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Commentary | VOICES / A FORUM FOR COMMUNITY ISSUES

Bill Would Inject Life Into Medical System

September 11, 2004|Melvin H. Kirschner

Food, water, shelter and care; those are the things that even the cavemen and hunter/gatherers knew were necessary for survival. Yet what is happening in our society? Are people starving? Are people lacking shelter and medical care? Unfortunately, yes.

As a physician, I have attended patients in the San Fernando Valley for 43 years. During that time, I've admitted many patients to the first hospital in the Valley, earlier called Valley Receiving Hospital and now known as Northridge Hospital, Sherman Way Campus. In my early days as a doctor, there were no paramedics or 911 to call in a medical emergency. If one of my patients called with chest pain in the middle of the night, I grabbed my EKG machine and stethoscope and did a house call, or had an ambulance take him or her directly to the only emergency room in the area, Valley Receiving Hospital.

Now that hospital has announced that it will be closing for financial reasons. Judging from my recent difficulty in finding a hospital bed for a very sick patient, I see no surplus of available beds. My patients complain about hours-long waits in overcrowded emergency rooms. Yet I hear of one hospital after another closing.

The law states that no one can be turned away from an emergency room without an evaluation and, if too sick to transfer, a patient must be hospitalized. The only exception is if the medical services required are not available at the hospital served by the emergency room.

Northridge Hospital's administrator says the facility is losing money -- despite the fact that bed occupancy is high and the emergency room is busy. The next-nearest hospital, about two miles away, claims it will be able to accommodate the inpatient and emergency room load when the Sherman Way Campus hospital closes. But I'm on staff at both hospitals, and I don't believe that can be done.

The people who analyze such things claim that hospitals are closing because of inadequate reimbursement by health insurance companies and the need to deal with the large number of uninsured people in California who cannot afford to pay. Add to that the recent state-required increase in the ratio of skilled nurses to the inpatient population, the rising cost of equipment and medication and required earthquake retrofitting, and you have an overhead that many hospitals can't tolerate.

The biggest obstacle for some hospitals is the expense of the earthquake retrofitting. But the Sherman Way Campus hospital has not had significant earthquake damage. It would be a pity if a buyer of the property tore down a perfectly good hospital building and replaced it with something significantly less important to the community.

If state Sen. Sheila Kuehl's legislation for a healthcare plan to cover all Californians passes in the next couple of years, we may yet have a way of paying for medical care and keeping our remaining hospitals financially solvent. Where would the money come from? Some from premiums now used by the health insurance industry for advertising, redundancy, obscene executive salaries and stockholder profits, not one penny of which is buying medical care for the patient. The state also would be able to hold costs down by negotiating prices for medicine and medical equipment. Providers would have fewer expenses because they would have a single agency to bill and one set of rules to follow. And we'd all have health insurance.

Melvin H. Kirschner is a physician in Van Nuys.

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