Los Angeles County Hospitals Closings Can Be Prevented

By Delaney "Doc" Smith, Jr.

Several hospitals in Los Angeles County have closed and many others are on the brink of closure largely due to financial reasons.

According to administrators, the closure of Martin Luther King Hospital was largely due to fiscal reasons, in that prior to closure there had been substantial funding cutbacks by the county, which triggered shortage of nursing staff. Under existing California law, even if beds are available... if the ratio of one nurse/ per 6 patients, is not met...patients cannot be admitted to a hospital bed. This has largely contributed to protracted waiting time, and delayed admissions from the Emergency Rooms, and most other problems stem from patient congestion in the ERs.

While it has not been widely publicized, MKL hospital in recent years has been ranked in the top 10% of all hospitals in the nation for the treatment [save rate] in cases involving severe traumatic injuries. Many of the surgeons of the US military trained at MLK, and while problems with ancillary staff existed, it would appear that this was overstated, and the financial problems of the hospital understated in the local newpaper releases.

The hospital would not have closed if the earlier recom-mendations of Dr. Smith had been adopted. Statistically, on any given day at a typical urban hospital, 70-80% of the patients seen in a hospital ER could have been seen more cost efficiently at an urgent care center. Decentralization of care from an expensive hospital to off campus, strategically placed urgent care centers would have left MLK with only the 20-30% of patients who were appropriately seen in the ER with life threatening emergencies. Additionally, the overall cost of care would have been sharply diminished.

The LA County Supervisors openly admit that because they have no training in healthcare matters, they had to heavily rely upon advisors, and consultants, who frequently did not offer the best advise... [which should have included the recommendation for decentralized care from busy County hospital emergency rooms to expedite treatment of more acutely ill ER patients, while at the same time sharply reducing the cost for ambulatory patients [seen in off campus urgent care centers].

State of California reimbursements for medical services rendered to the poor is called "Medi-Cal" and levels of re-imbursement for "Medi-Cal" are comparatively at the bottom of the 50 states. In past years a considerable portion of federal monies specifically earmarked for healthcare delivery expenditures, were frequently used for the other costs identified as " administrative" expenditures". The re-imbursement from Medi-Cal is so poor that even the state hospital UCLA at Los Angeles Medical Center accepts Medi-Cal only on a limited basis???

There are already enough federal and state healthcare dollars available, which as set forth above, could be spent in a more cost-efficient manner, that could then permit Medi-Cal payments to be competitive with other states.

The present state of our healthcare delivery system, par-ticularly in Los Angeles County highlights, the fact that someone with the education, training, and experience in healthcare delivery now take the lead, as a LA County Supervisor to make our healthcare and delivery system, once again number one in the country, as it had been prior to 1968, which began the era of cutbacks in healthcare, as the occupants of Metropolitan State Hospital would be dumped onto the streets,...thereafter becoming the first large wave of the "homeless".

WE CAN DO BETTER; ROCK THE VOTE; VOTE FOR CHANGE [OR EXPECT THE SAME]

DELANEY SMITH JR.PHARM.D.,M.D.
FOR COUNTY SUPERVISOR 2ND DISTRICT