ED closures spur worries of care crisis in L.A. | AMN | 9.20.04
The loss of a sixth hospital emergency department in the Los Angeles area in less than 14 months is evidence that a crisis is brewing that ultimately could deny emergency care to thousands of patients in the region and statewide, some health care officials say. …
The trend is the result of several factors, including California’s high number of uninsured residents, its low Medi-Cal reimbursement rates, and unfunded mandates requiring some hospitals to spend millions of dollars on nurse-to-patient staffing ratios and structural retrofitting to meet seismic standards, observers say. They worry that the Los Angeles shutdowns are a harbinger of what is to come in other communities in the state.
“We’re hitting a convergence of forces that have been at work for several years. It is becoming impossible for more and more hospitals to keep their doors open,” said Jan Emerson, spokeswoman for the California Healthcare Assn., a statewide hospital organization. “We are truly at a meltdown point.” …
Debating the solution
If passed, Proposition 67 would generate $500 million to $600 million annually for emergency services by raising the 911 telephone surcharge.
Proponents say:
- The initiative would protect patients’ access to care by helping to keep local hospital emergency departments and trauma centers open across California.
- It would provide equipment and training to firefighters and paramedics who respond first to emergencies.
- It would support local health clinics so EDs and trauma centers are reserved for true emergencies.
- It would help upgrade the 911 emergency telephone system.
Opponents say:
- Although the initiative would cap the surcharge for residential phone customers, there is no limit on how much cell phone and business customers could be charged, which could be a financial burden on them.
- It would benefit for-profit hospitals with public tax dollars.
- Less than 1% of the funding would go to 911 communications services.
- The initiative might make it more difficult to increase future spending on 911 services.
If Los Angeles were a state—it would be the 10th most populous state. Many that have followed emergency services in California know that LA resides on the thinest ice and the cracks are now beginning to fissure.
