Citing budget shortfalls and quality-of-care problems, L.A.
County government has said it must close the trauma unit at Martin
Luther King Jr./Drew Medical Center.
But King/Drew is a vital link in a critically strained health
care system. Los Angeles needs more hospitals, not fewer.
The proposed closure of King/Drew is a symptom of a much larger
and more serious problem that threatens the health and lives of
Southern California’s residents.
California as a whole has lost over 100 acute-care hospitals
since 1993. Since the 1980s, 10 trauma centers and 18 emergency
rooms have closed in Los Angeles County alone. Only 13 trauma
centers with a 24-hour surgeon remain, and they must serve a
population of 10 million ““ a number expected to grow by about
2 million in the next 15 years.
Already, wait times and delays at area hospitals are almost
intolerable.
Average ER waits are about one hour, but a study by the
California Health Care Commission showed that for every $10,000
drop in income, the average wait time for patients went up by 10
minutes.
And there are countless stories of individuals with minor to
moderate injuries who are forced to wait many hours to see a
doctor.
But access and timing are even more important when it comes to
trauma centers. At King/Drew, about 2,000 critically injured
patients are seen each year. Such patients have either a blunt or
penetrating trauma and require immediate care.
Only two other trauma centers are within 11 miles of King/Drew.
The Los Angeles Times quoted Sal La Barbera, a Los Angeles Police
Department homicide supervisor, commenting on the possible closure:
“This will definitely have an impact on how many lives are
saved. … Harbor (UCLA) is an extra 10 or 15 minutes.”
It is a matter of life and death and the County Board of
Supervisors must not sacrifice lives to save money. But the problem
does not begin or end with the supervisors.
California has faced critical funding problems within its health
care system since at least 1995. At that time, the Clinton
administration bent Medicaid rules to funnel close to $2 billion to
L.A. County hospitals.
The Bush administration stopped some of this aid, giving $250
million in 2003 when the county asked for $1.4 billion.
But the problem goes beyond the current administration. A study
released by the California Institute found that Medicaid funding is
calculated based on a state’s per capita income level.
California has a lot of very rich people that boost its average to
$33,000 a year. But many of California’s residents are
actually below the poverty line ““ $17,650.
Because of that discrepancy, only 50 percent of
California’s health care costs are covered by Medicaid. The
study found Mississippi, in contrast, received 77 percent of its
budget from the federal government.
When it comes to the particular case of King/Drew, there is no
doubt the hospital has operational problems. There have been a
string of unnecessary deaths, and a patient died Thursday after a
nurse apparently turned his heart monitor volume down. Incompetent
hospital workers should be punished or fired.
But the problems of King/Drew will not be solved simply by
closing its trauma unit. That situation is a tiny part of a much
larger problem the county, state and federal government must
address as a whole.