- The Washington Times - Monday, May 7, 2001

Finally, the D.C. Financial Responsibility and Management Assistance Authority (control board) and other pertinent parties have signed the contracts that privatize many of the essential services ordinarily provided at D.C. General, the citys public hospital. It almost didnt happen thanks to the D.C. Council, which tried to legally outmuscle the board, and unruly protesters, who tried to eclipse the boards April 30 public proceedings. Yet a succinct plan remains elusive.
That is because the fight to reform the citys health-care crises must be waged on two fronts. The one lost amid the drama and the politics is health care itself. A recent and unfortunate incident underscores the situation. A 14-year-old girl was five months pregnant. Her mother said the girl was feverish and in premature labor, so she called 911 for an ambulance. The ambulance, headed for the nearest hospital (D.C. General) only to learn through a radio dispatch that the hospitals obstetrics emergency room was not accepting patients. The ambulance then took the girl to Howard University Hospital. The baby died.
To be sure, hospital officials should have notified police and firefighters that certain services would not be available. Alas, mismanagement is a longstanding issue in the protracted debate. For example, the Public Benefits Corp. (PBC), the quasi-independent D.C. agency that runs the hospital and its network of clinics, overspent three consecutive budgets by a total of $90 million. D.C. officials, meanwhile, would grant it loans and cash advances based on reimbursements it planned to collect from patients and Medicaid but did not. At the same time, audits questioned hospital officials travel expenses, outrageous salaries and other expenditures.
Still what really and truly is problematic are astonishing rates of HIV/AIDS, teen pregnancy, infant mortality, substance abuse, high rates of unimmunized youngsters, and chronic illnesses among the poor. Moreover, seniors on fixed incomes fear D.C. General is their sole option, and the uninsured and the underinsured depend on its treat-now-maybe-pay-later practice. Stabbing, gunshot and similar patients caught up in street violence are routinely carted there for care. All that was enough to send similar hospitals in similar situations to their graves.
While D.C. lawmakers have rewritten laws and held countless hearings in recent years, including the legislation that created the PBC, it has become clear their primary interest was to maintain incumbency. "The proceedings were filled with bravado, chicanery and heavy doses of Marion Barry-esque obfuscation politics," one veteran scribe said not long ago. Now that the emotionalism regarding D.C. General has subsided, the D.C. Council and Mayor Williams must begin devising a health-care system that is at once efficient and effective. One without the other will not suffice.

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