Miami Herald | EDITORIAL

Yes to Jackson Health System


OUR OPINION: Aging hospital needs major upgrades to remain at the top

After years of mismanagement and chronic deficits, Miami-Dade’s once ailing public hospital, the Jackson Health System, has become one of the good-news stories of South Florida and has earned the right to ask the community for a vote of support in a bond issue next month.

Skeptics may have doubts. Didn’t we just agree to a huge bond issue for the school district last year? And didn’t we force the mayor to backtrack on a plan to raise property taxes for a good cause (public libraries and an expanded animal shelter) because we couldn’t afford to pay more?

Yes and Yes. Ideally, another public bond issue could be delayed until the effects of the painful recession are behind us.

But there is no time to waste because the hospital system has foregone needed repairs and upgrades for years due to its recurring deficits. Now, with the nation’s healthcare system undergoing fundamental changes, it can’t afford to wait any longer.

Moreover, a failure to support this particular bond issue would ultimately cost Miami-Dade’s taxpayers more in the long run.

The key to Jackson’s success is the ability to attract enough insured patients to fund those who cannot afford care. And in order to bring those paying patients through the doors, Jackson has to upgrade its facilities to compete with other hospitals throughout the region — hospitals that already count on Jackson to take the uninsured.

It really is just that simple.

As a public hospital, Jackson cannot refuse to accept patients regardless of their financial circumstances. Indeed, 6 to 8 percent of its patient base is undocumented — unable to obtain insurance even when the Affordable Care Act is up and running.

Jackson cannot attract those new patients that would allow it balance the books as long as the hospital is limited to aging buildings on a few campuses. Jackson CEO Carlos Migoya argues persuasively that the system needs the latest medical technology, neighborhood-based care centers and modernized hospital facilities in order to compete.

He makes a strong case. Patients who can afford to pay for medical care will choose the best place and Jackson has to be among them. Indeed, it already is, even with aging facilities. Jackson Memorial Hospital, the centerpiece of public hospital system, was ranked the No. 1 hospital in South Florida last summer in a survey by U.S. News & World Report, and sixth best in Florida..

That’s the sort of performance that should reassure the community, and probably one reason that only one of the 13-member County Commission voted against putting the bond issue on the ballot.

Commissioner Juan Zapata said he was put off by the price tag — $830 million. And he said Jackson should be restructured into a not-for-profit that would not answer to local politicians.

Fair points. But Mr. Migoya countered that operating rooms, patient rooms and other facilities are nearly 40 years old and many haven’t been refurbished since the 1970s. Jackson, he added, must invest in upgrades — including a new rehabilitation hospital — to stay competitive.

Community’s leaders who support Jackson are putting their own money behind the effort, helping raise $1.3 million for the bond campaign. One is Norman Braman, an outspoken foe of using bond money and taxes in other instances, but clearly someone who also recognizes a good cause that’s fiscally sound.

The financial stability of the Jackson Health System is of paramount importance to the economic and social well-being of Miami-Dade County and its residents. The way to ensure that the community maintains the first-class public hospital it deserves is for voters to support the $830 million bond issue.

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