Staff Decries Targeting of 2 Hospitals : County: Proposal urges closing Olive View, Harbor-UCLA instead of County-USC. They serve many patients who can’t pay for private care.

It was noon Wednesday at the bustling Harbor-UCLA Medical Center, and Dr. Frederick Bongard, an emergency room surgeon, was well into his second straight day on duty. During the night, he did three emergency surgeries on victims of traffic accidents and a shooting.

But a fourth case stood out in his mind: an emergency surgery to correct a perforated appendix. That patient had been brought to the doorstep of Harbor-UCLA by a private hospital because he did not have health insurance.

“We see those patients every day,” said Bongard, chief of the Harbor-UCLA trauma service. “We have wards literally full of patients sent by other hospitals because they are uninsured.”

Bongard’s experience is key to the debate going on in the county Hall of Administration over deep budget cuts in health services that might lead to the closure of Harbor-UCLA, Olive View-UCLA Medical Center or County-USC Medical Center.

County administrators, armed with maps of area hospitals, financial projections and plenty of wishful thinking, hope that nearby private hospitals will pick up many of the public hospitals’ patients to help cushion the blow.

Until this week, the future of County-USC Medical Center seemed most in jeopardy. County Chief Administrative Officer Sally Reed last month recommended closing the public hospital to help correct a $655-million shortfall in the Department of Health Services’ $2.5-billion budget.

But Tuesday, County Emergency Medical Services Director Virginia Price Hastings threw the names of Harbor-UCLA and Olive View into the mix, saying that closing those two public hospitals would have less impact on the county’s emergency 911 network than closing the bigger hospital.

Hastings made clear that either scenario would leave gaping holes in the county’s health system, but argued that there were more hospitals in the harbor and San Fernando Valley areas that could fill the void if Harbor-UCLA and Olive View closed than in the east Los Angeles County area served by County-USC.

Bongard, and other doctors and nurses who would be affected if Harbor-UCLA and Olive View closed, reacted Wednesday with dismay--and incredulity--to Hastings’ proposal.

They stressed that they are hospitals of last resort for thousands of poor patients that other hospitals turn away.

“Right now, we treat 99% of the indigent patients in the harbor area,” said Dr. Robert Hockberger, chairman of the emergency medicine department at Harbor-UCLA.

Both hospitals Wednesday offered pictures of their strategic importance.

Every emergency bed at Harbor-UCLA was full at noon, with another 50 patients in the waiting room, some of the 103,000 patients who go through the hospital’s emergency rooms each year. About 60% of them have no insurance, even state-subsidized Medi-Cal benefits.

A crew of doctors and nurses overseen by Hockberger were treating patients for electrical burns, congestive heart failure, asthma, appendicitis, high fever, a fractured jaw, a heart attack, internal bleeding, chest pains, a severe headache and so on.

A teaching hospital, Harbor-UCLA--which is near the junction of the Harbor and San Diego freeways--has a national reputation as a top emergency hospital, competing for surgical interns and research grants with hospitals such as UC San Francisco and Parkland Memorial Hospital in Dallas.

The hospital gets about $40 million a year in research grants from the National Institutes of Health and other agencies.

At Olive View, in Sylmar, the emergency room is not as busy as Harbor-UCLA’s, with 72,000 annual visits, but nevertheless it has the busiest maternity wards in the San Fernando Valley, delivering 4,600 babies a year, many of them to indigent mothers at high risk of problem pregnancies.

Back at Harbor-UCLA, emergency room nurse Laurie Anderson said the budget cuts were a hot topic. “We talk about it all the time,” she said. “We don’t quite believe it will happen, because we don’t see how these other hospitals can take on all these patients.”