In Prince George's, an impasse over health care risks the health of tens of thousands.

THE WRESTLING match for control of Prince George's County's main health-care network is perilously close to a point of no return.

County officials, intent on taking effective control of Dimensions Healthcare System, which runs Prince George's Hospital Center and a number of smaller facilities, are withholding millions of dollars in subsidies. Dimensions, which has lived hand-to-mouth on those subsidies to supplement its own anemic revenue stream, is suing for the money. There is a danger, within the coming weeks or very few months, that Dimensions, starved of cash, will be forced to close a network that serves 180,000 patients a year.
So frequent are the standoffs, warnings of impending doom and countdowns to disaster that the crisis has taken on the aspect of a daytime soap opera, the critical difference being that the health and welfare of thousands of real people are on the line. As they bicker and snipe at one another, the principals in this real-life drama run the risk that a benumbed public will simply stop caring -- until it's too late. And as they struggle over power, personnel and money, officials from both the county and Dimensions have lost sight of the only meaningful goal, which is to devise a workable plan to ensure the long-term stabilization and vigor of the health-care system.

Meanwhile, valuable paying patients as well as doctors may lose trust in Prince George's Hospital and abandon it for other facilities. Dimensions' bond owners, who hold tens of millions of dollars in long-term debt, may demand to be repaid on an accelerated schedule. Either scenario could doom the hospital, and the county's entire health-care system, in short order.

Officials at Dimensions as well as in the county may believe that state officials will ride to the rescue. It's a risky gamble. The state did set aside $20 million for the health network in April, but that money came with strings attached; it was to be used either to help fashion a long-term restructuring for Dimensions or to finance its orderly shutdown. It was not for bridge loans or other quickie fixes. And it is worth bearing in mind that the state, facing a $1.5 billion shortfall in next year's budget, has its own financial problems.

Jack B. Johnson (D), the Prince George's county executive, is behaving as a fine political tactician but a poor long-term strategist. By withholding $2 million in subsidies due last month to Dimensions, plus another $12 million due in the fiscal year that began this month, he hopes to force the network to bend to his will -- specifically, to pack the Dimensions board with four new Johnson loyalists. But in focusing his energies on that battle he has lost sight of the wider struggle to reform the county's main hospital system -- a job best done under state, not county, auspices. Mr. Johnson should step back from the precipice and focus on the larger stakes.

source:www.washingtonpost.com