THE QUESTION of the hour in the District is whether the D.C. Healthcare Alliance, the private health care network for the poor that replaced D.C. General Hospital and its affiliated clinics last year, can keep running. The alliance's flagship hospital, Greater Southeast Community Hospital, has been left stranded financially by its private owner, the heavily indebted and now bankrupt Doctors Community Healthcare Corp. of Scottsdale, Ariz. Mayor Anthony A. Williams, who reportedly has agreed that some restructuring of the alliance is needed, has nonetheless maintained that it is working effectively, delivering a higher level of care to low-income residents than they received when the city was in the health care delivery business. "Beyond our expectations, . . . a model public health program" is the way he put it during a news conference on Friday. But if that is true, why are other key health care providers in the city sounding the alarm?
Today we publish a letter from John F. Williams, vice president for health affairs and dean of George Washington University Medical School, and Dan McLean, chief executive officer of George Washington University Hospital. They state flatly that the District's emergency medical care system is seriously troubled, with critical care patients overwhelming the city's critical care beds, and that the strain has worsened since the closure of D.C. General. They aren't alone. Yesterday we heard from leaders of Washington Hospital Center and MedStar Health, the largest provider of charity care in the city. Their message was equally unequivocal: If the D.C. Healthcare Alliance and its alignment with Greater Southeast and Doctors Community Healthcare Corp. continues, "we believe it will derail the city's public health system and financially imperil the city's private hospitals," said John P. McDaniel, MedStar Health's chief executive officer.
We understand that the concerns expressed by GW Hospital and Washington Hospital Center officials are shared by other key private hospitals involved with the Healthcare Alliance. So what is the basis for the mayor's rosy scenario? Is it all happy talk to soothe the fears of Greater Southeast's 1,500 workers and the thousands of patients who depend on the privatized indigent health care system? Or does the mayor know something that private hospitals, groaning under the weight of picking up the slack from a faltering Greater Southeast, don't know?
Private hospitals contend that since D.C. General was closed, their trauma admissions and critical care patient loads have increased, along with their uncompensated care burdens. The closure of Greater Southeast would further weaken an already fragile system. Yet the mayor maintains the Healthcare Alliance is vibrant and serving the city and its poorer residents. Well? Where is the proof of that, Mr. Mayor?