Los Angeles Health Director Proposes Steep Service Cuts to County Health System
Los Angeles County's acting health director Fred Leaf proposed a series of cuts yesterday that "could lead to virtually dismantling the public health care system for the area's 3.2 million poor and uninsured people unless major new funding is found," the Los Angeles Daily News reports. In a report to county supervisors, Leaf said that the department's effort to reform the health system by sending patients to lower-cost clinics has failed. The health department, which has received $2.2 billion in federal bailout money over the past six years, faces a nearly $700 billion deficit by 2005. Neither the "resources nor the will appears to exist in either Washington or Sacramento to provide adequate financial relief," and without such assistance, "the department will be faced with offering drastically fewer services to a much smaller population than it presently serves," Leaf said. He proposed a multi-phase plan that supervisors are expected to consider today and approve "in concept," with a final vote expected next month. In the first phase, five public health clinics located in North Hills, Burbank, Los Angeles, Paramount and Compton would be closed by May. In addition, 100 administrative jobs would be eliminated or consolidated to save $8 million; the inpatient rehabilitation unit at High Desert Hospital would be closed; and 45 patients on life-support systems at county hospitals would be transferred to Rancho Los Amigos National Health Rehabilitation Center in Downey. The Daily News reports that the second phase of the plan contains four options for "radically restructuring the health department":
- Under the "worst-case scenario," the entire health system would be privatized, and the six county hospitals and more than 120 public clinics would all be closed, allowing the area's 2.5 million uninsured to receive care only in "serious situations." This option could "overwhelm private hospitals and clinics," the Daily News reports.
- All public emergency rooms would be closed, while only one or two hospitals would remain open "with increased availability of urgent care centers."
- All clinics would be closed except for a "narrow range of vital services."
- Finally, all clinics would close but hospitals would remain open, "focusing on providing only emergency, trauma care and other vital services."
"Our first actions are geared to start changing the system and eliminating waste," Leaf said, adding, "Then, as we move forward, we'll go into the larger areas of consolidation, as well as tackling the issue of varying costs among facilities with similar services. That will be one of the biggest areas of reform." Supervisor Zev Yaroslavsky added, "Anybody who believes we can close a half-billion-dollar deficit at the end of the day without impacting our core services is going to be seriously surprised. We have got to begin. We have waited too long" (Anderson, Los Angeles Daily News, 1/29).
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