November 16, 2006
King/Drew closing spotlights crisis in health care
Asking the 100,000 uninsured residents of South Los Angeles to take an hourlong bus ride for medical services they may not receive is hardly a solution to the current health-care
But that is exactly what the Los Angeles County Board of Supervisors did when it approved a plan to drastically cut services at King/Drew Medical Center, the only county hospital serving South Los Angeles, Compton and Watts.
Splashed across the pages of the Los Angeles Times, the problems at King/Drew have been framed as the county vs. a bad hospital, one mired in race politics and lethal incompetence. In this context, the near-shutdown of the hospital might seem a relief.
But the problems at King/Drew are more complicated than they seem, and they do not belong to any one ethnicity or neighborhood. They are harbingers of a systemic health-care shortage, one that undermines our democratic ideals and compromises the quality of care for the insured, along with the uninsured.
Its impact will reverberate far beyond the borders of South Los Angeles, one of our most vulnerable communities. The emerging health-care crisis in Los Angeles should not only bother us as Americans and Angelenos but also as Jews.
Jewish teachings on health care and current health-care service levels in Los Angeles County are a study in opposites. The rabbis in the Talmud mandate that people need to live near and have access to medical services. Maimonides lists health care first on a list of the 10 most important services that must be offered by a city to its residents.
In contrast, the closure of 12 hospitals and 10 emergency rooms in Los Angeles County since 1998 has overwhelmed the remaining emergency rooms and county hospitals. Wait times in county emergency rooms can approach 16 hours, and specialty referrals take six months. Yet these facilities are the only option for the 2.7 million people -- 20 percent of the population -- in Los Angeles County without health insurance, 1.2 million of whom live in households with incomes well below the federal poverty line.
The county's failure to provide basic health care to residents without insurance is a catastrophe in South Los Angeles, where more than 50 percent of the population lacks insurance. This region leads the county in lack of education, extreme poverty and highest rates of disease, including infant and child mortality rates. While the need for health care is most pronounced in South Los Angeles, the region has the fewest per capita hospital beds and physicians in the county.
King/Drew Medical Center was to be the guarantor of community-based medical care for South Los Angeles. Over the past decade, this vision has been obscured by patient deaths, quality lapses and accreditation losses. The ultimate authority for King/Drew and public health care in Los Angeles County rests with the Board of Supervisors.
Now, the same Board of Supervisors has approved a heavily criticized plan that will cut 130 beds from the hospital and further shrink emergency room capacity but will not address quality issues at the hospital. The plan will merge King/Drew with Harbor-UCLA Medical Center in Torrance. Almost all specialty services at the King/Drew will be eliminated. No new beds are being added at Harbor-UCLA.
The other day, I decided to see for myself what the tens of thousands of South Los Angeles residents will have to do to see a doctor. I took the bus that residents of South Los Angeles will have to take from King/Drew to Harbor-UCLA Medical Center. The bus runs every half hour and weaves circuitously through Compton, Carson and Torrance. During the hourlong ride, I tried to imagine bringing an ill child on this bus, riding home from a chemotherapy appointment or visiting a critically ill loved one in the hospital.
To be sure, the county is faced with a terrible dilemma: We must choose between the daunting task of providing quality and accessible health care for our most vulnerable residents and the tremendous societal cost of not doing so.
But the Board of Supervisors' plan will turn basic health care into a luxury for tens of thousands of Angelenos. Preventable medical problems will fill our emergency rooms. In the decision to close, rather than improve, King/Drew, we've all just missed the bus.
Catherine Schneider is the assistant director of the Progressive Jewish Alliance.