When Florida voters elected Rick Scott back in 2010 they may have thought they were getting a health care expert. After all, his claim to fame was building the largest for-profit hospital company. Boy were they wrong.
The list of Scott’s public health missteps are vast–such as trying to gag doctors from discussing guns with patients, taking credit for refusing to perform abortions at his old company, trying to shut down a monitoring database that would keep pain pill addicts from getting more prescriptions, and pushing the sale of the state’s public hospitals to buyout funds to raise money to close the deficit.
But this latest one may be the most tragic. In March Governor Scott moved to close A.G. Holley hospital, a small 100-bed safety net institution specializing in tuberculosis. The Palm Beach County public hospital had operated for 60 years. Closing it saved only $5.4 million, which is what its costs were last year. Scott justified the closure saying that TB cases had dropped by 10% in recent years.
Yet in April the CDC notified the state that a major TB outbreak was unfolding among homeless people in Florida, linked to 99 cases and 13 deaths, according to this report in the Palm Beach Post. Another 3,000 people had been exposed to the disease, mostly at shelters. The state kept the CDC report hush-hush, instead announcing in June a plan to transfer quarantined patients at A.G. Holley to TB wards in Miami and Jacksonville. This month it went ahead with the plans to permanently close the A.G. Holley TB facility.
While the closure of the hospital did not directly cause the outbreak–after all, TB is caused by bacteria–having a dedicated hospital to house patients who are contagious may have been contained it sooner.
Scott’s cavalier approach to public health is dangerous. He’s already proven, through his actions, that health care is less important than the hurt feelings of gun rights extremists, private equity funds’ returns, and manufacturers of pain pills. And now added to that list are the lives of vulnerable TB patients and those who are exposed to their disease.
Across the country, states are contemplating similar decisions. It’s easier to cut a safety net hospital, which has little voice in state capitals, than it is to cut payments to pensioners or teachers that have strong constituencies. But these facilities are still needed. Even with the ObamaCare’s imminent implementation, there will still be 25 million uninsured people (see table 3 in this CBO report), many concentrated in states like Florida and Texas that have large immigrant populations. De-funding these institutions–or forcing them to be sold to private investors, as Scott has recently been advocating–is very short-sighted. And it shouldn’t take tuberculosis epidemic to recognize that fact.
David Whelan is a contributing editor at Forbes, where he was a staff writer for 8 years covering health care payers, providers and policy. He’s currently studying and working in hospital administration. Follow him on Twitter @WhelanHealth