Muddled thinking by Steven Pearlstein (Post business columnist)

In my opinion, week-in, week-out, Steven Pearlstein, the business columnist for the Washington Post, is pretty damn good. I could count less than the fingers on my two hands the times I've probably disagreed. However, today's column takes up more than one digit... The column "The Right Cure for Howard's Hospital," is a muddle of under-considered points.

He does make a good point, linking the problems of Prince George's Hospital, Greater Southeast Community Hospital, and Howard University Hospital to the fact that these hospitals serve a great number of people with chronic health problems, and that they are likely to be uninsured.

Although I have been writing about this for some time such as this entry from last August, "Prince George's County's problems as but one more example of the impact of outmigration." In another entry around the same time I wrote:

Most DC Hospitals lose money. So does the Prince George's County Hospital, which should be thought of as a DC hospital in some respects. Most people use emergency rooms as their primary health care facility. Yet that is an inefficient and ineffective way to obtain health care. Plus, it's very expensive.

Wellness care is different from the care needed when people are very sick.

Health insurance programs were created not to ensure health, but to provide regularized income streams to hospitals during the Depression.

Pandering won't make people feel better if they are sick, although they might feel better politically.

In any case, shouldn't we really take this opportunity to address the real question, and come up with answers that truly solve the "problems".

But he messes it up by suggesting that PG Hospital and Greater Southeast are best closed and demolished in favor of a new HUH in Ward 6. How he jumped from persistent financial problems, problems that perhaps have exceeded the skill level of their management entities, to a need to demolish two hospitals and abandon a third and start fresh takes the argument that I call "blaming the building" to a new level.

Because most hospitals lose money, it makes sense for other hospitals to be concerned about adding more hospitals to the region's health care "system," it's not merely a matter of trying to out-lobby the competition (although yes, that is an element) as he argues.

The issue of providing under-compensated hospital care to people of limited means is an issue. So is providing the best kind of health and wellness care system to best address the health needs of this population.

Considering this issue in tandem, including evaluating the financial problems of Howard University Hospital, Greater Southeast Community Hospital, and Prince George's County Hospital--which would require Prince George's County and the State of Maryland to join with DC and study this issue--is necessary.

Deciding the issue in advance, as Mr. Pearlstein has done, helps no one.

As I wrote in January:

[H]ealth care and hospital issues in the area are regional issues that transcend political boundaries, given the financial problems with the Dimensions Health Care system in Prince George's County, Maryland. The Washington Business Journal, in "Gasping for air," editorializes about this in the [1/20/2006] issue:

The Cheverly-based nonprofit organization that runs the county-owned hospitals in Prince George’s County needs to find money – and must find it before the end of March. Dimensions has lost more than $50 million since 1999. The management company, which oversees Prince George’s Hospital Center, Laurel Regional Hospital, and Bowie Health Campus, has gone so far as to develop contingency plans to close the hospitals by April if additional assistance can’t be found. While the state and county have to step up and offer any necessary assistance to keep the much needed hospitals from turning away patients, the potential partnership between the University of Maryland Medical System and Dimensions appears to be an ideal long-term solution. The UMMS would likely pump new life into a health care system that Prince George’s County and the state have allowed to fall into serious disrepair. Besides being what many see as an ideal partnership for the county and the university, the deal quite possibly is the last hope for the residents of Prince George’s County.

It's amazing to me that these two hospital planning processes are occuring simultaneously, with seemingly no connection between the projects.
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Developing a "solution" for Howard University at the further expense of other hospitals doesn't appear to be the best use of precious resources.

If, after a true comprehensive planning process, that is a decision that DC and Prince George's County decide makes sense, after also assessing in a more in-depth fashion how best to achieve improvements in the wellness outcomes of people with chronic health problems, then I'd be the first to jump up in favor.

Index Keywords: health-care-planning