Dr. H. W. Foster Testimony to Congressional Briefing, March 22, 2001

[Dr. Henry Foster, a national figure in health care, was nominated to be the U. S. Surgeon General on February 2, 1995.]

I commend the committee, and Congressman Conyers, for holding this briefing today on the "National Public Hospital Safety Net in Crisis: D. C. General Hospital in Focus." The threatened close down, or curtailment of functioning of D. C. General Hospital would be a national tragedy, and parallels similar health disasters around the country. . I support very strongly the effort to keep this hospital open as a full service hospital.

I would say, in fact, that we have an obligation to keep this facility available. When a public service - a crucial service, such as D. C. General Hospital - cannot be obtained through the free market society, then there is an obligation for us to provide that service. That is clear. The implications of closing this hospital will translate into adverse health care outcomes and, obviously, in the long run, this will have negative economic consequences. We have a moral obligation to keep this facility open - unless, and this is an important point - unless there are facilities that can meet these needs otherwise. However, from what I understand, the loss of this hospital as a full service facility would create a void that would go unfilled. Therefore, as I said, I strongly support this effort in support of this hospital.

Now, we should also consider this issue from the standpoint of the national objectives of U.S. health care policy. A major objective of US Health Care policy has been to close disparities in health care - this directly relates to the effort of the Center for Disease Control (CDC), and Health and Human Services (HHS). This has been the stated national policy. Now closing this hospital will actually go in the opposite direction of decreasing health outcome disparities - and therefore, the opposite of stated national policy. We talk about getting rid of health disparities, but then consider doing something that is completely negative to that policy. Closing this hospital is, in fact, a contradiction to national policy, a mitigation of it - because - it will decrease access and utilization of critical services.

There is much more I could say on this question, and its implications for national health care policy in general. However, I will close my statement here. Again, I think our obligation as public and health officials is clear. D. C. General Hospital should remain as a full service facility for the citizens of this community If anything, the hospital should be expanded and improved -- as should our national health care systems in general. We are talking, after all, about life, and about death.