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Grant Miller, Publisher

On most issues decided by the Florida Legislature, the Republicans and Democrats withdraw to the furthest sides of the battlefield and snipe at each other. Partisans pick one side to support and one side to blame.

This year is a little different. Both parties in the Florida Senate have united and are aiming their fire at Florida’s public hospitals. Private hospitals get most of their funding from wealthier patients with good, and even great, health insurance.

The public hospitals, like Jackson Memorial here in Miami-Dade County, see a lower percentage of insureds, but take in the bulk of Florida’s Medicaid patients. Medicaid is health insurance program jointly funded by the federal and state governments. It covers low-income and needy people, children, the aged, the blind, and the disabled.

For profit hospitals are seeking to take the indigent funding for Medicaid away from the 28 safety net hospitals, a total of about $318 million. For three decades, these hospitals have used this money to care for low-income pregnant women, sick babies, children and the frail elderly.

That $318 million would represent about four percent of the monies that the out-of-state for-profit hospitals ship out of Florida. And while it might mean slightly higher dividends to shareholders or fatter bonuses to hospital executives, it would mean cuts of $59.6 million just to Jackson alone, the most of any hospital statewide.

It’s not as if Medicaid patients are a huge revenue stream for public hospitals. Hospitals lose money on every Medicaid patient they treat. Medicaid only reimburses hospitals about 60 cents for every $1 of hospital care. The $318 million that the for-profits are after is shared today among the 28 hospitals where at least one of every four patients is on Medicaid.

State of Florida Flag waving

Although the for-profit hospitals hunger for this state money like a zombie yearns for brains, there is no indication that they are prepared to expand their capacity to see more Medicaid patients. They look at this tsunami of Medicaid money as a reward for a job not done.

How have the for-profit hospitals snookered both Republicans and Democrats in the Senate? By spreading a big lie that public hospitals are bursting with cash hoards.

The truth is that local public hospitals actually remit money back to Tallahassee to help pay for the state’s share of the Medicaid and charity care programs. Without this support, Florida’s Medicaid and charity care programs will collapse.

Public hospitals, like Jackson, have to operate in the sunshine and account for every dollar and every dime. On the other hand, for-profit hospitals have been frequently cited, fined, and sanctioned for fraud and mismanagement. And money when local public hospitals do manage to eke out a small gain, that money is quickly reinvested in the community in clinics and new equipment. When a for-profit hospital invests in new equipment, it is just as likely to be for a private jet for the CEO as for a new MRI machine.

The Florida House, under Speaker Richard Corcoran, passed a budget that shows compassion for our low-income neighbors, putting patients before profits. In the closing weeks of the 2018 Legislative Session, we hope that the Democrats and Republicans in the Florida Senate follow their example.

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  1. Politicians do not care about people, animals, our environment or the future. They only care about their wealth & power. They are dishonest and have no integrety.

  2. “And while it might mean slightly higher dividends to shareholders or fatter bonuses to hospital executives, it would mean cuts of $59.6 million just to Jackson alone”

    Hey Grant, you should also be whining about the $900,000 salary the CEO of Jackson Hospital makes if cutting Jackson funding really bothers you. Jackson Hospital receives 1/2 cent of every 7 cents collected in sales tax in Miami Dade in addition to the millions they receive from the Feds and State. The more funding they receive, the more they waste. The CEO wants more so he can maintain his own lifestyle.

  3. Grant, I am trying to learn more about our healthcare system as someone who had access to the best healthcare in the world and it was affordable, and then I lost it all under Obamacare. It was the most frightening experience of my life to be in late 40’s and have no safety net. So having worked at a nonprofit health Insurance company, I learned a lot but want to understand better the current status of how hospitals work with respect to funding, etc. What your article does not state or prove, is what do politicians gain by allowing for-profit hospitals to use part of that Medicaid money? Your article has assumptions but offers nothing concrete. So still do not know why politicians are allowing for-profit hospitals to get part of this funding. There’s more to this I’m sure.

    What I offer is another perspective. Bringing costs down. How? bring down the number of Medicaid users. ELIMINATE THE FRAUD. Who’s committing fraud–the so called Medicaid recipients. I know first hand there are thousands of “fake low income” earners. I know this by working with them and my tax accountant sees this every tax season as well. People who are earning decent wages where they should be paying for insurance. I have a friend with full-time job. Actually she had two jobs with health insurance benefits yet she was still receiving Medicaid. She told me they never check to see if she has a job. One of my employees, has another job where I learned everything is under the table and doesn’t pay taxes so he’s always asking me for letter to show how much or little he earns to earn government benefits. My housekeeper “married” a friend has a ss# number and worked here 10 years yet she works as “housekeeper” and all kinds of gigs everything in cash. She lives in those nice new condos on Biscayne Bouelvard yet she’s “low income” on paper because I learned from a private investigator SHE HAS NEVER PAID TAXES in TEN YEARS!!! She herself told me that thousands of people live like this. It’s an entire world in Miami taking advantage of Medicaid.

    By reducing the number of illegal immigrants (who get free access to healthcare at Jackson), reporting all types of fraud, by getting to the root of the problem, will have impact on many economic issues such as cost of car insurance, health insurance, hospital costs, average salaries…Basic economics! (p.s. I am the daughter of legal immigrants. There’s a HUGE difference between legal and illegal).

    • REALLY?? YOUR contribution to the conversation is to ATTACK the POOR people that need it? How does a POOR person STEAL Medicaid … by going to the doctor for care too much! As it regards FRAUD the REAL and only thrives are the DOCTORS and HOSPITALS!!! and FRIENDS and FAMILY members of the politicians! ARE YOU KIDDING ME?! They DOUBLE and TRIPLE bill and rack in BILLIONS! THIS IS A FACT! . WOW! The HOUSEKEEPER making barley enough to LIVE never paid taxes! APPLE MADE BILLIONS AND NEVER PAID A DIME! JUST AS MOST AMERICAN HUGE CORPORATION and YOU are on here trying to get us to HATE ON a POOR women YOU are paying so POORLY she needs to work 2 jobs! This post sound racist and ignorant – SO YOU THINK RICH and WELL TO DO PEOPLE ARE PRETENDING TO BE POOR SO THEY CAN GO TO SOME OF THE WORST HOSPITALS and PRIVATE CLINICS IN AMERICA becasue its FREE?! REALLY? I don’t believe you are real … you must be a plant … you sound like FOX NEWS .. you know EVERYTHING and EVERYBODY doing wrong but never turned them in? As hateful as you sound in this well written ”SOUND-BITE- sounding post. YOU are spitting HATE and LIES’ and we BOTH know not ONE WORD is true – you work for what hospital or politician? SMH

      • Remember “Scarface”? Not Capone,….the movie. Based on a real life story, …yeah–it was. Tony Montana said to his sidekick Manolo,: You know,I should have come to this country a long time ago.By now,I would have…..”.. Then came Pacino`s visceral lamentation,using metaphoric agilty to eccentuate the character he portrayed,a broken criminal sociopath:” This country is like a big—–waiting to be —“. Kinda sums it up,doesn`t it? Medicaid fraud could be stopped. Its like,homeland security—you just need to make it a priority,and somehow,that just keeps being put off.

    • Miami Fusion you make very good points that our government needs to do a bit more investigating of who receives these benefits! It may cost the government to pay someone to investigate individuals but in the long run it will save money! It is disgusting how many people WORK they system for years and years and it is never looked into whether they are truly in need of the Medicaid or are just avoiding paying for insurance that may be offered to them.

  4. Unfortunatelly we have to remember the constant syphoning of the funds at Jackson memorial hospital. Not to mention the misappropriation of funds. Nobody remembers? Also, covering all the illegals & their children is very costly. A lot of ppl come from other countries to have their kids born here to stay and obtain Medicaid. The LA hospital went broke because of this same problem. I don’t know the answer, it has gotten very complicated.

  5. Thank you Publisher for acknowledging and reclaiming some social and fiscal responsibility to state government officials and while you are on a responsive mode please recognize the mismanagement of the allocation of property taxes in Sunny Isles Beach Government to repair the few roads, improve vehicular traffic, and police enforcement. The quality of life in Sunny Isles should a performance index for voted representatives and cronies representing a community that is not heard. A city satisfaction survey may help our public servants to rate their performance and learn they are not ruling but serving we the people who pay their salaries.

  6. Unfortunately, you are only telling part of the story. There are more than 250 hospitals in Florida — many of them in rural communities — who suffer under the House plan. These are not-for-profit hospitals that struggle to make ends meet without the support of taxpayers. What the senate wants to do is spread the Medicaid dollars more equitably among all hospitals.

    Why should a hospital be paid more for the same service provided by another hospital?.

  7. There are millions of illegals and undocumented residents in US gets Medicaid. This takes away from USA citizens with low income families and from veterans and from disables.


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