New York Times Examines Emergency Care ‘Crisis’ in Los Angeles County
The New York Times on Saturday examined the "crisis" in Los Angeles County's emergency health care system as Van Nuys-based Northridge Hospital Medical Center announced plans to close by Dec. 31. Northridge spent $13 million on charity care for uninsured patients during the fiscal year that ended on June 30, according to hospital spokesperson Tracey Veal. "We're mandated to treat anyone that comes in through those doors," she said. East Los Angeles' Elastar Community Hospital shuttered its emergency department a week ago, and the Times reports that four other EDs in the county have closed in the past two years, primarily because of the high cost of treating uninsured patients, officials say.
Across the state, 70 emergency departments and trauma centers have closed since 1990. Of Los Angeles County's nine million residents, 30% are underinsured or uninsured, according to Carol Meyer, director of the Los Angeles County Emergency Medical Services Agency. Statewide, seven million people are uninsured, according to the California Medical Association. A "severe" nursing shortage is also contributing to the "tenuous" situation, Meyer said, noting that the shortage stems in part from new state nurse-to-patient ratio rules.
"We are in real tough times here," Meyer said, adding, "It's not going to change until somebody in a high position has a family member die because they couldn't get treatment in an emergency room." Meyer said that because of higher medical malpractice insurance premiums and the lack of reimbursement for treating the uninsured, "fewer and fewer" doctors are willing to be on call in EDs. The state's 500 hospitals are "on the verge of a whole series of unraveling events," Dr. Jack Lewin, executive director of CMA, said, adding, "No place is safe when you have large volumes of people who need care, but there's no one to pay for it" (Madigan, New York Times, 8/21).