Healthy Fix for Conflict

In recent months, Los Angeles-area state legislators insisting that earthquake-damaged County-USC Medical Center be rebuilt with 750 beds have been sparring with members of the Los Angeles County Board of Supervisors, who have been fiercely defending their decision to downsize the facility to 600 beds.

Some Eastside activists have tried to portray the conflict as one between state legislators eager to serve the county’s growing number of uninsured Latinos and county supervisors hoping to dismiss their costly obligation to serve the uninsured.

In fact, the conflict has pitted state legislators clinging to the health care paradigm of the past--huge central hospitals serving the bedridden--against county supervisors hoping to seize the health care paradigm of the future: smaller, community-based hospitals supplemented by scores of outpatient clinics that use prevention counseling and early intervention to spot illnesses before they afflict patients with costly diseases that leave them bedridden.

On Tuesday, the supervisors took a step toward the future, voting unanimously to build a satellite facility to mammoth County-USC: a hospital of at least 60 beds in Baldwin Park, a low-income, rapidly growing neighborhood 15 miles east of downtown Los Angeles that has lacked a public hospital for too long. The hospital, though small, should have an emergency room, which should be staffed around the clock.

The new hospital would fall short of the expansion state legislators have said is necessary, but Supervisor Zev Yaroslavsky extended another olive branch this week, declaring he’d support more than 60 beds so long as the state is willing to pay for them. Assembly Speaker Antonio Villaraigosa has indicated he’d be in favor of funding as many as 120 beds, so there’s no reason why the feud can’t end now.

A report by Orange County’s health care agency shows that the percentage of Latina mothers receiving early prenatal care jumped from 64% in 1992 to 77% in 1997. This was in large part the result of a vigorous new outreach program. This sort of early prenatal care has been shown to significantly improve infant health and dramatically reduce the need for hospital stays. So long as Los Angeles is willing to commit to such aggressive outreach programs that promote preventive care for pregnant women and others, it will have no trouble relegating mammoth hospitals like County-USC to the past.