- The Washington Times - Friday, December 13, 2002

While supporters with the D.C. Health Care Coalition and the Emergency Coalition to Restore Prescription Benefits protested D.C. Mayor Anthony A. Williams' "health care fiasco" yesterday, the terminally ill patient, known as the D.C. Health Care Alliance, is barely breathing on life support.

Sooner or later, some brave soul is going to have to pull the ventilator's plug on the poorly privatized health care system that advocates rightly deemed "has been exposed as a sham." If he had his way, that brave soul would be Republican D.C. Council member David Catania, who could be likened to Don Quixote whistling in the wind while the crippled Mr. Williams hobbles around the health care crisis.

The disabled Teflon Tony appears deaf, dumb and blind to any real remedies to the city's medical mess even after a so-called health summit hosted at the Metropolitan Washington Council of Governments this week at which the mayor uttered all manner of platitudes but remained committed to the failed health care alliance anchored by the financially troubled Greater Southeast Community Hospital.

The prognosis is anything by promising.

Greater Southeast was kept on the respirator once again this week when a bankruptcy judge ruled that it could continue to operate until Jan. 24 using funds caught up in a complex arrangement with its parent company, Doctor's Community Healthcare Corp., and the parent company's lender, National Century Financial Enterprises. Mr. Catania and health professionals believe it's highly unlikely that Greater Southeast and all its players will ever emerge whole from bankruptcy and the District cannot continue to connect its medical recovery to this choking hospital's future.

"I don't have the confidence that they can give top-flight care," said Mr. Catania during a taping of "Viewpoint," a WRC-TV (Channel 4) public affairs show to be broadcast Sunday. Known for doing his homework, Mr. Catania suggests that the bankruptcy judge be petitioned by city attorneys to consider Greater Southeast's extraordinary status in the city's health care alliance, declare a "public crisis," and allow the city to assume responsibility for the troubled hospital. The District, in turn, could hire a proven hospital-management company to operate Greater Southeast, which Mr. Catania believes is necessary after D.C. General's closure.

The contracted management company could perform "a gut check" to make sure the hospital operates more efficiently and for the long run. A stream of revenue for the newly designated public hospital which is also needed to cut down on the overflow D.C. General's closure caused for the city's private hospitals, especially their emergency rooms could be created by treating Medicaid- and Medicare-eligible patients in ZIP codes 20019 and 20020 for all non-acute care problems at Greater Southeast.

"We could use this opportunity to make [Greater Southeast] a better hospital than before," Mr. Catania said.

Even so, bringing Greater Southeast out of bankruptcy for the second time does not preclude or deter Mr. Catania from his ultimate goal of seeking an improved safety net citywide for more uninsured patients by constructing another public hospital, possibly at the more central location of the D.C. General site.

"I'm not willing to call [the alliance] a success when we've dismantled the safety net," he said.

As Mr. Catania pointed out: "We are leaving a good many out" under the current alliance system. Under the old system at D.C. General, children and their parents who met a low-income threshold were automatically eligible for coverage. Under the current system, using Greater Southeast and private clinics, only single and married people earning well below the income threshold are eligible. This may account, in part, for why only 28,000 people are registered when by the city's own estimate two to three times that many were uninsured but eligible for coverage.

That means that anyone making more than $8.25 an hour is ineligible, Mr. Catania said, and that must be changed.

Dr. Michael Richardson, senior director of medical affairs for the District, said, Mr. Catania had come up with an intelligent idea and a "fascinating concept," which merits further discussion. He did not dispute Mr. Catania's claims about the number of uninsured patients who are ineligible under the current alliance's stringent guidelines, but he said the mayor was committed to a full-service hospital with emergency care east of the Anacostia River. "We're monitoring [Greater Southeast] closely for its viability as a hospital and for its quality of care. We'll all wait and see," said Dr. Richardson.

But sick city residents cannot wait until this hospital takes its last gasps of air. "Sooner or later, we have to step in before the problems get worse," Mr. Catania said.

Pull the plug.

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