MIAMI — Florida's government-owned hospitals will be in the political cross hairs after Tuesday's inauguration of Rick Scott, once leader of the nation's largest for-profit hospital chain.
The governor-elect's transition team has recommended creation of a panel to study whether government-owned hospitals -- Miami-Dade's Jackson Health System and Broward's two hospital districts among them -- are necessary.
"This is going to be a very hot topic during the legislative session,'' said Barney Bishop of Associated Industries of Florida, lobbyists for the state's large businesses.
The new focus on public hospitals comes as a related crisis looms: Because the state has failed so far to deliver promised Medicaid reforms, Florida stands to lose $350 million in special funding from the federal government unless it can get an extension of a waiver.
These funds, called the Lower Income Pool, are crucial to Jackson, which received $258 million from the pool last year.
Jackson -- with its record of financial troubles -- may face particular challenges in the new administration, according to Alan Levine, who chaired the committee that made the healthcare recommendations to Scott.
"Make no mistake,'' Levine said. "The governance of Jackson has historically been very poor. . . . They're going to find that the Legislature is going to be increasingly unwilling to fund the infamous misadventures of Jackson.''
Levine has been a healthcare policy adviser for former Florida Gov. Jeb Bush and for Louisiana Gov. Bobby Jindal. He served as chief executive of Broward Health -- the government hospital system in North Broward -- and is now an executive with Health Management Associates, a for-profit hospital chain based in Naples.
The time is ripe for reassessing the roles of government hospitals, Levine said, because major ``safety net'' hospitals across the country are converting from government ownership to nonprofit entities.
Levine points to Grady Memorial in Atlanta, which converted to a nonprofit run by a board of civic leaders to get it away from the control of politicians. After the change, Grady went from years of losing money to breaking even.
In Florida, Levine said, two urban counties have operated successfully without a major government hospital.
In Palm Beach County, the healthcare tax district pays for care for the poor and uninsured at whichever local hospitals they use. A health plan provides primary care for some.
In Hillsborough County, Tampa General Hospital converted from government ownership to a nonprofit. Tax dollars cover insurance for county residents unable to get regular coverage, who then go to any local hospitals, including for-profits.
But in places like Miami-Dade and Broward, the tax dollars go only to the government hospitals. Other hospitals that treat the uninsured don't get tax money. Instead, they frequently pass along the cost to patients who do have insurance.
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