Bless This Mess: Is Miami-Dade Really Desperate Enough to Copy Broward Health?

As the bearer of so much bad news for the North Broward Hospital District, we should acknowledge its recent note of favorable publicity. Despite recent scandals about the commissioners' ethics, their district is in far better financial shape than the public health care district in Miami-Dade, Jackson Health System, the subject of this Sunday feature in the Miami Herald.

But while we're at it, we may as well credit George W. Bush for being a better ruler than Kim Jong Il, and Christopher Maury for being a more responsible money manager than Bernard Madoff. The point being that it's foolish to judge anybody or any thing against catastrophe.

Jackson Health has many more indigent patients to care for than either the North or South Broward Hospital Districts and that -- rather than any managerial genius on the part our county's public health rulers -- is the difference. So it's hysterical to suggest that Jackson Health use the Broward districts as a blueprint, especially if that means giving the Florida governor the power to appoint commissioners.

Currently, that appointment power rests with the Miami-Dade County Commissioners, meaning that those hospital commissioners are accountable to the health care consumers in a way they're not in Broward. This being a Democrat-voting county, Governors Charlie Crist and Jeb Bush have had little reason to worry about embarrassing scandals on behalf of their appointed commissioners. After all, those Broward Democratic voters won't be casting ballots for them anyway. So why not use the appointment power that comes with the office to reward your most generous and devoted local cronies?

Which is how the roughly $2.5 billion public health care system in a Democrat county comes to be entrusted to a small pack of Republicans, for whom the very notion of "public health care" turns the stomach -- at least if they're a true, die-hard conservative. So is it any wonder that we've accumulated so much evidence that Broward commissioners abuse their power?

Finally, though Broward health care districts are better off than Miami-Dade's, they're still terribly wasteful when compared against health care administrators nationwide, any number of which would make a far better model for reform than Miami-Dade's neighbor to the north.

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