Evening star., 1946-08-11
D. c. Hospital Facilities
Fall Far Short of Needs
Expansion Now Under Way Raises Bed Capacity
To Only About IS Per Cent of Requirements;
Greater Federal Participation Urged
By Alan Johnsfone
General Counsel Federal Works Agency.

OHnSfOne
eral Works Agency.
To state the case in another way,
hospital requirements in the Capital
City of the United States are being met
to the extent of only about As per cent,
and the manner in which even that
small portion of the need is being met
leaves much to be desired.
How much would it cost to make good
this alarming deficit? Estimates vary,
and there is considerable price uncer-
tainty at present, but in the opinion Of
competent authorities the total bill, in
cluding the cost of land, buildings and
equipment. would be about as follows:
l. $50 additional new beds
aside from the two uni
versity hospitals now build
ing) at $4,000 per bed. in
cluding auxiliary facilities $4,000, 900
2. Complete replacement of
1000 existing beds at $4,000
per bed Observation-Disclosures 1900 900
3 Remodeling of certain ex-
isting hospitals -- 1000 900
Total 900, 900
Large as that sum Is. it doesn't tell
the whole story. To it must be added
an estimated s5.000,OO0 which would be
required for expansion and alterations
of public hospitals. The total bill, there
fore, comes to $4,000 900 in round fig
ures. That this sum is needed cannot
be doubted No one conversant with
the situation has challenged the esti-
mates, or disputed the statement that
without some such investment isolation
of contagious diseases, humane treat
ment of the mentally i'll and the indi-
gent sick, and even the minimum re-
quirements for safety, and for sanitary
and competent hospital service to the
population cannot be met.
Hospital Center Limited.
Congress has acted to meet this sit
uation by enactment of the bill, S. 223.
1t provides for the construction by
the Federal Works Agency of hospital
center, estimated to cost between $l5,-
100000 and s2o,ooO,oo0 And while tho
center. theoretically, would be open to
the District, the hard facts of the situa-
ton would limit participation to no more
than three of the institutions, leaving
nine nonprofit private hospitals without
assistance. For while the bill authorizes
an appropriation of $35, 900 900, which Is
the amount estimated to be needed to
meet the entire need (aside from that
of the public institutions, 1t was di-
vested by amendment in the House OF
those provisions which would have made
possible assistance in the form of grants
to the hospitals not affected by the
proposed hospital center. So here we
have curious legislative quirk by which
an appropriation to meet the greater
need Is authorized while the power to
meet most of the need is denied!
In its original form the bill contem-
plated the formation of a corporation
with board of trustees representing the
participating hospitals, the District gov
ernment, the Community Fund and the
Federal Government. The corporation
was to plan the hospital center, which
would be constructed for its account
by the Federal Works Agency at Fed
eral expense. The title to the center
would have been conveyed to the COR
poration, which would agree to- repay
80 per cent of the cost, plus per cent
interest, over period of so years.
The 70-30 division of the cost between
the corporation and the Federal Gov
ernment was suggested by Maj. Gen.
Philip B. Fleming, Federal works ad-
ministrator, for while Federal aid to the
States customarily has been on a $3.50
basis, he pointed out that the peculiar
situation of the District as ward of the
Nation under the guardianship of Con-
gress makes a $3.50 division nrealistic
here. Incidentally, the cost division in
the construction of the George WASH
ington and Georgetown University Hos
pitals under the Lanham Act is also 80
per cent for the sponsors and 10 per
cent for the Federal Government.
The administrator also questioned the
surrender by the Federal Government Of
all control over so large an investment Of
money.
AS enacted, the bill does away with
these objections. 1t authorizes the Fed
eral works administrator to enter into
lease arrangements with the participate
ing hospitals and makes the District it.
self rather than a corporation respon-
sible for the repayment of the sponsors
80 per cent of the cost, at such times
and in such amounts, without interest,
as the Congress hereafter may direct.
The hospitals going into the center
are required to assign their physical
assets to the Federal Works Agency
and 80 per cent of any future sale price
shall be credited toward the Districts
80 per cent share of the total cost
New Formula Needed.
While it cannot be contended that the
Districts hospital needs have been fully
met by this legislation, since it leaves
without assistance most of the city's
hospitals, long stride in that direction
has been taken. And, incidentally, it
may contribute substantially to the ulti-
mate solution of the Districts financial
problems. 1t is obvious that the Dis
trict's 80 per cent contribution cannot
be met out of existing sources of tax
revenue. 1t would seem unavoidable.
therefore, that Congress will be forced
to assist the District to find the means
of meeting its obligation, and from that
circustance may come the long
awaited overhauling of the fiscal rela-
tionship of District and Federal Gov
ernments.
Another development, perhaps funda-
mentally more important than Federal