|Ocala, FL -
March 5, 2012 |
Published in Star Banner on Monday, March 5, 2012 at 12:52 p.m.
I have remained open-minded throughout the process of the Munroe Hospital District Trustees examining potential nontax alternatives to address Munroe's long-range financial needs. However, I'm disappointed after studying the proposals submitted to the trustees by Ponder & Co., the consulting firm hired to explore lease/sale options.
Only seven proposals were received, and none are from not-for-profit organizations. All were submitted by for-profit health care corporations desiring to lease Munroe and apply their big-corporation operating model to running our community hospital. And let's not forget, Ponder has the potential of walking away with more than $1 million in fees from concluding a deal with a new leasee.
While some of the money being put on the table by the for-profit corporations seems favorable, the devil is in the details. How much of the money is really "transfer payments" that are merely going to be returned by the District Trustees in a different format to those making the payments? Sort of a carnival shell game.
The overall issue of health care delivery is in a massive state of flux, and a decision to lease Munroe for 40 years might be unwise at this time. Importantly, let's remember, the current Munroe leasing arrangement has historically been in increments of 10 years, with renewal consideration at the end of that time.
Medicare, Medicaid and the Patient Protection and Affordable Health Care Act (Obamacare) are all being examined as to the longer-range policy implications of each. At the federal and state levels, health care delivery is going through a period of economic, legal and political uncertainty. This uncertainty may be one reason no not-for-profit organizations expressed an interest in partnering with Munroe and the small number of for-profits submitting proposals.
This low level of interest raises an important question concerning whether now is a good time to give up control of Munroe for potentially the next 40 years. A decision based on today's health care environment may very well not be the same three to five years from now.
So what should the trustees do?
First, the workgroup presented with the task of evaluating the proposals should continue to more thoroughly study them. Complete the current phase of the process to determine if any of the proposals actually meet the trustees' established criteria around quality and service lines like, will they continue to deliver babies at Munroe? There are many questions needing answers and several very concerning provisions in the proposals submitted by the corporate entities proposing to take control of Munroe.
Next, the District Trustees should consider a suspension of the process Ponder is managing for them, and put the decision about Munroe's future in the hands of its community owners, the people of Marion County. Until the dust settles on the health care issue, a decision to let loose of a valuable community asset for 40 years seems a bit drastic. Let the people have a role in determining what should be done.
Providing Munroe with some temporary public financial support would go a long way in assuring a continuation of the current local not-for-profit model that has been successful for many years. This could be accomplished by placing a five-year, half-cent sales tax referendum on the ballot in November, enabling Marion County residents to decide whether or not to support Munroe.
A recent poll of 535 frequent voters conducted Feb. 16-22 by an independent polling organization, Barcelo & Company, indicates there is favorable sentiment toward the sales tax referendum idea among Marion County voters. The poll has a margin of error of +/- 4.2 percent. The polling asked several questions. Of particular significance were two:
• Do you think that leasing or selling Munroe to a for-profit health care company is a good idea or bad idea? The responses were: 64 percent indicating it is a bad idea; 20 percent a good idea; 16 percent no opinion.
• If a half-cent sales tax were on the ballot that enabled Marion County residents to maintain local control of Munroe, would you vote for or against the tax? The responses were: 59 percent for; 31 percent against; 9 percent no opinion.
To attract new business to a community, its leadership always focuses on what is known as the "Community Value Triangle," which includes quality in education, health care and culture/philanthropy. Marion County is fortunate to have two of the top quality hospitals in the state of Florida, and Munroe, as one of the top quality hospitals in the United States.
The polling numbers above tell me that this community is not ready to deal away one of the best assets it has today.
I encourage the district trustees to consider putting the long-term lease of Munroe on the backburner for the next several months. Why not let the voters decide if they are willing to provide financial support to Munroe before turning over control to a health care corporation with absolutely no ties to Marion County and, in most cases, Florida? The proposals offer no compelling reason to change course with our community hospital.