Informed Opinions on Today’s Topics : Must Public Sector Still Serve the Sick?

A month ago, Los Angeles County officials announced that because of a need to cut about $700 million from the health services budget, the survival of County-USC Medical Center, the largest public hospital in the county, was in doubt, as was that of the Olive View-UCLA Medical Center in Sylmar. The county’s 30 walk-in clinics are also all being considered for closure this week.

It is clear the county can no longer afford the level of services it had been providing, which raises the question: Are we wrong to rely on the government for health care?

Dr. Melvin Kirschner, co-chairman of the Los Angeles County Medical Assn.-Bar Assn. joint committee on biomedical ethics:

“I don’t see why the private sector should have all the public-sector patients shifted over to [it]. The government will have to take [health care] over as a utility, but as an independent utility, like the post office. There are a huge number of people being served, and to dump them on the private sector is going to be a disaster. [Private hospitals] can’t turn them away because it’s a law, and we are doctors. We can’t turn people away.”

Joel Diringer, an attorney with the California Rural Legal Assistance Foundation and director of the Rural Health Advocacy Institute:

“One of the rudimentary values of our society is that we take care of those in need. This isn’t a country where we let people bleed on the street. There is no one else in society who can meet the needs of those who can’t afford health care. I think that when people realize the danger to the public as a whole, the public officials will see the necessity of maintaining the public health infrastructure, perhaps in a more streamlined realignment . . . with some of the private-sector facilities.”

Burt Margolin, former state assemblyman and current chair of the Health Care Task Force created by Los Angeles County:

“It sort of proves the opposite point--that, in fact, with health care we have no choice but to rely on the government. This crisis exposed the inability of the private sector to care for the uninsured and provide adequate beds and adequate emergency services for those who represent the largest population of uninsured in the country. L.A. County needs to apply for a demonstration waiver under the Medi-Cal program and make L.A. County a laboratory for health care reform, and get the government to lift some restrictive rules and allow the county to put money into outpatient primary-care physicians.”

David Langness, vice president, Health Care Assn. of Southern California:

“There are several counties in California that don’t provide health care services. . . . They will receive money from the federal government they distribute to the health care providers based on the number of poor people that are seen in their hospitals. . . . The question is, ‘Would that system work in L.A. County?’ The answer many experts give is no, because we have too many people without health insurance. . . . What that means is we are going to need, for a long time, some kind of county health system. The question is, ‘Does it have to be as big as it has been?’ ”