- The Washington Times - Thursday, June 8, 2000

No matter where the line is drawn, the District's Health and Hospitals Public Benefit Corp. (PBC) is in serious trouble. The PBC is financially dependent on scarce tax dollars. It is politically dependent on detractors in high places. And its administrative record won't guarantee the support of either. The PBC's chief executive officer concedes in a May 12 internal memorandum, "the overwhelming issues about 'management' of the PBC have all to do with financial management, including the absence of timely and accurate billing and collections, [unavailable] routine management reports and management of cash flow."
It is important those problems be spelled out at this juncture because a 150-page report from a District consultant cites not only the aforementioned "overwhelming issues" referenced in the memo but major problems in hiring and medical care as well. The mismanagement and financial problems are forcing city officials to give more serious thought to closing D.C. General Hospital, which is run by the PBC, and to getting rid of the PBC's chief executive officer, John A. Fairman. While the hospital will probably still be around by year's end, Mr. Fairman probably will not.
Mayor Anthony Williams has practically guaranteed that by gaining majority control of the 12-member PBC board of directors, which also oversees city-run clinics and other public-health programs, such as the school-based clinics and health care for the homeless and prisoners. The D.C. Council controls the remaining five seats. The new board, if smart, will do precisely as the congressionally created control board did in 1996. That is, map out short-and long-term financial management plans and implement them. If the only way to achieve those goals is to cut services at D.C. General, then such an option must be considered.
Now that will not be easy in this town for several reasons, chief among them the mistaken belief that the poor have no alternative to D.C. General. To the contrary, there are eight public health clinics in various quarters of the city, and major hospitals in all but one of eight wards. Indeed, the city is long on health care facilities but short on tough calls that would be necessary to close unnecessary facilities.
Mr. Williams, as the city's chief financial officer, drew much criticism a few years back when he suggested the city end its subsidy to D.C. General. So you might imagine the heat he's taking now. Yet, quiet as it's kept, there are D.C. lawmakers who share that belief, too. Problem is, they lack the courage to speak out. They are too scared to say, "The city does not necessarily need a public hospital. The city needs a quality and efficient health care system."
On the other hand, Mr. Fairman, who was first appointed by Marion Barry in 1995, has been speaking up for some time now. He believes part of the hospital's problems stem from the fact that D.C. lawmakers, not the PBC, control the hospital's purse strings. And he is correct. The very legislation that created the PBC says the intent of the D.C. Council was for the PBC to become "financially stable and self-supporting without subsidy from the District's general fund" the same as the Water and Sewer Authority did. To the misfortune of taxpayers, employees and patients, though, that has not happened. One hopes the newly constituted PBC board, after being confirmed and seated, will correct that and other costly mistakes.

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