Although many of its residents receive inadequate care, the District of Columbia spends far more government money on health services than other large U.S. cities, reported a panel advising Mayor Marion Barry. In 1994, the city spent $852 per person in local aid, compared to $335 per person in Boston, $473 in New York City, and $743 in San Francisco--the city most devastated by the AIDS epidemic in the nation. Warnings about the state of the city's residents' health are not new. Compared with other cities, the District has the nation's highest death rates from cancer and liver disease and the most rapid spread of HIV. The panel blamed the expense and inadequacy of the District's health services on a lack of government planning and coordination of health services. It concluded that a number of city agencies that operate medical services sometimes duplicate their efforts and are poorly managed.

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