D.C. Control Board Moves to Privatize D.C. General Hospital, Despite City Council Opposition

Overriding the City Council's "angry and unanimous rejection," the Washington, D.C. financial control board on April 30 approved a plan to transfer management of the city's health care system for the uninsured to a private company that will "phase out" inpatient and trauma services at D.C. General, the city's safety-net hospital, the Washington Post reports. The new contract took effect at midnight after a federal judge denied a request by D.C. Council members to issue a restraining order against the control board (Goldstein/Miller, Washington Post, 5/1). Under the plan, backed by Mayor Anthony Williams (D), Doctors Community Healthcare Corp., a private hospital chain that purchases "troubled" hospitals in "impoverished" communities, will manage a network of more that 20 clinics that contract with private physicians. Greater Southeast Community Hospital, a facility owned by DCHC, will treat patients requiring hospitalization or trauma care (Kaiser Daily Policy Report, 4/20). Alice Rivlin, chair of the federally appointed control board, said the city would now be able to offer "expanded medical services to the district's 65,000 uninsured residents" and that the new plan would save the city roughly $32 million a year. The control board also abolished the "bankrupt" Public Benefit Corp., which until April 30 had run the city's health network at a cost last year of $122 million to the city. "It would be impossible to build a comprehensive, high-quality health care initiative with the existing, deteriorating, mismanaged and high-cost D.C. General Hospital and the deficit-ridden PBC as its anchor," Rivlin said (Washington Post, 5/1). Protesters, however, "shouted down" the initial meeting of the control board, forcing it to move to a second location, where the new contract was then signed (Bhatti, Washington Times, 5/1).

Will the Ends Justify the Means?
While the new plan "looks fine on paper," a Washington Post editorial states that "reasonable people ... can still have misgivings about the manner in which this change has come about." The editorial notes that the control board is "scheduled to go out of business in September," leaving Williams at the "mercy of a [city] council with a vested interest in seeing private health care delivery fail." The editorial also questions the ability of the city's health department to oversee the new network, stating it is "hardly distinguished in its oversight of publicly funded activities" (Washington Post, 5/1). Writing in a Washington Times op-ed, Adrienne Washington in her column strongly criticizes Williams, saying he has "misinform[ed]" D.C. residents about the "inadequate plan to privatize the city's health care system," adding that "the most troubling aspect of this sweeping change in providing health care to the indigent and uninsured has been the secretive manner in which so much of these negotiations were shrouded." Washington commends the D.C. Council for "try[ing] to resuscitate D.C. General as the hub of an improved system." Stating that "D.C. residents are not happy about the death of D.C. General as they know it," Washington asks, "Where is the public policy that matches the public will?" (Washington, Washington Times, 5/1). For complete Health Policy Report coverage of this issue, click here.