August 11, 2007

Feds Abandon ML King Hospital, State Kills It

Martin Luther King Hospital in Los Angeles has one of the worst reputations in the nation among major metropolitan hospitals. In 2004, the Los Angeles Times ran a devastating exposé on the hospital, showing how federal funds went to waste in a mismanaged muddle that spent far more per patient than any other hospital in the area. Yesterday, the federal funding disappeared -- and so will MLK Hospital:

Martin Luther King Jr.-Harbor Hospital shut down its emergency room Friday night and will close entirely within two weeks, a startlingly swift reaction to a federal decision to revoke $200 million in annual funding because of ongoing lapses in care.

The extraordinary developments mark an end to nearly four years of failed attempts to reform the historic institution, treasured by many African Americans as a symbol of hope and progress after the 1965 Watts riots.

Los Angeles County health services director Dr. Bruce Chernof announced the closure plan Friday afternoon, hours after the hospital learned that it had failed its final test, a top-to-bottom review by the U.S. Centers for Medicare and Medicaid Services. The hospital, formerly known as King/Drew, has shown itself unable to meet minimum standards for patient care since January 2004, according to the regulators.

This is a catastrophe for that area of Los Angeles, and an entirely avoidable catastrophe at that. California and LA knew of the decline of care and management at that facility for many years but felt powerless to intervene, thanks to an explosive political environment in the area. The hospital literally could not even clean its equipment correctly, despite numerous citations, and the level of care was so poor that keeping its doors open represented a grave risk to the community.

Supporters of the hospital used to insist that the state and federal governments purposely underfunded King, but the Times exploded that myth in 2004. It spent more per patient than 75% of the public and teaching hospitals in the state -- $685 more per patient than County/USC, which also operates in a tough neighborhood but with much better performance. King had a $342 million budget in 2002 compared to Harbor-UCLA's $372 million, but Harbor-UCLA is a much larger facility 10 miles from King. Harbor admitted 91% more patients and treated 61% more in its emergency room, and also performed more chronic-care treatments like transplants and cardiac surgery.

So where did the money go? Here are some examples from the 2004 article:

• In the last five years, King/Drew has spent nearly $34 million on employee injuries — 53% more than Harbor-UCLA and more than any of the University of California medical centers, some of which are double or triple King/Drew's size. Employees make claims for such things as damage to their "psyche," assaults by their colleagues and a variety of freak accidents, according to a Times review of workers' compensation claims.

• Last year, King/Drew employees billed for 299,804 hours of overtime, costing the hospital nearly $9.9 million. That's 61% more than the sum spent by Harbor-UCLA, which has about 400 more workers. Fourteen King/Drew employees pulled in more than $50,000 each in overtime. At Harbor-UCLA, there was one.

• Some employees habitually fail to show up, logging weeks, even months, of unexcused absences each year. And those who do come to work often don't do their jobs, causing one consultant in 2002 to remark that they had "retired in place." Others are distracted or impaired. County Civil Service Commission filings tell of staff members grabbing and clawing each other's necks; inspection reports tell of patients literally dying of neglect.

• King/Drew pays its ranking doctors lavishly. Some draw twice what their counterparts make at other public hospitals — often for doing less. Eighteen King/Drew physicians earned more than $250,000 in the last fiscal year, including their academic stipends. Harbor-UCLA had nine.

It's a disgrace, and the 2004 report should have changed things at King. Obviously, they did not. The new Medicare report lists some egregious failures, such as:

* A failure to clean bronchoscopes after examinations, which allowed the transfer of pulmonary infections

* Failure to respond properly to pediatric emergencies, including an inability to locate their equipment

* Leaving a psychiatric patient unattended with access to a scalpel, with predictable but non-fatal results

Last year, in an incident that clearly showed the facility's commitment to the health and welfare of its patients, a 43-year-old woman died after writhing in pain on the emergency room lobby floor for 45 minutes. Did any of the hospital staff come to her assistance? No, but the janitor dutifully mopped up the blood she was vomiting the entire time.

The decision to close King comes as no surprise, not even to the governments that funded and managed it. The only surprise was that it took this long to stop putting more money into a clear danger to the health of the community. The county now wants to see if a private-market group can be found to reopen King, but they haven't found one yet -- and it seems unlikely that they ever will.


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» Around The Sphere August 11, 2007 from The Moderate Voice
Our famous linkfest offering readers interesting links to websites of varying opinions so they can explore the ’sphere. Links do NOT necessarily represent the viewpoints of The Moderate Voice or its writers. It Has Been OBAMA VS. GATES VS. MUSHA... [Read More]

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Almost exactly two months ago, we reported on a sickening story out of Los Angeles: "(T)he folks in the ER at Los Angeles' Martin Luther King Jr.-Harbor Hospital and two different 911 dispatchers, who refused to send an ambulance to help the poor ... [Read More]

Comments (37)

Posted by Redman | August 11, 2007 8:49 AM

Just rename it "Hillary Clinton General Hospital."

Posted by GarandFan | August 11, 2007 8:55 AM

A lot of politics going on at that hospital, which is what kept it going all this time. Pick any problem and there would be 6 excuses for it.....and it was all someone elses fault. Now the inept workers can draw unemployment.

Posted by RBMN | August 11, 2007 9:08 AM

Once an institution becomes a "retire in place" workplace, then that's who it attracts. Run a whole city that way, and you end up with pre-Katrina New Orleans, where half the police force felt free to skip town, if something bad were to happen. Some people just need their 12 hours of sleep each day.

Posted by Bennett | August 11, 2007 9:08 AM

This hospital is located in a primarily Black community and most of the staff is presumably drawn from that community. Incompetence, corruption and neglect are not unique to the African-American community but an unwilligness for anyone to do anything about it until it's too late --because of incendiary racial politics-- is a terrible price for the sick and infirm to pay.

Posted by davod | August 11, 2007 9:58 AM

Socialised medicine at its worst.

Posted by blackstar | August 11, 2007 11:03 AM

Hey Bennett, just blame someone else. That's why libs like you can't be trusted with anything, no less running our entire nation's health care system: your corruption, your neglect and incompetence is now the White-man's fault. Pathetic. An unwilligness for anyone to do anything about it? Hardly. Anyone who tried to do something about it ended up like Vince Foster.

Posted by richard mcenroe | August 11, 2007 11:15 AM

Jusr a clarification: the useless Los Angeles Times did NOTHING to expose King/Drew. The alternative press in Los Angeles, particularly the defunct New Times, was exposing the disasters and patient deaths at that sump way back in the 90's. The LAT ignored the story, out of fear of offending African-American community leaders because the primary malefactors at the hospital (staff AND management) were black.

Of course, once they had the feds to hide behind, LAT was all over the story.

Posted by nahncee | August 11, 2007 11:51 AM

The only surprise was that it took this long to stop putting more money into a clear danger to the health of the community.

The thing is, the community WANTED this hospital to stay open, demanded it, even. As other posters have noted, it's in a heavily black, unemployed, uninsured neighborhood, so having their own hospital handy meant that (1) they could pretend like their lives are "normal" and that they get respect from "da man", and (2) it was sign of preferential treatment that was promised as appeasement after the Watts riots.

Never mind that the hospital was actively killing them -- that wasn't and isn't important.

I haven't seen statistics because I haven't paid *that* much attention to the issue, but I also wonder how much of the hospital's activities revolved around treating gunshot wounds and knife attacks, the results of a self-chosen lifestyle of gang association.

You gets what you pays for. The people in this are weren't paying anything, and that's what they got: nothing, and resultant death. It's never seemed right to me that this hospital was functioning on taxpayer generosity, and treating wounds that were the result of selfish and/or stupid behavior.

(Not that it makes any difference, but the woman writhing on the floor for 45 minutes was a crack addict and alcoholic who had been to the hospital for imaginery "emergencies" so many times before that her case was very much a case of crying "wolf" too many times catching up to you. From the stories about the case, I also question whether or not she spoke English.)

Posted by Bennett | August 11, 2007 11:54 AM

Thank you for proving my point, Blackstar.

The patients don't run the hospital. They shouldn't have to pay the price because the people who work there were allowed to run it into the ground because it's in a Black neighborhood and, therefore, no one wanted to do anything about the problems for fear of the Blackstar reaction, Al Sharpton style.

Posted by John Stephens | August 11, 2007 12:57 PM

I hope that janitor can find a new job. He was probably the only one there who did what he was hired to do.

Posted by Aldo | August 11, 2007 1:19 PM

In every article about the hospital the Los Angeles Times includes the boilerplate about how it is "treasured by many African Americans as a symbol of hope and progress after the 1965 Watts riots." In the context of racial identity politics, the word "symbol" (like "justice") translates into money, and the hospital has always been understood to serve as both a provider of healthcare and a provider of sinecures to African Americans.

MLK's downfall was a calculated move by the LA Times, which has served for decades as the house organ and protector of California's liberal establishment. The Times had been getting criticism for years over its biased and PC reporting. The criticism came to a head, and received national exposure, during the recall campaign against Democratic Governor Gray Davis, who the Times' worked hard to prop up. After they lost that campaign to Arnold, the Times began casting about for an investigative target that would rehabilitate its image.

MLK hospital was perfect, because exposing it was undeniably politically incorrect, incurring the wrath of all the usual racial demagogues, but the damage to the local Democratic establishment would be minimal. Both supporters of the hospital and critics of the way patronage had been allowed to destroy it would focus their anger over MLK's demise on Supervisor Yvonne Burke, a dinosaur who is retiring after a long and undistinguished career. Active liberal players and power-brokers would emerge unscathed.

If the Times had chosen to target the school district instead, which teachers unions that support the Democratic party have turned into the educational equivalent of MLK, the paper would cause too much damage to the liberal establishment.

Posted by pk | August 11, 2007 2:15 PM

Hey Aldo:

you got it right on the button.

liberal political patronage at its finest.


Posted by richard mcenroe | August 11, 2007 3:04 PM

Nahncee -- got it. She was puking up blood in Spanish. Makes all the difference. What was I thinking?

Posted by pk | August 11, 2007 3:52 PM

a certain lawyer quoted in the la trash was sniviling about the county deputies arresting the weoman just before she died.

they had been called and being fully aware that when finding someone in distress there was a regulation that they MUST take her to the NEAREST emergency room (which was where she was dieing by being ignored). they found out that she had a warrent and so they arrested her and were taking her to the nearest jail (lights and sirens) with medical facilities where they could at least find out what was wrong with her and treat it or take her to a really good hospital.

problem was she died as the deputies were wheeling her out the door.

and this festered r#$%*m wants to sue the deputies for malpractice.

there is a comphrensive set of articals in todays LA times (not requiring regristration at this moment).


Posted by NahnCee | August 11, 2007 4:05 PM

Nahncee -- got it. She was puking up blood in Spanish. Makes all the difference. What was I thinking?

Make any difference to you whether or not she's illegal, and YOU will have to pay the hundreds of thousands of dollars to patch her back up to where she can resume her career of addiction and alcoholism? Just like YOU have to pay for all the gangbanger shootings where they're not killed outright but require months of hospitalization and years of physical therapy.

But hey - we're all rich and just because bridges are collapsing because of lack of support for the infrastrucutre, I'm sure it's much more important to take care of illegal alien crack addicts puking blood.

Posted by acetag | August 11, 2007 4:13 PM

MLK is representative of what the dems want for national health care, as well as the result.

Posted by Bennett | August 11, 2007 4:36 PM

How a society cares for the least among it is supposed to be indicative of something, its decency I guess. The woman who died on the floor of the emergency room would represent the least among us. She didn't die because she wasn't worthy enough to live, she died because the people who were paid to see that she didn't were incompetent. At least the police tried to do something.

Posted by Del Dolemonte | August 11, 2007 6:44 PM

RBMN wrote:

"Once an institution becomes a "retire in place" workplace, then that's who it attracts. Run a whole city that way, and you end up with pre-Katrina New Orleans, where half the police force felt free to skip town, if something bad were to happen. Some people just need their 12 hours of sleep each day."

Speaking of New Orleans-and health care-grab an adult beverage and make some popcorn for this story about the lawsuit down there:


"Having missed a deadline to challenge a subpoena requiring Gov. Kathleen Blanco to testify in the St. Rita's nursing home trial, the state attorney general's office asked for an emergency extension and, barring that, requested that Blanco give a closed-door deposition rather than be cross-examined on her response to Hurricane Katrina in open court.

Defense attorneys subpoenaed Blanco on July 10 in connection with the upcoming negligent homicide trial for Sal and Mabel Mangano, who owned the St. Bernard Parish nursing home where 35 residents drowned during Katrina. "

entire story is here:

Posted by ERNurse | August 11, 2007 7:02 PM

Bennet, you wrote: "This hospital is located in a primarily Black community and most of the staff is presumably drawn from that community. Incompetence, corruption and neglect are not unique to the African-American community but an unwilligness for anyone to do anything about it until it's too late..."

This statement proves that you are a liberal jerkoff who thinks that he has the natural authority to pontificate on a subject about which he knows nothing. Furthermore, your interjection of race into the issue proves your idiocy to a deeper degree.

Only a liberal would do that. If this was a hospital in a predominantly white community, you would not give damn number one about it, would you?

I think that everyone here knows the answer to that question.

Posted by Bennett | August 11, 2007 7:34 PM

As I stated in response to another bilious commenter, thank you for proving my point. Reducing the issue to one of racial identity is why the MLK Hospital situation was never dealt with in a proper manner. This was, after all, my point. Because it was in a Black neighborhood everyone was afraid to do anything about it for fear of the backlash. And based on your response, apparently they were right.

The blog owner raised the issue of race in quoting from the article as follows: "The extraordinary developments mark an end to nearly four years of failed attempts to reform the historic institution, treasured by many African Americans as a symbol of hope and progress after the 1965 Watts riots."

Your political sensibilities are meaningless to the people who died because of neglect in that hospital. But hopefully they are of some comfort to you.

Posted by NahnCee | August 11, 2007 7:35 PM

If it was a hospital in a primarily white community, the citizens living around it would have jobs, would be insured, could pay for their care, and it wouldn't be the same problem.

Check out the remaining hospitals in Los Angeles, and especially the emergency rooms that are still open. You'll find 99% of them are in Santa Monica, Beverly Hills, Hollywood, Burbank, Glendale and Pasadena. Then check out census statistics on who makes up those neighborhoods.

Hospitals that are required, by law, to take a majority of patients who can't pay simply cannot make it any more without massive infusions of taxpayer dollars, like LA's County/USC. If you're determined to provide care for illegal crack smoking alcoholics who shoot each other, then we need to carve a bigger chunk out of our tax dollar to donate to that cause. I'm not convinced it's worth it, either personally for me as a taxpayer or to make my country stronger, partially because I don't see illegal crack-smoking alcoholic gunshot victims as being the weakest member of "my society".

Posted by Bennett | August 11, 2007 7:59 PM

My "God" badge hasn't arrived in the mail yet so I don't feel qualified to decide who's worthy and who isn't of proper medical care. And I can't really be sure that those who think only certain people are deserving of it would put me on the correct side of that line.

And if someone finds "illegal crack-smoking alcoholic gunshot victims" as unworthy, what should we do with chronic overeaters or people who don't watch their cholesteral or their salt intake and develop diabetes or hardening of the arteries. Oooh and smokers, what about smokers? Is bad behavior okay as long as you have insurance and live in a good neighborhood?

This hospital had more than enough funding to take care of its patients. The problem is it was run by incompetent people and allowed to be run that way because it was in a Black neighborhood and anyone who tried to do anything about it would run into the Al Sharpton barricades, that any effort to clean things up would be shouted down in a fever pitch of racist demogaugery. Alternatively, the attitude would be oh it's just illegal crack whores and gangsta gunshot victims, who gives a hoot (as demonstrated here today).

Posted by docjim505 | August 11, 2007 10:08 PM

I think some of the commenters here are talking past each other.

I think that we all agree that the situation at MLK was deplorable. I also think that race unquestionably played an role: the hospital (apparently) was built as a racial "peace offering" and, unfortunately, it escaped anything like good oversight for the same reason. And, at risk of sounding like a total bigot, I think that it's "clientele" had something to do with its problems, though they were not responsible for the outrageous negligence, apathy, and mismanagement that seems to have been rampant at MLK.

Do any of us want to see a hospital operated like this in ANY city or community in our country? Of course not.

Now, as for deciding who does and doesn't get to live... It IS hard for me to whip up a lot of sympathy for a crack head or gang banger who shows up at the hospital gravely ill or dying from his / her lifestyle choices (and, in answer to your question, Bennett, I'd have similar feelings about a grossly obese person, a heavy smoker, or a drunk driver). Should they be denied treatment? Of course not, but forgive me if I'm not as eager to save a hoodlum (or a 400 lbs cardiac patient) as I would be to save a four year old girl.

It will be interesting to see how this plays out. I think we can safely assume that there will be shrieks of outrage and cries of "racism" from the usual suspects. Calls for MORE federal funding won't be far behind. How DARE the US government stop funding a hospital in Los Angeles! (though I'm not sure where the Constitution gives the Congress the authority to fund any hospitals in the first place, unless they are for military use) Naturally, the solution to this problem will be (drum roll, please) higher taxes and socialized medicine! Yep; if ONLY there'd been MORE money available, MLK wouldn't have had these problems. In fact, MORE money would have made MLK a model hospital. If Chimpy McBushitler wasn't wasting so much money on his illegal war for oil in Iraq, the problems at MLK would never have even happened. In sum, it's All Bush's Fault (TM) because he hates black people just like Katrina was all his fault and the only people dying in Iraq are black.

My head hurts...

Posted by firedup | August 11, 2007 11:29 PM

Bennett, the real racial problem is not the clientele of the hospital but the administration and staff. To point out that black administrators and staff are incompetent would be the taboo heresy. But the facts show that some black administrators and doctors did not even have proper training or credentials, yet were highly placed due to the desired demographic.

Additionally, non-black competent staff were badly treated. I refer back to local press articles, such as New Times referenced above.

Listen, if you've never been a non-black person working in a black-dominated workplace, you have no idea. I do, and it so happens in a medical setting.

Nevertheless, now these patients will be shifted over to Harbor/UCLA in one direction and Kaiser Permanente WLA in the other direction. The West L.A. Kaiser hospital just happens to be one of six CA Kaiser locations recently slapped with multi-million dollar fines by the feds and deservedly so. Don't ask me about the "culture" at Kaiser, just put two and two together.

Nahncee, you forgot to mention Westwood in your list of local emergency rooms. UCLA hospital ER is also one of the few trauma centers, marked for mass casualty events/disasters. The ER is severely overburdened with indigent illegals also; in fact, they train the social work and medical staff to serve this non-paying clientele royally.

So, to get back to Bennett's assertions, you need not worry about the non-insured being underserved in L.A. area hospitals. But, for the insured, it can be a nightmare.

I have been on the "inside" for quite some time and that is what I base my comments on.

Posted by Bennett | August 12, 2007 1:12 AM

"Bennett, the real racial problem is not the clientele of the hospital but the administration and staff. To point out that black administrators and staff are incompetent would be the taboo heresy. But the facts show that some black administrators and doctors did not even have proper training or credentials, yet were highly placed due to the desired demographic."

Uh, this is pretty much the point I made hours ago. And more than once. Although I had no idea that it would lead to comments about how the patients are all crackheads and gangbangers and therefore not worthy of proper medical care, or something to that effect. Well, actually I think it's been decided that only the truly innocent are deserving of competent care. Small children and health nuts apparently. This will certainly free up a whole lot of hospital beds. And malpractice lawsuits will be resolved quickly if the standard of care is only important as long as the patient is sympathetic enough. Nor did I know that the lack of health insurance is now a badge of inferiority.

Two sides of the same coin here: can't call a Black person incompetent lest you be labeled a racist. Can't express sympathy for the victims of that incompetence lest you be called a socialist/liberal/illegal alien-crackhead-gangsta lover.

Posted by ERNurse | August 12, 2007 2:16 AM

Bennett, you wrote: Reducing the issue to one of racial identity is why the MLK Hospital situation was never dealt with in a proper manner.

And prior to that, you wrote: "This hospital is located in a primarily Black community and most of the staff is presumably drawn from that community.

Yet you accuse me of "Reducing the issue to one of racial identity," do you? God's teeth! Not only are you an idiot, you're a hypocrite, too.

Posted by jeanneB | August 12, 2007 6:31 AM

Acetag said: MLK is representative of what the dems want for national health care, as well as the result.

One small correction: it's not what they want. But it is what they will inevitably get.

In a bureacracy, the biggest difference between conservatives and liberals is that liberals see no reason to say "No" to any given individual, whether employee or patient.

First, look at the way MLK dealt (didn't deal) with employees: paychecks continued regardless of infractions. FIre someone for not producing? Forfend! Question a "Psyche" injury or work comp claim? You might appear "mean" if you say no! And that single mom NEEDS that paycheck! Who are YOU to judge another? Easier to just ignore it.

Now imagine liberals in charge of national health care. When would they say "No"? Perhaps to the cancer patient who wants to join a cult devoted to worship of the constellation Cancer? Well, she really really really believes it will help! Again, who is the bureaucrat to say "no" when this issue is SO important to the patient?!! The bureaucrat's answer is to go to her known-to-be-so-compassionate boss and arrange for the cult to be added to the list of approved providers. Now EVERYONE can join with all expenses paid! Not only that, it's only fair that we pay past expenses for people who had already joined...why should they be denied equal coverage?

That's how bureaucracies think. No one should ever have to make a difficult decision regarding someone else's life [like those mean old insurance companies do!]. That's why liberalism is so easy and, in the end, unaffordable. Nobody's in charge of saying NO. Of course, when the costs eventually catch up with them they start saying no, but only to whole groups, starting with designated "undesirables": first come the smokers....then the obese....then the gun owners....well, you get my point.

Posted by Bennett | August 12, 2007 9:32 AM

To ERNurse: you twist my comments and ignore the context of the point I was trying to make to prime your name-calling. I notice you conveniently ignore the fact that the blog writer first introduced the location of the hospital into this discussion.

You made it a black vs. white issue (that I'm a "liberal jerkoff" and don't care what happens to white people) hence my comment that you reduced the issue to one of "racial identity". Black people bad, white people good. Okay, got that. Others here have posited this as well.

But then perhaps you were one of the nurses who stood around while the woman choked to death on her own blood at MLK. Sounds like you wouldn't have had a problem with that (if you're an ER nurse at all). I can only hope you're not employed by any medical care facility within 1000 miles of where I live.

Hint: the first person to resort to pejoratives is always the loser in any debate, especially when the slurs aren't all that creative. Work on your name calling in between administering poison to any patient you suspect of being a liberal.

Posted by eaglewings | August 12, 2007 10:18 AM

I agree this is socialized medicine almost at its worst. But if dems had their way, and the entire system were socialized then I doubt the facility would be closed, taxes would be increased instead to fund these institutions and inefficiencies would grow exponentially. I feel sorry for the African Americans, latinos and others who lost a major medical facility, but again, dependence on the gov't for those 200 million in funds without running the hospital like a business produced a self destructive managerial mentality that became a self fulfilling prophecy.

Posted by firedup | August 12, 2007 11:49 AM

Bennett, your POV is not clear... that is why you get the responses you get.

From your further comments, I gather your sympathy lies with the patients, the community that will not longer be ill-served by this hospital. The closure of the hospital is a win for them. And, you may have overlooked my commentary that the uninsured patient is served by every extant hospital and ER in the area. Not to worry.

To other commenters: It's unbelievable to me that you expect medical staff to discriminate based on patient's lifestyle. There is such a thing as medical ethics as defined in the Hippocratic oath. That said, ER staff are trained to triage and have guidelines for addressing the most urgent cases.

For Heaven's sake, this has NOTHING to do with liberal politics or liberal thinking. Medical ethics are non-partisan. Kind of like God is non-partisan.

In medicine, life is the over-riding concern. MLK hospital showed negligence in upholding that concern.

Posted by BiilH | August 12, 2007 2:06 PM

Thats what happens when you hire dead beat Homies to work and run your business!

Posted by inmypajamas | August 12, 2007 2:09 PM

firedup -

I can vouch for your experiences working as a white "minority" in a public health setting. It is very, very touchy and skin color either protects you from accountablity or puts you in front for it. Most places I have worked do put patient care above the pettiness, thankfully (though the difficulty in removing incompetent staff "of color" is ridiculous).

As a health care provider, I am not permitted to withhold care for any reason from anyone. There are times when you fail to see the point of treating and releasing the alcoholic who comes in time after time for the same problem or the pregnant illegal who shows up in her eighth month but you do it anyway. I take care of the patient, not their legal or financial status. That is for others to work out though increased border enforcement and legislation (and I vote for those willing to take on those issues).

The MLK hospital is a lesson in pouring tax-payer money into a feel-good cause while protecting anyone with the right skin color from accountability. People make mistakes and need to be called on to correct them, regardless of race. Hope the powers that be keep that in mind if they build a new facility.

Posted by AC O'Brein | August 12, 2007 6:15 PM

Hippocratic doctors ripping a failing hospital off with $250,00 a year, letting patients die on the ER floor and the failed doctor/splodydopes in the UK. Oath, smoath! They're probably raising their left hand and using a fat phone book. Heh, heh...

Posted by firedup | August 12, 2007 6:29 PM

inmypajamas, you know better than I do what those words mean... you live them. I'm working as scheduler now, a patient liaison, I became familiar with names that recurred, or the "professional patients" as I called them.

Per the currently over-stressed ERs and healthcare system in general, it would be VERY helpful if someone with the authority had the guts to enforce immigration law... I AGREE!

Healthcare workers should never be placed in the position of having to do so. An attempt was made here in CA to pass legislation requiring hosp. admissions to report citizenship status.... thankfully, it failed!!

Posted by ERNurse | August 12, 2007 6:39 PM

Bennett, allow me to explain the realities of Emergency Medicine to you.

First, you need to understand that federal law prohibits turning any person (and I mean any person) away without providing at the very least a medical screening and care for life-threatening problems. That law is called the Emergency Medical Treatment and Active Labor Act (EMTALA for short). What that means is that if you show up in an ER, you have to be seen regardless of your ability to pay. And personally, I think that that's a very good thing.

Now, logically, ERs located in areas where the demographic relies more heavily on public funds for their health care are going to be flooded with patients who cannot pay their expenses. Note that the ER must still provide at least a medical screening and referral and must also provide care for life-threatening problems.

But hospitals do not operate on magic pixie dust. It takes a helluva lot of money to run an ER, let alone a top-flight one (including the one in which I work, which is one of the top 17 in the nation for heart attack care). Nobody works for free. Medical equipment is bloody expensive. And the bottom line is that whether it be staff, equipment, or whatever, if you can't afford it, you do without. Publicly-funded hospitals in urban areas serving a predominantly poverty-level community have a hard time keeping their doors open, because their patients don't pay for their care, and you can be sure that the government does not compensate the facility at an amount even close to the cost of providing the service. A hospital that can't recoup its losses cannot pay its staff, and so it loses staff. Fewer staff and poorer equipment directly translates to a degradation in the quality of health care.

Now let me say this: financial woes, understaffing, or lack of equipment aside; there is NO EXCUSE for allowing a human being to die in the triage area. It appears that this woman and another gentleman made alot of noise about the woman's deteriorating condition. Nothing says "I am sick" quite like vomiting a stream of bright red blood. It has a way of getting our attention, and any medical staffer with a conscience would get that woman beck to a room PRONTO. But that didn't happen. As a nurse, I want to know why the hell not just as much- probably even more- than you do.

It has been said here and elsewhere that King/Harbor has had a long list of grievances against it for years, and that JCAHO pulled K/H's accreditation for noncompliance. But here's the rub: whether the hospital had accreditation or not, the people still had to go there because it was the only game in town.

Why didn't K/H try to get into compliance with JCAHO and DOH? I don't have the answer to that. It could have been that the hospital did not have the capital to spend on corrective measures, but I am only guessing at that. But remember- money makes the world go around, and hospitals are no exception.

It isn't about race. It isn't about color or immigration status. It's about hospitals not being compensated for providing care that costs a helluva lot of money to provide. It's about the inevitable result of reduced finding which results in reduced staffing and reduced quality of care. And, more than any of those things, in this case it is, unfortunately, about apathy. Obviously, the people in the ER who could have done something instead made a conscious decision to ignore this woman. For the record, I find that decision to be morally and shameful, ethically repugnant and inexcusible. Any hospital that would allow its staff to treat human beings with such callous disregard deserves to have its accreditation yanked and its doors shut.

But the real losers in this awful situation are the people who live in the community who are now forced to go elsewhere and who, due to their continued inability to pay for their care, will create a greater burden on neighboring hospitals who must now provide care not only for their host community but also for these people.

And do you think that the government at any level is going to pony up to assist these hospitals in remaining in compliance? Hell, no. And let me tell you now: universal healthcare will only make it worse. If you think one woman dying in the triage area of one publicly-funded hospital is bad, you ain't seen nothing yet. Universal healthcare will make that a national trend.

So there you go. Finally, in answer to your willingness to smear my professional ethics and moral character in order to cover up your pitiful lack of understanding, here is my response: F**k you in the neck with a brick, you ignorant toad.

But if you are ever in my ER, your affiliations and personal stupidity mean nothing. You'll never find a fiercer advocate for your care and well-being.

Posted by jaeger51 | August 12, 2007 8:02 PM

Now wait a minute. The discussion here seems to have turned into one about expensive health care for people that CHOOSE to lead lives involving drugs and violence. Whatever happened to people taking responsibility for their own choices? Deciding to do crack and put yourself in situations where there is a pretty good chance you will be shot or stabbed is not the same as eating too many potato chips or not exercising. As someone who makes choices everyday based on the results of those choices, it annoys me when I am expected to cough up for those who do whatever and expect me and those like me to pay for them, meanwhile not having enough left after taxes and fees to indulge what I want to do. The statement "the wages of sin are death" is not necessarily a completely religious statement. It means if you make dumb choices, you may die. Some time ago in this country, many lost track of the difference between people that deserve help, and people that decide to do whatever they feel like at the moment then expect rescue from those who didn't succumb to impulse and therefore have more than they do. The four year old girl who gets cancer deserves aid. The grown man who decides to smoke crack and gets shot by another addict doesn't. Seems morally clear to me.

Posted by ERNurse | August 12, 2007 9:15 PM


Please don't misunderstand me; I am by no means a proponent of any program that enables addicts and layabouts to continue being addicts and layabouts. In fact, I think any government program that provides services for people without requiring them to seek gainful employment and legal entertainment is a bad one- which means just about any government program you may name.

However, an odd tension exists in the world of health care: We see firsthand how "welfare medicine" destroys the economic infrastructure of a hospital; yet we also recognize that to withhold care to certain populations due to financial status is morally wrong. And think about it: it really is. I don't think you'd want me, as a triage nurse, to tell you that I won't even look at you- or your loved one or child- until you first show me proof of current health insurance, and if you don't have it, then it sucks for you, pal, sorry about that.

The whole reason for EMTALA was that hospitals were having their ERs do precisely that. People died without receiving treatment for life-threatening conditions. It was bad, and it needed to change. In my opinion as an ER nurse- and a CONSERVATIVE one, I remind you- EMTALA has improved the overall health of Americans.

Now here's another thing about EMTALA: no liberal will ever cite it. Why not? Because it would make their claim that there are Americans who are barred from access to health care an outright lie. And because we have EMTALA, that argument is a lie. Any American can walk into an Emergency Department and receive medical screening AND life-saving treatment regardless of ability to pay.

King/Harbor notwithstanding, American healthcare is still far and away the best in the world. How do I know? Because I hear it from Canadians, Britons, Frenchmen, and other foreign nationals who come to the ER for emergencies. Every one of these people described their country's health care as "terrible," "bloody awful," "c'est merde," etc.

But the press doesn't want you to know that, of course. They want Americans to think that we have the worst, most heartless medical care on earth and that certain Americans have no access to health care- which of course I have already proven to be a damned lie from the pit of hell.

So I hope that clears things up a bit.

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