By ALISA ULFERTS
© St. Petersburg Times, published March 16, 2001
TALLAHASSEE -- Tom Barb knows the difficulty of launching an open heart surgery program.
The local CEO of the company that runs Brooksville Regional Hospital was passed over last month by the state in favor of nearby Oak Hill Hospital in Spring Hill.
Barb is challenging that call, saying the state helps create monopolies with its review process, which keeps tight hold on the number of permits it grants to certain medical programs.
On Thursday, the state House Health Regulation Committee agreed.
Committee members approved a bill that would exempt applications for new adult, open heart surgery programs from the state's lengthy and strict "certificate of need" review.
Hospitals desiring to start open heart surgery programs would still have to meet other licensing requirements, such as adequate staff, funds and equipment -- but would not have to prove their programs won't siphon too many patients away from other hospitals in the region.
"I see the licensure program as a way to ensure quality care, not as some broad limitation on competition," said Rep. J.D. Alexander, R-Winter Haven.
"It seems to me we may be at a point for less regulation."
Right now most health care facilities must go through the certificate of need process if they want to expand certain programs or add new ones. Some services, such as cardiac catheterization, are already exempt from the review, according to Agency for Health Care Administration spokesman Bruce Middlebrooks.
The process can eat up time and money, as other hospitals or medical centers in the same area have the right to challenge the state's decision to approve new services.
But the bill has the backing of House Speaker Tom Feeney, who said Thursday it will help lower health care costs.
"He is encouraged that there is legislation that will begin eliminating the red tape for hospitals and surgery centers, giving better access to more facilities," said Feeney spokeswoman Kim Stone.
The bill, sponsored by Rep. Marco Rubio, R-Miami, must clear one more committee before it heads to the House for a full vote. It also requires a task force appointed to study the certificate of need program to report back in January 2002. The bill's Senate companion has not yet been heard in committee.
Opponents of the bill, mostly hospitals that already have open heart surgery programs, say the state's current review process protects patients by allowing hospitals to build and keep strong surgery units.
"To have a good outcome, you have to have a good surgeon and you need a good program," said Jan Johnson Gorrie, a lobbyist for Tampa General Hospital and the state's six teaching hospitals. Currently there are 60 active adult open heart surgery programs in the state, and another four have been approved.
Also, Gorrie and TGH spokesman John Dunn said, hospitals use the proceeds from profitable operations such as heart surgery to subsidize other programs such as indigent care. Last year, doctors performed more than 34,000 open heart surgeries, of which 736 were done at Tampa.
"The free market is a wonderful thing, but it doesn't always translate into health care" especially since the hospital prices are constant, Dunn said.
Number of adult open heart surgeries performed at hospitals in Hillsborough County between Oct. 1999 and Sept. 2000:
St. Joseph's Hospital: 956
Tampa General Hospital: 736
University Community Hospital: 799
Florida Legislature Session 2001