COUNTY-USC: Portrayal of Conflict All Wrong

      An editorial in today's Los Angeles Times praised the Los Angeles County Board of Supervisors, applauding Tuesday's unanimous vote to build a satellite clinic to the "mammoth" County-USC hospital and a hospital with a minimum of 60 beds in Baldwin Park. The Times commends the supervisors for taking a "step toward the future," with the decision, saying the area "has lacked a public hospital for too long." The decision comes out of months of debate, during which state legislators have argued that earthquake damaged County-USC hospital should be rebuilt with 750 beds. However, the Los Angeles County Board of Supervisors decided to downsize the hospital to 600 beds, a move some activists say reflects the county's hope to "dismiss their costly obligation to serve the uninsured." Since the county's plan falls short of the expansion that state legislators deem necessary, county supervisor Zev Yaroslavsky declared that he would support more than 60 beds as long as "the state is willing to pay for them." But the editorial asserts that the real conflict isn't about need, but method: legislators "clinging to the health care paradigm of the past -- huge central hospitals serving the bedridden" and county supervisors' visions 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." It goes on to cite the successful drop in hospital stays and improved infant health as positive signs of "a vigorous new outreach program" that resulted in a 13% rise between 1992 and 1997 of Latina mothers receiving early prenatal care. The piece concludes, "So long as Los Angeles is willing to commit to such aggressive outreach programs that promote preventive care ... it will have no trouble relegating mammoth hospitals like County-USC to the past" (10/28).