1. Opinion

Column: Put patients before profits: protect our safety net hospitals

09/04/08--TAMPA--Tampa General Hospital's new Digestive Diagnostic and Treatment Center is on the sixth floor in the Bayshore Pavillion. Photo by Julie Busch/staff
Published Feb. 22, 2018

For decades, the most vulnerable Floridians have depended on the state's safety net hospitals to save their lives and care for their health. Each year, these hospitals care for large numbers of low-income children, sick babies, senior citizens and pregnant women. Safety net hospitals provide a critical public service that the state has historically supported with vital funding.

Now, Florida's for-profit hospitals want to raid $318 million in state tax dollars that goes to help these safety net hospitals care for those who need help the most. Hospitals owned by out-of-state corporations want to pad their profits with tax dollars that have long been used to safeguard Floridians' health. These hospitals are asking the state Senate to risk the lives of our vulnerable residents in order to pump up their stock prices.

We respectfully ask our senators to consider our perspective that this is bad policy: If the for-profits get their way, the impact on the safety net hospitals would be devastating. For Tampa General Hospital, the largest hospital in the region serving those most in need, it would mean additional cuts of $14.4 million.

Other large safety net hospitals across the state would suffer massive cuts as well. For example, Jackson Memorial in Miami would be faced with cuts of $59.6 million, and UF Health Shands would face a $20.2 million cut. By comparison, the dominant for-profit hospital system in Florida, Hospital Corporation of America, would gain approximately $44.7 million in this redistribution of funding.

Hospitals lose money on every Medicaid patient they treat, particularly those in Florida. It's well known that Florida has one of the lowest Medicaid per member per month allocations in the nation, reimbursing hospitals only about 60 cents for every dollar of hospital care. The $318 million that the for-profits want to take is now shared among 28 hospitals across the state where at least one of every four patients is on Medicaid.

HCA and its supporters argue that supplemental funding should go to any hospital for each Medicaid patient it sees, regardless of how many such patients are treated at that hospital. But there's a huge difference between operating a hospital where 5 to 10 percent of patients are on Medicaid and one where 25 percent are on Medicaid.

In reality, this argument is self-serving and doesn't make sense. The more Medicaid patients a hospital sees, the greater its losses will be in the Medicaid program — and the greater its need for supplemental funding. Hospitals that see fewer Medicaid patients can easily offset their losses with the higher reimbursements they receive from commercial insurers.

House Speaker Richard Corcoran and his leadership team deserve credit for proposing a Medicaid funding plan this session that supports safety net hospitals and their communities. The House budget would maintain the current distribution of supplemental funds and shows more compassion toward the low-income families, sick babies and frail elderly patients treated at safety net hospitals.

Safety net hospitals — which include Florida's largest public and not-for-profit hospitals — are different. They mostly serve large urban populations, have high Medicaid patient populations and offer many highly specialized yet money-losing services — like pediatric intensive care, burn units, and Level 1 trauma centers — that aren't available elsewhere in the community. Hospitals like Tampa General often care for sicker patients, providing complex care that is generally not adequately reimbursed by Medicaid.

Tampa General shoulders these costly services while providing outstanding care. U.S. News & World Report recently ranked Tampa General as No. 1 in Tampa Bay and No. 2 in the state of Florida, along with six specialties for being among the nation's best, making us the only hospital in the region to receive such recognition. Our physician specialists are so expert that they're training the next generation of physician leaders, and patients travel from across Florida — and even the country — to benefit from the innovative treatments available here.

Tampa General Hospital cares for the sickest patients in the Tampa Bay region. Patients from other hospitals in the region are transferred here each day because only Tampa General can treat their trauma injuries, burns, heart failure and other maladies. Tampa General is often, quite literally, their only hope.

We're fortunate that our community understands that there's only one Tampa General. They recognize what an asset Tampa General is to the region. Lawmakers need to recognize this as well. We, along with our fellow safety net hospital leaders, are calling on the Florida Senate to put patients before profits.

John Couris is the president and chief executive officer of Tampa General Hospital. John Touchton is the chairman of the board of Tampa General Hospital.


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