QUESTION FOR PANEL: HOW DOES CARE COMPARE IN PUBLIC, PRIVATE HOSPITALS

By JIM SAUNDERS
THE NEWS SERVICE OF FLORIDA

THE CAPITAL, TALLAHASSEE, December 22, 2011.......... With a Jan. 1 deadline fast approaching, a panel appointed by Gov. Rick Scott tinkered Thursday with a draft report about Florida's public hospitals --- debating how to address issues such as hospital profits, executive salaries and the state's "sick tax.''

But at least one big question won't be resolved: How does the quality of care at public hospitals compare to private facilities?

A draft report of the Commission on Review of Taxpayer Funded Hospital Districts says the commission "could not establish that there is a pattern of higher or lower quality in Florida hospitals based on ownership.''

But Chairman Dominic Calabro said the commission will call for lawmakers to support efforts by the Agency for Health Care Administration to improve and increase data about the quality of care at hospitals and other types of health providers.

The commission, which has been studying public hospitals since May, is required to issue recommendations to Scott and the Legislature by Jan. 1. It has scheduled another meeting Dec. 29 to finalize the recommendations.

Scott, the former chief executive of the Columbia/HCA hospital chain, issued an executive order in March to create the commission. The executive order included a series of issues for the commission to look at --- including quality of care --- as a possible precursor to making major changes in the hospital districts that dot the state.

A central recommendation likely will call for moving from hospital districts to "indigent health care districts.'' The basic concept is that tax dollars should go wherever indigent patients get care, rather than the money being tied to specific hospitals.

But as commissioners Thursday worked on the report, they debated a variety of details. As an example, the draft report included a statement that some hospitals receive local tax dollars while "making good and sometimes substantial profits.''

Commissioner R. Paul Duncan, a University of Florida health-policy expert, did not attend the meeting but submitted written comments that included questioning the profit statement. Public and non-profit hospitals do not make profits that are distributed to shareholders or owners.

Calabro defended the statement, though he said the final report could cite profits or "net income.'

"The reality is, non-profits have to earn a profit or they go out of business,'' said Calabro, president and chief executive of the non-profit Florida TaxWatch.

Similarly, the panel debated a proposed finding that said some district hospitals pay "excessive salaries.'' Commissioner Marshall Kelley, a health-care consultant, said salaries might seem exorbitant in some cases, but he said it can be difficult to determine what is excessive if, for example, a public-hospital executive could make far more money working at a private hospital.

Calabro acknowledged that he didn't want to "broad brush" the issue and would look at changing the wording. But Commissioner Brad Dinkins pointed to information the panel has received about such issues as large bonuses being paid to executives at some publicly funded hospitals.

"This is a finding. This is true,'' Dinkins said. "This is not an inaccuracy.''

Dinkins took issue with a recommendation that would call for the Legislature to consider giving give some public hospitals a break in a patient-care tax known as the "sick tax.'' Lee Memorial Health System brought the issue to the commission, saying that a reduction in the tax would free up money that it could use to help finance a major children's hospital project.

But Dinkins said the state would have to use general revenue to make up for the lost money. He said the hospital system could instead ask Lee County voters to approve a sales-tax increase to help fund the project.

That drew a sharp response from House Health Care Appropriations Chairman Matt Hudson, a Naples Republican who serves on the commission. Hudson said the proposed recommendation is not only tailored to Lee Memorial but could apply to other hospitals.

Also, Hudson made clear that the commission is simply making recommendations and that lawmakers will ultimately decide such issues.

"All of this is going to be decided by the Legislature,'' Hudson said. "And you know what? The wordsmithing will be done by us.''