PLATFORM : How Many Will Die in County Cutbacks?

The debate has begun over whether Los Angeles County will allow citizens to die because they do not have health insurance or the money to pay for medical care.

This is not hyperbole. The current waiting time to get into a Los Angeles County clinic is many months, and our hospital emergency departments are so overcrowded that even people with life-threatening conditions are unable to get medical care. Now, the Board of Supervisors is considering even more cutbacks at clinics and hospitals. What will happen to the people served by these facilities? Where will they go? We doctors know.

The usual answer from county analysts is that patients will have to travel farther and wait longer to receive care. This is simply not true. Patients cannot wait longer or travel farther than they are already. Many of our patients travel two hours by bus to come to an emergency department where they may have to wait 10 hours or more to be seen. There are only 24 hours in a day. The truth is, many people simply will not get medical care. And we know what that means.

In 1991, I and others at Harbor-UCLA found that thousands of people, many of them with life-threatening illnesses, came to our emergency department and left without being seen by a doctor after waiting an average of six hours. Eleven percent of those people were hospitalized within the week after their attempt to get medical care failed. You don’t have to be a doctor to know what happens when sick people don’t get medical care; they get sicker, and some die.

There are now 3 million people without medical insurance living in Los Angeles County. If even a tiny fraction of these develop a serious illness or injury and cannot get care because of the proposed cutbacks, we’re talking about hundreds of people (at least) dying unnecessarily.

Our country spends a great deal of money on disaster relief. Helping the victims of earthquakes, hurricanes and floods is a noble cause. It’s rare that we get a chance to prevent a disaster. This is such a moment. If we heard that thousands of people in a small town nearby would die in the next year if they did not receive emergency relief, we would rescue them, somehow. I do not know where the county can find the money it needs, but I want everyone to be clear about the consequences of doing nothing.

The uninsured in Los Angeles are not strangers. They are neighbors, co-workers, probably even in your own family. Most of us are one paycheck or one car accident away from falling into the public hospital/clinic safety net. Will it be there when we need it? Or will the Board of Supervisors have taken it away to patch up the deficit in the county ledgers?

No one should have to die from an illness or injury that was treatable with basic medical attention. But they are. The Board of Supervisors is responsible. We all are responsible.