Miami-Dade County voters face an agonizing choice Tuesday over a bond referendum to produce $830 million for the Jackson Health System.

Of course there is need for expansion that will take healthcare to the people. Operating and emergency rooms need to be modernized and information technology systems need upgrading. These are some of the areas where Jackson executives say the money will be spent.

The modernization will partly enable Jackson to compete for paying patients to minimize the impact of having to treat everyone, including the indigent and undocumented immigrants.

But troubling questions surround this bond referendum. One is the timing. The voting will take place in a special election, when few voters go to the polls.

That means a very small percentage of voters will decide the fate of the referendum. A more appropriate time would be during a mid-term election or, more preferably, a general election, because of the magnitude of the measure.

Another consideration is the financial hardship which the bond will place on taxpayers. On the surface, the amount, varying from $6.20 to $30.99 a year, seems small. But when combined with at least $5 incurred with passage of a schools bond a year ago, the financial impact is significant for many people, whose personal earnings have declined, or have lost their jobs or have experienced a cut in food stamp benefits as of this month.

But the biggest flaw in the referendum is in the wording. There is no provision for accountability over the use of nearly $1 billion of taxpayers’ money. Both Miami-Dade County Commissioner Audrey Edmonson and Jackson President/CEO Carlos Migoya are promising that an oversight committee will be appointed.

But that is not good enough. Both the county and Jackson have a history of using money unwisely. Either a second ballot question should have been presented or the current ballot question should have included wording that an independent committee would monitor the disbursement of the funds to ensure the money is used for the designated purpose.

In fact, it is way past time for a restructuring of the relationship of Jackson and its governing body, the quasi-autonomous Public Health Trust, on the one hand, and the County Commission on the other. This healthcare system must be administered by an independent authority free of political control, whether by simply upgrading the status of the Public Health Trust or creating a special hospital taxing district.

Should this referendum fail, it can be brought to voters again in the mid-term election next year – after steps are taken to fix the flaws. At this time, though, South Florida Times recommends a “No” vote.