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    A Times Editorial

    Bolstering Bayfront

    The hospital's long-standing commitment to care for indigent patients can't continue indefinitely without more generous government support.

    © St. Petersburg Times
    published December 22, 2002

    When considering the challenge Bayfront Medical Center faces, the Christmas story is instructive: A mother gives birth in a manger for lack of a better alternative. Pregnant women in Pinellas County, no matter how poor they are, will have access to a modern medical facility and quality care thanks to Bayfront, which provides more indigent care than any hospital in the county.

    In addition to providing maternity care, Bayfront has an emergency room and trauma center that serve all, no matter their ability to pay. Without the hospital's sense of duty, Pinellas County would be a less desirable place to live. Of course, service to the community comes at a price. It costs Bayfront $13.5-million a year to care for people without insurance.

    Meanwhile, Bayfront expects to lose $3-million to $4-million this year, according to Sue Brody, the hospital's president and chief executive. Last year, the first after the city forced Bayfront to drop out of BayCare Health System, the hospital overcame its own dire warnings and had $8-million in net earnings.

    But running a hospital has become ever more challenging. Managed-care providers, worried about their own bottom line, aggressively pressure hospitals to keep their charges down. Medicare is cutting payments for some medical services, and Medicaid funding is on shaky ground. Costs are rising, too, especially for malpractice and property insurance and for nursing personnel, Brody said.

    Yet Bayfront is not trimming services. Brody vows the hospital will not close its trauma center, as other hospitals are threatening to do. She said she plans no job cuts either, and intends to continue making capital investments in the facility.

    Bayfront's sense of mission is admirable, but no hospital can continue to suffer multimillion-dollar losses for long. Soon, Bayfront is going to need help with the cost of indigent health care.

    "I should be more clear on our needs," said Brody, momentarily suppressing her natural optimism. "There is not a way to do this (charity and trauma care) in the long term without additional financial support. I think we are worthy of support."

    Yes, Bayfront is worthy, but Florida is a cheapskate when it comes to social services for its less-fortunate residents. The governor and Legislature have an obvious interest in seeing that financially strapped trauma centers continue to operate, and you would think they would feel some moral obligation to see that the working poor receive adequate health care. But with a growing budget deficit and other obligations demanding attention, hospitals can't count on much help from Tallahassee next year.

    That brings the challenge of paying for charity care back home. Pinellas County should be embarrassed by its record on the issue.

    This year, Pinellas County allocated only $12-million for indigent health care countywide and stopped enrolling residents in its program for three months to limit expenditures. According to a study by BayCare, 50,000 county residents are in need of such care, but only 3,000 will be helped. Have we become so cold-hearted? By comparison, Hillsborough County raises $80-million with a 1/2-cent sales tax dedicated to meeting the health care needs of the poor.

    If shame doesn't motivate the Pinellas County Commission to finally face up to its responsibility, maybe the spirit of the Christmas season will.

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