A Healthy Response

THE HEALTH-CARE legislation introduced this week by the administration of D.C. Mayor Anthony A. Williams (D) comes with a big price tag -- at least $245 million. Equally important is the array of major initiatives to be funded by such a large investment. If implemented according to the multi-phase approach outlined in the legislation, dubbed the Community Access to Health Care Omnibus Amendment Act of 2006, the proposal offers the promise of a healthier District population.

The proposal is the handiwork of the Williams administration and D.C. Council member David A. Catania (I-At Large), who is chairman of the council's Health Committee. As Mr. Catania said when the bill was introduced, the District has "never invested this kind of money in the health-care infrastructure of the city." He, along with Mr. Williams and city health officials, is convinced that the investment, more than half of which would be directed to poorer communities in the eastern half of the city, will go a long way toward addressing glaring health disparities in the nation's capital.

Clearly the method of funding the measure -- through the use of the city's tobacco settlement funds -- makes sense. Tobacco use, as Mr. Catania has noted, contributes to five of the 10 leading causes of death in the city. Tobacco use is also the leading cause of cancer deaths in the District. What better use for the settlement funds?

Phase one of the program would direct $10 million directly to anti-smoking campaigns, school-based tobacco prevention programs and health education programs in health centers, homeless shelters and community organizations. Phase one also would tackle cancer, the second-leading cause of death in the District, with a $20 million plan designed to improve treatment; early detection of gynecologic, prostate and colorectal cancers; and education and public awareness. Another key feature is $40 million to build at least two comprehensive ambulatory care centers -- with at least one each in Wards 7 and 8 -- that would address the city's high rates of chronic disease by offering offer primary and mental health care, specialty care, and pharmacy and laboratory services.

Phase two would provide $80 million to enhance and expand the emergency rooms of Howard University Hospital and Greater Southeast Community Hospital, and additional money to purchase medical emergency vehicles. Phase three anticipates building a $79 million "healthplex" with 24-hour emergency services, primary and specialty care, day surgeries, and diagnostic imaging on the grounds of the former D.C. General Hospital.

Ambitious? Yes. Affordable? It's the best and most efficient use of tobacco settlement funds by the city to date. Doable? With only a few months left in the legislative year, and with reservations expressed by a few council members who favor alternate health proposals, the clock may not be on the mayor's or Mr. Catania's side. Hanging in the balance, however, are District residents desperately in need of health services.