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Hospital CEO Pledges To Make Health Care Prices Public

The chief executive of a Miami, Florida hospital has pledged to begin addressing one of the most dysfunctional aspects of the American health care system, according to MedCity News. He’s striving for greater price transparency — giving patients and doctors the ability to easily see, before purchase, just what hospitals charge Medicare and other insurers for a given procedure.

A recent report gave over half the states in the U.S. a grade of “F” when it comes to price transparency. And after the Center for Medicare and Medicaid Services recently provided a huge data dump on what hospitals charge government health care programs for common procedures, they found a staggering amount of variation across the country with no discernible justifications on economic or quality-of-care grounds. But the prices charged to private insurers still remain secret.

So in the wake of mounting pressure following the government’s data release, Steve Sonenreich — the chief executive of Mount Sinai Medical Center in Miami Beach — promised on a radio show on Monday that his hospital will reveal the contractual rates that it charges private insurers:

“We will post our prices relative to Blue Cross, and Aetna, our contractual prices, and we’ll challenge Baptist and the other systems in the community to do the same,” said Sonenreich, who made his pledge during a studio interview on WLRN 91.3-FM with host Tom Hudson.

Also in the radio studio was Brian Keeley, chief executive of Baptist Health South Florida, which manages seven hospitals in the region. Keeley declined to accept Sonenreich’s challenge for price transparency, but acknowledged “That’s where the whole industry is going, undoubtedly.”

It remains to be seen whether other hospitals will follow Sonenreich’s lead. But the inability of consumers, doctors, and even many insurers themselves to compare different rates and charges openly is one of the key factors hamstringing the American health care market. With greater price transparency, it’s possible health care could begin behaving a bit more like markets are traditionally supposed to behave, and drive down prices through open competition.

Alyssa

Miami Dolphins Threaten To Move After Stadium Financing Plan Fails

Sun Life Stadium

The Miami Dolphins have canceled plans to upgrade Sun Life Stadium after the Florida state House of Representatives ended its 2013 legislative session Friday without voting on legislation that would have put the franchise one step closer to securing $380 million in public funding for the renovation project. Had the legislation passed, it would have triggered a May 14 referendum election in which Miami voters would have decided whether to hand their tax dollars to the Dolphins.

The stadium upgrade has been a priority for Dolphins owner Stephen Ross, the billionaire who bought the team in 2008 and wants the renovation to attract future Super Bowls to Miami. But Speaker Will Weatherford (R) ended the session without a vote (it had already passed the state Senate) because, he said, the legislation didn’t have the requisite support for passage. Lawmakers on both sides of the aisle and particularly those from the Miami-Dade area, Weatherford said, weren’t in favor of it. Dolphins CEO Mike Dee, unsurprisingly, didn’t make it through the weekend without issuing veiled threats to leave South Florida if they didn’t end up with public financing to renovate the stadium, the Palm Beach Post reported:

We cannot do this without a public-private partnership,” Dee said.

Dee also said the lack of a deal could increase the chances of the Dolphins eventually leaving South Florida. Dee said Ross, who paid an NFL-record $1.1 billion for the Dolphins in 2009, isn’t threatening to move the team, but sources close to Ross, 73, believe he has no intention of passing the team on to his heirs and will sell it within 10 years.

The Dolphins are one of the only franchises in the NFL that don’t have a long-term lease with their community,” Dee said. “At some point somebody’s going to buy the franchise from Steve, and clearly the stadium is the first thing they would need to address.”

It’s worth noting that Sun Life Stadium (née Joe Robbie Stadium) was built entirely with private funds in 1987, and it has served as a more than capable home of Dolphins, five Super Bowls, and four college football national championship games since. But in this era of publicly-financed stadiums (that almost always hurt taxpayers) and an NFL that requires teams to secure public money before giving owners access to low-interest stadium loans, private financing is unconscionable to owners like Ross.

Dee sent that signal more clearly than any recent owner has: it doesn’t matter that the Dolphins have called Miami home since 1966, longer than 17 of the NFL’s 32 teams have played in their current city. Without public financing, the team doesn’t care — not about taxpayers, particularly not about those who just forked $400 million to the city’s Major League Baseball team two years ago only to see that deal blow up in their faces to the tune of $2.4 billion over the same type of “long-term lease” the Dolphins are now seeking.

I want this to be my legacy for Miami-Dade County,” Ross said after the legislation failed, according to the Miami Herald. If that’s the legacy Ross wants, he has enough money in his own wallet to ensure it’s the legacy he gets.

Alyssa

‘Billioniares Have Options’ Doesn’t Mean Miami Taxpayers Should Finance NFL Stadium Renovations

Miami voters will go to the polls on May 14 to decide if they want to hand over hundreds of millions in public money to renovate SunLife Stadium, the home of the Miami Dolphins. Approval is far from assured, and though Dolphins owner Stephen Ross has insisted that he won’t sell the team if the proposal is voted down. But today, ProFootballTalk’s Mike Florio reported that Ross may sell the team to new owners less willing to keep the Dolphins in Miami if the proposal fails, and because of that, Florio says Miami voters should get over their “philosophical concerns” about handing over tax dollars to Ross because “billionaires always have options” that may leave the city without a football team if they don’t:

The other alternative would be for Ross to simply fund the renovations without public money. By blinking, however, Ross and the NFL would be setting a horrible precedent for any future efforts by other teams to finagle public money.

The easiest long-term solution would be for folks in Miami-Dade County to support the referendum. The small increase in hotel taxes would result in a stadium that would attract Super Bowls and other events that would drive plenty of money into the region.

Despite any philosophical concerns about the use of taxpayer money to subsidize billionaires, billionaires always have options. For Stephen Ross, one or more of those options could lead to the Dolphins leaving town.

If Florio’s screed appears lifted from the talking points of franchise owners across the country, that’s because it essentially is. Owners consistently use the threat of relocation to appeal to fans and extort hundreds of millions of dollars from taxpayers to fund new or improved stadiums. Ross, to his credit, hasn’t done that — Florio is instead doing it for him. And owners often argue that the public should pay for stadiums because the benefits — in this case, the Super Bowl — will repay them for it.

Research shows that Super Bowls and other mega events don’t boost economies by the sizable figures event promoters claim; other research shows that stadiums and arenas are hardly investments that eventually pay for themselves. Taxpayers are paying more than $4 billion a year to fund stadiums across the country at costs $10 billion more expensive than originally estimated. And those investments are hardly paying for themselves. At almost every turn, the deals fail to live up to revenue and economic growth projections used to sell them, forcing taxpayers to pick up the tab through higher taxes or huge budget gaps that lead to cuts to valuable public services.

That’s the case in Minnesota, where a new NFL stadium has turned sour even before ground was broken. It’s also the case in Cincinnati, where the city handed over $500 million to the Bengals then had to sell off a public hospital to cover a budget shortfall. It’s even the case in Miami, where deception over a new baseball stadium led to the recall of city lawmakers and a $2.4 billion tab for taxpayers. That “billionaires always have options” doesn’t mean taxpayers should ignore the economic concerns that come with funding a stadium, and in almost every instance, the economics are bad for everyone but the billionaire owner who profits.

Alyssa

The Miami Marlins Are The Epitome Of Corporate Sports Cronyism

On July 1, 2009, Major League Baseball’s Florida Marlins were cruising toward a second-place finish in the National League’s East division. The same day, county commissioners in Miami-Dade County finally approved a package that would give the team public funding for a new stadium — $409 million in public bonds, to be precise — ending a struggle that had lasted nearly five years.

On April 4, 2012, Marlins Park opened, and the franchise that had won two World Series titles but hadn’t fielded a playoff team since 2003 was starting over. They were now the Miami Marlins, replete with a new stadium, new uniforms, and a host of new faces. Owner Jeff Loria, banking on big revenues from his shiny new stadium digs, had spent big, bringing in All-Stars like Jose Reyes and Mark Buerhle to give his fans a contender.

Last night, after the once-promising Marlins failed to contend for the East Division title and finished in last place, the team traded its best players — Reyes, Buerhle, and star pitcher Josh Johnson — to the Toronto Blue Jays in a lopsided deal that, combined with earlier trades of star third baseman Hanley Ramirez and closer Heath Bell, will almost assuredly keep the Marlins in the National League basement next year.

It turns out the promises Loria made to fans — that he’d spend the money it took to turn the Marlins into a contender — in order to secure a stadium deal were emptier than Marlins Park was all season.

From the start, Marlins Park has been a disaster. Negotiations between the Marlins, Miami, and Florida’s state government repeatedly broke down between 2004, when a new stadium was first proposed, and 2009, when a project was finally approved. A federal judge dismissed a lawsuit that attempted to put the funding plan to a popular vote, and once a deal was approved, the initial bond sale fell far short of expectations on Wall Street.

In the end, the cost of the stadium rose to $634 million. All told, the cost of repaying the bonds will be an estimated $2.4 billion over the next 40 years. The stadium deal, and leaks of official documents detailing franchise profits that indicated a higher value than the team had let on during negotiations (and that owners had pocketed revenue-sharing money), led to an investigation by the Securities and Exchange Commission.

Read more

Alyssa

‘Magic City’ Is Good For the Jews, But Enough With the Gangsters

At the beginning of Knocked Up, when a group of nerdy Jewish dudes find themselves unexpectedly admitted to a nightclub, schlubby Ben Stone (Seth Rogen) tells his friends that “If any of us get laid tonight it’s because of Eric Bana in Munich.” Magic City, Starz’s next attempt to burnish its reputation as a provider of high-quality drama along with its standard doses of reasonably explicit sex and violence, follows the noble and recent pop culture trend of portraying Jews as something other than nebbishes. It stars Jeffrey Dean Morgan as Ike Evans, a recently-remarried widower who built his dream hotel, the Miramar Playa, on Miami Beach, just in time for Castro to take Havana and kick out the casinos, creating a hot new market for a Caribbean vacation spot. It’s the first of the current crop of period shows to put Jewish characters at the center of the frame, and it’s one of the best decisions Mitch Glazer, the show’s creator, made in standing up this gorgeous-looking but uneven drama.

Magic City‘s a personal story for Glazer, who in a conversation with me in January described starting out as an “assistant engineer”—or janitor—a job his father, a lighting engineer who ordered the chandelier for the Eden Roc and put in gambling machine hookups below the floor of the Fountinbleau lobby, got him. Living in the city was also his introduction to both Cuban immigration and the Civil Rights movement. “My parents, I was 7, dragged me to Civil Rights marches in Flagler Street, and we had rotten garbage thrown at us. I remember, because they were very active in what was then a very Southern town,” he told me. “Most of my friends when I was in sixth grade, the first-wave of Cubans, were the white-collar Cubans who came to America, guys who had been lawyers who became short-order cooks. Those were my best friends’ parents. I tried to pass for Cuban for about six months. They just seemed cooler. My high school was 60 percent Jewish, 40 percent Cuban, and Mickey Rourke.”

Magic City is at its best when the show reflects that transition. Ike’s second wife, Vera (Olga Kurylenko) contemplated converting to Judaism on the eve of Ike’s daughters bat mitzvah, and Ike and his father squabble over which of them is the worse Jew. Older Russian emigrees play balalaika on the beach and a louche State Senator from Tallahassee goes on at length about the “Aryan” charms of a potential beauty queen. We’ve had Jews at the margins of Mad Men for years, and with the arrival of Michael Ginsburg in the office, we’ll finally have one at the center of the frame. But I enjoyed how Magic City puts Jews and Jewishness at the forefront of the show, giving a Florida Jewish community far richer than the stereotype of retirees we have today. And Jews aren’t the only community Magic City examines. Work in the Miramar Playa kitchens grinds to a halt as word comes over the radio of Castro and Che’s advance on Havana. And Ike plays off the black residents of Overtown against white picketers who want to unionize the hotel, busting up the picket line by violence. It’s that kind of conflict that shows how perceptive characters are of how the world around them is changing, and how bold they are about taking advantage of shifting power dynamics.

It’s less good when it overreaches in search of drama. Starz’s existing viewers may depend on a heavy dose of nipples and killings, but the gratuitousness of both elements in shows like Magic City or Boss seems more likely than not to turn off the new subscribers Starz would like to woo. There’s a troika of characters in Magic City that should have been recast and rewritten: Steven Strait as Ike’s oldest son Stevie, a sullen seducer whose charms are inexplicable to me but appear to turn every woman around him stupid, Jessica Marais as Lily Diamond, the wife of mobster Benny Diamond (an insanely over-the-top Danny Huston), who begins an impossibly foolish affair with Stevie that serves only to fulfill the sexual quotient, and Huston himself, who lurks around killing dogs and threatening to feed people to sharks. Maybe these things really happened. But I wouldn’t mind if Glazer appeared to trust the power of his memories a bit more.

Alyssa

‘Burn Notice’ Open Thread: Mother Love

This post contains spoilers through the Aug. 25 episode of Burn Notice.

One of the things I find most interesting about a season of Burn Notice in which my interest is fading is the role of Madeline, his mother, in Michael’s life and in his operations. Particularly after he and Jesse get her involved in an operation where they dramatically underestimate the intensity of the crime being planned and the willingness of the people committing it to employ fairly extreme violence.

Maybe my favorite episode was the one, earlier this summer, in which Michael enlists her in an operation where she has to pretend to be a nurse treating a Yakuza agent Michael’s captured. As the situation escalates, Michael and Madeline act out the abusive dynamic between Madeline and Michael’s father. She’s both necessary to the operation, and the operation provides a setting where she and Michael can work out some deeper-seated psychological issues. It was a nice little bidirectional bit of plotting.

It’s interesting that an older woman without preexisting criminal tendencies would not only turn a blind eye to the activities of her son and his associates, but actively enlist in them for things like simple photographic surveillance, when it could risk her spending her retirement years in prison. Certainly Michael, for all of his extralegal activities, is the more functional of her two sons, and it makes sense that she would want to be close to Michael, even to understand better the son who left her at 17 by involving herself in his work. In this case, it seems like she might have taken an assignment from Jesse, her surrogate son, because it makes her feel valued by someone other than her preoccupied boy. And there’s no denying that by comforting hostages or duping criminals, she gets a kind of power and influence that would be otherwise unavailable to women in her life situation.

But it can be risky to have her there, as when she blows his cover trying to convince the hostages that Michael is credible and has a plan for their escape so they shouldn’t surrender. At some point, he’s going to get her in enough danger that he will have to make a choice and compromise an operation, or one of his other cohorts — or the show risks getting incredibly boring. Right now, Fiona can outrun cops chasing a guy under house arrest. Jesse can walk into a federal facility and impersonate an FBI official. Even vicious criminals never pull the trigger before getting taken out themselves. Burn Notice‘s lawless Miami-Dade County is increasingly uncomplicated, and as a result, uninteresting. It’s time for the characters to face some real costs, and I don’t mean murdered semi-anonymous CIA contacts.

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