Is bad medicine better than none?

HealthMinority GroupsDeathSocial IssuesPovertyDisasters and AccidentsIllnesses

FOR THE RECORD:
In an earlier version of this article, one of the contributor's names was incorrect. The contributor is Joe R. Hicks, not Bill Hicks.


Today, Hicks and Hutchinson debate how the troubled hospital and its potential closure affect the local community. Later this week, they'll discuss how the situation became such an emergency.

If King closes, where do the poor go?By Earl Ofari Hutchinson
The great myth is that King-Harbor is an inherently lousy hospital filled with incompetent, neglectful and malicious doctors and nurses who routinely kill patients. The tragic death of Edith Isabel Rodriguez and a handful of other sensationalized cases of patients neglected further feed this myth that the hospital is a medical train wreck and needs to be shuttered.

The facts are far different. The currently downsized King treats at least 100 emergency patients daily, nearly 1,000 in a week and more than 40,000 per year. It has one of the highest emergency patient loads of any urban hospital. At one point, King provided sustained care for more than 10,000 patients, and it treated nearly 170,000 as outpatients. That equals the population of a small city. The U.S. Centers for Medicare and Medicaid Services, which cited King for deficiencies, has never stated that King was a threat to patients' lives.

Who are these patients the hospital serves? They are mainly African Americans and Latinos who have a per capita income below the federal poverty rate. Many lack adequate private transportation. King is not one of the few options they have for medical care; it's their only option.

So if the hospital were padlocked, where would the patients go? In 2005, University of California researchers looked at hospital closures in L.A. County between 1997 and 2002. They found that the closures overwhelmed staff and facilities at the county's four general hospitals, which included King. The closures triggered a stampede of patients to doctor's offices, clinics and emergency rooms. They increased the time and distance that patients had to travel to get to a healthcare provider.

That meant that fewer patients saw doctors, fewer children had checkups, patients were less likely to seek and get preventive care, and there was a jump in the number of deaths from injuries and heart attacks. This virtually guaranteed that the number of people who suffered from acute illnesses would climb. These ailments are more costly to treat. In the case of King, there are even more deadly consequences. It treats more victims of life-threatening gunshot wounds than any other area hospital.

County officials have engaged in wishful thinking in the hope of finding a private healthcare suitor to take over and run King. If that fantasy scenario happened, the hospital would be run on a bottom-line, for-profit basis. This would leave thousands of poor patients out in the cold. Many could not afford to pay for services or qualify for Medicaid payments.

King hospital is the latest but hardly the only casualty of a bloated medical healthcare system that has failed thousands of poor persons in desperate need of healthcare. The poor need and deserve quality medical care too. Except for a relatively few cases blown wildly out of proportion by the media, King has provided that level of care for most -- and that included my sister (cancer) and a nephew (gunshot).

During the fierce debate over King, the dangling question the supervisors, the feds, the L.A. Times and Gov. Schwarzenegger did not satisfactorily answer is this: If King closes, where are the poor to go? The question still hangs unanswered.

Earl Ofari Hutchinson is an author and political analyst. His new book, "The Latino Challenge to Black America: Towards a Conversation between African-Americans and Hispanics," will be out in October.


Close King now -- the community deserves better By Joe R. Hicks
For me, the question isn't , "Where do the poor go if King-Harbor closes?" but the larger and more pressing question, "Why aren't civil-rights activists demanding first-class hospital services for this hard-pressed constituency?" Since the hospital came under increased scrutiny in 2004, community activists have demanded that the hospital be "left alone" and claimed that the hospital "is ours" -- which gives some hint to the backward racial politics underlying the dilemma.

The view that King-Harbor's long-standing problems are nothing less than media sensationalism turns a blind eye to years of incompetence and misconduct that have earned the hospital the name "Killer King." This, mind you, from people who live in that institution's service area, not among members of the media. The allegation that there have been only a "handful" of ugly and needless deaths, epitomized by the example of Edith Isabel Rodriguez -- who writhed in agony on the floor of the ER room as staff joked about her plight and a janitor mopped up bloody vomit from around her body as she lay dying -- downplays a history that cannot be so easily discounted.

People die in hospitals all of the time. This is most often the result of deadly diseases and accidents that send people to hospitals, often in desperate need of medical care. So the fact that people have died while at King is not the issue. The issue is how and why these people succumbed to their injuries and illnesses. Those who have investigated the hospital, including federal officials, say that a culture of incompetence at King-Harbor has resulted in patients' deaths. This staff incompetence has often been in deadly combination with a culture of corruption and a system of racial patronage that has made this major-city hospital function more like that of a hospital located in some backwater third-world nation, not in this country's second largest metropolis.

Some will argue that King-Harbor is being targeted because it serves poor black and brown patients and its administrators are primarily black. This is utter nonsense, and a prime example of the politics of racial victimization. Rather than attempting to defend the indefensible, activists should demand the hospital be reformed immediately. And if that means shutting it down so that something better can blossom, that would serve the purposes of the Watts-Willowbrook community far better than "Killer King."

Joe R. Hicks is vice president of Community Advocates Inc., a Los Angeles-based human relations organization. He is currently writing "What's Race Got To Do With It: Building Bridges Across America's Racial Quicksand."

Day 1  |  Day 2  |  Day 3

Send us your thoughts at opinionla@latimes.com.

Copyright © 2014, Los Angeles Times
Comments
Loading