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Editorial: More time for hospital reforms

Ocala, FL - December 1, 2011

Published in the Ocala Star-Banner on Thursday, December 1, 2011 at 6:30 a.m.

More time for hospital reforms

Rick Scott has been governor less than a year, but he recognizes that the upcoming session of the Florida Legislature will be uniquely challenging due to timing, budget shortfalls and the contentious process of redrawing political boundaries.

Gov. Scott, a former CEO of the nation’s largest for-profit hospital chain, suggested this week that it would be difficult for the Legislature to thoroughly consider new initiatives — such as recommendations that are expected to be made by the Commission on Review of Taxpayer Funded Hospitals — in light of the issues already on the agenda for the 2012 session.

Agreed: It would difficult, if not impossible — and inadvisable.

During an editorial board interview with the Daytona Beach News-Journal on Monday, Scott said the timing of the commission’s recommendations — due by no later than Jan. 1 — and the expansive agenda of the session, which commences Jan. 10, may push major changes for the public hospitals into 2013 or later.

That is welcome news on several counts.

As the commission has found, the structure, governance, effectiveness and funding of public hospitals vary widely in Florida.

What’s more, in many counties — including Marion County — the public hospital provides the bulk of care for patients without insurance and offers costly but vital services often shunned by private hospitals.

So far, at least, the commission — created by Scott, who appointed seven of its 10 members, including Ocala’s Brad Dinkins — has yet to show signs that it can reach consensus. Whether the commission can produce cogent recommendations that recognize the complexities of health care in Florida is highly questionable. Furthermore, the directions from Scott to the commission were so ideological — favoring the “transition” of public hospitals to “more appropriate governance models” — that any recommendations will warrant heavy legislative and public scrutiny.

Fortunately, in his comments in Daytona, Scott seemed cognizant of the need for legislative committees to vet the commission’s proposals and, in light of the full agenda for the 60-day regular session beginning earlier than normal in 2012, the unlikelihood of that level of review happening anytime soon.

Some tweaks to other hospital districts across the state might be in order, based on specific local needs, and objective analysis of public and private hospitals is welcome. But wholesale changes, based solely on ideology, should be out of the question.

Even if the commission’s proposals aren’t considered, the Legislature will grapple with huge challenges related to hospitals and health care: avoiding additional, steep reductions in Medicaid; the health-insurance program for more than 3 million low-income Floridians; and maintaining funding for hospitals that care for among the most chronically ill patients who qualify for the Medically Needy program.

Those tasks — along with redistricting and election-year politics — should keep the Legislature busy enough to avoid rash decisions on public hospitals. Let’s hope.


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