FSU–TMH 101: Tallahassee’s Next Leap, From College Town to Health Capital | Opinion
- Bugra Demirel
- Oct 2
- 7 min read
Updated: Nov 10
Tallahassee has a rare opportunity in front of it. For decades, we’ve relied on Tallahassee Memorial HealthCare (TMH) to serve as our community hospital. But now, with Florida State University (FSU) stepping forward, we have the chance to transform that hospital into something far greater: a true academic health center that can drive better care, higher-paying jobs, and long-term economic growth for our city.
This isn’t just about healthcare—it’s about Tallahassee’s future. Across the country, academic health centers anchor regional economies, attract top medical talent, and bring cutting-edge treatments to patients who would otherwise have to travel. For us, this is a chance to take public assets and put them to work for the people who live here.
Now the debate begins. Critics claim this is a “takeover,” that the City is “giving away” assets, or that “local control” is being lost. But those talking points don’t hold up against the facts.
Economic Impact
Before we dig into the myths, let’s start with what excites me most: the enormous economic development this deal will unlock for Tallahassee’s future, the reason I’m motivated to advocate for it.
Academic medical centers contribute $728 billion annually to the U.S. economy and support over 7 million high-paying jobs. Gainesville is proof: UF Health/Shands employs about 10,000 people—and that’s just the hospital system, not counting the thousands of additional jobs created by the University of Florida. Together, they’ve turned Gainesville into a healthcare and research powerhouse.
Tallahassee now has the same opportunity. The Tallahassee - Leon County Office of Economic Vitality has already identified Healthcare as one of four targeted industries—alongside IT, Applied Sciences, and Manufacturing—that can transform our economy. With FSU leading TMH into an academic health center, we finally have the anchor to make that vision real.
Hospital jobs pay more than the Tallahassee average, and that’s a big part of why this deal matters. The average hospital employee earns about $64,000 a year, compared to Tallahassee’s median household income of roughly $56,000. And for specialized roles, the numbers climb even higher—registered nurses, for example, earn a median wage of nearly $94,000. Healthcare jobs aren’t just plentiful, they’re high-wage jobs that can lift incomes across our community.
Thousands of new healthcare jobs mean wages spent at our restaurants, dealerships, grocery stores, and coffee shops—circulating through the economy, creating even more jobs. That’s how you grow a strong, resilient economy—one paycheck at a time. This is different than a seasonal bump tied to football or the academic calendar; it’s the foundation of a true 12-month economy that supports families year-round.
The impact also extends beyond city limits. Rural communities in North Florida need access to specialized care. Right now, many patients travel to Gainesville, Jacksonville, or Pensacola. With an academic health center here, they’d come to Tallahassee instead—supporting our businesses while getting care closer to home.
And beyond direct jobs, an academic health center anchors an innovation ecosystem: biotech startups, pharmaceutical R&D, medical device firms, telehealth platforms, healthcare software, and clinical research organizations. The spillover is huge—patents, lab space, supply chains, and licensing royalties all flow back into the community. With FSU Health, Tallahassee has the chance to build a full medical-innovation cluster—not just a hospital.
Critique 1: “But, we’ll lose local control.”
This has been the loudest argument against the FSU–TMH partnership. But let’s be honest—what we had before wasn’t genuine local control at all.
The City owns hundreds of millions of dollars in hospital assets, yet TMH ran them for just $1 a year—with virtually no public input. There was no oversight of executive pay, no citizen advisory boards in place, no City-appointed board members, no annual performance reviews, no accountability in procurement, and no consequences for poor outcomes. In short, there were no repercussions for underperformance that directly affected our community’s healthcare.
Yes, TMH Board members and executives were local residents. But residency doesn’t equal “local control”. If that were the definition, then FSU executives and faculty—who also live and work in Tallahassee—would qualify.
The deal has good news for those who want to preserve the status quo: TMH will still have a seat at the table under the new structure, holding a slight edge on the board—10 members in the first year (to FSU’s 7), and 9 members from the second year onward (to FSU’s 8). And for major decisions, neither side can dominate: the MOU requires a supermajority of 13 out of 17 votes, ensuring collaboration instead of unilateral control.
Bottom line: Local control never truly existed—claiming otherwise is just PR spin, not reality. The new structure is balanced and requires both sides to collaborate, preventing unilateral decisions.
Critique 2: “We’re giving away City assets.”
It’s a dramatic talking point—perfect click-bait—but it doesn’t hold up. Yes, the City is transferring ownership of the hospital land and facilities to FSU. But this is not free. No one ever said it would be free. That claim was simply made up.
The City Commission has made it clear that, under the new structure, the transfer will come with a price tag—whether through a one-time payment or annual payments—and we’ll soon know exactly what that is.
Critique 3: “Community care will suffer.”
This argument is built on fear, not facts. Opponents want you to believe that patients will be left behind if FSU takes ownership, but nothing in the agreement supports that claim.
TMH will continue to operate as the hospital provider, and the charity care policy remains in place. That means uninsured and underinsured patients will still have access to treatment. Suggesting otherwise is nothing more than a scare tactic.
In reality, FSU’s involvement expands capacity. With access to research dollars, clinical trials, and state support, TMH can bring in more doctors, more specialties, and more services that keep patients in Tallahassee instead of sending them to Jacksonville, Gainesville, or Pensacola.
Critique 4: “FSU isn’t local.”
This one doesn’t make sense. Florida State University is as local as it gets.
Yes, FSU receives funding from the Legislature—just like FAMU and TSC. But its leadership, faculty, staff, doctors, and students all live right here in Tallahassee. They raise families here, coach Little League, buy homes, shop, and volunteer. FSU isn’t some faceless corporation from out of state—it’s our university.
Critics try to paint FSU as distant, but the reality is the opposite: FSU has already invested hundreds of millions of dollars in new schools and facilities right here in Tallahassee. No other institution in this city has more skin in the game.
Critique 5: “This is a billion dollar asset!"
The Ankura Consulting Group valuation report, made public by the City Commission, offered the first detailed look at Tallahassee Memorial HealthCare’s (TMH) financial position. The report was commissioned to help the City understand the hospital’s asset value as part of ongoing discussions about its partnership and property structure. According to the findings, TMH’s assets were valued under several approaches, but all showed that substantial long-term debt significantly reduces the hospital’s net worth.
Under the cost approach, TMH’s assets were estimated at about $438 million, with $364 million in long-term debt, resulting in roughly $74 million in equity. The sales-comparison approach showed $418 million in assets and about $54 million in equity, while the market approach estimated $584 million in assets and $220 million in equity. Together, the figures show that while TMH operates a large and valuable campus, its heavy debt load limits the real value available to the community if the system were ever to default.
Who’s Really Behind Critiques?
It’s worth asking the question: if this deal is so clearly in the community’s interest, who benefits from fighting it? The answer comes down to four camps.
First, those benefit from the existing TMH ecosystem. For decades, TMH leased City-owned assets for $1 a year, enjoying near-absolute control with noone asking any questions. That’s a great deal—and some people don’t want to lose it.
Second, politicians looking for a platform. Every election cycle needs an issue, and some see this partnership as a convenient way to generate followers, even if it means standing in the way of helping our residents get better health care.
Third, the hired guns. PR professionals and consultants are being paid to spin talking points, muddy the waters, and create fear where none is warranted.
And finally, well-meaning community members who’ve been misled. They’re hearing the sound bites without knowing where they came from or who’s paying for them.
Recent Polls
Public sentiment around the FSU–TMH partnership remains overwhelmingly positive. An independently verified survey showed that more than 75% of the community supports creating an academic medical center through the FSU–TMH partnership. A Sachs Media poll found that 65% of Tallahassee residents have traveled outside the city to receive medical care—a clear sign that the current system isn’t meeting the community’s needs. In that same poll, 60% of residents said the hospital would be better run under FSU Health.
Grow Tallahassee recently conducted a text-message poll asking residents whether, given the hospital’s current performance, they would support an FSU–TMH partnership to deliver better care for the community. The poll drew more than 5,100 total responses, with 4,220 people expressing an opinion. Of those, 80.6% said “yes” to supporting the partnership, while 19.4% said “no.”
Together, these results send a clear message: Tallahassee residents are ready for change and overwhelmingly support a partnership that will deliver better healthcare, stronger accountability, and long-term investment in our region.
Using Stalling as a Tactic to Kill the Deal
Knowing the community is firmly behind the FSU–TMH academic medical center, critics won’t come out with a flat “no.” Instead, they will try to deploy delay tactics—calls for more studies, more reports, more reviews, more debate—anything to run out the clock. They’ll use sound bites like “it’s being rushed.”
Hell yes, it should be rushed. In fact, we are about 15 years late on this deal compared to Tampa, Miami, Jacksonville and Gainesville. Every day of delay means more families on the road for complex treatments, and more harm done in real time.
Closing
We’ve argued about this for months. Meanwhile, families still drive hours for specialty care, our graduates chase better-paying jobs elsewhere, and public assets underperform for the people who own them. The status quo isn’t neutral—it’s costly.
This partnership finally flips the script. It turns a good hospital into a great academic health center, and converts major research investments into local paychecks. It builds a twelve-month economy, keeps care close to home, and makes Tallahassee the healthcare hub between Pensacola and Jacksonville. Let’s make this happen.
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This article is an opinion piece by Bugra Demirel, a longtime Tallahassee resident, entrepreneur, and community advocate. A graduate of Florida State University and Tallahassee State College, Bugra was inducted into the Tallahassee State College Alumni & Friends Hall of Fame in 2024 and honored as a Seminole 100 recipient for leading Demirel International—one of the fastest-growing businesses owned by an FSU alumnus. His company holds investments across retail, hospitality, manufacturing and commercial real estate industries.
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