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A Plea to Save Hospitals

LOS ANGELES — Nurses, politicians and union leaders stood on the steps of the Los Angeles County-USC Medical Center on Thursday to decry proposed state budget cuts to health programs, which they called the biggest blow to hospitals in a quarter-century.

Almost immediately, the more than $50 million in proposed cuts to the Los Angeles County health-care system would lead to longer emergency room lines at private hospitals, reduce the number of ambulances and slash services to the county’s most needy residents, they warned.

“The prisons get built, the roads get built, the real estate market gets taken care of,” an angry county Supervisor Zev Yaroslavsky said of the cuts. “It’s the human services that get the shaft.”

Union leaders and members of the nonprofit group L.A. Health Action said the cuts would cause an estimated 60,000 children — enough to fill Dodger Stadium — to lose health benefits.

“We are also focused on the ripple effect of these cuts throughout our community,” said Annelle Grajeda, state president of the Service Employees International Union, California’s largest health-care union. “If we don’t find new revenue solutions to strengthen our state, kids will miss school, parents will miss work, employers and employees will see insurance premiums rise.”

But state officials said health care gets the second biggest share of public spending, after education, said H.D. Palmer, spokesman for the state’s Department of Finance.

“When we have to close a $17.2 billion deficit, there is going to be a number of difficult decisions,” Palmer said.

Jim Lott, executive vice president of the Hospital Association of Southern California, said he hasn’t seen such drastic cuts in nearly 30 years.

“In my recollection, this is the biggest hit to health care since 1982, when we had the big round of medicare reforms and benefits,” Lott said.

L.A. County-USC Medical Center is considered the nation’s busiest public hospital, with 41,000 patient visits annually. It is also a vital pillar in the county’s health-care network that serves as a safety net for the insured and uninsured alike.

System in jeopardy
The proposed cuts put that system in jeopardy, Yaroslavsky and fellow Supervisor Gloria Molina said.

“If you get in a car accident in downtown Los Angeles, you would come to County-USC. If you get a heart attack in Torrance, you would go to Harbor-UCLA. If you get hit by a ball in a Little League game in the San Fernando Valley, you would go to Olive View in Sylmar,” he said. “The county system is the great equalizer.”

Yaroslavsky, whose district includes a portion of the East Valley, painted a dire picture of how every resident could be impacted, “no matter the size of your bank account.”

The cuts to the health system come in two parts, one of which already was passed by state lawmakers in February, when a 10 percent reduction in fees to Medi-Cal providers was approved. That law is expected to take effect July 1, saving the state about $544 million for the 2008-09 fiscal year.

The additional $50 million-plus in cuts means public employees would see no cost-of-living pay hikes and fewer services for residents eligible for state coverage.


If the cuts affecting public hospitals go through, private hospitals would see a dramatic increase in emergency room visits, experts say. And when you factor in losses to private hospitals — which will be affected by lower reimbursement rates — the total loss to L.A. County hospitals would be an estimated $189 million, Lott said.

There are 75 hospitals with emergency rooms, three of which are in the county system, he said. Those three county hospitals provide one-third of all emergency care in the county.

“A lot of hospitals will be looking at what services are marginal and may consider eliminating those services,” he said. “And there will be layoffs. There will be some serious belt-tightening.”

Lott also said physicians already are planning to limit their treatment of Medi-Cal patients, which translates to more uninsured residents turning to emergency rooms. By law, no emergency department can turn a patient away.

Nursing homes also might have to turn away clients, further exasperating the situation.

“We’re looking at a catastrophe being visited on 75 hospitals,” Lott said.

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