Positive Reception For Mayor's Health Plan
Tuesday, November 14, 2006
Mayor Anthony A. Williams's plan to spend a record $245 million on health prevention and primary and urgent care, mostly in eastern neighborhoods, got a largely supportive reception yesterday before the D.C. Council health committee.
The endorsements were not surprising, given most of the people who testified. Several speakers were on a task force that led to the proposed legislation. Others are with organizations that would be key to carrying out its provisions, including smoking cessation initiatives, programs to prevent cancer and lessen chronic diseases and new ambulatory care clinics in Wards 7 and 8.
Williams's bill, which could face a vote before the new mayor and council take office in January, veers from the 250-bed National Capital Medical Center that the city and Howard University once intended to build together in Southeast. Instead, it backs construction of a $72 million "healthplex" there, with 24-hour emergency services, primary care doctors and specialists, day surgeries and diagnostic imaging.
The change remains the heart of the issue for some people. Although only three residents offered comments, each said that anything short of a new hospital does not meet needs east of the Anacostia River, where communities suffer disproportionately from poor health and trauma.
"We want a fighting chance," said Cleve Mesidor of Ward 7, who repeated the Rev. Martin Luther King Jr.'s words that "injustice in health care is the most shocking and inhumane" of all forms of inequality.
But the exchange that followed with committee Chairman David A. Catania (I-At Large) illustrated the crux of the debate for most of the city's health leaders, who believe chronic disease is better addressed through expanded community-based care than through a new hospital or emergency services.
"Why is it one or another?" Mesidor asked.
"Because we live in a world with [only] $245 million," Catania replied. And there are many things the city can do "that do not require pouring all these dollars into a hospital," he continued. "Is it a perfect solution? I don't think it is. But is it a reasonable solution?"
Howard officials still believe the proposed medical center is "by far the most compelling" approach, as the university's senior vice president, Hassan Minor, put it. But Minor termed "an industrial-strength critical care facility . . . the next best alternative" and said the university would want to be involved in any health venture that could benefit the city.
The top executives of Providence and George Washington University hospitals offered unqualified support and indicated their institutions would be interested in collaborating on the healthplex, possibly by providing specialty or diagnostic care.
"This is something that can work if the right resources are put into place," said Providence Hospital President Julius Spears Jr.
The money that Williams would direct toward the array of health programs and construction comes from the District's tobacco settlement funds, part of a 1998 national settlement between states and tobacco companies. If the legislation is approved, it would mark the first time that any of those funds has gone specifically toward District health efforts.
Williams wants to spend $83 million to strengthen emergency care, with $2 million for new ambulances and $1 million for an assessment of the city's system. Based on that evaluation, the rest would be used to help expand emergency department capacities at Howard University Hospital and Greater Southeast Community Hospital, contingent on a change in the latter facility's ownership.