Editorial: Don’t trade hospitals for toll roads, gambling

The Florida Legislature appears poised to repeal the state approval process for new hospitals. That’s bad for nonprofit hospitals and for patients.
SCOTT KEELER   |   Times
Left to Right: House Speaker Jose Oliva, R- Miami, and Senate President Bill Galvano, R- Bradenton, watch lawmakers before a joint session of the Florida Legislature in the Florida House in March.
SCOTT KEELER | Times Left to Right: House Speaker Jose Oliva, R- Miami, and Senate President Bill Galvano, R- Bradenton, watch lawmakers before a joint session of the Florida Legislature in the Florida House in March.
Published April 24
Updated April 24

Would you risk the financial health of Tampa General Hospital and its high quality of care in exchange for toll roads to nowhere? How about swapping the financial viability of the respected BayCare Health System hospitals in return for more gambling? Those aren’t hypothetical transactions. Those are bad deals being cooked up between Republican leaders in the Florida Legislature, and they are putting at risk nonprofit hospitals that provide most of the health care to the poor people in this state.

For several years, the House has pushed to eliminate the certificate of need system that requires the state to sign off on new hospitals or expansions after determining whether the additional beds and services are needed. The House Republicans’ obsession with deregulation reflects a misguided belief that the free market will result in more accessible, more affordable health care. The more practical Senate has consistently refused to go along, recognizing that hospitals are not the same as car dealerships.

Until this year. The House again voted last month to fully repeal the certificate of need process. Without warning last week, the Senate Appropriations Committee embraced the House’s approach and abandoned its more measured version. As Sen. Tom Lee, R-Thonotosassa, accurately noted, “The process stinks to high heaven.’’

Here is what really smells. Deregulating health care is the top priority for House Speaker Jose Oliva, R-Miami. Senate President Bill Galvano, R-Bradenton, wants to extend the Suncoast Parkway to the Georgia line and build another toll road from Polk County to Collier County, a concept that has been rejected for years. Galvano also wants to legalize sports betting and negotiate a new gambling agreement with the Seminole Tribe of Florida. The House traditionally has opposed any expansion of gambling.

Now suddenly the Senate is amenable to deregulating hospitals, the House is reviewing the toll roads sought by Galvano -- and Gov. Ron DeSantis says he and Oliva have been given an outline of a new gaming agreement negotiated by the Senate and the Seminoles that would legalize sports betting. Is your nose picking up the scent?

Deregulating hospitals would financially penalize Tampa General and other nonprofit hospitals like Morton Plant in Clearwater and St. Anthony’s in St. Petersburg, which are part of the BayCare system. More than a quarter of Tampa General’s patients and about 15 percent of BayCare’s patients are covered by Medicaid, which does not come close to covering the true cost of treating those vulnerable patients. Tampa General alone performs more than $100 million in charity care every year. Allowing for-profit hospitals to swoop in and build boutique facilities that cherry-pick patients covered by private insurance would exacerbate the financial burden.

The quality of care also could be harmed by spreading the same pool of patients for particular surgeries across more hospitals. Paying for the latest technology, hiring the best surgeons and performing to the highest standards requires a high volume of patients. Fewer patients results in fewer surgeries and lower overall quality.

There is a reason about 40 states regulate the construction of new hospitals or expansions like Florida does now. Don’t gamble with the future of Tampa General and other nonprofit hospitals. When the full Senate takes up the certificate of need legislation, it should forget about other bad ideas like toll roads and sports betting and focus on what’s best for patients. At the very least, senators should revert to their original approach rather than embrace complete hospital deregulation and create the wild west of health care.

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