In a breathtaking display of common sense, Mayor Anthony A. Williams and the D.C. Council are acting to help the District's most vulnerable residents live longer, healthier lives.
For years, research has shown that low-income minorities are sicker and die younger than more affluent whites. A major cause is a lack of primary care.
Untreated, high blood pressure can cause stroke, resulting in disability or early death. Untreated, diabetes can cause loss of limbs, kidney failure or blindness, resulting in disability and early death. Untreated, HIV infection causes AIDS, resulting in disability and early death.
Many of these illnesses could be halted, treated or reversed with early intervention. A January report by the D.C. Primary Care Association -- with research completed by Rand Corp., the Brookings Institution and Capital Link -- documented that more than 50 percent of D.C. residents in areas with high concentrations of poverty have chronic illnesses and use emergency rooms too often. These same residents report no regular source of care.
The mayor, the council and City Administrator Robert Bobb are taking a practical approach to this problem: They are expanding insurance so that people have someone to pay for care; then they are making sure these folks have a place to use their new insurance.
Thanks to the 1998 expansion of Medicaid and the 1999 creation of the D.C. Healthcare Alliance, city policymakers have helped an astonishing 52,000 additional low-income people get benefits; that's one in 10 D.C. residents. Today 165,000 low-income people, or one in three D.C. residents, receive health benefits from the government through a mix of local and federal funds.
So Others Might Eat and Bread for the City are experts in subsidized and free health care. When the District created the alliance, our patients were included. And, for the first time, we were paid for the care we provide our low-income patients.
Before the alliance, we relied on charitable giving. Unfortunately, health care is expensive, and the money we raised from our generous donors was never enough. Though things are much better with the alliance payments, most primary-care centers still are paid less than 50 percent of the cost of providing care. Consequently, many of the newly insured have found they still have nowhere to go for care.
Two sensible things are happening to solve this problem:
The District is paying the second installment of $14.5 million in a project known as Medical Homes D.C. that will last more than five years and cost more than $100 million. It will result in bigger and better-equipped medical centers so that low-income residents can find doctors in their neighborhoods.
The mayor also has included money in the fiscal 2006 budget to give the primary-care centers a first, small "pay raise." This will result in these centers hiring doctors and nurses who will dispense the care inside those bigger, better buildings.
The mayor has made good on his promise to make it easier for low-income people to find primary care. Now it's the D.C. Council's turn. It should do its part for the health of the city's most vulnerable population by approving the $14.5 million for Medical Homes D.C. and supporting a primary-care pay raise.
-- George A. Jones
-- Mary Ann Sack
are, respectively, executive
director of Bread for the City and
health services administrator
of So Others Might Eat.
gjones@breadforthecity.org
masack@some.org
