Miami Herald | EDITORIAL

Keeping Jackson viable


OUR OPINION: Time to revive the idea of changing hospital’s governing structure

Sometimes, Miami-Dade County taxpayers must feel like they just can’t catch a break.

Fresh off a referendum on $1.2 billion worth of school bonds that voters approved by a hefty 2-1 margin a scant eight months ago, Jackson Health System’s Public Health Trust wants voters to assume another load of debt in a referendum next November that would increase the property tax burden for decades to come.

Leaders of the county’s public hospital won’t have a hard time showing that the $830 million they’re seeking for building repairs, upgrades and new equipment is urgently needed. In the red for years, the hospital system couldn’t afford needed repairs and knew the public was in no mood to go deeper in debt for a money-losing proposition, so repairs took a back seat. Now the hospital system needs to catch up after years of neglect.

The issue, however, is how much more of this the public can take.

Over the 30- to 40-year life of the bonds, according to county projections, this debt issue could add as much as $48.80 in the 10th year for a home with a taxable homeowner value of $200,000 in unincorporated Miami-Dade. In the first year, the increase would be closer to $9.80.

Not so bad, some would say, But in approving last year’s school bond issue, property owners saddled themselves with extra debt — an average of $27 for every $100,000 of assessed value each year, with a maximum of $35, according to figures published in the Herald. Plus, Miami-Dade voters are still paying off the $2.9 billion Building Better Communities funding that was approved in 2004.

To some extent, all of this is a reflection of the sad state of our infrastructure.

Just two months ago, the county commission voted 12-1 to approve $1.6 billion in repairs to Miami-Dade’s decrepit sewer and water system, and significantly higher monthly water bills are expected to follow. Commissioners didn’t like it, but the need to avert disaster obliged them to act decisively.

Obviously, taxpayers will bear the ultimate cost of this expense, as well. It all adds up to more debt and a higher cost of living for the residents of Miami-Dade when the local economy is still struggling to add jobs.

On Tuesday, when commissioners are asked to approve a referendum on Jackson’s $830 million bond issue that voters can take up in November, the issue will once again be cast in stark terms: Either the county supports this investment for the future or its only public hospital falls deeper into disrepair at a time when the nation’s new healthcare law will require it to become more competitive.

The responsible decision is to let the voters have their say. As the brief history outlined above shows, when the need for a bond issue is clearly demonstrated, voters usually go along. Indeed, they approved the half-penny sales tax to support Jackson years ago precisely because they believe in maintaining a first-class public hospital system.

But commissioners need to go further. Under the leadership of Carlos Migoya, Jackson has made undeniably strong strides to get back into the black and earn the confidence of the public.

The bottom line, though, is a public financing system that’s unsustainable. The county must focus on turning Jackson into a nonprofit hospital, with an independent board. This would still require public support, but it would remove the hospital from the political arena and put it on a self-sustaining path to viability, removing the need to repeatedly ask taxpayers for more money in the form of a subsidy or assuming greater debt..

It would require vision from the commission and political courage to overcome the expected complaints from public unions, but in the long run it would benefit taxpayers and patients. Voters should get a chance to have a say about Jackson’s governance system.

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