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Emergency Rooms Under Siege

January 22, 1992

Imagine the scene: Sick people, some of them naked and bound by leather arm straps, lying on gurneys, unattended for hours in the hallways of a public hospital. Something out of a poverty-stricken Third World country or a former communist satellite turned fledgling nation? No, this is happening here in Los Angeles, at a public hospital with a proud tradition that is being undercut daily by its inability to cope with the consequences of a woefully inadequate public health care system.

The Times wrote this week about the horrifying overcrowding at Los Angeles County-USC Medical Center, but a sad report could well have been filed about all of the county's six public hospitals.

There are 37 million Americans who have no health insurance; Los Angeles County, with 2.7 million, has the highest rate of medically uninsured in the nation. The uninsured, whose ranks include middle-class people who lost their medical benefits when they lost their jobs, often have come to rely on emergency rooms as the health care provider of last resort.

By the time they reach the emergency room, a child's untreated minor bacterial infection has evolved into a life-threatening case of pneumonia; unrecognized symptoms of diabetes have turned into shock or coma. Such illnesses, not treated early, become emergencies that pile atop classic emergency room cases like injuries from car accidents or shootings. Emergency room physicians and nurses do the best they can in a situation that no one should have to face outside the battlefield. In a sense, it is war, one of priorities and resources; while the insured and those who can afford it in Los Angeles receive the best health care in the world, others who are not insured and cannot afford it get what some physicians at County-USC have called "rationed" health care. That's not quite the same as taking a number in a meat market, but almost.

Let there be shame in this. Let the Los Angeles County Board of Supervisors know that there is a limit to what people can and should endure. Supervisors must shrug less and scream more, to hospital administrators and to the state and federal governments.

And let federal leaders know that voters understand that only a rational national health care system can cure what ails Los Angeles' overwhelmed emergency rooms.

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