The Hospital District’s Latest Deal: Fear of Rick Scott?
BY BUDDY NEVINS
Is the North Broward Hospital District’s board running scared?
That could be the reason behind their dirty deed last Friday, unexpectedly voting to privatize the system.
Under the plan as outlined by the Sun-Sentinel’s well-respected medical writer Bob LaMendola, the district will still own the system, but lease out the facilities to a non-profit group. Although it could still use tax dollars, the new district wouldn’t have to follow the Sunshine Law or make its documents public.
Are the district board members acting because they are scared that GOP candidate Rick Scott might become governor?
We all know what Scott did before retiring. If you missed it, here it is from his campaign website:
“Rick is the founder of two health care providers, Columbia Hospital Corporation and Solantic Corporation, which builds and operates urgent care facilities throughout Florida.
Not the kind of guy who would be sympathetic with private hospitals having to compete with a public, tax-assisted hospital system. The private systems believe that Broward’s public systems have an unfair advantage because they use tax dollars.
Let’s look at the record:
The Hollywood-based South Broward Hospital District drove all its private competitors out of business.
The North Broward District has four hospitals and it desperately tries to grab every insured patient it can find, using billboards and television advertising. The district has a facility in Weston to soak up for-profit patients.
You hear the private companies constantly complaining in Tallahassee about having to compete with Broward’s public systems.
They may have a sympathetic ear in the governor’s mansion after November.
Did the district pooh-bahs see the handwriting on the wall and decide to cut a deal stat? That way they frame the terms rather than wait for a deal to be shoved down their throats by Tallahassee?
One thing is clear. The district as we have known it for generations is about to be labeled DNR, as in do not resuscitate. Its on its way out.
More people are asking the questions:
Why do we need the public districts? Why not just pay private hospitals to treat the uninsured poor?
How many uninsured will there really be after the new federal health care kicks into gear? Surely less than now. Do we need a public district if we have fewer uninsured?
Public health care is changing in Broward fast. Stay tuned.
September 13th, 2010 at 2:58 pm
Buddy,
Could you clarify that last line for me?
September 13th, 2010 at 4:31 pm
I was thinking more along the lines of who is out of power re: the N. Broward Hospital District and how this person is lining up their ducks to feed at the trough again.
Just look at Broward fund raising for Scott.
It could not be more obvious.
September 13th, 2010 at 6:36 pm
Rick Scott has to get elected first.
Sink was up in both the polls and fund-raising as of this morning.
I’m just sayin’.
September 13th, 2010 at 10:57 pm
it is the secrecy of this change that is suspicious – what about the sunshine law? press releases already wrtitten; there was a lot of thought and action prior to the vote at the Board Meeting. where were the open discussion(s)?
September 14th, 2010 at 8:36 am
This move will allow the district to eliminate a tax that is no longer needed. A non-profit lessee can turn a profit and meet the objectives of the district’s charter without need for tax subsidy. Instead of chopping down every single idea before it gets explained, why not go and ask what the benefits of this move could be and then conclude.
You people are not only ignorant but arrogant about it also. Healthcare reform is going to change everything about that business. You had better get used to some changes because that’s what “change you can believe in” is all about.
PS — Nobody except you insiders gives a rats turd about the sunshine law. They care about getting good quality healthcare at the lowest possible cost to them.
FROM BUDDY:
If the concept will “allow the district to eliminate a tax that is no longer needed” then why not remove the tax as part of the change?
Call me cynical, but the way this was rushed through smells like a multi-million dollar inside deal in the making.
Eliminating the Sunshine Law and the Public Records Law would be fine if they weren’t planning to use public dollars.
Your allegation that nobody but insiders cares about the Sunshine Law is ridiculous. The insiders are exactly the ones who hate having to do business in public.
Anybody can do all the business they want privately. Just don’t use my tax money to do it! I have a right to know what my money is being used for.
The Sunshine Law was enacted in 1967 because too much of the public’s business was being steered to insiders behind closed doors. Despite your comment that nobody cares, the idea has spread across the country.
By the way, Florida has had a public records law for 100 years for good reason. It has long been known that the public has a right to know how tax money is being spent.
September 14th, 2010 at 11:42 am
no matter how you slice it reform comes down to who decides on the issue of denial of services…i want a government ‘death panel” making the decisions on my life…everyone else can have a profit making insurance death panel make that choice for them…
September 14th, 2010 at 1:19 pm
This death panel stuff is BS. We have had public option for years in the form of Medicaid and Medicare and not one mention of a death panel. If you want to find one of those, you must go to private insurance companies to find one. They are the ones denying treatment to covered patients, not government.
September 14th, 2010 at 1:43 pm
“Why not remove the tax as part of the change?” is the kind of question that should be asked before drawing conclusions like “is the NBHD running scared” or is a particular candidate running for governor somehow driving the decision.
If they were truly scared a move like this would be unlikely. Bold policies are rarely made by scared people.
Under any circumstance they should have explained it better. People are entitled to know why and how this makes sense.
September 15th, 2010 at 7:31 am
If we sold the districts assets, hospitals and all, put the money in an endowment fund, we could eliminate all hospital district taxes, and fully fund all indigent needs permanently. We would just pay the private hospitals for that care just like they do it in Palm Beach County.
By the way, as people get the mandatory health insurance, it will reduce the number of people that go without health insurance requiring indigent care. Therefore mandatory health insurance will actually reduce everyones taxes so that taxpayer dollars don’t go to pay for other people’s health insurance.
September 15th, 2010 at 1:51 pm
Did you see the district’s letter to the editor today in the Sentinel? In line with this post I was wondering your view of what they said. It sounded pretty convincing to me. Since over 20 hospital districts in Florida alone are moving in that direction there must be some logic and legal basis for doing it.
FROM BUDDY:
The op-ed piece by Rhonda Calhoun and Frank Nast gave almost no details how the new operation would work. The piece was extremely vague.
“Under management of a community not-for-profit corporation, the system will have greater flexibility to face these forthcoming challenges and opportunities, and to pursue strategic ventures that will make it stronger.” How will it be stronger? Who is this non-profit and who will be running it? What strategic ventures?
“Actually, the new structure will enhance our ability to fund indigent care through potential new sources of income with the goal of reducing the NBHD’s tax-revenue base.” If true, why use taxes? What are these “new sources of income”?
“Since 1982, more than 20 such transitions have transpired in Florida alone. The experience of other hospital systems, in Florida and around the country, shows that they were able to continue meeting the needs of indigent patients while expanding services to other paying patients.” Where are these other hospital systems? Why should a public system expand services to other paying patients, thus competing with private business? Expanding many types of service requires permission of the state. There is no guarantee that the NBHD would get such permission. The last time it attempted to expand into Davie, the state turned the NBHD down.
September 15th, 2010 at 6:33 pm
Your poster, Ann, above is right–this sounds like a major violation of the Sunshine law to me. Don’t they have a lawyer to advise them about this stuff?
September 16th, 2010 at 8:17 am
You are asking the right questions.
I believe that the District has a responsibility to answer all those questions among others. I also believe the way they rolled this out was bent on getting it done but short on providing details to a concerned public. It was rammed through for sure.
This morning’s news suggests that NBHD board members are getting lots of heat for not being forthcoming. A series of public forums are now expected to take place. I encourage caution to those that want to just trash the idea. Listen to the issues carefully because despite appearances the reasons behind this stuff appear to be sound.
Healthcare reform at the federal level will make government owned hospital systems change the way they do business. Hospital systems like Broward Health that treat insured and uninsured at the same time have great difficulty justifying how dollars given it for care to the poor are being used, justifying the level of funding they get, segregating out their costs. Yet they argue that the funding is not enough and that they can’t account for it differently.
This is a major theme in healthcare reform because it goes to the heart of cost containment. The theory is that service to the poor is supposed to break even while service to the insured generates profit. Federal health leaders suspect that both are generating profit in most hospital systems especially those that tax locally. Reducing the cost of care is a basic pillar of reform. So the Administration put rules into healthcare reform that force hospitals to be more accountable and limit what they can and can’t do in the future. That’s part of the issue.
Another part is that the private hospitals and their beef with the system. They wanted rules limiting how government owned health providers would participate in health care reform. These were Republican driven measures that few liked but helped get enough votes to pass healthcare reform. Private health providers are protected from the “unfair” competition they get from government funded providers. Those providers will not be allowed to compete with private entities in the creation of clinics and other ventures.
That is a big part of why Broward Health is looking at this. Jackson, Memorial and other systems will likely need to go down this same road unless healthcare reform in DC gets revisited soon. The federal law itself incentivizes these changes.
The Democrats in control of Congress need to revisit how to fix this problem.
September 21st, 2010 at 9:05 pm
Mr. Nevins, don’t know if you are aware but the exact same thing was attempted back in the 1985-1990 time frame by certain players who are connected to the current coup. Check the archives of the Sun-Sentinel. Around 1985 it all started and obviously did not succeed then. Great story btw. I think you are dead on right.
December 22nd, 2010 at 4:17 pm
[…] hospitals, having spent his working life building private public health companies. As I wrote here in September, I thought the backroom deal cooked up to take the North Broward District private was […]
March 23rd, 2011 at 6:35 pm
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