The Perfect Enemy | Conservatives promising ‘health freedom’ battle for control of a Florida hospital
August 11, 2022

Conservatives promising ‘health freedom’ battle for control of a Florida hospital

Conservatives promising ‘health freedom’ battle for control of a Florida hospital  The Washington Post

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SARASOTA, Fla — When his blood oxygen dropped to what he described as a critically low level in September, Victor Rohe knew he had “a bad case of covid.”

But like growing numbers of conservatives here in southwest Florida, Rohe didn’t trust the doctors at Sarasota Memorial Hospital to treat him, even though it’s part of one of the state’s largest and highest ranked medical systems.

Rohe, a longtime Republican activist and self-described strict “constitutionalist,” instead rented his own oxygen unit and hooked it up at home. For the next several days, Rohe battled his coronavirus infection in his living room, relying on medical advice from friends and family members.

“If I went to the hospital, I believed I would die,” said Rohe, pointing to online videos and conspiracy theories he watched raising questions about the care some coronavirus patients received at the hospital.

Now a year later, Rohe is part of a slate of four conservative candidates trying to take over control of the board that oversees Sarasota’s flagship public hospital, highlighting how once-obscure offices are emerging as a new front in the political and societal battles that have intensified across the country since the start of the pandemic in 2020.

Although the contenders are considered underdogs to win on Aug. 23, health policy experts say the campaign is a troubling sign of how ideological divisions are spilling into the world of medical care as fights over abortion, the coronavirus and vaccines increasingly fall across party lines — alarming doctors, hospital administrators and medical experts.

“All you need to do is look at how [school boards] have now become very political … and how boards of education have ignored the science of education,” said Michele Issel, a public health professor emeritus at the University of North Carolina at Charlotte. “There’s this new disregard for the professional training that medical people have, and a disregard for the science of what is best for the population.”

The Sarasota candidates, at least three of whom are skeptical of coronavirus vaccine mandates, are rallying behind the theme of “medical freedom.” The term is increasingly being utilized by the conservative movement nationwide and hits a belief that patients aren’t given enough control over their medical care. Proponents point to vaccine mandates and difficulty accessing unproven coronavirus treatments like Ivermectin that were touted by politicians but rejected by physicians.

“All 4 of us are devoted Christians, conservatives and patriots who deserve to make the [Sarasota Memorial Hospital] system stronger, more accountable with greater transparency,” one of the candidates, Joseph S. Chirillo, a retired physician, wrote in a social media post.

Several Florida-based conservative or far-right organization are supporting Rohe and his running mates in their bid to join the nine-member Sarasota hospital board.

Tamra Farah, senior director of MomForce, the education-focused branch of Moms for America, a group pushing to elect more conservatives to local offices, said campaigns for low-profile positions such as the Sarasota hospital board demonstrate conservatives have “woken up.” Issues involving medical care also increasingly galvanize conservatives to the polls, Farah said, amid their growing distrust of the health care establishment.

“No one should ever feel threatened by one group of doctors’ thoughts versus another group of doctors,” Farah said. “Everyone should have their debates. Everyone should have all the information available. And people should be able to decide for themselves.”

‘Controversial noise’

In Sarasota, the county hospital has long been a source of pride while also serving as a magnet drawing both retirees and doctors and nurses to the region. U.S. News and World Report recently named Sarasota Memorial Hospital as the sixth best hospital in Florida, and the top hospital in the broader Tampa Bay region.

Moderate and left-leaning residents now worry that the hospital’s prized reputation could be shattered if the current board is ousted in favor of more conservative candidates, who have largely still have not explained how they would yield their new powers.

“I am not sure what they are looking to prove, because we have a phenomenal hospital system,” said Teri A Hansen, president and CEO of the Charles & Margery Barancik Foundation, a Sarasota-based charity that oversees a $636 million endowment. “I would like to think that the people running just want to see it grow and be a winner, but I suspect that is not why they are running.”

As a taxpayer funded public hospital, Sarasota Memorial Hospital also operates as one of the region’s safety net hospitals. Nationwide, 951 of the nation’s 6,093 hospitals are affiliated with a state or local government, according to the American Hospital Association. In Florida, those public hospitals can either have elected or appointed boards of directors.

Sarasota’s elected board members — who represent districts but are elected by voters countywide — hold staggered four-year terms. Sarasota County Public Hospital Board members hire the CEO, provide strategic guidance, oversee the system’s $1.3 billion annual budget, and have the power to assess a property tax to raise money for hospital projects.

The current board members up for reelection this year, all of whom are also Republicans, appear stunned to now face a challenge from the more conservative wing of their party. Many have extensive backgrounds in medicine or business, and find themselves in the middle of a battle that could also help determine whether relatively moderate GOP candidates can continue to fend off more conservative factions.

Darryl W. Henry has served on the hospital board since 2008 and is facing a challenge from Patricia Maraia, a nurse running with the slate of conservative candidates.

Before retiring in Sarasota in 2006, Henry worked for the Joint Chiefs of Staff at the Pentagon in Washington, serving as the director of the tech-focused Joint Warrior Interoperability Demonstration program. In the 1980s, Henry also served as chief engineer of the U.S. military’s “Milnet,” which he described as a forerunner of the internet.

In an interview, Henry said he is not sure why Maraia decided to challenge him, although he recalls how she would show up at board meetings as “controversial noise” during discussions about the hospital’s coronavirus and vaccination policies.

“The people running will probably regret if they won this position,” Henry said. “It is hard. It is time demanding and it requires deep intellectual thought and requires you gaining knowledge of the entire medical process, and entire medical financial process.”

Maraia did not return phone calls seeking comment. On her campaign website, Maraia describes herself as a “conservative who is committed to serving her community” by advocating for “patient’s rights” and the “rights of the medical profession to practice medicine with freedom.”

Another incumbent GOP board member, Joseph J. DeVirgilio, Jr., is president of a consulting company and a former utility executive who also previously served on a hospital board in Upstate New York. DeVirgilio is being challenged by Bridgette Fiorucci, a nurse at Sarasota Memorial Hospital who helped organize opposition to the hospital’s vaccine mandate policies, and one other GOP candidate.

Fiorucci did not respond to telephone and written requests for comment. In January, Fiorucci posted a photograph on Facebook of herself standing beside Robert Malone, a controversial activist who has spread discredited information about coronavirus vaccines.

“Over the last 3 years, we have seen our freedom slowly eroding,” Fiorucci wrote on her campaign website. “Decisions have been made in the medical profession that have ruled over a patients’ autonomy … I want to make sure you have ALL medical options available.”

DeVirgilio, however, said he believes Sarasota voters will continue to support him, noting his experience and the current board’s accomplishments, including overseeing the recent construction of a 100-bed hospital and opening a new cancer care center

“As an individual schooled in engineering,” DeVirgilio added, “I support the expansion of science-based health care initiatives for improved care for my Sarasota neighbors.”

‘Medical freedom’

Located about an hour south of Tampa, Sarasota County is home to about 450,000 residents who live among some of the nation’s top-ranked beaches and historic arts venues. Although the county has been a relative stronghold for Republicans for generations, voters here largely tended to align with the moderate, business-oriented wing of the party.

But over the past 2½ years, Sarasota has been an epicenter of some of Florida’s nastiest brawls over what policies should be implemented to keep residents safe during the pandemic.

Initially, the county school board voted to maintain a mask mandate for students, even though Gov. Ron DeSantis (R) and GOP legislators barred school districts from implementing one.

Floridians give DeSantis points for his covid stance. Will it hold?

The policy enraged some parents, leading to months of tense school board meetings. Meanwhile, the public feud over the pandemic increasingly centered around covid patient care at Sarasota Memorial Hospital, even though the facility has consistently earned A ratings for patient safety. Rohe said one incident in particular last summer spurred the conservative challengers’ bids for the board.

In August, Sarasota County resident Stephen Guffanti, a former emergency room physician and outspoken conservative activist, was admitted to Sarasota Memorial Hospital for coronavirus treatment. Guffanti, who was skeptical he really was infected with the virus, was placed in a hospital room with another coronavirus patient. Within days, Guffanti said in an interview, both he and his roommate develop pneumonia — a complication of the virus.

As his roommate’s condition deteriorated, Guffanti said he became worried the man was not receiving quality care and became his “patient advocate.” He said he notified nurses and the on-call doctor that his roommate was getting worse — and accused them of not taking his concerns seriously. After raising his concerns, Guffanti said he was separated from the man and placed in a room by himself. Later, he signed a document to get out of the hospital, even though it was against medical advice. The patient he’d expressed concern about died a few days later, he said.

Kim Savage, a hospital spokeswoman, declined to comment on Guffanti’s allegations, citing privacy laws. But Savage said hospital employees “worked with dedication and diligence throughout this pandemic.” She added “unsubstantiated, untrue and often politically motivated accusations” do “a grave disservice to patients, caregivers and the community.”

But after he was released from the hospital, Guffanti produced viral videos that documented his alleged experience in the hospital and claiming that the hospital had become “a jail” — fueling conspiracy theories that health institutions were trying to inflate coronavirus numbers. The videos quickly circulated among conservative and anti-vaccine groups, leading to demonstrations outside the hospital.

About a month ago, Guffanti decided to press his grievance with the hospital even further by recruiting the slate of candidates to run for the health system’s board, personally reaching out to Rohe, Fiorucci, Maraia and Chirillo to launch their campaigns under the banner of “medical freedom.”

“The biggest problem, and it’s not just here, it’s all around the country, is the interruption of the doctor-patient relationship,” said Rohe, adding Guffanti’s experience at the hospital is one reason he decided to self-treat his own coronavirus symptoms. “If you went to a hospital. Would you want your medical decisions made a bureaucratic? Or by your doctor? … The culture of the hospital has changed.”

‘All we think about is the patients’

Shortly after Rohe and his running mates announced their candidacy, a coalition of conservative political groups began rallying in support, often linking the slate with a simultaneous effort by the right to win a majority on the Sarasota County School board.

In addition to Sarasota Moms for America, the slate has been endorsed by Sarasota Watchdogs, a far-right group whose leaders have been involved in several testy political fights in the county. Rohe said the slate is also being supported activists affiliated with Defend Florida, a group pushing to rewrite state elections laws to limit mail-in ballots.

“Conservatives just want to live our lives, do our own thing, and just be left alone,” said Victor G. Mellor, a local business executive who is supporting the slate. “That didn’t happen [during covid] … so everyone now understands you have to start sacrificing, wake up and get involved.”

Dr. Matthew N. Goldenberg, an associate professor of psychiatry at Yale School of Medicine, said he’s not surprised the politicization of medicine is now presenting itself in highly localized elections.

“Partisanship is creeping more and more, and in fact sprinting, into all facets of society,” said Goldenberg, who studies political trends in health care. “And one of the things that people can do to hopefully protect themselves is just be aware of that phenomena.”

Issel, the University of North Carolina professor, said a conservative takeover Sarasota’s hospital board could have a variety of implications.

With the board having the authority to raise Sarasota County property taxes, Issel said new board members could use that to drain hospital revenue. If new board members tried to enact policies that limited the administration of vaccinations, for example, Issel said that could result in conflict with major insurance companies.

“Would they pick a new CEO that is aligned with their perspective?” Issel asked. “And how would the new policies of the CEO trickle down?”

Thomas R. Oliver, professor of Population Health Sciences at the University of Wisconsin School of Medicine and Public Health, said he worries politicization of health care could eventually filter into the boards of larger, statewide hospital systems.

Some public hospital networks, such as the University of Wisconsin Hospitals and Clinics Authority, have boards of directors appointed by governors. And in recent months, some Republican officials have appointed vaccine skeptics to state health care boards or commissions.

“If you suddenly get new boards of government health care systems, you could really impact things significantly and cause a lot of reconsidering of what are our services? Who has a say?” Oliver said.

Dr. James Fiorica, the chief medical officer of the Sarasota Memorial Health Care System, said he doubts the makeup of the board would influence how medical care is offered. Instead, Fiorica said the bigger risk is that a new board could “slow down projects.”

“You certainly don’t want to rock the boat of a good system that is making good progress,” he said.

Social media posts made by one of the conservative candidates, Chirillo, provide some insight into his views. On Facebook, Chirillo, the retired doctor, has downplayed the ongoing spread of the monkeypox virus, mocked the effectiveness of vaccines, and questioned whether the term “assault weapon” should be used to describe such weapons.

Rohe, a former New York City police officer who also previously worked in the financial services industry, also expressed controversial views about the coronavirus vaccine.

“Calling it a vaccination is a joke,” Rohe said. “All it really is is a government-mandated shot to inoculate people to the fact that the government owns your body, and you do not.”

Still, Rohe stressed, if elected he and the rest of his slate will stay focused on bolstering oversight over hospital management, saying they are merely trying to create a hospital where residents feel comfortable talking to their doctors about a variety of treatment options when they need medical care.

“All we think about is the patients,” Rohe said.