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THE POLITICS OF D.C. HEALTH CARE
Unanimous council bucks mayorís plan
(Published April 23, 2001)
By KATHRYN SINZINGER
The political fight over privatizing the cityís public health-care delivery system is fast shaping up as a showdown over who runs the D.C. government.
The fight pits a unanimous 13-member elected D.C. City Council against one elected official, Mayor Anthony A. Williams, whose privatization plan for D.C. General Hospital and its associated services for the poor and uninsured has the backing of the powerful presidentially appointed D.C. financial control board.
A proposed contract with Greater Southeast Community Hospital in Southeast Washington, negotiated at the behest of the control board, would eliminate all inpatient medical and surgical services at D.C. General Hospital. D.C. General, the cityís only public hospital, would be converted into a campus of health clinics and an emergency room for only those patients not needing immediate care for life-threatening injuries or ailments.
The city council, seldom unanimous on controversial issues, came together April 12 to announce that all 13 of its members support keeping D.C. General open as a full-service hospital. They called for making the public hospital, rather than a private one, the "core" of a health-care delivery plan similar to the one Mayor Williams and the control board are proposing under a contract with Greater Southeast Hospital and a network of subcontractors.
Council Chairman Linda Cropp said the councilís plan to strengthen D.C. General Hospitalís "safety-net" services for the cityís poor and uninsured, rather than privatizing them, follows recommendations made in December by the mayorís health commission. She said it would be "more effective to work within the system" that currently exists under the Public Benefit Corp. than to create a whole new system of public health care. Retaining the publicly operated hospital as the core of a reformed health care system "is the best approach to maintain quality and control costs," she said.
"The PBC has begun to make the changes that were demanded," she said. "Those investments should not be abandonedÖ.The exact same services that the mayor wants, this council embraces."
The council unanimously voted to allocate $21.5 million for continued operation of D.C. General from money that was uncommitted by the mayor in his recent request for council approval of a supplemental fiscal 2001 budget. Officials said the supplemental budget request was made due to city revenues exceeding previously budgeted estimates.
The mayor immediately announced his intention to veto the councilís action but has been unable to date to rally enough council members to prevent a veto override. The legislation authorizing additional money to support D.C. General and other related health-care services operated by the PBC must follow the routine congressional oversight procedure, which permits Congress to block the elected councilís legislative actions during a 30-day review period.
During a press conference April 12 at which she was flanked by 11 of the councilís 12 other members, Chairman Cropp said Congress has never overruled a supplemental budget appropriation passed by the council. She noted serious implications for continued democratic home rule in the District if Congress or the congressionally created control board chooses to overrule the elected council on this issue.
"It would be a disservice to the citizens of the District of ColumbiaÖ.The executive and legislative branches (of the D.C. government) are doing what they ought to do Ė engaging in the process of checks and balances," Cropp said. "I would hate to see the same thing happen if the president and Congress disagreed."
Council members David Catania, R-At Large, and Kevin P. Chavous, D-Ward 7, acknowledged during the same press conference that they have retained a local law firm to represent them as private citizens to sue the control board for overstepping its legal authority if it chooses to implement the privatization plan over the councilís objection. Changing the local governmentís health-care policy is not part of the control boardís mandate, they said.
"They must live within the law," Catania said.
Copyright 2001, The Common Denominator