HOSPITALS/POLICY: King-Drew and the wider issues of care for the poor

It looks like it might be the end for King Drew, or as it’s known now, King–Harbor. Some of the LA board of supervisors are in favor of closing the hospital immediately, and yesterday the State of California initiated proceedings to revoke its license. No one can pretend that this hasn’t been coming for quite some time.  A couple of years back, a long series in the LA Times found incredible graft, mismanagement, and corruption and appallingly poor care quality at King Drew. Given the hospital’s origins after the Watts riots of the 1960s, and its special place in the African-American downtown community, doing anything to King-Drew has always been politically charged issue. But after the recent incidents, particularly the one where the woman was left to die on the floor of the emergency department waiting room while nurses ignored her, and cleaning staff swept up around her, the hospital seems to have finally run out of defenders.

On the other hand, this is emblematic of a wider problem in American health care—how do you provide care to the poor in a system where there is no universal coverage or systemic primary care?  Bob Sillen, who now runs California’s prison health care system, but used to run Santa Clara Valley Medical Center used to remark that if there wasn’t a County Hospital in which to showcase how the poor were treated it would be impossible to get any attention on to the issue.

So it is my hope that as we enter a period of concern about the future of universal insurance coverage, we don’t abandon the extremely limited safety net that is in place for the poor while we all focus on fixing the wider systemic problems.

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  1. Chinese government officials are striving deal with recent reports and statistics on the overheated economy, high unemployment rates, and rapidly aging population.
    China has the world’s largest elderly population, with 148 million people over 60 years old, a figure that predicted to reach 492 million by 2050.
    In 2006 the proportion of China’s population which was over the age of 60 was 12.7 percent.
    The aging process is speeded up especially in the cities as the one-child policy was adopted in the 1970s. Since the economic boom, more couples now tend to postpone pregnancy or not to have babies at all.
    Implementation of the one-child policy in the past decades successfully prevented fast population growth, but it also expedited the aging process of the demographic structure.
    By 2020, experts young couple will have to look after at least four parents from both families and then caring for the elderly will not be a family issue but a social one.
    More than two decades ago when the nation was still under the planned economy, it was considered a shame to send an older parent to a rest home, which was then prepared for those who had no families or income.
    Nowadays, most young people are occupied by office work and housework, and most can not provide space within their apartments for their parents.
    In the late 1990s, the Chinese authority authorized the first private Nursing Home License. In 2005, China opened the senior housing market to foreign investment. In late 2006, Beijing Municipal Government announced that they would not construct any more senior housing facilities and encouraged private companies to take up the challenge. Beijing Department of Civil Affairs went as far as to off RMB 190 per bed subsidy for private operators.
    Beijing is looking to the west to provide professional aged care management. Criticism has risen in the past years over the management of state managed facilities and the central government had to reiterate rules on the issue and warned against embezzlement and ill management.
    In 2001, China’s Ministry of Civil Affairs launched the “Starlight Project” to build community-based service for elderly people. After a total investment of US$602,000,000 20,000 community care facilities have been established in over 600 cities.
    “China has the largest senior housing demand of any country in the world. Skilled Nursing Facilities (Nursing Homes) are a new concept to China with the very first private Nursing Home established in 1996, just 11 years ago.” says Tucson Dunn, Chief Executive Officer of Silver Age International, China’s first American-backed senior care company.
    During the past two years, Mr. Dunn and a team of Chinese and American healthcare researchers have investigated China’s aged-care phenomena.
    “What we found was astounding. We surveyed a large sample group of middle-class Chinese, asking them where would they send a parent for long term “skilled nursing” care. 88% of those surveyed said they would place their elderly relative in hospital for long term care,” says Mr. Dunn
    Based on this finding, Mr. Dunn led his team into the major hospitals of Beijing and Shanghai to validate the survey results. “A key indicator we found straightaway was excessive lengths of stay in hospital. In Shanghai, for example, the average length of stay in hospital is 22 days as compared to the USA standard of 5 days. We found that 48 percent of the hospital beds were filled with long stay patients over the age of 75. In each case, the top 10 hospitals in each city had long waiting lists for admissions.” stated Mr. Dunn.
    Mr. Dunn and his investors believe the Senior Care industry in China will boom as demand continues to sky rocket. “We want to blend best practices from the west with Chinese culture to create a model for China’s senior care industry.
    Source: Howard Sun, China Healthcare International

  2. I agree with Jim. Harbour Hospital is indeed government funded and has a very long history of problems. Mr Moore conveniently left this fact out of his movie. He made it seem that all American hospitals are bad and that other healthcare systems work well. Moore has not presented the complete story about the other systems (None are as perfect as Moore has reported). I’ve actually had Canadian nurses in response to “Sicko” tell me how terrible the American healthcare system is, but these nurses usually have not even worked in the US. Often they have very little experience outside the Canadian system. As a Canadian, I find Mr. Moore’s deceit offensive.
    My life was saved at Sutter Hospital in Sacramento where I received exceptional care for a severe asthma attack (status asthmatics). I was a very ill young woman (only 18 at the time) when my family took me to Sutter. As a Canadian I’ll be forever thankful to all the physicians, nurses, respiratory therapists, and others at Sutter that were involved in my care. They were amazing and the care received was top-notch. I believe that Sutter is a non-profit hospital.

  3. “woman was left to die on the floor of the emergency department waiting room while nurses ignored her, and cleaning staff swept up around her”
    In the brave new world, the cleaning crew would administer first aid until the resident coffee break was over.

  4. Sir: that hospital was run by government. Did it ever dawn on you that if government ran all U.S. health care operations, the same thing would be repeated? You and Mr. Michael Moore ought to think more carefully — the public does.