- The Washington Times - Wednesday, February 2, 2005

D.C. Mayor Anthony A. Williams said yesterday that the city’s efforts to improve health care among poor residents are working, yet he continues to face fallout over his support of the closing of D.C. General Hospital in 2001.

“I’m still paying the political price for the privatization of D.C. General,” Mr. Williams said at his weekly press conference.

The mayor said he did not regret the decision. “It was right,” he said of the hospital closure.

The congressionally appointed D.C. financial control board, with Mr. Williams’ support, closed the Southeast hospital before city officials enacted the D.C. Healthcare Alliance. The nearly $100 million city-funded program provides health care coverage for low-income residents who are not eligible for Medicaid.

Mr. Williams said his approval of the hospital closing cost him the support of some voters who were never “really on board” politically, but in the face of unanimous opposition by the D.C. Council he said he has given those voters “reason to stay off board permanently.”

Mr. Williams has not decided whether he will seek a third term next year.

Though the hospital has been closed for four years, the issue is still divisive in city politics and likely will be campaign fodder.

In their inauguration speeches last month, several D.C. Council members — including Vincent C. Gray, Ward 7 Democrat, and Marion Barry, Ward 8 Democrat — chided the mayor for supporting the hospital’s closing.

Mr. Williams said he is heartened by statistics that show the D.C. Healthcare Alliance is helping residents live “longer, healthier lives.”

Mr. Williams and D.C. Department of Health Director Dr. Gregg A. Pane said statistics show a 38 percent increase last year in visits by alliance members to primary-care clinics, and a 29 percent drop in the number of visits to emergency rooms.

The mayor said the program is meant to encourage patients to visit primary-care clinics for early detection of health problems, rather than waiting until conditions worsen and require an expensive hospital stay.

Mr. Williams also said the program likely will have an “unexpected” surplus this year. In previous years, the program’s expenditures exceeded its budget.

A study by the Henry J. Kaiser Family Foundation in 2003 showed that the District is the only jurisdiction in the nation to offer health care coverage to all residents below 200 percent of the federal poverty level.

But some doctors are reluctant to participate in the healthcare alliance because of problems receiving payment for services, an internal review of billing practices showed.

The health plan also has been criticized for paying for services to ineligible recipients, including patients who do not live in the District.

D.C. Council member David A. Catania, at-large independent and chairman of the council’s Committee on Health, said the alliance has turned into a fee-for-service system, rather than a coordinated approach to improving health care.

“I think the alliance has not been what it was envisioned to be,” he said.

Earlier this week, Mr. Catania and Mr. Gray proposed an expansion of health care coverage for low-income D.C. residents.

Under their plan, children would be eligible for the District’s subsidized health care coverage if their household income is below 250 percent of the federal poverty level, up from 200 percent.

Despite annual spending of about $1.2 billion for Medicaid and nearly $100 million for the healthcare alliance, many city residents, including some with insurance, still have trouble finding access to health care, a local nonprofit reported.

The District of Columbia Primary Care Association found that nearly 300,000 city residents live in areas designated as “medically underserved,” with too few physicians or clinics.

The group is recommending a 10-year, $145 million project called Medical Homes DC that would improve primary care throughout the city.

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