|Ocala, FL -
June 17, 2013|
Published: Sunday, June 17, 2012 at 6:30 a.m.
Marion County voters must wait until the November election to weigh in on a proposed 1-mill property tax to support the community-owned Munroe Regional Medical Center. While five months is a lifetime in politics, both supporters and detractors are joining the fray now, creating websites and embarking on campaigns to build a base of support and sway voters.
Driving much of the debate over the request for tax support is the potential alternative. Trustees of the Marion County Hospital District are also considering offers from four healthcare company suitors seeking to take over the facility's operations. In exchange, they are willing to pay hundreds of million of dollars in lease payments and additional millions for upgrades to the 421-bed medical center.
For the money, the hospital would become a for-profit institution for the next 40 years. Control, beyond ensuring the terms of the lease are followed, would be out of local hands.
One of the first residents to publicly weigh in on the issue is Lynette Vermillion, a former district trustee and now head of Friends of Munroe, a not-for–profit group that formed in January.
Its website encourages voters to help fund the hospital and keep it out of private hands.
Vermillion doesn't think joining the hospital fight months before voters decide the issue is jumping the gun.
“This is a very important issue for our community. Once a decision is made (on the referendum), it's undoable,” she said.
To those who might say there's plenty of time to get the message out, Vermillion has a response. “I would say all of us in Marion County, as voters, need to pay attention…and the earlier, the better. They (the voters) need to be educated on the issue.”
At issue is Munroe's finances.
Executives have had to dip into hospital reserves and rely on investments to make ends meet almost annually. An earlier hospital study showed Munroe would need $150 million in capital improvements to remain competitive. That's in addition to the annual $20 million for facility improvements and equipment.
The public hospital, often the hospital of last resort for many, has a higher-than-typical number of indigent patients, a high ration of bad debt and increasing Medicaid/Medicare caseloads.
Munroe Regional Medical Center is owned by the state-sanctioned Marion County Hospital District and overseen by seven trustees who are appointed by the County Commission. The seven trustees currently lease the hospital to Munroe Regional Health System, Inc., which is overseen by a 13-member board, some of whose members are also district trustees.
Beginning six years ago, hospital district trustees began floating the idea of a public tax. But only more recently have they pushed the idea to the forefront, as local elected officials put more pressure on trustees to fix the hospital's finances.
If approved, the referendum would allow a property tax of as much as 1 mill per year for five years. One mill is $1 for every $1,000 of taxable value after the homestead exemption is accounted for.
The tax would be used to back a $65 million bond issue. The trustees' other option is to lease or sell the hospital.
The four health care companies currently being reviewed by trustees are each offering to invest the $150 million trustees say is needed in capital improvements, in addition to between $50 million and $75 million over the next five years in other infrastructure improvements. The companies also are offering between $119.2 million and $325 million to lease or buy the hospital.
While the tax referendum wouldn't be enough to solve all the hospital's ills, supporters say it would negate the need to lease the hospital to a for-profit company and buy Munroe leaders time to both work out long-term financial plans and to hope for general economic recovery.
Many who oppose the tax say that voters can't afford an increase in their property tax, that a private company can run the hospital more efficiently than current stewards, and that a lease agreement could require any new operator to maintain key services and care for poor and indigent patients.
Vermillion said there is too much at stake to wait until a few weeks before the November election.
“We need to think of this not as a tax, but as support for their local hospital and to maintain local control and ownership,” she said.
And if the hospital is leased, “I believe you would definitely see changes,” she said. “They're going to have to make changes (to be profitable).”
Vermillion said Friends of Munroe began with about 75 members, but is unsure how many make up the organization now or how many have seen the website at friendsofmunroe.org.
Chuck Pardee, who opposes the tax, started a Facebook page six months ago. Its title: “Improve Munroe Hospital With a New Tenant, Not New Taxes.”
“I was born in that hospital. I want it to succeed. I just have a different idea how it should succeed,” he said.
Pardee, a real estate broker, wants the hospital leased to a private healthcare company and says services the community deems important would stay in place if they are made part of the lease agreement.
He also cited Florida law, which requires all hospitals to provide emergency medical care to anyone needing help, regardless of ability to pay.
He predicts the referendum will fail.
“There are a lot of people with financial problems. There are a lot of people hurting. If they tell you they're not hurting they're lying to you,” he said.
Pardee doesn't think it was too early to start the Facebook site. He said he created it because the public needed to know about alternatives for the hospital other than those given by the trustees who support the tax.
He said the warnings that services will be cut and the poor will go without medical help are hospital-created “scare tactics” and calls the referendum “the referendum of deception.”
He said rather than demonizing the four healthcare companies wanting to lease Munroe, those companies' offers should be compared to the current operations of the hospital by Munroe Regional Health System, Inc.
The Munroe issue is getting attention well beyond the hospital's walls and beyond the few members of the public who regularly attend hospital board and district trustee meetings.
A perfect example is the Rev. Dr. Harold McSwain of the First Congregational Church of Christ. McSwain sent nearly 200 letters to other Ocala religious organizations emphasizing the importance of Munroe remaining a nonprofit hospital.
“The purpose of this letter, however, is not to reiterate the materials on the (Friends of Munroe) website, but to highlight elements of the quality of care offered by (Munroe) intersecting the work that we, as clerics and religious leaders, offer to members of our own communities of faith and members of our community,” he wrote.
McSwain said during an interview that he “can't imagine the best healthcare occurring if the first concern is corporate profit.”
McSwain said that, in addition to sending his letter, he has preached from the pulpit about the importance of the hospital structure remaining as is.
He said he didn't see his involvement as stretching beyond the role of a cleric.
“Doctors, pastors, clerics, religious leaders. All people in the caring business…are all in the same business of improving the lives of people…That's not limited to healthcare (professionals),” he said.
McSawin said about 20 fellow religious leaders have responded so far — all in favor of his efforts.
“Morals and ethics are issues of the church,” he said, adding later, “The way we see this is providing care for needy people.
“My responsibility is to argue for support of the referendum,” he said. “I think it's reasonable for all communities of faith to wrestle with the issues (regarding) the referendum.”
McSwain said although the referendum won't go before voters until November, its importance warrants his involvement now.
Munroe Vice President of Strategic Planning and Marketing Mike Robertson said the early activism and enthusiasm isn't unexpected.
“I don't really think it surprises me if you consider its importance. I do think it's important that all of our community be engaged …no matter what side of the coin their opinion falls on,” he said.
Robertson said he also wasn't surprised that religious leaders were weighing in.
“(Religious organizations) take care of the poor, sick and dying,” he said, “just as we do.”