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Hospital vote makes architect sick



It's going to be the best hospital on the planet. The 60-bed, gold-plated facility, designed by the famous Disney architect Robert A.M. Stern and sprawling over 260,000 square feet, will serve the residents of Celebration with such non-hospital amenities as a gym and cutting-edge wireless technology. The lobby will look like a 1930s Mediterranean resort. There will be valet parking, a sun-lit atrium and the complete absence of squawking intercoms. But Disney has a problem. What if it builds this big new $111 million hospital, and the state doesn't approve it? That's what happened recently with the Florida Agency for Health Care Administration. Because of the increasing amounts of state and federal money spent on health care, the agency has the power to license new hospitals based on the projected needs of an area's residents. "It's not introducing new services," the agency wrote in its rejection of Celebration Health, which Disney and partner Florida Hospital are appealing. "It is unlikely the project could sustain itself in a competitive environment." An ironic claim. Across the country, for-profit (and even some Catholic) hospitals are adding deluxe suites to serve the needs of the rich, reasoning that the higher profit margins extracted from these patients will help the facilities serve the burgeoning poor. But critics say the strategy is stupid: as hospitals compete for the relatively small number of wealthy patients, they will undercut and out-bid each other, using resources that are needed to serve more ordinary patients. Thus the licensing issue illustrates a problem with the Celebration concept. The 20,000-population planned community is aggressively upper middle class, with rents for studio apartments starting at around $750 and condos priced over $140,000. It's an exclusive berg without the walls. Celebration Health would be as a giant wealth ward. The agency rejected Celebration Health in part because it would bleed wealthy patients away from other area hospitals, leaving them with the responsibility for a greater percentage of indigent patient care. Florida Hospital applied to "delicence" 60 of its existing beds in order to move them to Celebration Health. And the new hospital submitted no plan for indigent care or Medicaid recipients. "The applicant has not demonstrated how or why constructing acute care beds costing $1,855,733 each would improve efficiency, appropriateness and adequacy as opposed to existing beds with no cost," the agency wrote, adding that the design of Celebration Health was pointlessly "monumental." Architect Stern, who sits on Disney's corporate board of directors, was not amused. "The same people who criticized this design are probably responsible for the design of the schools in Florida, which often are trailers," he told the Hospital News. "I have to go to the hospital now. My blood is boiling." State approval or no, Celebration Health will be completed in November.

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