The Missing Option From Jackson Health System Governance Proposals, Real Democracy

S. Nappalos

With the recent barrage of crisis, attacks, corruption, and mismanagement at Jackson Memorial Health System, it is reasonable to wonder what the public stands for in public health. Miami-Dade Mayor Carlos Alvarez has attempted to reopen debate over Jackson’s governance structure through calling for an overhaul of the present system and replacing it with the county commission in charge. The Miami Herald on May 5th 2010 reported Alvarez as saying, “My opinion is that the PHT should cease to exist and the county commission should be in charge” (1).

Presently Jackson has a hybrid system of decision making made up of the Public Health Trust, a 17-member board that overseas the hospital. The trust chooses the CEO and overseas management, while the county ratifies union contracts, the budget, and land purchases, sales, and revisions to infrastructure. Commissioners also sit on the board, and other county administrators are non-voting members. Elsewhere, public health systems largely exist as either privatized NGOs, private-public hybrids with non-elected management and public funding, or publically run through the cities, counties, or states.

Libertarian statement of solidarity with the comrades in Oaxaca, Mexico

In light of the tragic events of 27 April 2010, when a solidarity caravan of observers bound for the Autonomous Municipality of San Juan Copala (Oaxaca, Mexico) was subjected to a cowardly attack by paramilitaries linked to governor Ulises Ruiz Ortiz, resulting in the death of comrade Beatriz Alberta Cariño Trujillo and Finnish comrade Jyri Jaakkola, we, the undersigned organizations, declare:

SOLIDARITY WITH THE GREEK WORKERS’ STRUGGLE!

The Greek working class is angry, and with good reason, with the attempt to load responsibility for the bankruptcy of the Greek State onto their shoulders. We maintain instead that it is the international financial institutions and the European Union who are responsible. The financial institutions have plunged the world, and Greece in particular, into an economic and social crisis of historical proportions, forcing countries into debt, and now these same institutions are complaining that certain States risk not being able to repay their debts. We denounce this hypocrisy and say that even if Greece – and all the other countries – can repay the debt, they should not do so: it is up to those responsible for the crisis – the financial institutions, not the workers – to pay for the damage caused by this crisis. The Greek workers are right to refuse to pay back their country’s debt. We refuse to pay for their crisis!

Privatizing Medicaid In Florida: cutting services and subsidizing profiteers

by S. Nappalos

The Florida House and Senate both have been considering bills to privatize Medicaid through turning over management of the health insurance to HMOs (health maintenance organizations). The house bill would extend this throughout the state, while the senate bill seeks merely to expand an ongoing pilot project in a few counties to 19 other counties (1). Medicaid is a state-insurance program which receives funding from the state and federal levels on a basis of financial need. This differs from Medicare which is mostly a federal program distributed largely on the basis of age. Medicaid draws a significant amount of funds from Florida, and Florida (especially South Florida) has been plagued from Medicaid fraud. The proposal seeks to cut spending and fraud based on claims that HMOs in particular and market-competition generally will reduce costs. Business Week reports that sponsors of the bills will not be able to settle on a common bill during this legislative session (2). Instead, they look to 2011 for another attempt (ibid).

A New Center of Trauma? Irrationality and Healthcare

Recently Kendall Regional Medical Center initiated the application process to be given the right to operate a trauma center under its hospital. The Miami Herald reported on 04/16/10 (1) that Kendall Regional released the following statement “Supported by data that shows that Miami-Dade/Monroe counties need additional trauma services and the ever growing challenges that traffic and congestion pose in our community, Kendall Regional Medical Center has submitted an application to open a trauma center at their campus in West Miami-Dade County”. Jackson Memorial Health System and the University of Miami have opposed this move. The reason is that Ryder Trauma center, at Jackson staffed largely by UM doctors, is the only trauma center in the county. Trauma centers generally speaking treat patients suffering from burns, gunshot and knife wounds, automobile accidents, etc. The opening of a trauma center in Kendall, a suburban traffic heavy and wealthy area, would inevitably drain the patients who have insurance from Ryder. This would lead to an excess of uninsured trauma victims at Jackson, and less financial stability in the long term.