D.C. LAWMAKERS have finally decided to do something about the wasteful spending at the troubled public hospital in Southeast. We wish we could applaud the move to cap spending and eventually close the hospital, but it is long overdue and — even more troubling — hinges on plans to replace it with a costly new hospital built at taxpayer expense. When will the city realize it doesn’t belong in the hospital business? When will it consider other, more effective ways to meet the urgent and critical health needs of people who live east of the Anacostia River?

As part of its preliminary approval of next year’s budget, the D.C. Council voted May 14 to cap annual subsidies to United Medical Center and to close it within four years, presumably when a new city-built hospital will be ready to open under still-to-be-arranged private management. Over the years, the city has pumped tens of millions of dollars into the facility, formerly known as the Greater Southeast Community Hospital, and hospital officials say they will need a $40 million subsidy in the next fiscal year to continue operations. That the hospital was hemorrhaging money prompted Council Member Vincent C. Gray (D-Ward 7), chairman of the council’s health committee, to draw the line against writing another blank check. He led the effort to cap the city’s subsidy at $15 million. If the current hospital board can’t figure out how to rightsize the hospital while still providing an emergency room and psychiatric services, it would be replaced by a financial control board.

We credit Mr. Gray for standing up to the unions — which are ferociously lobbying the council to protect hospital jobs before a final vote is taken later this month — and insisting on some measure of fiscal discipline. Nonetheless, the city’s politically driven approach to the health-care needs of residents in Wards 7 and 8 remains shortsighted. No politician wanted to close the only hospital east of the river, so elected officials propped up a hospital that provided substandard care and was shunned by the very people it was supposed to serve. The same flawed thinking has propelled the city’s plan to spend $325 million on a new facility and get a health-care partner — current negotiations are with George Washington University Hospital — to manage what officials argue would be a viable model of a community hospital connected to a regional system. It’s unclear what will happen if the city can’t reach agreement with George Washington.

There is no question that residents of Wards 7 and 8 are underserved when it comes to health services. But jurisdictions across the country have moved away from traditional inpatient facilities to health-care systems that provide a continuum of care through outpatient clinics, free-standing emergency rooms, enhanced maternity and infant health programs, and other innovative thinking. To opt for outmoded brick and mortar without considering alternatives — including possible cooperation with Maryland, which is nearing completion of a state-of-the-art hospital in nearby Prince George’s County — represents a failure of leadership.

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