No. 10

Smaller County Medical Center Approved

It was years in coming, but in November county supervisors finally approved a downsized County-USC Medical Center.

Turning away recommendations from health officials and health advocates who pushed for 750 beds, supervisors voted 4 to 1 to replace the existing facility (which has a utilized capacity of 860 beds) with a new 600-bed hospital.

County-USC is the cornerstone of the county’s public health system, but it was severely damaged in the 1994 Northridge earthquake. The new hospital would cost between $788 million and $907 million, depending on the final design. It would be completed by the year 2004.

The board chose fiscal caution over public health concerns. Three years ago, the county was on the verge of declaring bankruptcy, in part due to runaway costs from treating uninsured patients. It was saved by a federal bailout, on the condition that supervisors would set up more outpatient centers and decrease the emphasis on more-expensive inpatient care.

Losing out to the fiscal reality was Supervisor Gloria Molina, who had lobbied hard for the 750-bed option.

The decision means that the county will contract out even more of its health care operations to private hospitals. It is part of a larger statewide trend in public health driven by the push toward managed care and the ever-increasing cost of dealing with the uninsured population.

The board had put off making a decision for months until Federal Emergency Management Agency officials threatened to withdraw $462 million in federal earthquake repair funds.

The vote sets the stage for protracted battles with labor unions over the downsizing. Meanwhile, area hospitals are concerned that they will have to foot the bill for handling more indigent patients. With the county slated to stop receiving $250 million a year in Medicaid reimbursements by the year 2000, hospital representatives are concerned that the county will not cover the full cost of treatment for the uninsured.

Howard Fine