September 19, 2009
On Thursday, county Supervisor Mark Ridley-Thomas and a delegation of business and labor leaders traveled to San Francisco to urge the University of California's Board of Regents to approve an agreement that would end the state's most pressing public health problem.
Three years ago, federal regulators began the process of closing down Los Angeles County's scandal-plagued King-Drew Medical Center in Willowbrook, leaving South L.A. without a public hospital. The regulators had no choice, but the fact remains that, ever since then, the mainly African American and immigrant Latino people of the area have been without even the vestigial care the old facility provided. Most residents of the community could best be described as members of the working poor, the group that has suffered the most in the current downturn.
Over the last few months, UC and county negotiators have hammered out a model agreement for reopening Martin Luther King Jr. hospital as a public/private partnership. The university would provide the doctors and pay for their malpractice insurance; L.A. County would provide $350 million in capital funds, $63 million in annual operating expenses, plus a $100-million line of credit to cover emergencies. (Actually, because of the way federal funds flow through the state to the county, a $100-million credit line is worth $200 million.)
To insulate it from the unsavory local and ethnic politics that afflicted the old King-Drew, the new hospital would be governed by an independent board -- two members to be named by the regents, two by the county, three jointly.
So what's the problem? The regents continue to vacillate. Sherry Lansing, the former film executive who heads their health services committee, says there's "a moral imperative" at stake, but she wants to make sure "this is a sound financial situation for us." Fair enough, but as Ridley-Thomas, who represents the area, points out, UC "has no financial risk of consequence. All they have to do is provide the physicians." That's true. Thus, the regents' request for additional financial guarantees and significant financial donations from private sources really is excessively cautious. The regents simply should approve this agreement as it is when they next meet in November at UCLA.
South L.A. and the adjoining unincorporated areas that make up Ridley-Thomas' 2nd District are among the poorest, most congested and medically deprived areas in the county. In less than a decade, its population has grown at triple the overall county rate and now tops 1.32 million. Rates of debilitating chronic diseases -- including diabetes and coronary and pulmonary illnesses -- are in double figures.
County health officials estimate the percentage of 2nd District residents without health insurance of any sort at 32.9%, and -- with unemployment now at post-World War II highs and state funds for healthcare slashed -- more than 50% of the area's residents are either without insurance or reliant on Medi-Cal, California's primary assistance program.
Not long ago, a New York Times story called South L.A. "one of the most difficult places in the nation to receive ... medical care." Slightly more than 55% of South L.A.'s 1.32 million people are under 17 years of age, yet the area has just 11 pediatricians per 1,000 patients, compared with 57 in the county as a whole and a whopping 193 per 1,000 children and adolescents on the Westside.
Yet for nearly three years, this area has been without a public hospital. The old King-Drew Medical Center was a scandal of mismanagement, malfeasance and corruption, but the absence of any public hospital in the county's neediest region is a moral scandal and a profound violation of the social contract.
Progress on this issue really began last May, when Supervisor Zev Yaroslavsky proposed in an essay on this page that the University of California run a new hospital. As he said Friday: "UC is the one institution whose participation will instantly inspire confidence in the quality of care and independence of the new public hospital South L.A. needs."
Gov. Arnold Schwarzenegger, who knows a sound idea when he sees it, took an active role in pushing talks along, and, since his election as the 2nd District's new supervisor, Ridley-Thomas has made reopening the public hospital his top priority. Now there's an entirely sensible and desperately needed agreement sitting on the table, waiting for the regents' approval.
No one expects men and women in a position of public trust to behave imprudently, but neither can we accept a notion of public service whose sense of responsibility ends in a crabbed reading of the bottom line. We can -- and should -- expect them to acknowledge that the people of South L.A. have a right to the university system's assistance.
As Yaroslavsky said Friday, the regents "have a social obligation to do this. There's no more compelling need in this state."
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