Hospital Care for the Uninsured in Miami-Dade County

Hospital Finance and Patient Travel Patterns

by Catherine A. Jackson, Kathryn Pitkin Derose, James Chiesa, Jose J. Escarce


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One-quarter of the population in Miami Dade County, Florida, lacks health insurance, a fraction well above the national average. To address the problem of financing health care for the uninsured, a surtax on sales was approved by Miami-Dade County voters to help support the activities of the county's sole public health-care facility, Jackson Memorial Hospital (JMH). Recently it has been suggested that surtax revenues should be distributed across a wider range of institutions that also provide uncompensated care. This study examines the extent to which uncompensated care is provided by hospitals other than JMH, and whether the greater access to surtax-funded care at JMH might cause patients to pass up facilities much nearer to their homes and travel long distances for care. The report concludes that Miami-Dade County should consider finding ways to reduce the number of uninsured persons in the county; revisit the financing of health care for the indigent; examine the role of community benefits in the county and their impact on the provision of indigent care; and monitor the dynamics of hospital-care provision in the county.

Table of Contents

  • Preface

  • Figures

  • Tables

  • Summary

  • Acknowledgements


  • Chapter One


  • Chapter Two


  • Chapter Three

    Distribution of Uncompensated Care

  • Chapter Four

    Geographic Access to Care

  • Chapter Five


  • Appendix

  • Bibliography

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