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OTHER VOICES: The Public Good

Some things in society just should not be for sale, including our community hospital

Ocala, FL - September 2, 2012
Published: Sunday, September 2, 2012 at 6:30 a.m.

In a recent article in The Atlantic ("What isn't for sale"), political philosopher Michael Sandel raises some interesting questions about the role of markets in our society. Few would argue against the value and efficiency of our market economy, a critically important aspect of capitalism. The question Sandel raises, which he believes needs significant public debate, is what are those things in our society which should not be for sale.

At what point do we move from being a market-driven economy to being a market-driven society — and the difference is significant. As Sandel says, "to decide where the market belongs, and where it should be kept at a distance, we have to decide how to value the goods in question."

With little public debate, we seem to be privatizing more and more of "the goods." Running our prisons, supporting our wars and putting our satellites in orbit are just a few examples of "goods" we have, in part at least, turned over to the private market. For-profit schools and for-profit hospitals also have proliferated of late.

I am not suggesting that privatization should not be an option in many cases but that such decisions are not without consequences, including moral ones, and should be fully debated. In addition to a financial cost-benefit analysis, there are legitimate questions about whether moving "a good" to the private sector might disenfranchise some in our society, based on income, for example.

Over the next few months, the residents of Marion County will have the opportunity to decide on additional public support for Munroe Regional Medical Center and, in effect, make a decision on whether this "public good" should be turned over to the private market.

Much of the debate will be about money, but I would argue that is not the most important consideration. We must decide if are willing to trust that the private market — a for-profit hospital chain — will serve our health care needs better than they are being served now by a locally controlled, not-for-profit hospital.

Many know the story of Munroe's beginnings. In 1898, rushing to help a man who had just been injured after being struck by a horse and buggy, Ben Reinauer is reported to have said, "This is another example of why Ocala must have a hospital to care for the sick and injured." A number of local residents responded to that call, and Marion General Hospital soon opened in temporary facilities. From that humble beginning, the hospital has grown into a first-rate hospital delivering quality care to tens of thousands of Ocala/Marion County residents each year, regardless of their ability to pay.

The part of that story which touches me most deeply is the community spirit that enabled the creation of a local hospital to serve local needs. A public institution was created to serve the community because of the obvious need that existed. If anything, the needs are much greater now. But regardless of the needs, a fundamental question to our future is who will determine how those needs are best met — local residents or a corporate board of directors headquartered somewhere else.

There is uncertainty about the future of health care, and our hospital is facing many challenges. But challenge also brings opportunity, and I believe Munroe will have many options to assure a successful future without losing its local focus.

These are difficult economic times, but that is an opportunity for us to demonstrate our courage to come together as a community to make an investment in a better future. Those who started our hospital more than 100 years ago are long gone, but their legacy lives on to serve us. Surely we can do as well for those who will live in Marion County 100 years from now. Our hospital is a "public good" we must protect.

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