On Monday, the emergency room at Jackson South was crowded with patients awaiting medical treatment. The demand on the ER facilities caused RN Sherita Cummings to ask, “Can you imagine the impact on patients, if the hospital is really closed in another few weeks?”

Nurse Cummings was referring to the proposal made by Jackson Health System’s CEO, Eneida Roldan, to ease the public health system’s strangling financial woes, through laying off 4,487 workers and closing Jackson South Community Hospital in Coral Reef, South Miami, and Jackson North Medical Center in North Miami Beach and two satellites of Jackson Memorial Hospital in the Miami to save $165.4 million. Jackson provides critical services to the underprivileged population of the respective communities.

Roldan said the Public Health Trust requires an urgent (within 10 days) decision on her proposal, as cash to sustain operations could expire by May 1. Without either an inflow of funds from the county, state or federal government, or making the drastic cuts, the health system could lose some $229 million this year.

Should the Trust agree with Roldan’s proposal, and the Miami-Dade County Commission verifies the decision, patients treated at Jackson facilities would have to revert to a situation that existed in the 1980s where the only public hospital in the county was Jackson Memorial Hospital in downtown Miami.

Cummings, said before Jackson South opened in 1991, the situation at Jackson Memorial “was chaotic,” with ER patients waiting hours for treatment. “It’s inhumane for the poor citizens of Miami-Dade to have to revert to such an adverse system.”

According to reports since the proposed closure was announced, the members of the Public Health Trust, have been seeking alternatives to closing the hospitals. One alternative would be for unionized hospital workers to take a 10 percent salary cut.

Closing Jackson South would be particularly unfortunate and ironic, as it is in the midst of a $102 million, 160,000 square-foot expansion project, which would add more facilities, including seven new operating rooms, a 12-bed critical care unit and an increase emergency room beds from 15 to 22. The expansion is 40 percent complete. However, despite the planned expansion the hospital is expected to lose $25 million in 2010.

Roldan analysis of the losses is that an increasingly poorer and older population has been seeking the hospital services. Most of these patients are either uninsured or on Medicaid.

A doctor at Jackson North, speaking on condition of anonymity, said Jackson Health System’s problem is symptomatic of the urgent need for healthcare reform to pass. “It won’t be long before more public hospitals in the nation experience severe financial challenges, if patients have no health insurance.”