TESTIMONY AT THE APRIL 27, 2001 DISTRICT OF COLUMBIA CITY COUNCIL
HEARING CONCERNING THE CLOSING OF D.C. GENERAL HOSPITAL GIVEN BY THE
HONORABLE ERIK R. FLEMING, MEMBER, MISSISSIPPI HOUSE OF REPRESENTATIVES,
To Chairman Cropp, Members of
the District of Columbia City Council, Ladies and Gentlemen:
My name is Erik R. Fleming and
I am a member of the Mississippi House of Representatives from District
72. I have served in the House since 1999, representing approximately
The testimony I am about to
present today is similar to the testimony given before U.S. Congressman
John Conyers at his March 22"d Congressional briefing concerning
health care. For the indulgence of the council, I will make these points
again to reemphasize the national implications of this issue.
A subject that is important to
my constituents is quality health care. My district is considered the most
affluent African-American district in the state of Mississippi. Yet, I
know there are a significant number of people in my district that are not
covered by health insurance.
In fact, according to the most
recent statistics, a 1997 survey by the Urban Institute, there are some
476,000 Mississippians that do not have health insurance. That's around 17
percent of the state's population.
I believe the District of
Columbia has an estimated rate of 27 percent uninsured, some 150,000
people. Of the number of patients that D.C. General treats, 55 percent of
them are uninsured.
It would seem most appropriate
to have a discussion concerning the expansion of D.C. General, one the
premier public hospitals in America, and how their medical expertise could
help my state handle its health crisis. However, instead of something
positive like that, there is a move afoot to close the doors of this
institution, an institution of quality health care, which has been a
beacon of hope on the Anacostia River, since 1806.
I am here to recommend to all
who would hear this testimony that closing D. C. General Hospital would
exacerbate the problem of health care in this city and in this nation. Use
Mississippi as an example.
In 1987, it was strongly
recommended that the state's three eleemosynary, or charity hospitals
should be closed. That recommendation came from a Louisiana physician
hired as a consultant by the state's Performance Evaluation and
Expenditure Review, or PEER, Committee.
The PEER Committee report
(#184, 2/17/87) suggested that there were 13 alternate ways to treat
indigent citizens of Mississippi, including taking the money that was used
to fund the hospitals, and putting it into the Medicaid system. The theory
was that the $3 million the Legislature appropriated to the hospitals
could be turned over to Medicaid, which would create more jobs and give
the state a return of $12 million for health care.
According to the state's
Eleemosynary Board that oversaw the hospitals, the amount of care the
three hospitals provided with $3 million, was worth about $25 to 30
million a year. Therefore, instead of seeing a windfall of $9 million,
contended the board, it would be a potential loss of $27 million in
available health care.
Despite passionate arguments
against such an irredeemable recommendation, the state of Mississippi
closed its three charity hospitals by June 30, 1989. Another one of the
alternatives cited in the PEER report was that needy citizens could
continue to use the University of Mississippi Medical Center (UMMC) in
Jackson, hospitals under the Hill-Burton mandates and community health
Since that time, the U.S.
Congress has repealed Hill-Burton. However, even if Hill-Burton were not
repealed, those mandates would have expired by August of 2000. The
community health centers do a fine job with outpatient care, but do not
provide the trauma units, neo-natal services or in-patient care a full
service, fully funded public hospital could.
Even more compelling than
that, the number of patients seen by the UMMC has not drastically changed
since 1985. In 1985-86, UMMC saw an average of 26,214 patients, while the
three charity hospitals saw 10, 272 patients. In 19992000, UMMC saw an
average of 26,196 patients, while the charity hospitals had been shut down
for 10 years.
Where did those 10,000 extra
patients go? To this day, no one in the state of Mississippi knows. That
is the tragedy that is waiting to befall on the indigent and the uninsured
in the District of Columbia if D.C. General suffers the same fate as
Mississippi's charity hospitals.
If a public hospital in the
nation's capital closes for whatever invidious or nefarious reason, such
as upscale urban redevelopment, what hope is there for America to solve
its national health care crisis?
With that open-ended question,
I thank the chairman and the council for allowing me this opportunity to
testify at this hearing.