September 14, 2011; Source: Miami Herald | Jackson Health System in Miami-Dade is apparently among the many “troubled” public hospitals in the U.S. We say “troubled” because public hospitals typically absorb the bulk of a region’s charity care cases, but because they are dependent on public funding, they are often poorly equipped to respond. In Miami-Dade County, however, a grand jury concluded that the Jackson Health System was a “colossal mess” based on, among other factors, its loss of $400 million over the past three years.

A task force on the future of the public hospital had been pushing to convert the Jackson Health System to a “nonprofit entity free of county control,” but that effort has apparently hit a brick wall with the County Commission. According to County Commissioner Rebecca Sosa, “We have heard from the community . . . [and] . . . they . . . do not support privatizing. They have made that loud and clear.” But which community? Sosa complained that Jackson union members had turned town hall meetings about the possible conversion into a “circus.” To the union members, making Jackson a nonprofit was “privatizing” a public hospital. Steven Marcus, a member of the task force who runs the Health Foundation of South Florida, complained that holding two of the town halls at a Jackson Health System hospital was “completely geared to support the union point of view” because the union members could simply walk to the meetings.

What is the union objection? The Herald quotes union leader Martha Baker raising questions about whether a nonprofit could continue to receive county money and whether workers at a nonprofit hospital could have access to the “sovereign immunity” protection against malpractice suits that they currently enjoy at the public hospital. 

Unlike hospitals, most nonprofits aren’t really large enough to deal with union issues. Is a nonprofit hospital so different in terms of labor relations that it would cause Jackson’s unionized workforce to vehemently protest a potential nonprofit conversion? Apparently so.—Rick Cohen