Poorer communities of color in the region around the nation’s capital are inching toward getting more equitable hospital care — with new facilities slowly coming online to replace decrepit and risky institutions.
Politicians and public leaders in Maryland celebrated a decade-long fight to see the opening in Largo of a new hospital, a “620,000-square-foot, glass-paneled facility [that] will replace the 75-year-old Prince George’s Hospital Center in Cheverly,” the Washington Post reported.
The new University of Maryland Capital Region Medical Center, near the Largo Town Center Metro station, had been stalled for years in political and regulatory battles over its size and funding. It will be part of the University of Maryland Medical System’s network of 13 hospitals, and officials hope it will anchor major development in Largo.
Proponents pushed for the hospital to have more beds than it will open with — 205 versus the 235 that its Cheverly predecessor had. But after years of wrangling, getting the $550-plus-million facility launched, as is, with $400-million in state and county funding, will be a key step in addressing documented health care inequities in the area, advocates said. As the Washington Post reported:
“[I]n Prince George’s … residents disproportionately suffer from conditions such as heart disease and diabetes and there are far fewer physicians and hospital beds per capita than in neighboring jurisdictions. The county has 0.75 hospital beds per 1,000 residents, for example, compared to 1.47 in Montgomery County, 1.47 in Fairfax County and 3.42 in the District [of Columbia].”
A longtime problem for politicians and patients
The Cheverly hospital was the flashpoint for decades among residents and state and local politicians, as the facility slid into decline. Hard, real-life experience and research studies found that the financially embattled and poorly run hospital contributed to its own exodus of medical talent and patients. While it still provided crucial emergency and trauma services to a huge area, it also struggled with problems, such as the closure of its neonatal intensive care unit due to a bacterial outbreak tied to its crumbling infrastructure, notably its plumbing.
Republicans, notably Gov. Larry Hogan, resisted plans to alter the running of a regional hospital to replace Cherverly, arguing plans pushed for Democrats were too ambitious and costly. The new Largo hospital will be smaller but can be expanded later. As it officially opened on June 12, the Baltimore Sun reported this:
“The 11-story, 205-room hospital [occupies] a 26-acre site. It will offer a 41-bay emergency department with a trauma care, 32 intensive care beds, two endoscopy suites, two catheterization labs, eight operating rooms and a 15-bed pediatric unit operated by Mt. Washington Pediatric Hospital, a joint venture of [the University of Maryland Medical System] and Johns Hopkins Medicine.”
The Washington Post reported that Joseph L. Wright, chief medical officer for Capital Region Health, showed off before its official opening the hospital, which will feature private rooms:
“Wright led a tour of the hospital with reporters last week that included light-filled rooms with views of gardens; a new heart and vascular institute; pediatric beds; and a rooftop with two helipads. Wright said the goal is to draw new patients from the county and create a network of care that prioritizes preventive medicine, in addition to taking care of people once they are sick. Touring a spacious maternity delivery room overlooking a flower-filled garden, Wright talked about the high percentage of county residents who give birth at hospitals outside Prince George’s — a figure that Rand Corp. put at 85% for hospital-based births in 2017. ‘We really, really want to deliver babies close to home,’ Wright said. ‘And we know the aesthetic is important.’ He said the 16-bed cardiovascular unit, taken together with the institute the hospital launched last year, means physicians will be better able to address one of the leading causes of mortality in the county. ‘The intent is getting ahead of the disease progression before they require heart surgery,’ Wright said. ‘So many patients present to us in a state of severe disease progression.’”
Progress on new D.C. hospitals
Even during the pandemic, District officials have pushed ahead with their plans to support construction of two new hospitals that will serve impoverished communities of color. The facilities will be in Wards 1 and 8 and will replace the Howard University Hospital and the United Medical Center (UMC) in Southeast D.C.
D.C. Mayor Muriel Bowser announced in March the awarding of a construction management contract to a joint-venture between Turner Construction Company and MCN Build for the new hospital at St. Elizabeths East in Ward 8, which will be run by George Washington University Hospital and its parent company, Universal Health Services (UHS). That news release also noted that:
“The District’s plan to develop a new 136-bed hospital at St. Elizabeths East and improve the District-wide system of care includes opening two new urgent care centers in Wards 7 and 8 by UHS. Last month, the Mayor and UHS announced that the first Urgent Care Center will open by the end of 2021 at the Maple View Flats development in Ward 8. The District and expect the facility in Ward 7 to open in 2022.”
Last September, District officials advanced the deal with Howard to rebuild its hospital and provide more services in exchange for government funding, notably a tax abatement. As the Washington Post reported last fall:
“A $225 million tax abatement for Howard University sailed through the D.C. Council [on Sept. 22], a day after an ethics probe revealed how the university offered to create a job for a high-ranking city official even as it was seeking the official’s support for a bigger tax break. The legislation lowers Howard’s future property tax bills in an effort to boost the university’s planned redevelopment of land it owns along Georgia Avenue NW, which would include a new hospital and mixed-use development. It’s part of a broader effort to improve health-care access in D.C. and build better hospitals for some of the city’s poorest residents — a project that has drawn widespread acclaim…”
Former City Administrator Rashad Young was found to have inadvertently violating District conflict of interest rules in discussing a job with Howard, while negotiating over the hospital with the university. He was fined $2,500, resigned from his post, and joined the school.
In my practice, I see not only the harms that patients suffer while seeking medical services, but also their struggles to access and afford safe, efficient, and excellent medical care. This has become an ordeal due to skyrocketing cost, complexity, and uncertainty of treatments and prescription medications, too many of which turn out to be dangerous drugs. For communities of color, unacceptable and persistent inequities in society and notably in health care only worsen the problems of access and affordability as well as safety and quality of medical care. These issues all got exposed even more during the coronavirus pandemic, which has infected and killed black and brown patients hard.
Those who pushed for the new Prince George hospital expressed their sadness that the facility was delayed and could not help patients in desperate need more during the pandemic. But getting folks moved out of Cheverly and into a better place will be an improvement by itself. The prospect of even more and better hospital care for an area that had lacked it is something we all need to watch and praise. Still, we have much work to do to ensure that racial injustice is never a part of modern medicine. In the wealthiest nation in the world, health care must be a right, not a privilege for the wealthy few. And it cannot be separate and unequal.