The example of South Los Angeles
A City Where Hospitals Are as Ill as the Patients
By Jennifer Steinhauer
The New York Times
June 5, 2008
For thousands of residents of South Los Angeles who had depended on the large county-run King-Harbor hospital, the past 10 months have been a grueling exercise in cobbling together medical care. When King-Harbor was shut by federal officials, it became the 15th general acute care hospital to close in Los Angeles County since 2000, about half of which served residents in South Los Angeles.
The loss of King-Harbor was less a seminal moment than another episode in the continuing health care ordeal among this city’s sickest and poorest residents.
South Los Angeles is one of the most difficult places in the nation to both receive and give medical care. Family doctors are few and far between, and the area is one of the hardest to draw new doctors to, physician recruiters say.
The vast majority of residents in central Los Angeles are uninsured or are on the state’s Medicaid program — known as Medical — which offers the lowest reimbursement rates in the nation, and a growing population of illegal immigrants who are not eligible for government insurance have flooded the ranks of the uninsured.
Gov. Arnold Schwarzenegger, a Republican, has proposed another 10 percent cut in the state’s Medicaid program to balance the state’s budget while Congress contemplates a host of reductions to the program that, if approved, would mean $240 million less for Los Angeles.
From 2000 to 2006, the number of Medicaid-covered patients using the South Los Angeles hospitals on Medicaid increased 18 percent and the uninsured ranks rose more than 20 percent, while patients with commercial coverage fell 20 percent, according to the hospital association’s figures.
As a result, many hospitals in the South Los Angeles area are unable to stay afloat, and centers that once served 100,000 patients here have closed.
http://www.nytimes.com/2008/06/05/us/05southla.html
Comment:
By Don McCanne, MD
There are a great many problems that must be addressed if we are to ensure that people in underserved regions, such as South Los Angeles, have access to adequate health care services. But there is one absolutely essential resource that must be available to establish the necessary health care infrastructure: money.
When government budgets are perceived to be tight, where do our elected officials turn to try to reduce spending? Amongst the more vulnerable sections of budgets are the various health programs for low-income individuals - a sector of our society with only a feeble political voice. Reform proposals that would build on our current fragmented system of financing health care would continue to perpetuate this chronic underfunding stemming from the acquiescent anti-welfare mentality of those participating in the budget process.
Without adequate funding, health care will not be provided. The first step is to make sure that the money is there. A single payer national health program would do precisely that. All facilities and services would be fully funded. More work certainly would have to be done, but the financial barrier would have been removed.
There is reason for pessimism. A tour of the medical facilities in South Los Angeles is confirmation that, whatever makes America great, it is not our social solidarity. Maybe we need to start a campaign against acquiescence. Then maybe we’ll find the spark needed to ignite our social solidarity.