‘California’s Medical Crisis’

“California’s Medical Crisis,” described in your Feb. 9 editorial, after Hollywood Presbyterian Hospital withdrew from the Los Angeles County trauma system, is the result of a domino effect.

The critical financial balance in which the public and private health-care sectors were able to manage hospital care for the indigent in this county was tripped up by shortsighted state payment cutbacks last summer. Now both the county and private hospitals are being forced to close down services that are needed by indigent patients.

One of several important elements in this chain reaction occurred last June when the Deukmejian Administration cut $20 million from medically indigent funding to Los Angeles County. This resulted in the county withdrawing from the Los Angeles Indigent Services program. This program had been a model for the nation on sharing responsibility for indigent medical care between the public and private sectors. While the private hospitals were paid only a fraction of their costs (below 35%) for providing this care, it had been enough of an offset to keep the doors open. When those funds were withdrawn the public/private system of care for the indigent started to crumble.

The closing of the Hollywood Presbyterian Hospital trauma center is another critical step in that process, which in turn will place even greater strain on those that remain open.

For some time now we have taken for granted the quality and availability of our hospital emergency services. We have been apathetic as the ability to pay for those services has been steadily dismantled. We had better pay attention now or somebody--a lot of somebodies--will be hurt.

STEPHEN W. GAMBLE

Los Angeles

Gamble is president of Hospital Council of Southern California Center of Health Resources.