but are not sure a tax and a tax alone is the only answer. We want to hear more.
The debate over Munroe's future would be far simpler if it was not one of the finest publicly owned community hospitals in the country. If it were a money-loser that provided mediocre service and care, the idea of selling it or turning it over to new management would not engender so much angst. But it is, as one speaker noted Monday night, a "community jewel," and the unpalatable political gamesmanship enveloping the discussion is not serving the community or Munroe well.
It is time to focus solely on the prize, a world-class community hospital, and figuring a way to keep it — without backroom politics.