Second of two parts
Sunday's column began to examine a controversy in The Villages that surrounds the Moffitt Cancer Center, which is scheduled to open in the fall.
The building to house the center is being paid for and constructed by H. Gary Morse and his family, who own and have developed The Villages. Moffitt's partner in the project, the Central Florida Health Alliance, will pay rent, just like any other business leasing any other Morse-owned commercial property in The Villages.
The developer has asked residents of the massive retirement community to donate $6.3 million to buy equipment to provide radiation treatments at the center.
"Asked" is an understatement. The family is behind a relentless media blitz pushing residents to write checks, which they have very kindly calculated at roughly $78 a piece, in case residents can't do the math to figure "their share" for themselves.
Since the announcement last summer, questions have been swirling over whether the center is needed, who really will staff it and why residents should be expected to buy equipment.
Villagers have been told that such cancer treatment isn't currently available inside the community, and when Moffitt opens in the fall, residents won't have to "settle for second-rate or third-rate" care.
The remarks have angered Dr. Norman Anderson of Ocala, who operates a cancer-treatment center in The Villages, located on the north side of The Villages Health System, which is owned by Central Florida Health Alliance. He said he partnered with Morse in June 1999 to build the Robert Boissoneault Oncology Center in The Villages. (Morse has since sold his interest in the center.)
Anderson owns the property where his center sits. He said he offers the same treatments, using the same machines as those proposed for the Moffitt center. He said he doesn't mind the competition, but he's tired of hearing that radiation oncology isn't available when Villages officials know perfectly well what he offers. In fact, he said, he negotiated with them before they chose Moffitt as a partner in the new center.
"When you ask for money from someone, you're ethically and morally obligated to be truthful," he said. "If you aren't, you undermine the whole medical process."
So, what does this "partnership" mean to the average resident?
Moffitt will do two things at the proposed center, said Nick Porter, executive vice president for institutional advancement and corporate relations.
First, Moffitt will act as an adviser to oncologists who have existing practices in Lake. The center is not sending oncologists of its own here from its base in Tampa to diagnose patients.
"We'll be providing guidelines, pathways, the mechanics of treating cancer as well as the opportunity to use clinical investigational drugs that we're using," he said.
Under the five-year agreement, local doctors will be able to participate in Moffitt "tumor boards" — meetings of Moffitt experts to discuss individual patients and recommend therapies — and may be able to join "some clinical trial activity."
How does that compare with the Boissoneault center? Anderson said his center for some years has had an "affiliation" with Moffitt that allows his doctors to participate in tumor boards, sponsor Moffitt lectures in the community, receive advice from Moffitt doctors and streamline referrals for patients. The Boissoneault center also has a similar affiliation with the Mayo Clinic, Anderson said.
Secondly, Porter said, Moffitt will be providing "the physical component of radiation therapy," which means that they'll supply the staff — physicists and dosimetrists, experts who measure and evaluate the dose of radiation — to run the machines.
Initially, only one part-time doctor, a radiation therapy physician, will be at The Villages center to oversee the process. The doctor will split his or her time with a second proposed Moffitt facility, this one on the campus of Leesburg Regional Medical Center, which is also owned by Central Florida Health Alliance. It is expected to be nearly identical to the one in The Villages in terms of services and equipment, Porter said.
'In their best interest'
So who is shelling out the cash for the equipment in the Leesburg center?
"It will not be Moffitt buying," Porter said.
The cancer center cannot afford to get into the costly business of expansion in rural areas, so it sees this deal as a way to expand its philosophy and method of treating patients without a big investment.
A statement from Central Florida Health Alliance indicated that the hospital plans to embark on a fundraising drive to come up with $25 million to build and equip the Leesburg facility.
If it's all constructed as planned, there would be three sets of the same pricey radiation equipment, rather than one, within a 20-minute drive. Two will be roughly 1,000 feet apart inside The Villages.
Will Moffitt be unnecessarily duplicating extremely expensive equipment? Porter said he did not know what machines Anderson is using at the Boissoneault center.
"You'll have to talk to Central Florida Health Alliance about that," Porter said. "Clearly, they feel it's in their best interest to provide radiation therapy on their hospital campuses, and that's exactly what we're helping them with."
'Hard for people to understand'
The Alliance's response on the question of foolish duplication remains a mystery. Lee Huntley, Central Florida Health Alliance president and CEO, declined to take questions or be interviewed.
Diane Maimone, associate vice president of marketing and public relations, said, "That would just add fuel to the fire."
Asked what the Moffitt-Alliance partnership would offer patients that they can't get now, Anderson said he doesn't believe there is anything. Asked the same question, Maimone said she didn't want to explain because "it's so hard for people to understand."
Goooollly, Gomer. I guess us morons will just have to set our dim brains a-figgurin' on it.
Let's see. How about that last remark by Porter? Could that hold the key? He said executives at the Alliance believe that having this cancer equipment is "in their best interest."
I'll bet they do. Cancer doctors are the first to acknowledge that while radiation oncology equipment is expensive, it pays for itself in two to three years, leaving the machines with at least another eight years of use. In fact, radiation is considered one of the "most lucrative" portions of cancer treatment, a doctor at The Villages said during a meeting last week on the topic.
That explains why most hospitals don't fundraise for it. They don't have to.
But what about Anderson and Boissoneault?
"I get the same [Medicare] reimbursement that the nonprofits get, and we have not had any difficulty funding equipment," the doctor said.
So why should Villagers reach into their pockets to give the Alliance $6.3 million worth of equipment that will begin making money for the Alliance instantly but won't provide Villagers with any new or improved service?
Pete Wahl, head of the foundation in charge of raising the money, didn't return a call to explain what benefit residents might get.
Clearly, the Alliance and its local buddies don't want to tackle serious questions. They just want Villagers to give without scrutinizing the request. So they put out their message on a rising tide of warm and fuzzy feelings that features touching stories about cancer survivors. People do tend to write bigger checks if you can tap into their emotions.
But there is another, larger question. Consider that the Alliance's 2008 tax return, the most recent one available, states that the company has $175 million worth of net assets and investments, nearly all unrestricted. If the Alliance so badly wants its share of the lucrative radiation therapy market, why doesn't it invest in the equipment itself?
Big bucks for CEO
Huntley isn't saying. And that's just wrong. When you're making nearly $450,000 a year like the Alliance's CEO, perhaps it is annoying to explain to local dopes why you "need" donations. But this is a community hospital with an obligation to answer every last question openly and fully, regardless of whether the most important or lowliest member of the community asks.
And this particular hospital company is even more indebted to the public than most. Taxpayer dollars built that hospital in 1953, and it continues to receive annual payments of tax dollars. The giveaway last year was $5.4 million.
Companies offering medical services of all kinds are highly competitive, and it's because unfathomable dollars are at stake, even in a small communities like this one. That's why residents shouldn't blindly give just because they're being asked. Lots of worthy nonprofits are dying for cash. If you're blessed enough to have a few bucks to share, is radiation equipment your best choice?
Lauren Ritchie can be reached at Lritchie@orlandosentinel.com Her blog is online at http://www.orlandosentinel.com/laurenonlake You may leave her a message at 352-742-5918.Copyright © 2014, The Baltimore Sun