Governor Assailed at Hearing on L.A. Emergency Network

Pounding on a table, state Sen. Diane Watson (D-Los Angeles) asserted Tuesday that “a lot of people will probably die” unless Gov. George Deukmejian takes action to head off a potential crisis threatening the area’s emergency care network.

Two major downtown hospitals have announced that on June 1 their emergency rooms will close to paramedic ambulances. Three other central Los Angeles hospitals have indicated they may soon follow suit, leaving the prospect of major gaps in emergency care in the central city.

Bleak Prognosis

Health officials and doctors testifying at a Senate Health and Human Services Committee meeting presided over by Watson at the state building downtown painted a detailed portrait of the complex problems underlying the crisis and made dire predictions of more cutbacks accompanied by a great loss of life. They stressed that the cutbacks are symptomatic of an ailing, inequitable health care system that needs a drastic overhaul as well as a massive infusion of funds.

The three Democratic senators--Watson, Cecil N. Green (D-Norwalk) and Art Torres (D-Los Angeles)--who conducted the hearing, also took the opportunity to accuse the Republican governor of turning his back on the problem.

“The Legislature is not the problem; the governor is,” said Torres. He urged officials at the two hospitals curtailing their emergency service next month--California Medical Center and the Hospital of the Good Samaritan--to poll their trustees to find those who are Republicans and “have them call the governor.”

Confessing deep frustration, raising her voice and pounding on a table, Watson lashed out at Deukmejian, declaring: “What is it the governor is willing to do? How can we benefit the people who are surely going to die?”

Revenue Shortfall Cited

The governor was unavailable for comment, but his chief health adviser, Clifford Allenby, secretary of health and welfare, said the chance of securing extra funds for hospital emergency services may be difficult because of a recently forecast state revenue shortfall that could total as much as $1 billion. Even so, he said there is legislation pending that will pump an additional $50 million into local health care systems throughout the state. The money is earmarked for medical care to illegal aliens, he said. But this should, in turn, free other funds to help pay for emergency room services for the poor.

Green announced that he will introduce legislation to give the county an estimated $20 million in surplus state revenue that would ordinarily revert to the state’s general fund at the end of the fiscal year.

A $20-million infusion “would be a big help and the sooner, the better,” said the county’s director of health services, Robert Gates. He said the county has “no funds whatsoever to deal with the emergency room crisis” that threatens to provoke a “domino effect” among other hospitals.

Telegram to Governor

Curtailment of emergency room service at five central Los Angeles hospitals, he pointed out, would leave a big hole in service for the “poor and non-poor alike.”

In a separate action Tuesday, the county Board of Supervisors, composed of three Republicans and two Democrats, sent a telegram to Deukmejian urging additional state funds to prop up private hospital emergency rooms that are losing increasing sums of money by treating patients who cannot pay their medical bills.

In addition to the two nonprofit downtown hospitals that announced emergency room cutbacks last week, officials at two other nonprofit hospitals--Hollywood Presbyterian Medical Center and French Hospital of Los Angeles in Chinatown--have indicated they may cut back emergency services soon, as has Linda Vista Community Hospital, an investor-owned institution in Boyle Heights.

Also, officials at the nonprofit White Memorial Medical Center in East Los Angeles are considering cutbacks. “They are nervously looking on . . . and certainly not going to allow the hospital to go broke under the burden of providing indigent care,” according to the chief emergency room physician, Brian Johnston.

“From the hospital’s point of view,” Johnston said, “there is only one door through which bad debt comes in: the emergency room.”

By law, hospitals must treat and stabilize all emergency room patients without regard to their ability to pay. Providing this so-called “uncompensated care” is costing private hospitals in Los Angeles millions of dollars a year.

The cost amounted to between 1.2% and 7.8% of the total operating expenses for private hospitals in Los Angeles for the year ended June, 1987, according to a recent analysis by The Times.

Meanwhile, hospital officials say they are facing a new, competitive environment in California caused by changes in payment methods by government health care programs.

Gamble, of the Hospital Council, said that more than 50% of the hospitals in the state are expected to suffer operational deficits this year.

A principal reason, he said, is that hospitals in California are no longer able to absorb bad debt by shifting the cost onto private insurance carriers and government health care programs.

William Haug, head of California Medical Center, which lost $2.6 million last year, said that several factors prompted officials to downgrade the hospital’s emergency room to “standby status,” meaning that some 800 rescue ambulances a month will have to be diverted to other hospitals.

He pointed out that cuts in public neighborhood health clinics have reduced services for the poor, resulting in rising numbers of sicker patients seeking care at the medical center’s emergency room. Also, he said, overcrowding at the public hospitals has made it more difficult for the medical center to transfer poor patients in stable condition to public hospitals for continued care.

Furthermore, he said, this influx of poor patients has at times saturated the hospital’s critical care units, “to the point that our physicians could not admit their private patients to the hospital.”

CENTRAL L.A. EMERGENCY ROOMS

These central Los Angeles hospitals have state licensed emergency rooms with a physician on duty 24 hours a day.

1. Childrens Hospital of Los Angeles, 4650 Sunset Blvd.

2. East Los Angeles Doctors Hospital, 4060 Whittier Blvd.

3. French Hospital of Los Angeles, 531 W. College St.

4. Hollywood Presbyterian Medical Center, 1300 N. Vermont Ave.

5. Kaiser Foundation Hospital, 4867 Sunset Blvd.

6. Linda Vista Community Hospital, 610 S. St. Louis St.

7. Martin Luther King Jr./Drew Medical Center, 12021 S. Wilmington Ave.

8. LA County-USC Medical Center, 1200 N. State St.

9. Queen of Angels Medical Center, 2301 Bellevue Ave.

10. Santa Marta Hospital, 319 N. Humphreys Ave.

11. White Memorial Medical Center, 1720 Brooklyn Ave.

12. California Medical Center, 1414 S. Hope St. *

13. Hospital of the Good Samaritan, 616 S. Witmer St. *

*Hospitals that are eliminating some emergency services.