No easy solution to Prince George's hospital mess -- Gazette.Net


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Are the stars finally aligned for a new regional hospital in Prince George’s County?

After 15 years of failing to end the county’s hospital crisis or stem the bleeding that has cost the state and county huge sums of money, political leaders seem to be in alignment.

Yet we’re far from the finish line.

All that has been achieved is an agreement in principle. Key concerns must be addressed to everyone’s satisfaction.

At the top of the list is paying for a brand-new, $600 million teaching hospital in the central part of the county run by the University of Maryland Medical System and serving Prince George’s and Southern Maryland residents.

That’s a staggering amount to raise. Just last week, Comptroller Peter Franchot warned Maryland “is fast approaching” its self-imposed debt limit. Floating another $200 million in bonds for the Prince George’s medical complex could blast a gaping hole in that ceiling.

This would only cover a third of the construction. Politicians in Prince George’s must come up with their third — which is feasible through bond issues — and the state’s hospital regulatory commission must agree to charge even higher rates for hospital care in Prince George’s.

All that assumes a lot.

It assumes 100 acres of land can be found in the central part of the county, preferably near the Capital Beltway and U.S. Route 50.

It assumes the perennially deep-in-debt and mismanaged Dimensions Healthcare, which runs the hospital system, can find a way to pay off its $160 million in IOUs and not accumulate more losses.

It assumes Prince George’s political leaders remain steadfast in their unity for a regional hospital and don’t return to the bad old days of political interference in the hospital’s hiring, management and fiscal affairs.

It assumes the University of Maryland Medical System — a private nonprofit despite its public-sounding name — finds the eventual plan financially realistic and operationally achievable. Otherwise, UMMS wouldn’t participate.

It assumes the University of Maryland in College Park and Baltimore will populate the new campus with medical residents, visiting physicians, nurses, dentists, pharmacists and social workers (all from Baltimore) and public health professionals (from College Park). It also assumes UM won’t be devastated by federal budget and deficit-reduction cuts.

And it assumes the rate-setting commission finds a way to support the new hospital. There will be opposition from health insurers and other hospitals whose own rates would be reduced to offset the large increases required in Prince George’s.

In many ways, the lack of a quality medical center symbolizes Prince George’s unmet aspirations. Despite pockets of affluence and a thriving upper middle class, the county lacks amenities associated with a well-to-do jurisdiction of 865,000 people.

The one bauble in the county is the National Harbor waterfront resort. But even there the exciting new addition being built for county residents is a large outlet center.

Time and again, state politicians have tried to straighten out the county’s self-inflicted hospital morass. Every time, political infighting, jealousies or greed got in the way. Making matters even tougher is the fact that 25 percent of the hospital’s patients are uninsured.

It has reached the point where County Executive Rushern L. Baker III (D), who is a prime mover for reform, told a UMMS committee that the hospital situation is “an embarrassment.” No one disagreed.

Every year, 25,000 sick residents with health insurance leave the county to get in-patient treatment at hospitals in the District of Columbia or in surrounding jurisdictions.

This illustrates the low regard local people have for their local hospital. A huge economic stimulus for the county — a thriving health care system — is lost.

UMMS paid for its own consultant study of the Prince George’s health care situation.

The conclusion: With a new hospital and a professional staff beefed up by UM’s School of Medicine, it is possible to keep patients from traveling long distances for their surgeries and medical procedures.

Such an arrangement also should attract many more insured, middle-class county patients if they have confidence they’ll receive quality treatment.

But UMMS is a $2.7 billion medical behemoth. It has fiduciary obligations to its hospital partners throughout the state. Unless the deal is viable, UMMS can’t afford to participate and risk endangering its own financial health.

Much depends on Baker’s ability to keep local politicians unified behind a plan in which the county agrees to major sacrifices. That’s essential for gaining support in Annapolis.

It might not be simple. It could require a series of deals with the Montgomery County and Baltimore area delegations, which might block the hospital deal unless there is offsetting support for their own capital projects.

The agreed-upon concept of a high-class medical center in Prince George’s with strong ties to a medical school and academic health care professionals could be a winner but only if the political and financial obstacles can be removed.

Much heavy lifting remains to be done.

Barry Rascovar is a State House columnist and communications consultant. His email address is brascovar@hotmail.com.