New Los Angeles County Health Director Faces ‘Gigantic’ Effort to Save System from Collapse
Dr. Thomas Garthwaite, the new director of the Los Angeles County Department of Health Services, must prove that the "county is serious about doing its share" to reform its "beleaguered" health care system and "persuade the federal government to do theirs," according to a Los Angeles Times editorial. In the first nine months of his tenure, Garthwaite must "find $100 million in savings," overcome the union opposition that will result from consolidation or closure of "underused facilities" and avoid reductions in services for the county's 2.5 million uninsured residents. After the first nine months, the editorial says that Garthwaite will have to "persuade the federal government to change the way it reimburses Los Angeles County for caring for the poor" or face "even more drastic cuts" to services, including the "worst-case scenario" -- closure of the county's public hospitals. The editorial says that although "bungling bureaucrats and turf-defending county supervisors" have contributed to the county health department's projected deficit -- an estimated $688 million by fiscal year 2005 -- several additional factors have exacerbated the problem. Los Angeles County has the most uninsured residents among counties nationwide and faced with a number of financial restrictions, the county "cannot by itself keep up with the costs of caring to this ever-rising population," the editorial says. The editorial adds, "What [the county] needs from the state and federal governments, if not more aid, is at least fewer strings and more flexibility." However, to receive additional federal funding, Garthwaite must demonstrate the county's commitment to reform, the editorial says. The editorial concludes, "Garthwaite will not have powerful lobbyists behind him. He will have only the poor -- unless every other county resident realizes that fixing this problem is not just the right thing to do but the only way to keep the health care system intact for everyone" (Los Angeles Times, 2/4).