Hospital crisis in DC

If they do close, the picture gets even worse. The remaining District hospitals get hammered. Some have threatened to close their trauma centers and ERs if the D.C. government lets Greater Southeast close; that is the prod being used to force the city government to continue support (which it promised to do after closing D.C. General Hospital in the late 1990s, because it was costing the city too much money.) This isn’t the first crisis with Greater Southeast. There was another major one a couple of years ago when their receivables re-seller defaulted, depriving them of needed income for operations. At that time payroll and suppliers were in default.

D.C. is not “run by Congress.” The District has been governed by a home rule process for nearly four decades. The mayor and city council are elected. Because of spectacular and abusive corruption and mismanagement, the city was put in a type of receivership whereby the mayor was effectively stripped of nearly all fiscal authority. This was in fact a good thing, as the then mayor, Marion Barry, ran an egregiously corrupt and abusive administration while the city went bankrupt. The receivership plan was the only option save a de facto revocation of D.C. home rule and an outright takeover of city’s day-to-day management by the Congress. The latter was a situation neither the city council nor the Congress wanted, for different but equally compelling reasons.