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<v Woman 1>[music plays] L.A. County USC Medical Center is bursting at the seams. <v Man 1>Patients come in who are in need of immediate help. <v Man 1>And we're not able to help them immediately. <v Man 1>We are slowly committing criminal acts against the poor. <v Narrator 1>Major funding for By the Year 2000 was provided by the James Irvine <v Narrator 1>Foundation to promote civic and social responsibility and the development <v Narrator 1>of sound public policy through the understanding of community issues. <v Narrator 1>And by the Michael J. Connell Foundation. <v Narrator 1>Additional funding is provided by the law firm of Latham and Watkins, proudly <v Narrator 1>supporting public discussion of community issues.
<v Eric Burns>Being poor is a burden. In Los Angeles, being poor and in need of a hospital can <v Eric Burns>turn a burden into misery. <v Eric Burns>At the rate we're going by the year 2000, health care for the poor will exist in name <v Eric Burns>only. I'm Eric Burns. <v Val Zavala>And I'm Val Zavala. <v Val Zavala>California has been spending less on health care for the poor every year. <v Val Zavala>We now rank behind almost every state in the nation. <v Val Zavala>47th in per capita spending. <v Val Zavala>Even in Mississippi, the poor get a better break. <v Eric Burns>In Los Angeles, the poor usually end up at the Los Angeles County USC Medical <v Eric Burns>Center. It's a massive facility strained to the limit. <v Eric Burns>As for the quality of health care it delivers. <v Eric Burns>Critics call it third world. <v Val Zavala>While researching this story, we requested permission to videotape areas of the county <v Val Zavala>hospital where crowding is severe. <v Val Zavala>But hospital officials denied our request, believing that the public has a right to know <v Val Zavala>what is going on in this public facility, we obtained some of our video through the use <v Val Zavala>of a hidden camera. Here's our report.
<v Val Zavala>[sirens] <v Man 2>Welcome to the war. This is the closest to our a- army combat evacuation <v Man 2>hospital you're gonna get to without being shot at. <v Woman 2>Sometimes there just isn't an operating room. <v Woman 2>So we do the best we can. <v Man 3>Somewhere around 3 or 4 in the morning uh we ran out of instrument packs. <v Woman 3>Someone who's been stabbed or shot has to ?inaudible? for someone who needs their leg <v Woman 3>operated on. <v Val Zavala>The sounds of a MASH unit. But this one is in the shadow of downtown Los Angeles. <v Val Zavala>L.A. County USC Medical Center, the largest public hospital in the country. <v Val Zavala>L.A.'s hospital of last resort for the poor and uninsured. <v Val Zavala>By law, it has to treat everyone who shows up at its door. <v Nurse 1>It's like this is the final place dumping ground is is is called, <v Nurse 1>you know, the buck stops here. <v Val Zavala>But today, the county's flagship hospital is bursting at the seams. <v Val Zavala>It is crowded with the growing number of people without health insurance who can't get <v Val Zavala>treatment anywhere else. The hospital is understaffed and underfunded.
<v Val Zavala>There are long waits for emergency room visits, for surgeries, for intensive care beds. <v Val Zavala>Resources are stretched so thin that doctors and nurses say patients are dying from <v Val Zavala>neglect inside the hospital. <v Physician 1>Sometimes I've gone to these codes where the patients are stiff. <v Physician 1>They've been dead for hours and the only time that they find them is <v Physician 1>the next morning when they have a change of shift. <v Val Zavala>Numerous lawsuits filed against the county also charge that delays in care <v Val Zavala>are resulting in injuries and deaths. <v Val Zavala>The county admits it paid out eleven million dollars last year in malpractice <v Val Zavala>settlements involving the medical center and then insisted on gag orders for most of <v Val Zavala>those cases. The county says they do this to keep the information from becoming <v Val Zavala>public. Everyone agrees the medical center is overburdened. <v Val Zavala>But what does that mean for the patients who come here and for the taxpayers who pay the <v Val Zavala>bills. To find out, we looked at three areas of the medical center that experts say <v Val Zavala>are especially overcrowded: the emergency room, intensive care and
<v Val Zavala>labor and delivery. <v Val Zavala>1 out of every 200 babies born in the United States is born in <v Val Zavala>this building. <v Val Zavala>This tape, [crying] taken with a hidden camera last month, shows what staff members say <v Val Zavala>are frequent conditions on the labor and delivery ward. <v Val Zavala>Most of these women have not had prenatal care and are at high risk for complicated <v Val Zavala>deliveries. Yet 11 women are in labor in the hallways because of overcrowding. <v Val Zavala>3 in this hall, 3 in this hall, 3 in yet another hall [screaming], 2 <v Val Zavala>in front of the nursing station, and more coming in. <v Dr. Debra Grubb>On a busy day we have a- all of our labor rooms full. <v Dr. Debra Grubb>We put usually 2 laboring beds in each of our hallways so we <v Dr. Debra Grubb>have 6 to 8 patients laboring in the hallways. <v Dr. Debra Grubb>And if there are more than that, they have to wait in ?terrace?. <v Val Zavala>The facility is designed and staffed for 34 deliveries a day. <v Val Zavala>Last month, the daily average was 56. <v Val Zavala>When it's this busy, doctors say it's difficult to monitor patients adequately.
<v Dr. Debra Grubb>Usually if the patients are in the hallway, there isn't a nurse assigned to watch them. <v Dr. Debra Grubb>And whoever happens to be available at the time will have to do the best they can. <v Val Zavala>The best they could do was not good enough for Amelia Lopez, who recently filed <v Val Zavala>a claim against the county. She gave birth to one year old Gabriel at County USC <v Val Zavala>last July. He has been diagnosed as brain damaged. <v Amelia Lopez>[speaking Spanish] [translator speaking] It pains her to see her son so ill. <v Val Zavala>Last July, Lopez was in labor for nearly 24 hours at County USC. <v Val Zavala>[child whimpering] She says during three of those hours, she was in labor in the hall. <v Val Zavala>She was hooked up to a fetal monitor. <v Val Zavala>Lopez's attorneys, Michael Piuze and Jeff Wells, had an obstetrician review <v Val Zavala>the fetal monitor tapes. <v Val Zavala>They allege that the readings were normal for 17 hours. <v Val Zavala>Then they charged the fetus went into distress, an indication that immediate surgery <v Val Zavala>was required, say the lawyers.
<v Val Zavala>But according to their obstetrician, the fetus remained in distress for more than an hour <v Val Zavala>before his cesarean section was performed. <v Val Zavala>On the baby's chart is the diagnosis severe perinatal asphyxia. <v Val Zavala>In other words, he was deprived of oxygen. <v Michael Piuze>We know from the fetal monitors strips that just before he went into severe fetal <v Michael Piuze>distress, he was in effect, a normal baby. <v Michael Piuze>And we know that when he was delivered 60 to 90 minutes later, <v Michael Piuze>his life was irreparably wronged. [child crying] <v Michael Piuze>Because this child was deprived of oxygen, major portions of his brain were destroyed <v Michael Piuze>permanently. And so this baby was never going to be ale to walk, talk, take <v Michael Piuze>care of his bodily function needs or lead a normal life. <v Val Zavala>The county would not comment on this case. <v Val Zavala>However, hospital officials admit that in general, conditions on the ward can lead to <v Val Zavala>injuries. Dr. Tom Kirschbaum, director of labor and delivery, says it's not
<v Val Zavala>unusual for all the operating rooms to be full, causing women to wait hours for an <v Val Zavala>emergency cesarean section. <v Dr. Tom Kirschbaum>We've had women who've had to wait uh 4 to 6 to 8 hours for cesarean section <v Dr. Tom Kirschbaum>lose part of their cervix because of the pressure, the presenting part against the cervix <v Dr. Tom Kirschbaum>uh during the period of time between the time of the medical decision and the ability <v Dr. Tom Kirschbaum>to carry out the procedure. <v Val Zavala>Recently, Dr. Kirschbaum wrote this letter to administrators warning that the medical <v Val Zavala>staff cannot be responsible for the safety of patients. <v Dr. Tom Kirschbaum>The principal problem, from our point of view, uh from the point of <v Dr. Tom Kirschbaum>view of the medical staff, is that we're being called upon to deal with more patients <v Dr. Tom Kirschbaum>than it's safe for us to have. <v Val Zavala>Doctors say staffing is so thin on labor and delivery that more than two simultaneous <v Val Zavala>caesarean sections can take all doctors and nurses off the floor, leaving <v Val Zavala>patients unattended. <v Dr. Tom Kirschbaum>We've had instances where um uh in the midst of several emergencies, <v Dr. Tom Kirschbaum>one doctor has been uh uh obligated to look after 30 or 40 women
<v Dr. Tom Kirschbaum>who are laboring. And you simply can't do that. <v Dr. Debra Grubb>You might leave 40 women attended by no one if everyone is in a delivery. <v Val Zavala>Dr. Sol Bernstein, chief of staff at the medical center, admits present conditions in <v Val Zavala>labor and delivery could result in patient harm. <v Dr. Sol Bernstein>Whenever you work under chronic stress there are op- <v Dr. Sol Bernstein>there's a potential for mishap. <v Dr. Sol Bernstein>You're more liable to make some errors. <v Val Zavala>[child crying] Amelia Lopez claims her child's delivery was one of those potential <v Val Zavala>errors. Experts estimate that medical care for a child like Gabriel over the <v Val Zavala>course of a lifetime could cost up to a million dollars. <v Val Zavala>[inaudible speaking] In <v Val Zavala>the emergency room, overcrowding causes similar problems. <v Val Zavala>Unlike private hospitals, County's emergency room can't close when things get busy.
<v Val Zavala>[woman speaking on phone] The emergency room is handling 50 percent more patients today <v Val Zavala>than it did in 1982. <v Val Zavala>But the size of the staff has remained the same. <v Val Zavala>It is not unusual, according to emergency room staff, for seriously ill patients to wait <v Val Zavala>up to 8 hours to see a doctor. <v Val Zavala>Sandy Correia is an emergency room nurse. <v Sandy Correia>Patients with appendicitis can wait in the emergency room for hours because they're not <v Sandy Correia>deemed critical. In our emergency room, they can wait hours and hours ?inaudible? <v Sandy Correia>um seizure t- patients that have had seizure disorders. <v Sandy Correia>They can wait, you know, 2, 3 hours to see a doctor on a busy night. <v Val Zavala>This was a scene on a busy Saturday night last month. <v Val Zavala>A man waiting to see a doctor in the emergency room fell to the floor in convulsions, his <v Val Zavala>body expelling blood and urine. <v Val Zavala>[nurse shouting sir] According to doctors, after patients are seen in the emergency room, <v Val Zavala>the ones that need to be admitted to the hospital sometimes wait on gurneys in the hall
<v Val Zavala>for up to 4 days. Nurses say the situation is so common that it's <v Val Zavala>part of the hospital system. <v Clayton Cortinas>We'd start carried off hallway slots. Hallway 1, hallway 2, or hallway 37. <v Clayton Cortinas>Hallway 38. Until we have every patient with a slot, that's all for the <v Clayton Cortinas>uh patient uh computer that lists location. <v Val Zavala>Eventually, all the patients who need a bed on the regular ward will get one if they're <v Val Zavala>willing to wait. But in the intensive care unit, there are only 14 beds and doctors <v Val Zavala>say not every patient who needs one will get one. <v Val Zavala>Doctors in the ICU face tough choices. <v Val Zavala>Which of the critically ill patients will receive intensive care and which will not? <v Val Zavala>Dr. James Tuschmidt is director of the Medical Intensive Care Unit. <v Dr. James Tuschmidt>1, 2, 3, 4. We have 5 patients- <v Val Zavala>Each morning, he and his team of residents have to decide which patient they will admit <v Val Zavala>to the ICU. <v Dr. James Tuschmidt>As a physician, I have a primary responsibility to the patient
<v Dr. James Tuschmidt>uh that comes through the door and to uh be in a position <v Dr. James Tuschmidt>where I have to decide um to admit one patient to the intensive <v Dr. James Tuschmidt>care unit or another patient to an intensive care unit, puts me I think, in a very <v Dr. James Tuschmidt>awkward uh position from a uh ethical point of view. <v Dr. James Tuschmidt>[chattering] Clearly yeah I think out of out of these other patients I mean <v Dr. James Tuschmidt>this patient probably has the most reversible uh disease process here. <v Dr. James Tuschmidt>No one ever was said anything about this when I went to medical school. <v Dr. James Tuschmidt>If they did, I'm not sure I'd be here today. <v Dr. James Tuschmidt>But uh because these are clearly very, very tough uh decisions that people <v Dr. James Tuschmidt>have to make. <v Val Zavala>Tuschmidt says that his patients face the prospect of not receiving care because <v Val Zavala>politically there's no one to stand up for them. <v Dr. James Tuschmidt>Many of our patients are kind of invisible. <v Dr. James Tuschmidt>They are not voting members of society. <v Dr. James Tuschmidt>Um many of them are very indigent. So they don't have a lot of clout in terms of of <v Dr. James Tuschmidt>politics. And um as a consequence, they're
<v Dr. James Tuschmidt>kind of a forgotten uh group of people. <v Val Zavala>When there's no room in intensive care, critically ill patients are put in a holding area <v Val Zavala>called the Red Blanket Room. <v Physician 1>These are patients who have had heart attacks and they can have fatal <v Physician 1>arrhythmias or irregular heartbeats that can literally kill them in <v Physician 1>or within the first 24 or 48 hours. <v Val Zavala>Yet because there aren't enough intensive care beds, these patients can end up in the <v Val Zavala>hallways. Clayton Cortinas is a nurse in the red blanket holding area. <v Clayton Cortinas>We have 18 monitored beds available but we average anywhere from 34 to <v Clayton Cortinas>48 patients a day in the room at any given time. <v Val Zavala>Further evidence of overcrowding in the Red Blanket Room was provided last April when the <v Val Zavala>L.A. City Fire Department cited the Medical Center for Fire Code violations in the area. <v Val Zavala>The report warns overcrowding of this area causes an extreme life safety <v Val Zavala>problem. All aisles and exits are blocked with patients. <v Clayton Cortinas>We had one patient that arrested that we could not get the crash cart ?to?
<v Clayton Cortinas>the crowd. It was so crowded we took the equipment off and hand it around the room until <v Clayton Cortinas>we could get the crash cart. It took us a good 5 to 10 minutes to get the crash cart over <v Clayton Cortinas>to the patient. <v Val Zavala>Another danger of overcrowding in the Red Blanket Room, according to the doctors and <v Val Zavala>nurses, is that the area is not staffed or equipped to handle so many <v Val Zavala>unstable patients. <v Physician 1>Sometimes we don't even have enough monitors because it gets so crowded <v Physician 1>and these patients can can literally die and we won't <v Physician 1>know it. <v Clayton Cortinas>Essentially, the patients are watching each other. <v Clayton Cortinas>They have somebody that's in a hallway and they're laying off to the side of the room, <v Clayton Cortinas>one they're not attached to a monitor. <v Clayton Cortinas>They're not attached to a monitor not not attached to a alarm system. <v Clayton Cortinas>If they're not attached to an alarm system, if something happens and there isn't anybody <v Clayton Cortinas>looking at 'em right at that moment then the chances are that it may go unnoticed. <v Val Zavala>Does that happen? <v Clayton Cortinas>Uh yeah, it could happen. And it has happened. <v Physician 1>The nurse can come by with some medication that the patient, you know,
<v Physician 1>is supposed to be receiving and find that the patient's not breathing or <v Physician 1>you know, doesn't have a pulse. <v Physician 1>That's usually the scenario. <v Val Zavala>Chief of Staff Dr. Saul Bernstein denies reports of preventable deaths <v Val Zavala>in the Red Blanket Room. <v Saul Bernstein>If somebody dies there, it's not because of lack of attention. <v Saul Bernstein>I mean, every death is reviewed uh by us uh to determine <v Saul Bernstein>you know, whether anything could have been done to prevent it. <v Val Zavala>David Langness is vice president of the Hospital Council of Southern California, a <v Val Zavala>lobbying organization for private and public hospitals. <v Val Zavala>He claims that conditions at County USC are resulting in preventable deaths. <v David Langness>It usually happens quietly because people don't like to talk about it. <v David Langness>And it happens one by one. <v David Langness>So it never becomes a big crisis. <v David Langness>It's not like an airplane disaster or a massive car pileup. <v David Langness>Although many more people die as a result. <v Val Zavala>Many doctors and nurses at County USC blame conditions at the medical center on the
<v Val Zavala>politicians who control the funding. Taking inflation into account, the facility's <v Val Zavala>budget has decreased nearly 20 percent since 1981. <v Clayton Cortinas>I think there's a real attitude on behalf of the Board of Supervisors that <v Clayton Cortinas>uh if if you can't support yourself and <v Clayton Cortinas>uh y- you can't find your own means, then be happy for what you get. <v Clayton Cortinas>You're lucky you're getting what you're getting. Shut up and take it. <v Val Zavala>What can be done to improve conditions at County USC? <v Val Zavala>For some answers, we go to Eric and guests. <v Eric Burns>They are Carl Williams, first of all. He is the director of hospitals for the county of <v Eric Burns>Los Angeles. And next to him, Stan Dorn, an attorney for the National Health Law <v Eric Burns>Program, a group uh which deals with issues involving health care for poor people. <v Eric Burns>Mr. Williams, first of all, that last allegation that the attitude of the Board of <v Eric Burns>Supervisors is poor people are lucky to get what they can, they should accept it and shut <v Eric Burns>up. <v Carl Williams>?inaudible? to that, I don't think any of the supervisors feel that way or act that way.
<v Carl Williams>The Board of Supervisors are faced with very difficult decisions to make in allocating <v Carl Williams>limited resources between many very justified needs. <v Carl Williams>Just as the physicians are faced with difficult decisions. <v Eric Burns>Is what we just saw along those lines an accurate portrayal of what goes on <v Eric Burns>at the County USC uh Medical Center? <v Carl Williams>Well, there's no question but what there are long waits and crowded conditions <v Carl Williams>at County USC Medical Center. <v Carl Williams>Uh we've known that for a long time. And I think the staff there do a very creditable job <v Carl Williams>in dealing with limited resources and limited staff. <v Eric Burns>Let me deal with the phrase limited funding, uh limited resources that we heard. <v Eric Burns>Is that in your view, Mr. Dorn, the uh the nub of the problem? <v Stan Dorn>Well, yes and no. It is the nub of the problem in that too few resources are going to <v Stan Dorn>this county hospital system, which is the sole source of health care for all <v Stan Dorn>low income people in Los Angeles County. <v Stan Dorn>But the reason why we have too little money going to our indigent health care system is <v Stan Dorn>that very political decisions have been made both at the state and the county level.
<v Stan Dorn>State support for indigent care has been cut in half over the last 7 years <v Stan Dorn>and the county's commitment to indigent care has dropped from 16 percent of the county's <v Stan Dorn>budget 5 years ago to 8 percent today. <v Stan Dorn>So there's a reason why we have too few resources. <v Eric Burns>Which is to say the kinds of people who need this health care don't vote and thus are not <v Eric Burns>a priority of politicians. <v Stan Dorn>Well they don't vote and they don't give campaign contributions. <v Eric Burns>[sighs] Given the present limited resources, which I'm sure you both <v Eric Burns>bemoan. Can anything be done to improve the quality of health care short <v Eric Burns>of more money or differently allocated money? <v Eric Burns>Mr. Williams, first of all. <v Carl Williams>Well, certainly one of the biggest assists that would help us would be to get more <v Carl Williams>registered nurses. There is a nationwide shortage of registered nurses, <v Carl Williams>and that shortage is acutely felt in Los Angeles County. <v Eric Burns>That's a matter of more money, isn't it? I mean you're not gonna get them under the <v Eric Burns>present- ?inaudible? <v Carl Williams>Not necessarily. Not necessarily. <v Carl Williams>We have positions that are funded and we simply can't hire nurses. <v Carl Williams>A good example is the dedicated AIDS ward at County USC that we tried
<v Carl Williams>to open. We have money to open 20 beds and we're only able to <v Carl Williams>open 10 at the present time simply because we can't hire the nurses. <v Eric Burns>Let us assume we somehow could get greater allocations of uh of <v Eric Burns>money, Mr. Dorn. What should we do with it? <v Stan Dorn>Well, we should- <v Eric Burns>At county USC. <v Stan Dorn>Well, we should use it to bring the quality and accessibility of care back <v Stan Dorn>to the standards that we expect in the civilized world. <v Stan Dorn>You mentioned in your introduction that uh what goes on at county facilities <v Stan Dorn>is sometimes likened to third world medicine. <v Stan Dorn>The phrase the analogy that I've often heard used by doctors and nurses working in the <v Stan Dorn>system is not to third world countries of today, but 19th century medicine. <v Stan Dorn>They often feel as if they've stepped into textbook photos of the horrors of what <v Stan Dorn>happened to most of us 100 years ago. <v Eric Burns>Is it that bad at that hospital? <v Carl Williams>No, I don't believe it's that bad. <v Carl Williams>There are very crowded conditions. The staff work very hard, long hours, <v Carl Williams>and the patients just keep coming. <v Carl Williams>One of your earlier clips stated that we can't close that hospital.
<v Carl Williams>That's not exactly true. We can close the emergency room to saturation <v Carl Williams>and that does shut down the traffic except for patients who are in <v Carl Williams>extremis or patients who walk in. <v Eric Burns>Yeah, to shut down the traffic is to shut down the care. So that's obviously the problem <v Eric Burns>there. But let me stop at this point to say that uh we wanted to hear from more than just <v Eric Burns>the two of you today. We invited each member of the Los Angeles County Board of <v Eric Burns>Supervisors to join us in the studio, but each member declined. <v Eric Burns>Kenneth Hahn, of course, has been ill. <v Eric Burns>Ed Edelman, is the chairman of the Board of Supervisors and represents the districts <v Eric Burns>where the hospital is located. <v Eric Burns>We were able to catch him at the Hall of Administration and ask him about this matter. <v Eric Burns>Reporter Jeff Kay recorded the following interview. <v Ed Edelman>We're aware that uh there is a need to improve staff numbers <v Ed Edelman>to improve the physical facility. Unfortunately, the state which controls <v Ed Edelman>the funding for health has not provided us each year enough money. <v Ed Edelman>Now, this year, we seem to have done v- well, although we can't tell precisely, ?prob?
<v Ed Edelman>99 funds are available. <v Eric Burns>The Tobacco Tax Initiative- <v Ed Edelman>The Tobacco Tax Initiative and the CAO is uh this very moment figuring <v Ed Edelman>out how much uh money we'll be able to be put into health to improve <v Ed Edelman>it somewhat and uh hopefully uh we can continue to increase <v Ed Edelman>rather than cut back the service level ?in our? <v Ed Edelman>health ?inaudible?. <v Eric Burns>We've heard horror stories. We've heard stories about babies being born brain <v Eric Burns>damaged because the mothers didn't get the surgery they needed. <v Eric Burns>We've heard about people on gurneys, in hallways unmonitored who <v Eric Burns>sometimes have been uh die before they they receive attention. <v Eric Burns>Well, how long can those kinds of conditions continue? <v Ed Edelman>Well, obviously uh no uh condition, which you ?cite? <v Ed Edelman>is acceptable. <v Ed Edelman>Uh we have to obviously uh find the funds uh since uh ?prop? <v Ed Edelman>13, uh the county has been cut uh in terms of its funding. <v Ed Edelman>The state is up against the ?gan? limit.
<v Ed Edelman>Uh they have funds, but they can't spend 'em uh we found a down rule that <v Ed Edelman>instead of increasing the service level, uh we've seen the service <v Ed Edelman>level deteriorate because of funding problems. <v Ed Edelman>We hope that that won't continue. <v Ed Edelman>We hope that the state will face up to their responsibility. <v Ed Edelman>We face up to our responsibilities and we correct some of the deficiencies that we <v Ed Edelman>know exist there. <v Eric Burns>You know what are you optimistic or pessimistic about for the future- <v Ed Edelman>Well, I think right now we're just trying to stabilize our health system. <v Ed Edelman>We don't want it to have it deteriorate any further. <v Ed Edelman>Uh the question is, are we going to be able in the next years, the next two or three <v Ed Edelman>years, be able to increase funding for staff as well as facilities? <v Ed Edelman>That'll be the test. Right now, we're sort of in a period where we can take a breath, but <v Ed Edelman>it's gona be a short breath because uh in the next year, if we don't find additional <v Ed Edelman>revenue, we're gonna find the level deteriorating again. <v Eric Burns>It seems to me uh two questions are raised by what Mr. Edelman said. <v Eric Burns>First, do you agree that the problem or one of the problems is that the state is not
<v Eric Burns>providing enough money? And second, if you do agree, what happens if the state doesn't <v Eric Burns>provide more? ?inaudible? <v Stan Dorn>Well, it's certainly true that the state hasn't provided enough money. <v Stan Dorn>In particular, Governor Deukmejian over the years has repeatedly vetoed hundreds <v Stan Dorn>of millions of dollars for county health care expenditures statewide. <v Stan Dorn>But as I indicated earlier, the county government has to bear a huge share of the blame <v Stan Dorn>here. The county's commitment to indigent care has been cut in half over the last <v Stan Dorn>5 years. And believe it or not, county officials are proposing an additional reduction <v Stan Dorn>of 55 million dollars in health service cuts, plus what the CAO terms 75 <v Stan Dorn>million dollars in administrative adjustments, which means the potential for another huge <v Stan Dorn>step downwards. <v Eric Burns>So what happens if these cuts aren't rescinded, if larger allocations aren't made? <v Eric Burns>What do you do at that hospital? <v Carl Williams>Well, conditions won't get a whole lot better. <v Carl Williams>Uh the the way- <v Eric Burns>That's much too euphemistic. And they're mad now and they're gonna get a lot worse. <v Eric Burns>Isn't that more accurate? <v Carl Williams>The waits will get longer and uh we will have to do more triaging of <v Carl Williams>patients. We are trying to increase the services that our comprehensive health centers
<v Carl Williams>throughout the county to triage some of the less critical patients out to them. <v Carl Williams>We're considering a little tram system that will pick patients up from our waiting <v Carl Williams>rooms who are well enough to travel and take them to our comprehensive <v Carl Williams>health centers. <v Eric Burns>There are problems at the at at this hospital, not just with the health care, but also <v Eric Burns>with the uh building in which the health care is provided. <v Eric Burns>And Val now has a report that tells us something about that. <v Eric Burns>[sirens] <v Val Zavala>The monolithic structure was built more than a half a century ago. <v Val Zavala>Not terribly old, but well-worn. <v Val Zavala>County officials admit that the building will not last until the year 2000 without major <v Val Zavala>capital improvements. They include reworking the electrical system and replacing the <v Val Zavala>plumbing. The estimate to fix the plumbing alone is 60 to 80 million <v Val Zavala>dollars, and that's not all. <v Val Zavala>We obtained copies of numerous fire department citations. <v Val Zavala>Because of these violations, the federal government is ordering millions of dollars in <v Val Zavala>repairs to bring the hospital up to fire code. <v Val Zavala>Renovating the old building is only one of the options facing the Board of Supervisors.
<v Val Zavala>The cost of refurbishment is still under study. <v Val Zavala>A second possibility is to put up a brand new building. <v Val Zavala>That carries a price tag of 550 million dollars. <v Val Zavala>And a newly proposed third option is that the county not have a hospital at all. <v Val Zavala>Supervisor Michael Antonovich suggests that all health care should be contracted out to <v Val Zavala>private hospitals. With the federal government breathing down its neck, the Board of <v Val Zavala>Supervisors will have to take action soon. <v Val Zavala>The hospital isn't getting any younger. <v Eric Burns>And what should be done to keep it from aging in such perilous condition? <v Carl Williams>The building uh the buildings on that campus are in serious condition. <v Carl Williams>Uh the consultant tells us they have 5 to 7 years life for the infrastructure <v Carl Williams>left. We are very close to proposing a master plan for <v Carl Williams>the replacement of the county USC Medical Center, which would include a new 950 <v Carl Williams>bed hospital and an additional 350 bed hospital out in the <v Carl Williams>San Gabriel Valley. We feel that if a bond issue can
<v Carl Williams>be issued or if other funds are available to do that, that that's the best <v Carl Williams>long term solution. We will, at the instruction of the board, be looking at <v Carl Williams>the issue of contracting out however, and I think there is some skepticism <v Carl Williams>about whether or not the public sector or the private sector would be able to handle <v Carl Williams>those patients or in fact, with the limited funding available, would want to handle <v Carl Williams>them. <v Eric Burns>So you agree that it's necessary to give up on the present building? <v Carl Williams>Absolutely. <v Eric Burns>Your thoughts about that, Mr. Dorn? <v Stan Dorn>Well, I'd like to focus not so much on the physical plant, although it's a serious <v Stan Dorn>problem. The underlying problem is the structure of our health care financing system, <v Stan Dorn>where we rely on these year by year political decisions to determine <v Stan Dorn>the lives and the future safety of all low income residents of Los Angeles County. <v Stan Dorn>It's a patchwork system. It's doomed to fail. <v Stan Dorn>Um the only long term answer is to provide a program of universal health insurance for <v Stan Dorn>all Californians. We are the only Western country without a universal <v Stan Dorn>health care coverage program. We are the only country in the world where scenes like that
<v Stan Dorn>we just saw earlier about L.A. county, USC occur. <v Stan Dorn>And it's time for us to stop this sort of shameful uniqueness. <v Eric Burns>Is that, in fact, your view of of the ultimate long run solution? <v Carl Williams>Well, we're very open to a national health insurance or a local statewide health <v Carl Williams>insurance for the indigent. <v Carl Williams>Uh my concern would be that it be funded adequately so that the private hospitals <v Carl Williams>would be able to share in some of this money and they could uh relieve us <v Carl Williams>of some of the patients with adequate funding. <v Eric Burns>But in the meantime, there is simply no extremely short run <v Eric Burns>solution to the terrible problems of this hospital. <v Eric Burns>And it's gonna be a matter of just catch as catch can on a daily basis to to treat as <v Eric Burns>many people as can be treated. <v Stan Dorn>I disagree. I think a tone of fatalism is completely incorrect. <v Stan Dorn>The problems exist because of political decisions that have been made by state officials <v Stan Dorn>and by the Board of Supervisors. And the future of the patients of L.A. <v Stan Dorn>county now rests in the hands of the Board of Supervisors. <v Stan Dorn>They can determine that additional funds are gonna be provided to keep patients alive.
In Poor Health
Producing Organization
KCET (Television station : Los Angeles, Calif.)
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The Walter J. Brown Media Archives & Peabody Awards Collection at the University of Georgia (Athens, Georgia)
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Program Description
"In Poor Health is a half hour investigative report giving the public its first glimpse into what experts call the 'third world conditions' at the largest public hospital in the United States. For at least five years local television has tried to get access to L.A./USC County Medical Center because of reports of deplorable conditions, but had no success. Doctors, nurses and patients at the center tell stories of preventable deaths and injuries they say occur routinely in the hospital because of shortages of staff and basic supplies. It merits Peabody consideration because it exemplifies achievement of one of journalism's highest objectives the pursuit and disclosure of an accurate and fair report containing information crucial to the public interest and well being. In addition, in this case, it was in the face of strong efforts by government officials to keep the story from being told. "Many obstacles were encountered including: Hospital administrators forbid doctors and nurses to speak with us. Some of the staff who felt strongly about the dangerous conditions at the hospital risked their jobs and spoke with us anyway. Unfortunately some were reprimanded by the hospital for their participation. The hospital administration also prevented us from videotaping anywhere inside the hospital except for two waiting areas. Backed with a letter from the Los Angeles Radio and Television News Association, we requested permission to tape in other areas of the hospital, based on the fact that it is a public facility and that patients' identities would be protected. Permission was still denied. We felt the story warranted use of a hidden camera, so we took one into the hospital to document the conditions that hospital staff were describing. Finally, because the county insists on gag orders on all of the hospital's liability settlements in order to keep the information from becoming public, it was difficult to get information on individual cases. So while we were able to find hundreds of court records claiming deaths and injuries due to delays in treatment, we were unable to find a victim willing to discuss his or her case until just three days before our air date. That patient agreed to talk because it was a new case which had just been filed and was not yet under a gag order. "RESULTS, SO FAR "After the show ran, the State Office of Facilities Licensing and Certification requested a copy of the show to consider during a review of the hospital's license to operate. Other television news organizations have begun trying to follow the story both locally and nationally. And Doctors within the system have increased their efforts to get improved conditions at the hospital and have told us it is a direct result of out story."--1989 Peabody entry form.
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Producing Organization: KCET (Television station : Los Angeles, Calif.)
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The Walter J. Brown Media Archives & Peabody Awards Collection at the University of Georgia
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Chicago: “In Poor Health,” 1989, The Walter J. Brown Media Archives & Peabody Awards Collection at the University of Georgia, American Archive of Public Broadcasting (GBH and the Library of Congress), Boston, MA and Washington, DC, accessed June 26, 2022,
MLA: “In Poor Health.” 1989. The Walter J. Brown Media Archives & Peabody Awards Collection at the University of Georgia, American Archive of Public Broadcasting (GBH and the Library of Congress), Boston, MA and Washington, DC. Web. June 26, 2022. <>.
APA: In Poor Health. Boston, MA: The Walter J. Brown Media Archives & Peabody Awards Collection at the University of Georgia, American Archive of Public Broadcasting (GBH and the Library of Congress), Boston, MA and Washington, DC. Retrieved from