assault on a community

Richard S. Baker, M.D.Charles R. Drew University of Medicine and Science

Assistant Dean, Office of ResearchProgram Director,

Research Centers in Minority Institutions

Assault on

a

Community

Discussion Points

• What is the purpose of a public hospital?

• The public hospital system in Los Angeles County (Department of Health Services)

• How important is KDMC in the County health system?

• Why is King a target for elimination?

• How is King hospital being set up for failure?

Function of Public Hospitals

• Special services for the entire community

• Specialty services for physician shortage areas

Special Services

• Burn unit

• Trauma unit

• Neonatal Intensive Care Unit (NICU)

Specialty Services

• Cardiology

• Ophthalmology

• Ear, nose, throat

• Neurosurgery

• Dermatology

Discussion Points

• What is the purpose of a public hospital?

• The public hospital system in Los Angeles County (Department of Health Services)

• How important is KDMC in the County health system?

• Why is King a target for elimination?

• How is King hospital being set up for failure?

L.A. County Health System

• Largest county in the U.S.

• Second largest public hospital system

• 5 hospitals

Discussion Points

• What is the purpose of a public hospital?

• The public hospital system in Los Angeles County (Department of Health Services)

• How important is KDMC in the County health system?

• Why is King a target for elimination?

• How is King hospital being set up for failure?

Five mile service areaDemand for services

Hospital

Total population

Service population

High Desert 49,985 10,765

Olive View 199,420 78,539

County/ USC 740,386 431,156

King/Drew 721,188 449,172

Harbor/UCLA 416,629 132,403

Five mile service areaPhysician density (specialists per 100,000)

Hospital Specialists Service Population

Physician per 100,000

High Desert 6 10,765 56

Olive View 46 78,539 59

County/USC 470 431,156 109

King/Drew 96 449,172 21

Harbor/UCLA 355 132,403 268

Number of hospitals per SPA

SPA (Service Planning Area)

# of hospitals Service Population

SPA 1-Antelope Valley

3 104,844

SPA 2-San Fernando Valley

28 635,639

SPA 3-San Gabriel Valley

26 581,696

SPA 4-Metro 27 612,548

SPA 5-West 8 141,881

SPA 6- South 5 547,388

SPA 7-East 23 521,313

SPA 8-South Bay/Harbor

21 548,106

Department of Health Services “speak” and Department of Health Services code words

• Decompression

• Consolidation/regionalization

• Efficiencies

• Utilization statistics

Discussion Points

• What is the purpose of a public hospital?

• The public hospital system in Los Angeles County (Department of Health Services)

• How important is KDMC in the County health system?

• Why is King a target for elimination?

• How is King hospital being set up for failure?

L.A. County Department of Health Services

• 2 federal (billion dollar) bailouts

• 2 DHS failures

• $500-$750 million dollar deficit

Original Rational Health Plan

• Reduce L.A. County/USC

• Reconfigure/reduce Harbor/UCLA

• Reconfigure/reduce High Desert

Discussion Points

• What is the purpose of a public hospital?

• The public hospital system in Los Angeles County (Department of Health Services)

• How important is KDMC in the County health system?

• Why is King a target for elimination?

• How is King hospital being set up for failure?

Department of Health Services “speak” and Department of Health Services code words

• Decompression

• Consolidation/regionalization

• Efficiencies

• Utilization statistics

Designed System Failure

• Systematic reduction in resources

• Institutional character assassination/media campaign

• Cronyism/conflict of interest

• “Race politics”