As the Jackson Health System grapples with its financial mess, Miami-Dade's world-renowned teaching hospital and its suburban annexes are losing paying patients. Daily.

Ambulances are steering insured patients to other hospitals. Surgeries are down.

People are scared for good reason: Our leaders aren't leading beyond telling Jackson CEO Eneida Roldan that there's no money at the county, in Tallahassee and likely not much in Washington to plug part of its $229 million hole. Union leadership blames management, taking little ownership of the crisis even though pay and benefits are out of whack.

Grand jury involved

Ms. Roldan didn't create that mammoth hole. She became CEO less than a year ago and aggressively focused on cost savings.

Any allegations of mismanagement should be pursued and those responsible made accountable. Miami-Dade State Attorney Katherine Fernandez Rundle already has presented complaints to a grand jury. Good.

But grand juries can take months. Jackson doesn't have months, as Miami-Dade Mayor Carlos Alvarez pointed out in his letter this week to Dr. Roldan and the Public Health Trust, the board that recommends Jackson's budget to county commissioners. Mr. Alvarez is right to press for urgency -- the county's taxpayers, after all, pay Jackson's bills. Within weeks, $80 million will be due to pay salaries.

Consider oversight board

Commissioner Carlos Gimenez has offered one way to help Jackson and the Trust move quickly -- without it becoming a political power play. Mr. Gimenez's proposal, modeled in part after Miami's state-run board when it nearly went into bankruptcy in the 1990s, would create a seven-member Financial Oversight Board to work with the Trust. It merits a look.

Such a volunteer board would have four members tapped by county commissioners (selected from a list of 13); one picked by the mayor, one by the county's legislative delegation and one by the governor. Members would have expertise in finances, accounting, hospital operations or other areas critical to Jackson's survival.

Jackson's mission as the hospital of last resort for a county that has almost one in five residents living in poverty cannot be given short-shrift. In this down economy, with tax revenues plunging, a perfect storm is dragging down Jackson's world-class reputation -- and with it the well-being of an entire county.