When incoming House Speaker Jose Oliva coined the term “hospital-industrial complex” during a press conference late last year in which he promised to explore ways to lower health care costs, the ears of health care executives and their lobbyists perked up across the state. Oliva’s turn of phrase evoked comparisons to former President Dwight Eisenhower‘s famous warning about the “military-industrial complex,” and all of the abuses taxpayers have suffered at the altar of national defense. And while Oliva didn’t coin the phrase, he’s made it his during talks about health care, even invoking again during the opening remarks of the 2019 legislative session.

But if there is a prime example of abuses within Florida’s “hospital-industrial complex,” there exists a group of hospitals that has effectively burrowed like a parasite into the very heart of the state capital to suck out millions of dollars for a very select special interest group found at the corner of Park Avenue and North Gadsden Street in Tallahasee. There, in a modest building that belies the vast financial resources it works to protect, is the headquarters of the Florida Safety Net Hospital Alliance. It is at once the most potent and effective lobbying organization in the state, hidden behind one of the most brazen branding campaigns in the history of Florida politics.

Headquarters of the Florida Safety Net Hospital Alliance

Behind the carefully-chosen words, charity-esque slogans and philanthropic branding, the Florida Safety Net Hospital Alliance has the same motive every time the legislature is in session: convince state lawmakers and officials – those that allocate billions of dollars for health care in Florida – to adopt arbitrary mathematical funding formulas crafted specifically to divert hundreds of millions of dollars away from other Florida hospitals and specifically into the already swollen coffers of its privileged members.

Founded in 2005, the alliance postures itself as a champion for the member hospitals it claims are providing all Floridians with access to affordable, high-quality healthcare, regardless of their ability to pay. That much may be true, but it’s also true of many other hospitals who are not members of this exclusive club: just 26 member hospitals comprise the association, out of the hundreds of hospitals in the state. Together, these 26 institutions are among the most profitable, earning an estimated $1.3 billion collectively in 2016, according to data submitted to the Florida Agency for Health Care Administration and audited financial reports from the hospitals.

Undoubtedly, the alliance’s executives and the throngs of government lobbyists and public relations experts it keeps on retainer, bristle at the use of the term “profitable” to describe their members. That’s because each of the member hospitals are organized as not-for-profit corporations, a legal label they use to their advantage to convince lawmakers and government budget hawks that the members of the alliance shoud be given special levels of deference. By leveraging their “non-profit” status, the alliance’s members benefit from the public misconception that non-profit organizations are more charitable and thus more deserving of extra state revenue to offset their philanthropic endeavors. This is fundamentally false.

The alliance even uses their non-profit status as a competitive marketing tool to push messaging that they value “patients over profits.”

But that doesn’t mean that many of the members of the alliance aren’t among the most “profitable” institutions in the state.

Many alliance members have vast financial resources and far-flung investments. They park their excess millions of dollars in assets like real estate and other sophisticated financial instruments – investments that have little to do with health care and everything to do with padding their bottom line.

And they should. Many of the alliance’s member hospitals are pillars of their local communities. Citizens rely on them to provide safe, reliable and even advanced medical care.

But the safety net hospital alliance, speaking for just these elite hospitals, does a disservice to the work of the hundreds of other hospitals who are not members, yet who never turn away patients, regardless of their ability to pay.

In past years, Florida’s safety net alliance has enjoyed a special status among some state lawmakers who have come to accept the group’s branding campaign at face value. And with the 2019 Legislative Session well underway and a $91 billion state budget to divvy up, the alliance and its army of lobbyists, PR professionals, and health care executives are once again working to persuade and cajole any holdout lawmakers into tipping the scales in their favor yet again.