County-USC Compromise No Panacea, Some Warn

Few places on the Eastside draw a more emotional response than County-USC Medical Center, towering on a Boyle Heights hilltop over a sprawl of predominantly Latino neighborhoods, a symbol of protection and safety for the working poor.

That is why the recent compromise reached by state and county legislators to rebuild the hospital--the nation’s second-largest--with 600 beds instead of the 750 pushed by local leaders resonated deeply with those who live and work in its shadow. About $820 million will be spent rebuilding the quake-damaged hospital. An 80-bed, $47-million annex is planned for Baldwin Park.

Local political leaders called the compromise a landmark victory for Latinos because the terms of the project were largely driven by Eastside legislators. But some health care experts said the outcome, from a medical prospective, is shaky.

Historically, it has been outsiders who controlled such large capital improvements, said William C. Velasquez Institute President Antonio Gonzalez, citing Dodger Stadium in Chavez Ravine and the freeway interchange in Boyle Heights.

“The worm is turning,” Gonzalez said. During the 1990s, he said, local politics have been changing, “but Latinos have still been losing out on the money.”

But with pressure from Los Angeles County Supervisor Gloria Molina and many Latino state legislators, Gonzalez said, the deal’s outcome “provides a strong sense of empowerment.”

Others aren’t so sure, including Salvador Flores, a 28-year-old patient. His eyes were blackened and swollen from a mugging at a South-Central bus stop.

Because of a bed shortage, which is expected to worsen under the compromise, the uninsured house painter waited nearly eight hours for treatment. His wife, Beatriz Flores, flicked her hand toward a waiting area full of patients staring into space and said: “Can you imagine waiting here all day? All day, people wait here and nothing happens.”

Health experts worry that the so-called safety net for the uninsured will remain riddled with holes after the new hospital is built.

“We are going to have a big disaster on our hands unless we find another solution,” said Dr. Demetrios Demetriades, director of trauma and critical care at the medical center. With 770 beds in the current facility, he said, “We are at full capacity,” turning away as many as 150 uninsured patients a day.

Other health experts said the new Baldwin Park annex--about 16 miles away--will not make up for a smaller County-USC hospital, especially with public and private clinics closing throughout Los Angeles.

“They are rationing care by making it 600 beds,” said Rodolfo Diaz, executive director of the Community Health Foundation in East Los Angeles.

With nearly 3 million uninsured county residents, “there are a number of people in Los Angeles who have never been to a doctor in their life,” Diaz said. “What will the county do when they need emergency care?”

Already, the overburdened hospital places patients with heart problems, diabetes and hepatitis on waiting lists that can stretch for months, hospital officials said.

Molina and others said such worries will be resolved in a component of the deal that leaves the door open to eventually adding beds, if needed.

Both state and county officials agreed to conduct a joint study in 2005 to determine whether the 600-bed hospital needs to be expanded by refurbishing the adjacent Women’s and Children’s Hospital--which has 150 beds.

That means Lincoln Heights could end up with 750 beds after all, said legislators involved in the deal, with the added benefit of a much-needed facility in the San Gabriel Valley.

“It could be more than 750 beds, as far as I know,” said Assembly Speaker Bob Hertzberg (D-Sherman Oaks), who was instrumental in the negotiations. “The test will be: What does the community need? And we’ll determine where we go from there.”

Hertzberg helped ease ethnic tensions in the standoff.

Latino legislators say ethnicity and race were only incidental to their aggressive stance. But at its most basic level, the debate was over how much public money to spend on improved facilities for a predominantly minority community.

Molina accused her fellow board members of prejudice during one debate, and later apologized. A group of local Latino state legislators threatened to withhold $200 million from the project unless the hospital was built with 750 beds. The threat was seen as ethnic posturing, and a risky move that could have backfired.

Hertzberg, aware of the hospital’s symbolic importance to the area after working for 20 years as an Eastside political organizer, helped reframe the debate as a countywide concern.

“One only need look at the growing population of the county to realize better services are needed there,” he said.

Taking in more than 700,000 patients every year, County-USC has a service radius of more than 60 miles. Its trauma center and other specialty wards are considered among the best in the country.

As Assemblyman Martin Gallegos (D-Baldwin Park) put it, “If the president of Sanwa Bank gets into an accident on his way home while on the freeway, where do you think he’ll be taken? . . . The maintaining of the L.A. County medical center in a centrally located area like East L.A. is important to the entire constituency of L.A. County.”

Steve Catarino, 41, said it is people like him who are most affected.

Born at County-USC and treated there in the past for a host of ailments, Catarino said most people who go to the medical center know that the inconvenience and frustration they experience is just part of being poor and uninsured.

The Boyle Heights resident said a smaller county hospital won’t change that view.

“Nobody likes waiting around a long time to see a doctor, but you learn to live with it,” he said while at the hospital with stomach pain.

With that, he looked up at a waiting room television set and continued to wait.