Essential Investigation

The appalling situation at Martin Luther King Jr./ Drew Medical Center, revealed in Claire Spiegel's recent articles in The Times, is a measure of mismanagement and community neglect that translates into a failure of Los Angeles County leadership.

The county supervisors have now agreed to investigate the situation, but an examination is likely to turn up little more than what the board has known for a long time: The state and county are not providing enough money for the hospital and this problem has been compounded by egregious administrative failures. The Los Angeles County supervisors bear a heavy responsibility for failing to bring the problem into the open and for postponing the necessary corrections.

The revelations have a meaning beyond the confines of King. They measure the conscious, deliberate, structural under-funding of public medicine in the United States. The nation remains alone among industrialized democracies with a system of health care that excludes from the basic protection substantial numbers of people, an estimated 37 million Americans, including more than 5 million Californians.

Some of the problems at Martin Luther King already are being resolved under the vigorous leadership of Dr. James Haughton III, brought in as medical director to address the disarray. Some of the problems will be resolved in the longer term by new commitments of the county supervisors to provide replacements for some of the out-dated equipment and to construct a new trauma center.

But many of the problems will persist in the absence of closer supervision from the county Department of Health Services and the Board of Supervisors. Added out-patient facilities are needed. Increases in medical staff compensation are essential to recruitment of quality staff. There must be a new ordering of the controversial relationship with Drew University of Medicine and Science, intended to be the teaching and research arm of the medical center.

There is a risk, in the effort to accelerate reform, that the distinguished commitment of many on the staff will be forgotten. The hospital's doctors, nurses and technicians are forced to work in the most trying circumstances, many at substandard wages, to maintain this vital link in the county public health network.

Those supervising doctors who failed to provide hands-on direction and slept through their shifts would appear to be the exception--a regrettable anomaly of the past, according to Dr. Haughton. Failures have at times cost the lives of patients and that is unacceptable. But services provided at great sacrifice have also saved lives in surprising numbers, given the desperate conditions of the hospital.

In this crisis, there is also reconfirmation of the wisdom of the county, under the leadership of Supervisor Kenneth Hahn, in building the Martin Luther King Jr./Drew Medical Center. It has proven its importance. But it is not, as Hahn suggested recently, "one of the finest in America." Tough administrative decisions and marked funding increases, not the palliative of rhetoric, are urgently required if it is to begin to meet the standards appropriate to Los Angeles County.

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