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MTA Strike Interrupts Health Care

Many of L.A. County's poorest residents are going without medical care because they can't get to doctors or hospitals.

November 15, 2003|Sharon Bernstein | Times Staff Writer

For the full month that the mechanics strike has idled most of Los Angeles County's buses, 8-year-old Gerardo Garcia has been sick.

He has a bronchial infection that is so bad his doctors are afraid the passages in his lungs will swell and prevent him from breathing. He has an ear infection that has gone untreated for so long that he could lose his hearing.

Without public transportation, his mother had no way of getting Gerardo to a doctor. He made it, finally, to the offices of Dr. Pedram Salimpour on Tuesday, after his mother, Martha Garcia, found a ride.

"He started coughing, and then the strike came," she said.

Throughout the county, in the free clinics and the practices specializing in Medi-Cal where the poorest residents are treated, doctors and patients are telling stories like Gerardo's. Among them: the 78-year-old-man who suffered for three days with a dislocated finger before walking 17 blocks to White Memorial Medical Center in Boyle Heights and the diabetic who ran out of insulin and got a ride to a South Los Angeles clinic with overwhelming levels of sugar and acid in her blood.

At the 40 community clinics that provide care to many of the 2 million uninsured people in Los Angeles County, cancellations of routine medical appointments are as much as three or four times higher than typical rates, according to clinic directors. Similar no-show levels are reported at some county hospitals and clinics, as well as at private medical offices that serve the poor and working poor.

"It's a fiasco," said Salimpour, whose Sherman Oaks practice is several miles from the Garcia family's home in Panorama City.

The trains and buses that serve 400,000 Los Angeles County residents a day stopped running Oct. 14, when the mechanics who maintain the vehicles for the Metropolitan Transportation Authority walked off the job in a dispute over wages and health insurance. They were supported by unions representing drivers, dispatchers and clerks.

MTA board Chairman Zev Yaroslavsky and mechanics union President Neil Silver have worried about the effect of the strike on patients' access to health care -- and each has blamed the other.

"If somebody is getting sick because he can't get to the doctor, it's because of him," said Yaroslavsky, who believes that Silver called the strike in part to improve his position in an upcoming union election.

Pointing to a union offer -- spurned by the MTA -- to go back to work if the dispute were submitted to binding arbitration, Silver said, "It's not our fault. We offered to go back to work."

As the strike drags on, doctors and hospital administrators are scrambling to help patients as best they can. Most will see patients whenever they can get in, even though that can mean long waits and significant juggling of loads for labs and physicians.

Several hospitals are running shuttles to help employees get to work, and White Memorial has maxed out a program that offers patients van rides to the doctor.

Doctors at Kaiser Permanente's hospital on Sunset Boulevard in Hollywood gave a woman and her 11-year-old daughter a voucher for a taxi ride home after the girl underwent surgery on her arm. The two had walked two hours to get to the hospital for the operation, said a Kaiser spokeswoman, Pamela Dean.

Most medical offices and clinics have few such resources.

Yasser Aman, director of the University Muslim Medical Assn. Free Clinic in South Los Angeles, said that, in cases of extreme need, he passes out a small number of taxi vouchers that have been donated for use in emergencies.

Salimpour is trying to negotiate with taxi companies for discounted fares for his patients, and is referring them to social service organizations that provide rides and access to other services.

Many of his patients -- including the Garcias -- come from families that own cars. But the vehicles are needed to transport parents to work.

Sylvia Drew Ivie, executive director of T.H.E. Clinic in South Los Angeles, used her own car to drive expectant mother Shawn Garbutt to a hospital on Tuesday.

Garbutt, two children in tow and two weeks overdue with her third child, went to Ivie's clinic without an appointment because she thought the baby had stopped moving. She got a ride for part of the way and walked another 20 minutes, arriving at the clinic well into the medical condition that precedes labor.

"I had an appointment to come in every week," Garbutt said. "I was worried about the baby, but the only way I can get to the doctor is by the Metro."

At particular risk from missed appointments are children with asthma and related breathing problems, as well as people with chronic conditions such as diabetes, said Jim Mangia, chief executive officer of St. John's Well Child and Family Center, which cares for 40,000 people annually at six clinics in Los Angeles.

Since the strike started, patient loads have dropped by 200 people per week at the organization's clinic near Exposition Park, Mangia said.

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