The government’s decision to shutter D.C. General Hospital in May 2001 split the city. Poor folks who depended on the ramshackle medical facility on the west bank of the Anacostia River were furious. D.C. General had served as the city’s public hospital for nearly 200 years. Closing it became a symbol of the city’s neglect of poor African Americans who lived east of the river. Why, they wondered, were so many top-notch hospitals in Georgetown and Upper Caucasia? Advocates rallied and marched. Politicians took sides and hunkered down. The city’s sick worried.
A decade later, is the nation’s capital in better health? Can poor folks get decent medical care? Do we need another D.C. General?
I stopped by the annual meeting of the D.C. Primary Care Association on Thursday to try and get some answers. If any person in the city has a sense of the city’s progress, it would be Sharon Baskerville, who has directed the nonprofit since its inception in 1998.
So, has health care improved?
“Absolutely,” says Baskerville. “Instead of depending on an extremely expensive hospital, we have created a system that offers a continuum of care.”
Baskerville is one of those extraordinary leaders who sits atop a complex organization yet manages to remain close to the streets and the people who need care. She’s a fighter. She knows.
“Relying on D.C. General was a broken system,” she says, because sick people would show up at the emergency room for everything from colds to HIV/AIDs to gunshot wounds. “Now we have a system where people can receive basic care, preventive care, medications and hospitalization, if they need.”
Baskerville is a primary architect of that system. The District now has an estimated 60 community health facilities. Her association represents 14 nonprofits that operate 48 of those health care centers. Baskerville battled to control $70 million in funds from the tobacco settlement and devote them to building health centers. She leveraged the funds to build five facilities and refurbish eight more.
She credits Alice Rivlin, who was on hand Thursday, and the financial control board for making the unpopular decision to close D.C. General and create a system that would provide care for people with or without Medicaid.
The startling fact — to me, at least — is that about 240,000 of the city’s residents are eligible for Medicaid, the federal program that subsidizes health care for the poor. That’s nearly half of the people who reside in the nation’s capital. So are they healthier now?
“Is there better access? Better care?” Baskerville asks. “Yes.”
Though the care is available, too many poor people won’t use it or cannot advocate for themselves and demand the care. Result: D.C. still ranks in the top 10 for cities where chronic illness — such as stroke, hypertension, diabetes and HIV — afflicts the community.
“We have to keep trying to make the new system work for everyone,” says Baskerville.
Does that mean we need a new D.C. General? No way.
Harry Jaffe’s column appears on Tuesday and Friday. He can be contacted at [email protected].
