Frustrated emergency room doctors filed a class-action lawsuit against the state Tuesday, saying that California's overstretched emergency healthcare system -- which ranks last in the country for emergency care access -- is on the verge of collapse unless more funding is provided.
Across the state, scores of hospitals and emergency rooms have shut their doors in the last decade, leading to long waits, diverted ambulances and, in the most extreme cases, patient deaths.
Doctors say the situation is only getting worse. State officials, struggling to balance the budget, have proposed another $1.1 billion in Medi-Cal cuts.
"Are people truly suffering consequences? Absolutely," said Irv Edwards, one of the doctors represented in the lawsuit and president of Emergent Medical Associates, which staffs 14 emergency rooms in California. "This could happen to you or me. We could be traveling through San Francisco or San Jose, get in a car accident, have a broken leg and end up in the ER, where it takes hours to be treated regardless of our screams. Then we get to diagnosis, and they say, 'There's no orthopedic on call. I'm sorry.' "
The lawsuit comes a year after several healthcare groups, led by the California Medical Assn., sued the state and were granted an injunction that stopped a proposed 10% cut to the reimbursement rate for doctors, dentists and other healthcare providers. The Legislature instead passed a bill reducing current reimbursement rates by 1% to 5%, beginning March 1.
Emergency room physicians say they have been particularly hard hit by the state's low Medi-Cal reimbursement rates. Unlike other doctors who can choose not to accept Medi-Cal patients, emergency room doctors are required by federal law to treat every patient who walks through the door, regardless of their ability to pay.
In 2007 alone, emergency room doctors statewide say they have subsidized more than $100 million in services provided to Medi-Cal patients because the reimbursement rate often barely covers half the cost of treatment.
The problems are widespread, affecting urban cities as well as rural and poor areas of the Central Valley.
A national report card released last month by the American College of Emergency Physicians gave California a failing grade for access to emergency care. The state ranks last in emergency departments per capita, with only seven per 1 million people, compared with the national average of 20. And it ranks 43rd in the country for Medi-Cal reimbursement.
