The Tax

I speak collectively for many citizens in which share the same sentiment. Please allow me the opportunity to share hard evidence to discontinue the taxation

 

1.  According to The Baptist Annual Report, Fisherman's hospital has earned $17,484,000 in 2022 & earned $13,693,000 in 2023. This is a combined $31million in earnings in 2 years, while also collecting from the MSTU taxing district.  During their 2021 filling, they earned $872,000.  Currently, the hospital is a profitable business while collecting a subsidy from the community. Collectively, as of March 26, 2025 since Fiscal Year 2020, Baptist has collected approximately $13,497,254.09 from the MSTU.  With another $2,328,364 estimated for 2023.  Also the Baptist Health System received $52.3million from the Cares Act in 2022. Baptist Health has collected in September 30,2022 & 2021, approximately $27,680,000 & $28,230,000 respectively from the Low Income Pool funds (definition) from the state of Florida for BHSF Hospitals.  At this moment, is evident the community does not need to subsidize the hospital anymore. Please remember the original “ask” was to fund the hospital’s build. At this time, the community has done their “share” in helping the hospital through its financial initiation.

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Baptist initially requested funds to aid in the construction of the hospital, but later found out they were not allowed under state law to levy a tax for construction without a vote from the community (Under Florida law local governments cannot levy taxes to benefit one private company’s brick and mortar project, like the construction of a privately owned hospital without a voter referendum.)2.Keys Weekly They had to immediately request the taxation in a different manner to obtain approval without a community vote

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2. Here is a snippet of the discussion during a Town Hall meeting with Baptist:

 “I’ll plead guilty,” said Baptist Health South’s attorney, David Friedman, at a August 13th townhall meeting about the tax in Marathon:

Paraphrasing: The tax funding is for “indigent care” – but that’s only on paper. In fact, the purpose of the tax is to help build Baptist South’s new hospital.

“Ultimately the goal of the community … is to get the hospital built. Paying for indigent care for ten years is a way to pay Fishermen’s hospital for something that is legal and supportable for the County to pay to a private charitable hospital.” 3.Blue Paper
 Ultimately there was a course change to legally obtain funding via a tax levy without requiring a vote from the community.

 

3. Baptist is a religious based non-for-profit organization, which legally is able to be exempt from paying property taxes & federal corporate tax. This has been implemented by the IRS to provide a benefit to institutions which are non-for-profit status. Locally they pay NO ad-valorem real-estate taxes on their properties (medical offices, library and hospital 5. Tax Link) . Baptist did pay Marathon stormwater/wastewater.  Please note, as their non for profit status allows, they DID NOT contribute to the MKHC tax, which ironically they are collecting an annual revenue. The hospital is assessed at ~$12.8m for the year of 2023 & they paid ZERO in Ad Valorem Tax.

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4. Baptist Health System owns many hospitals which operate at a continuous loss, such as Homestead Hospital (-$42M), Bethesda Hospital (-$100M), Boca Raton Hospital (-$23M). While Fisherman's Hospital operates at a profit (+$13M). Fisherman's Hospital is the ONLY hospital collecting from a municipality and generating profits.  The entire hospital system operates at profit +$386M. 

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5. During last years meeting on 3/8/2022 several big points were brought up by John Bartus (JB). I have the link of the video. Please allow me to share some highlighted points:

 

link to the video:
https://cloud.castus.tv/vod/city-of-marathon/video/622a3768f4ab4f0008a2cc8b?page=HOME

 

I have placed the time stamps for you to look at and fast forward.

a.     39m44s: JB asked: what is the out of town uninsured patient population Vs insured population from in town whom use the hospital. CEO answered: “we don’t have that figure”. If the taxation is designed to help those within the taxation district, why isn’t this crucial piece of information calculated and monitored?
 

b.     41m20s: JB asked: will you provide pediatric care at the new medical arts building. CEO Answered “that is not part of critical access” and JB followed by, “will pediatric care be part of the new medical arts building?” CEO: “NO it will not”.  Only surgical services and other outpatient services.  No mention of women's health.   As a community hospital they are purposely leaving out over half of the community.  Children must drive to Key West or Tavernier to obtain pediatric care, when there is a hospital in town.  Women must drive to Key West or Miami for care.  If members of the city council vote in favor of continuing the taxation, you are deliberately siding with the institution, which does not value the care, needed for over 50% of our citizens. Services for children & women will not be provided because it does not generate significant profits.
 

c.      42m29s: JB asked, part of the community is being left out, do you have any idea how we can serve the younger community. CEO: we must work on it.  An entire year has been provided for to Baptist to “work on it” and provide at least pediatric care, have they allocated the funds or priority to recruit a pediatrician or Gynecologist to our community? 

 

6. Most of the uninsured patients using the hospital are not living in the taxing district.  Therefore we have placed an unfair financial burden on the citizens on whom the district represents (MM 61-47) to pay for a service in which they don’t receive any special treatment and for others that don’t contribute to use.  The questions to ask: What is the percentage of UNISURED patients that live in the taxing district vs outside of the taxing district use the indignant care?

 

The Board has the right to stop the taxation.  The hospital is clearly successful in it’s current modus operandi. The Baptist Hospital System of Miami is clearly financially healthy with a positive balance of $291,297,000 in 2022 & $385,940,000 in 2023 for“Excessive Revenue over Expenses”. In 2022, Baptist Health spent $377million on capital projects such as opening and acquiring new hospitals in the Miami Area

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I ask that city council reconsider supporting The MSTU, which uses the community’s hard earned taxed dollars to subsidize Fisherman's Hospital. If you truly feel you are speaking and representing the Community, please ask your constituents for their opinion or ask the referendum to be placed on a vote

 

Please please watch this video. This is a direct sentiment of what the community felt. Its a 7 min video showing the frustration of the citizens opposing the tax.

https://thebluepaper.com/county-turns-down-taxpaypers-pleas-for-referendum/

 

 

This video shows the original Attorney speaking on how to legal intact a loop hole to request money from the community without holding the tax to a vote.

https://www.loom.com/share/b444ec58c02d44d6935ce41787856183

“I’ll plead guilty,” said Baptist Health South’s attorney, David Friedman, at a August 13th townhall meeting about the tax in Marathon:

Paraphrasing: The tax funding is for “indigent care” – but that’s only on paper. In fact, the purpose of the tax is to help build Baptist South’s new hospital.

“Ultimately the goal of the community … is to get the hospital built. Paying for indigent care for ten years is a way to pay Fishermen’s hospital for something that is legal and supportable for the County to pay to a private charitable hospital.”

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Here is some additional information to digest:

Video shows concern of the community during discussion of the taxation: 7. Video

Several studies show that non-profit hospital charity care provisions were not aligned with their favorable tax exemptions and treatments. “Our results suggest that the largest component of community benefit supposedly provided by nonprofit hospitals (i.e., unreimbursed Medicaid costs, net of supplemental payments) is poorly aligned with the (effectively automatic) tax subsidy that these institutions receive” Source

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Study Suggests Misalignment Between Tax Subsidies for Nonprofit Hospitals and the Community Benefit These Hospitals Provide. source
Actual Study from Jama 
For profits spent $3.8 per $100, while non-profits spent $2.3 per $100. Source

Great article with a time line of events leading to the vote: “No Taxation without verification”

Reference:

1. https://keysweekly.com/42/baptist-shares-data-on-uninsured-underinsured-fishermens/

2. https://keysweekly.com/42/a-commitment-works-both-ways/

3. https://thebluepaper.com/fact-checking-george-neugent-on-middle-keys-hospital-tax/

4. https://ahca.myflorida.com/medicaid/finance/finance/lip-dsh/lip/background.shtml

5. https://monroe.county-taxes.com/public/search/property_tax?search_query=FISHERMEN%27S+HEALTH+INC

6. https://baptisthealth.net/about-baptist-health/fulfilling-our-mission/charitable-care

7. https://thebluepaper.com/county-turns-down-taxpaypers-pleas-for-referendum/