Wash Business Journal: Councilmember Catania Interview

David Catania switches focus from health care to education

Premium content from Washington Business Journal – by Melissa Castro

Date: Wednesday, November 24, 2010, 12:01pm EST

Related:

Health Care, Insurance, Education

Enlarge Image

Catania

Fiercely independent D.C. Councilman At-large David Catania, a former lawyer, currently chairs the council’s Committee on Health. From that perch, he has fought to preserve and rebuild the beleaguered United Medical Center, to limit the ability of D.C.’s largest private insurer to raise premiums and pad reserves, and to improve the health of D.C. residents.

Catania was re-elected Nov. 2, and has since expressed interest in giving up the health care committee in favor of chairing a new education committee that would oversee the 50,000-student public school system.

Here are excerpts from an interview about Catania’s view of health care in D.C.

Why do you feel it’s important for D.C. to maintain ownership of United Medical Center? I don’t want to sell today, tomorrow or the day after because we’re in the process of paying off certain creditors, and improving services and revenue. We foreclosed on the hospital in July. On Sept. 27, we opened a fantastic new pediatric center in partnership with Children’s National Medical Center, and the utilization is already off the charts. We recently opened a skilled nursing center. We’re introducing an obstetrics center in early November that will more than double the number of births there — and every baby born there represents $3,500 in revenue. We will soon have an announcement with Howard University Hospital about bringing more HIV services to UMC. We recalibrated our charity care and Medicaid reimbursements to better reflect the costs the hospital was bearing. The hospital’s chief financial officer has produced a 2011 budget showing the hospital will take in $10.6 million more in revenue than expenses, so going forward we’re going to have a hospital that’s actually making money and can use that money to further enhance its services and equipment.

So why not sell that hospital to the highest bidder? It will take a few years for this reality to be reflected on the balance sheets. In 2010 America, where nonprofit hospital corporations are nervous about the economy and their future, well-resourced and well-run entities are too risk-averse to take a chance on a hospital with this track record. I think health care reform is really exciting because it will mandate that all states have to provide insurance to childless adults who make up to 133 percent of the poverty level. The District has already been doing that; Maryland and Virginia do not. Rather than our hospitals subsidizing our neighbors by providing more than $50 million a year in charity care, these suburbanites will have insurance.

D.C. has relatively few specialists, due in part to the high malpractice premiums they pay here. Do you think that’s something worth fixing? That’s utter nonsense. This city has one of the highest concentration of specialists in the country. It’s ironic to me that these states take on a superiority complex but when it comes to taking care of their poor and sick citizens, they do nothing but direct them to D.C. When do I get to have a story about how Maryland and Virginia have no safety net other than to send their poor to D.C. to receive care on our dime, while working in our city and paying no taxes here? We do all this while having half the rate of uninsured residents that Maryland and Virginia have, and the lowest rate of uninsured children in the country (3.2 percent).

What drives you? I do believe that health care is a fundamental right. And we are a rich city with enough resources for all of us to have high-quality health care — not just access, but high-quality care. I would not tolerate for a minute any one of my wards going without a high-quality hospital — it’s just my responsibility to make sure we do our part to insure our health care succeeds.

Did you feel that way when you were a Republican? I always believed in the safety net, even when I was a Republican. I still believe in the free market system, but markets are not perfect. The role of government is to step in and fix those market imperfections. The only way we’re going to have a civil society is to build a civil society — not by leaving a quarter of the population to their own devices. One of the reasons I’m so committed to this hospital — despite people saying the city has no business being in the hospital business — is to prove that this hostility toward government is wrong.

Let’s talk about CareFirst. The District has passed legislation to force it to reduce its reserves and to limit its premium increases. With the uncertainty surrounding reform, they felt they needed to increase their reserves. Do you think the council’s relationship with CareFirst is improving? I do. We worked through our disagreements. I don’t think the public is well served by blood feuds, but I also don’t see how the public benefits from allowing CareFirst to accumulate huge reserves in a way that forces people off of insurance.

What do you want the business community to know about your work? Our efforts to expand and improve our health insurance system, and to improve public health — for instance, our smoking cessation efforts — will ultimately mean fewer costs coming out of the pockets of businesses. We have some very challenging pockets of poverty and a very, very challenging legacy of disparities in health care. It’s a challenge to address those issues and not overly tax the business community. But I think we’re doing a good job of meeting those challenges.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: