On 30 April 2001, a Congressionally-installed financial control board initiated the closing of D.C. General Hospital (DCGH). The control board acted at the behest of D.C. Mayor Williams, but in the face of unanimous opposition from the D.C. City Council.
Mayor Williams asserts that DCGH has been mismanaged, is costly, is not needed, and consumes resources that could be better invested in primary and preventive care. He argues that the District would save money and provide better care by contracting with a for-profit hospital, an HMO, and other caregivers to provide services to some of the DCGH's uninsured patients.
Opponents of the merger assert that DCGH was in process of reforming itself and cutting costs; that the hospital's beds and its ER and ICU are needed; that closing the hospital would leave the people of the eastern sector of the District dependent on a single for-profit hospital that was recently bankrupt; that the mayor grossly oversold prevention; that the mayor’s alternative care network would short-change primary care and would be unreliable, inadequate, and extraordinarily costly to administer; and that the mayor’s plan would leave many uninsured people unprotected.
This paper analyzes the evidence for and against closing DCGH, the processes that led to the hospital’s probable closing, the differences between the DCGH closing and those of public hospitals in Philadelphia and St. Louis two decades ago, and the lessons for surviving hospitals that serve vulnerable patients.
See dcc2.bumc.bu.edu/hs/ushealthreform.htmLearning Objectives: 1. To identify the arguments and evidence for and against closing the District of Columbia's public hospital. 2. To identify lessons from the fight to save D.C. General Hospital and apply them to other hospitals--public and private--that serve large numbers of patients who are vulnerable to denial of needed services. 3. To identify the five possible causes of public hospital closings: revenue, cost, perceived medical quality, physical plant, and local politics.
Keywords: Hospitals, Access
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Serve as occasional consultant to Committee of Interns and Residents, SEIU.