"I know the service delivery system is not there [east of the Anacostia River] in ways it is in other parts of the city," D.C. Mayor Vincent Gray said last week as he introduced Dr. Mohammad N. Akhter as the new-old director of the Department of Health. "[The problem] isn't about access. It isn't about availability. It's less about health care coverage," Gray continued. "We have to be able to change health care behaviors."
In other words, the city's new mayor is from the force-the-horse-to-drink-school. Good luck with that.
For decades, elected officials and advocates have decried the government's so-called lousy treatment of residents east of the river, particularly in Ward 8. The recent record disputes their contention of disinterest and neglect.
Despite its meager revenue stream, the District has nearly exceeded other states in the free or low-cost health services it provides to residents -- many from Wards 5, 7 and 8. In addition to its trendsetting Health Care Alliance insurance program, the city funded what is known as medical homes or neighborhood clinics that focus on preventive services. Last year, the city invested millions of dollars to shore up United Medical Center, the only hospital in Ward 8. Earlier this year, when Specialty Hospitals of America didn't meet goals set by the government, the District reconstituted UMC's board and assumed authority. A new owner is being sought.
"There is no question people east of the river deserve better health care delivery," said Akhter, who served as the District's commissioner of public health from 1990 through 1994. That was when Sharon Pratt (Kelly) was mayor. At that time, Gray, as director of the Department of Human Services, technically was Akhter's boss.
During those years, as a daily reporter, I covered Akhter's commission. I knew him to be a dedicated, hardworking administrator. A Pakistani, he brought a Third-World missionary zeal to the job. I had great respect for him and regretted his departure. When he left, he blasted the bureaucracy, complaining of cumbersome procurement rules and insufficient funding, among other things.
The more things change, the more they stay the same: There may have been some reforms in procurement, but that system still needs a lot of work. The city faces a possible $440 million budget deficit in fiscal 2012.
Currently the senior associate dean for public and international health at Howard University's College of Medicine, Akhter said his return is a "great opportunity to set the system right -- to redo some things." Neither he nor Gray outlined what they think needs to change at the mammoth agency charged with everything from HIV/AIDs prevention to vital records administration, professional licensing, immunization and community health.
But, if Gray and Akhter have decided they should be evaluated based on whether people actually avail themselves of certain programs, they may have set themselves up for failure. After all, government can only provide the services. People have to decide whether to use them.
Jonetta Rose Barras's column appears on Monday and Wednesday. She can be reached at firstname.lastname@example.org.