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September 23, 2004


There's a big stink over the imminent closure of the Trauma Center of the twentysomething MLKJr Hospital down in the ghetto. It would be the 6th Tramua Center closed in LA County in the past couple of years. The others were due to budget irresponsibility, this is due to incompetence.

It seems to me that if a hospital is incompetent, the ER should be the last thing you close down. It's the thing the community needs the most. Not just because its a ghetto, but because most people don't need to be hospitalized, they just need to see a doctor. On the other hand, if you've been critically injured, there's no quicker way to kill you than in an incompetent ER.

So the question is would you rather see an incompetent doctor who is 10 minutes away or a competent doctor 40 minutes away. That depends on where you've been shot or how small your automobile was when it wrecked. The LA County Board of Supervisors, whose call this is, are going for quality over quantity, and hoping beyond hope that more people don't get wrecked or shot.

It's a crapshoot.

One thing I've learned as I've followed this is that the more ERs you close, the higher the murder rate of the city goes. More people die who might have lived.

Posted by mbowen at September 23, 2004 10:51 AM

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Tracked on September 23, 2004 06:40 PM

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Tracked on September 30, 2004 08:10 PM


They could just fire the staff and replace them.

Tavis Smiley has segment on this.

Posted by: BH at September 23, 2004 11:20 AM

Sad to hear. I remember that they were having problems there and trying to come up with solutions before we left in '99. Too bad the Sups still can't get their collective head out of their ass. If there's any neighborhood in LA that needs a hospital with a competent ER, that's it.

Posted by: caltechgirl at September 23, 2004 12:39 PM

Do we understand that our process of providing medical care is insane?

"Best medical care in the world"

is a lie....

Posted by: Robert at September 24, 2004 08:47 AM

What's insane is that emergency rooms are being used as walk-in clinics, so that people with true emergencies frequently can't get prompt care. I don't think it's possible for the same ER to focus successfully on treating trauma patients AND deal with the 2-year-old with an earache.

When Tennessee switched to TennCare several years ago, that was supposed to help because people on TennCare were supposed to find a primary care physician. After a stated period of time, the ERs were supposed to tell people on TennCare who weren't having a real emergency that they weren't going to treat them and they needed to call their doctors. But for some reason the ERs are still just as full as ever, and it's the same non-emergencies. I don't know why there can't be a walk-in clinic next door to each ER. The triage people could direct the appropriate patients to those clinics and let the ER personnel focus on dealing with traumas and emergencies.

Posted by: Laura at September 24, 2004 10:25 AM

Laura, the ER's are being used as walk in care because that's how the system is set up. You can't get in except through the ER. My mom had to wait 23 hours to be seen because when her gall bladder went bad, and then waited 6 months for the surgery to remove it. (The job she held at the time didn't provide health coverage.) I agree with you in that there should be some sort of triage scheme where patients are directed to otehr departments, but of course money is always an issue.

I only partially agree w/Cobb on the issue of incompetence. While it's true that any socialized health care scheme is incompetent at it's core, this system was not only victimized by it's own ineptitude, it was also victimized by the crush of illegal immigrants seeking care. Let's face it, LA County is not a bottomless pit of revenue, and illegals are net users of gov't services, not contributors.

Posted by: robert at September 25, 2004 10:32 AM

Robert, I know the system is set up that way in some places but it really isn't set up that way here. People are using it that way anyway. If you lived in Tennessee, and your mom works, she might not qualify for TennCare, it's true. But she shouldn't have to wait hours to be seen in the ER (which she would) because the people who do qualify for TennCare shouldn't be using it as a walk-in. I guess it's just too-oo much trouble to call the primary care doc and get an appointment.

As to the illegals - there I think we as a country are just schizophrenic. We obviously want these people here or we would make a serious effort to stop them at the border and deport them. So why not go on and regularize them so they can start paying taxes (apart from the ones they already do) and so forth? Why pretend they aren't here? Is it really because businesses demand workers who don't have to be paid minimum wage or social security and who won't call OSHA? I really, really believe in the free market system but this whole situation makes me wonder if Marx wasn't right, that capitalism depends on an underclass.

Posted by: Laura at September 25, 2004 04:00 PM

By what objective measure does socialized medicine (which we don't quite have) fail?

Posted by: Lester Spence at September 28, 2004 07:14 AM

Lester, it fails in that it cannot provide timely care to those in need.

Case in point, a man who couldn't get to an NHS dentist in Britain pulled his own teeth in desperation.

"His home town of Scarbrough, North Yorks, is so hard-hit with the lack of NHS dentists that queues stretched hundreds of yards earlier this year when one finally opened."

Why should anyone have to queue up just to see the damn dentist?

Or shall we follow Canada's example?

"Comparing Canada with other industrialized countries in the Organization for Economic Cooperation and Development (OECD) that provide universal access to health care, a study released by The Fraser Institute in May revealed that Canada spends more on its system than other nations while ranking among the lowest in several key indicators, such as access to physicians, quality of medical equipment, and key health outcomes."

Id say that the examples cited are very objective examples of why we don't want this here in the States. I used to work with a lot of Canucks in my days at Microsoft. They go through a nightmare of red tape to terminate their tax payments to the NHS when they pay for benefits here in the US. If the NHS is so great why would they do that?

Simple, because they get better care here.

I may have complained about my mom being in the ER for 23 hours, but that sure as hell beats 17.7 weeks.

Posted by: Robert at September 30, 2004 07:08 PM