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Rancho's Past Merits a Future

November 09, 2002

Re "Prognosis Doesn't Look Good for Acclaimed Rancho Rehab Center," Nov. 1: The old county poor farm -- yes, that is how the now world-renowned Rancho Los Amigos facility began in the 1880s. It was a working farm with cattle, sheep and pigs, as well as vegetables and flowers. The residents able-bodied enough to work became the caretakers of the farm. There was also a train line through the grounds to pick up passengers as well as products for sale. At one time, there even was a zoo and an aviary.

Over the next 100 years, "the Ranch" went through numerous historical moments: early care of the mentally ill, the polio epidemic, massive use of the "iron lung." All the while, the mantra was to get the best use of what you have remaining after a devastating physical or mental insult. Rancho was where I spent the major part of my professional career as a nurse anesthetist. I lived through so much Rancho history, seeing firsthand the invaluable work done for babies with birth defects, for spinal injuries, for severe arthritics and on and on. I worked with the finest people in the world, trying to find ways to make life better, where the Ranch was the last hope. It seems incredible that Rancho should even be considered for closure. We must find the means to carry on the pioneering spirit that is the Ranch.

Lorraine B. Kirk CRNA

Rancho Palos Verdes

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I am appalled and saddened by the proposal to close Rancho Los Amigos. Having worked there for 16 years in various capacities I saw the remarkable success of the rehabilitation programs conducted by creative, committed professionals in partnership with patients who had severely disabling conditions including strokes, spinal cord injuries, arthritis and head injuries. What will happen to these and future patients if Rancho ceases to be? The "indigents" who make up one-third of those served by the center are primarily working people who cannot afford health insurance. These people will therefore be left powerless to survive, rediscover a place in their culture, make a contribution and find something worth doing in the face of lifelong, severe, disabling conditions. Many will end up dying untimely deaths because of inactivity, while others will become lifelong residents of nursing homes.

In a compassionate, ethical society, every life is precious. We should not have to make a choice between acute medical care and rehabilitation for our citizens. The proposal to close Rancho underlines the crisis in our entire health system in which so many people are left vulnerable because they cannot afford health insurance. We are one of the few industrialized countries in the world that fails to provide health care for all of its citizens.

Rancho has been a significant source of knowledge and know-how for rehabilitation all over the U.S. and in the rest of the world. It is a leader in educating physicians and other health-care workers in the newest and best ideas and technology to help restore people to equality of capability. Many might believe that this "is nice but it doesn't apply to me." However, with increasing longevity, many of us will have disabling conditions. The knowledge generated by Rancho might be personally essential just as it is no longer available. I urge our county, state and federal officials to seek a comprehensive solution to our health-care crisis and rescind the vote to close Rancho Los Amigos.

Elizabeth J. Yerxa

Bishop, Calif.

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In "Seniors See a Doctor Shortage" (Nov. 4) you report that Medicare's low reimbursement rates are not the main reason why doctors are reluctant to take on new Medicare patients and point out that there are other reasons as well, including the "paperwork hassles, complex billing codes and a 'paranoia' about being accused of 'fraud and abuse.' " For many physicians, their unwillingness to take on Medicare patients is prompted more by this second group of factors than it is by the money issue.

Many physicians are fed up and worn out by having to waste precious time and energy on nonmedical tasks and worrying about being accused of not complying with the many regulations that are strangling them. Some doctors see every new patient taken on as a bundle of nonmedical, time-consuming and mind-numbing hassles. Doctors must be allowed to practice medicine unimpeded by the ever-increasing encroachment of guidelines and regulations, made worse by the fear of being prosecuted for fraud. This applies not only to Medicare patients but to all patients.

Edward J. Volpintesta MD

Bethel, Conn.

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