OVER THE past 10 years, the District has spent $179.7 million on the United Medical Center in Southeast Washington. What it has gotten in return is a perennially troubled hospital that has done little to meet the real health needs of residents in Wards 7 and 8. That experience — along with its calamitous operation of the old D.C. General Hospital — should have taught the city to stay out of the hospital business. Instead, officials are blithely talking about spending as much as $330 million to build a new hospital.

One reason is politics. Closing the only full-service hospital east of the river would cause an uproar. Just ask former mayor Anthony Williams (D), who had to weather the backlash after he made the hard but necessary decision to shutter D.C. General in 2001. That Mayor Muriel E. Bowser (D) faces a possible challenge from Vincent C. Gray (D), former mayor and current Ward 7 council member who has made a new hospital his cause, adds another wrinkle to the situation.

There is no question, as study after study has shown, of the health disparities faced by vulnerable populations in Wards 7 and 8 — or of the need for the city to play a role in helping to improve the quality of care. But as the District of Columbia Hospital Association pointed out in a recent position paper, a new hospital is not the cure-all for the health system east of the river. The group detailed the need for a community-wide infrastructure that includes a properly sized acute-care facility but also integrates multiple levels of health-care delivery, including preventive, appropriate specialty and post-acute care, as well as community and social services.

Administrative officials are in the early stages of planning for a new hospital that would be located at the St. Elizabeths campus. An outside consultant has been hired to develop a comprehensive proposal for structure and design. Among the questions that need to be answered: Given the financial struggles of United Medical, would a new facility be economically viable? Since Prince George's County is proceeding with plans to build a hospital nearby, is there an opportunity for a regional partnership that could better address the acute-care needs of Ward 7 and Ward 8 residents? Are there hospital systems interested in partnering with the District?

So far the District has not been successful in persuading the region's major health-care players to take over operations in Southeast. That's despite what sources told us were generous offers to protect against losses. Officials believe the new location — with its promise of an increasing and gentrifying population — will provide better opportunities to attract a partner. Recent problems at United Medical, including dangerous mistakes that forced the closure of the obstetrics department and horrifying revelations about the death in August of an nursing home patient, underscore the consequences of picking a partner that might not be up to the job.