Emergency Rooms Closing

The Lewin study (“California Private Hospitals Low in Charity Service,” Metro, May 5) draws a totally inaccurate conclusion. There is no such thing as “free” health care, or education, or food stamps. All have a cost that some group of people must pay in order for it to be provided.

In the case of hospital services, almost all free or uncompensated care is paid for by either additional charges to other patients, higher taxes, or a combination of both. Years ago, California established a system of public hospitals so that the uncompensated care cost would be borne by both the taxpayers and the paying patients--spreading the burden over the largest possible base of payers so that no one was disproportionally hurt by it.

Then the state changed the rules!

To cut taxes, the state ratchetted down its payments to the county for indigent medical care services to the point where Los Angeles County now receives only 45% of the funds promised in 1982. To cut private health-care costs, the state passed legislation which literally eliminated the ability of hospitals to spread their charity or uncompensated care costs among their paying patients.

Today we are reaping the harvest of this folly.

- Seven of 23 trauma centers, 30% of the coverage for Los Angeles County, have closed.

- The busiest private hospital emergency department in central Los Angeles is forced to drastically curtail its services and others will probably have to follow suit.

- By the end of 1986, 44% of the hospitals in California were operating in the red; by the end of 1987 that number had climbed to 47%.

You cannot provide charity care with red ink! When uncompensated care losses force the closure of vital hospital services, access to that service is taken away from all of us.

JANE HURD

Chairman of the Board

Hospital Council

of Southern California

Los Angeles