Hamilton County Auditor Dusty Rhodes would like to see county hospitals bidding against one another for the right to provide health care to the poor.

        It's an idea that would radically change the way indigent health care has been provided in Hamilton County since the 1800s, when then-General Hospital was funded by the city of Cincinnati to provide the service.

        General Hospital turned into University Hospital, the University of Cincinnati took over in the 1960s, and the county began putting on countywide levies to pay the bills.

        Mr. Rhodes wrote a letter to county commissioners Thursday asking that they consider his proposal.

        “I believe this is good business practice and captures the spirit of providing needed services in a cost-effective manner which will be positively received by taxpayers,” Mr. Rhodes' letter says.

        Commissioners are deciding whether to place a tax levy on the November ballot to pay for indigent care at University Hospital and Children's Hospital Medical Center.

        Commissioners Todd Portune and John Dowlin rejected placing it on the May primary ballot to allow time for more study. The tax expires this year.

        Mr. Portune said he favors the tax money following individual patients regardless of which hospital they go to.

        “Why should the poor be restricted in their choices or access to heath care?” Mr. Portune asked.

        Mr. Dowlin said he'll have to learn more about the auditor's suggestion. He said the Tax Levy Review Committee will look at how indigent care in other counties and other states is handled before making a report to commissioners.

        The levy now goes to two hospitals — University and Children's.

        As proposed, the tax would generate more than $291 million over five years and cost the owner of a $100,000 home about $65 per year. The tax now costs a homeowner about $50 a year. The levy serves about 40,000 people a year.

        Levy proponents are asking for the increase because the cost of health care has increased.

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