Problems of Area Public Hospitals Reveal National Trend
By Talib I. Karim, Esq.
Special to the Informer
Thursday, April 24, 2008
Recently, lawmakers in Annapolis approved a bail out package aimed at keeping afloat ailing Prince George’s County Hospital. Yet, the problems faced by the largest publicly funded hospital in Prince Georges’s County are not new. Observers see a clear similarity between the problems of Prince George’s County Hospital and the issues that caused the closure of the District’s public hospital, D.C. General.
According to Robert A. Malson, president of the District of Columbia Hospital Association (DCHA), the underlying issue that crippled both D.C. General and P.G. County Hospital comes down to simple economics: too much demand and insufficient resources to fund the supply of services to meet the demand.
The economic realities that threaten a medical crisis in both the nation’s capital and the Maryland suburbs are also troubling public hospitals across the country, according to Rick Wade, spokesperson for the American Hospital Association (AHA).
“The primary financial drain on public hospitals is the emergency room. One-third of the patients seen in [public hospital] emergency rooms don’t need to be there. Another third of public hospital emergency room patients suffer from ailments that could have been treated by a family physician or other primary care provider,” Wade said.
Therein lies the root cause of the nation’s public health crises - a large portion of the public does not have access to a family physician or other healthcare services, stated Malson, who draws a picture of the public health problem as follows:
“The larger community is divided into three segments. The majority gets insurance from employers. The other end includes people who are unemployed who get insurance through Medicaid and Medicare. Public hospitals filled the gap of services that were not covered by Medicaid or Medicare. In the middle, you have people who are working but whose employers cut back on medical coverage or people who are not working but who are not covered by Medicaid and Medicare,” Malson said.
This economic reality has most recently plagued public hospitals in Atlanta, Chicago, and Los Angeles. Los Angeles’ public hospital, named in honor of Dr. Martin Luther King, Jr. and Dr. Charles Drew, the African American inventor of blood plasma, exemplifies the national problem. The Martin Luther King Jr./Drew Medical Center (later renamed King/Harbor), was founded in the wake of the 1965 Watts Riots to serve the poorest areas of Los Angeles County.
The King/Harbor Medical Center was designed to handle the full scope of health crises facing uninsured patients in Los Angeles, according to Jim Lott, executive vice president of the Hospital Association of Southern California. Unlike similar urban public hospitals, the King/Harbor Medical Center had adequate financing. The primary cause of its failure and eventual closure was mismanagement, contends Lott.
“Nobody would check them because they were African American and no one dared touch them,” asserted Lott.
Eventually, widely publicized patient deaths forced the Center for Medicaid and Medicare Services (CMS) to withdraw $200 million in annual federal funding for King/Harbor. With the loss of its funding, the doors of King/Harbor were closed last August, thus creating a public health emergency, stated Lott.
“Presently, the community once serviced by King/Harbor has 0.9 beds for every 1,000 patients, compared to 4.3 beds for everybody in America. Nearly a year after King/Harbor’s closure, government officials have yet to find the right fix to reopen the hospital,” Lott said.
According to Malson, this is the problematic position that Maryland and Prince George’s County officials hope to avoid through their deal to save Prince George’s County Hospital by agreeing to split in half $24 million in funding for Prince George’s County Hospital over the next two years.
“This is not the end of the save Prince George’s County Hospital story,” said Rion Dennis, lead organizer for Progressive Maryland of Prince George’s County.
“In the weeks to come, there are a number of deadlines that must be met to ensure the survival of the county’s public health facilities. This includes identifying a company to take over the hospital from Dimensions Health Care, a not-for-profit company based in Prince George’s County,” Dennis said.
Dennis’ group has set up a Web site, www.saveprincegeorgeshospitals.com to monitor what’s going on, and keep the process “transparent.” To Malson, this deal is vital.
“The collapse of Prince Georges’s County Hospital means the collapse of the [District’s publicly funded hospital,]” Malson said. “They are both critical since they serve the same community.”
Talib I. Karim is an attorney and writer focusing on health and environment issues. Contact him at tkarim@TECLawgroup.com.