An examination of the governance of public funds for health care in Miami-Dade County. Principles of good governance are discussed, and approaches of other locales to providing health care to the uninsured are summarized. The agency that operates Miami-Dade's health care facilities is also responsible for countywide health care planning, a dual mission that inherently creates a conflict of interest. Over time, accountability has diminished reducing the public's trust. We recommend that service provision and countywide health care planning be separated and that funding be provided to implement innovative approaches for improving indigents' access to health care.
