THE JOINT PROJECT of the District government and Howard University to build a $400 million, 250-bed hospital on grounds formerly occupied by D.C. General Hospital has moved beyond the talking stages. But the idea of using the land known as Reservation 13 to construct a state-of-the-art facility with Level 1 trauma capabilities, a medical office building and a research complex financed in part with about $300 million of D.C. government borrowings and a contribution of nine acres of D.C. land valued at $70 million is not a done deal. Nor should it be. Residents in neighborhoods formerly served by D.C. General Hospital need access to health care services, including treatment for chronic diseases, diagnostic testing, and emergency and primary care. Whether they and taxpayers across the city will be best served by the proposed National Capital Medical Center is a question that must be thoroughly examined before -- not after -- a deal is finalized.
Fortunately, there is sufficient time to explore all of the issues surrounding this extraordinary undertaking by the D.C. government and the university. The D.C. Council's health committee, chaired by David A. Catania (I-At Large), intends to conduct additional hearings on the project in late September or early October after city and Howard officials develop a full financing plan. In the meantime, council members, health care providers, residents and other key stakeholders should examine questions that have a bearing on the wisdom and feasibility of the National Capital Medical Center.
Does the District need a new hospital requiring such a substantial investment of public money? According to the D.C. Hospital Association (DCHA), the city's hospitals are licensed for 5,000 beds. Currently about 3,000 beds are in service. Nearly 2,000 additional beds can be put into service without the investment of new public dollars, the DCHA reports. If that is the case, what is the justification for an expensive new hospital?
Is the proposed investment of $400 million being put to the most effective and practical use? If, as medical experts and hospital executives have argued, the problems plaguing the District's medically underserved residents -- diabetes, asthma, heart disease, hypertension, cancer, HIV-AIDS and the like -- lend themselves to quality outpatient care in an ambulatory setting, why is an additional hospital necessary? Would an alternate facility meet the needs?
Would a new hospital duplicate expensive services already available in the city? Does the District need another Level 1 trauma center when it already has three (at Howard University, Washington Hospital Center and Children's National Medical Center)? All of the trauma centers, as the city points out, are within a mile of each other. Why should Howard maintain two such centers, and at what cost to the university and the city? Has an independent and objective "certificate of need" study been undertaken to determine whether a new hospital is necessary to address unmet health needs? Should not that question be explored before millions of tax dollars are committed?
Where would the District find the money for a new hospital? The city is committed to borrowing nearly $500 million for a new baseball stadium and $175 million for a new mental hospital, and now it could end up on the hook for an additional $300 million for another new hospital, increasing the city's indebtedness by 25 percent. How will that play on Wall Street? In a similar vein, Howard University should publicly address questions concerning its financial capacity to operate two full-service hospitals without any operating subsidy from the District either at the start-up or during the life of National Capital Medical Center.
These are among the many issues that must be candidly addressed by the District and Howard University before this project goes forward. The interests of both institutions and all D.C. taxpayers dictate that such a searching examination take place in an open forum.