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Erik R. Fleming, Member, Mississippi House of Representatives
Testimony at
“National Public Hospital Safety-Net in Crisis: D.C. General Hospital in Focus,”
A Congressional Hearing Sponsored by Rep. John Conyers
March 22, 2001

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TESTIMONY AT THE MARCH 22, 2001 CONGRESSIONAL BRIEFING, "CRISIS IN THE NATIONAL PUBLIC HEALTH SAFETY NET - D.C. GENERAL IN FOCUS," GIVEN BY THE HONORABLE ERIK R. FLEMING, MEMBER, MISSISSIPPI HOUSE OF REPRESENTATIVES, DISTRICT 72.

To Chairman Conyers, Members of Congress, Ladies and Gentlemen:

Good Afternoon.

My name is Erik R. Fleming and I am a member of the Mississippi House of Representatives from District 72. I have served in the House since 1999, representing approximately 25,000 people.

One of the issues that are important to my constituents is quality health care. My district is considered the most affluent African-American district in the state of Mississippi. Yet, I know there are a significant number of people in my district that are not covered by health insurance.

In fact, according to the most recent statistics, a 1997 survey by the Urban Institute, there are some 476,000 Mississippians that do not have health insurance. That's around 17 percent of the state's population.

I believe the District of Columbia has an estimated rate of 27 percent uninsured, some 150,000 people. Of the number of patients that D.C. General treats, 55 percent of them are uninsured.

However, instead of having a discussion concerning the expansion of D.C. General and how their medical expertise could help my state handle its health crisis, there is a move afoot to close the doors of this institution, an institution of health care, which has been a beacon of hope on the Anacostia River, since 1804.

I am here to recommend to all who would hear this testimony that closing D. C. General Hospital would exacerbate the problem of health care in this city and in this nation. Use Mississippi as an example.

In 1987, it was recommended that the state's three eleemosynary, or charity hospitals should be closed. That recommendation came from a Louisiana physician hired as a consultant by the state's Performance Evaluation and Expenditure Review, or PEER, Committee.

The PEER Committee report (#184, 2/17/87) suggested that there were 13 alternate ways to treat indigent citizens of Mississippi, including taking the money that was used to fund the hospitals, and putting it into the Medicaid system. The theory was that the $3 million the Legislature appropriated to the hospitals could be turned over to Medicaid, which would generate more jobs and give the state a return of $12 million for health care.

According to the state's Eleemosynary Board that oversaw the hospitals, the amount of care the three hospitals provided with $3 million, was worth about $25 to 30 million a year. Therefore, instead of seeing a windfall of $9 million, contended the board, it would be a potential loss of $27 million in available health care.

Despite passionate arguments against the action, the state of Mississippi closed its three charity hospitals by June 30, 1989. One of the other alternatives cited in the PEER report was that citizens could continue to use the University of Mississippi Medical Center (UMMC) in Jackson, hospitals under the Hill-Burton mandates and community health centers.

Since that time, the U.S. Congress has repealed Hill-Burton. However, even if Hill-Burton were not repealed, those mandates would have expired by August of 2000. The community health centers do a fine job with outpatient care, but do not provide the trauma units or the in-patient care a hospital could.

Even more compelling than that, the number of patients seen by the UMMC has not drastically changed since 1985. In 1985-86, UMMC saw an average of 26,214 patients, while the three charity hospitals saw 10, 272 patients. In 1999-2000, UMMC saw an average of 26,196 patients, while the charity hospitals had been shut down for 10 years.

Where did those 10,000 extra patients go? No one in the state of Mississippi knows, and that is the tragedy that is waiting to befall on the indigent and the uninsured in the District of Columbia if D.C. General suffers the same fate as our charity hospitals.

If a public hospital in the nation's capital closes for whatever invidious or nefarious reason, what hope is there for America to solve its national health care crisis?

With that question, I thank the chairman for allowing me this opportunity to testify at this briefing.

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