Troubles at Howard University Hospital should concern us all

howard-300x231It may be easy to forget. But hospitals not that long ago refused to care for black Americans. If they did so, they kept them separate and far from white patients, shunning African Americans in separate wards in “freezing attics or damp basements.” Blood transfusions were taboo. The medicine was dismal and unequal, with black patients sometimes resorting to becoming test subjects to get any kind of treatment.

The nation’s capital also contributed its own notable example of a once-thriving such spot: Freedman’s in Northwest DC, which opened in 1862 and “stood out for the medical care it offered freed slaves and became an incubator for some of the country’s brightest African American physicians.”

But that venerable haven, known now as Howard University Hospital, has fallen far, the Washington Post says. Howard’s care, still for predominantly black and now poor patients, is unequal and lagging, the paper’s investigation found:

The once-grand hospital that was the go-to place for the city’s middle-class black patients has been beset by financial troubles, empty beds and an exodus of respected physicians and administrators, many of whom said they are fed up with the way it is run. The facility has faced layoffs, accreditation issues, and sexual harassment and discrimination lawsuits, and it has paid out at least $27 million in malpractice or wrongful-death settlements since 2007. …The Post reviewed more than 675 medical malpractice and wrongful-death lawsuits filed since 2006 involving six D.C. hospitals: Howard University, George Washington University, MedStar Georgetown University, Providence and Sibley Memorial hospitals and MedStar Washington Hospital Center. Of that group, Howard had the highest rate of death lawsuits per bed. The $27 million paid out by Howard represents just 22 of the 82 cases filed against the hospital and tracked by The Post; the terms of most of the settlements were not made public. The Post also found that Howard University Hospital has frequently been cited by the District for violating the hospital’s own policies, as well as local and federal laws. City health regulators have documented dozens of problems, including little oversight of medical residents, inoperable emergency room equipment, sloppy record-keeping and a lax nursing staff.

Howard’s leaders dispute the picture the Post draws, asserting conditions at the “safety net” hospital are on the rise after it partnered with Paladin Healthcare Management.

The situation will require public oversight and action. It serves as a painful reminder about pernicious gaps in the nation’s health care, as well as the perils of what some political partisans are pushing anew: caregiving that separates Americans, by economics, race, and other unacceptable criteria.

Much of the fury over the Affordable Care Act, aka Obamacare, has focused on a central element of health care: insurance to make it more accessible and affordable to all. But coverage is only one aspect of a system that’s incredibly complex—shocking though that may be to President Trump.

I’ve written how a consequence of the GOP efforts to repeal and replace the ACA may be Americans’ recognition, finally, that health care is not a privilege but a right. This also means that collectively the country must share in its risks and burdens. That’s a prime part of health insurance, which pools many and spreads costs and risks among them so no one individual gets hit too hard. This requires constant choices about trade-offs and balances. It also means that the country can’t have too disparate care, significantly better and supported, say, in California or Minneapolis than Mississippi and Texas.

Medical science, correctly, is struggling to identify and address health disparities—blacks’ struggles with hypertension, Asian Americans’ issues with diabetes, women’s challenges with reproductive cancers, the fair-skinned’s woes with melanomas.

For politicians, policy-makers, legislators, and all of us in the public, it may be as big an issue to take on and resolve legacy inequities in health care, tough talks and decisions about caregiving and race.

The Los Angeles Times won a Pulitzer Prize for its reporting on the dreadful conditions at King Drew, a local hospital known for its treatment of poor and black Angelenos. County officials were held to account for their neglect. And the academic and medical community also stepped up to share in major reforms. The hospital, by reports—most especially by those it serves, including its patients and community—has shed its infamy and is a much better albeit smaller place now.

Washingtonians should do as well by Howard, and especially by their fellow citizens who need its care, no matter their race or economic standing.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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