Between the Lines: Dr. Anthony Asadullah Samad
The Fall of King Drew Hospital: Neglect was Financial, Not Because of the Black Middle Class
Los Angeles Sentinel 8-23-07 A7
The entire Black community of the County of Los Angeles is bereaved, almost panicked, over the failure of King-Drew Hospital to pass its last review to keep its federal funding in order to maintain full operation status. To clarify what will happen to the hospital-let's eliminate the biggest misnomer. The hospital will not be closed. As crazy as it sounds in a time where need for health care among the poor is at an all-time high, the hospital's services will be reduced to minimal outpatient services until a private health care operator, with an infusion of capital, will take over the hospital. After all, that's what it's always been about with respect to "under" operation of King Hospital, the lack of money. The quality of patient care, no matter what ANYBODY (are you listening, Los Angeles Times??) tells you, was directly tied to quality of funding. The "episodes" at King were no greater than any hospital in the area (percentage of care-related incidents far the number of patients seen). However, King Hospital being a "political football" for the better part of two decades, was under a different level of scrutiny than any other hospital in the area. Why? Because it was community run and operated. By whom? Black doctors and administrators, who for years had asked for adequate funding and resources to provide the level of patient care commensurate with the increased patient load.
It's too simplistic to say that King Hospital was not a funding priority for the County of Los Angeles. But it's true. King Hospital was servicing more than twice the number of (largely poor) patients in 2007 than it served 30 years ago, but it's staffing never grew proportionate to its patient load. So nurses that were (under contract, suppose to being seeing seven patients, had 20). Doctors' patient loads were just as disproportionate. It's too conspiratorial to say that there was a "take-over plot" with respect to King Hospital, as HMO providers began to target low income and uninsured populations as "growth industries" to supplement their operations with state and federal health care dollars. But it's true. The attempts to displace community based administrators with outside operators or academic research institutions (that need those same dollars) have been the constant remedy to "save King." And it's just too outrageous to suggest that King Hospital fell because the "Black middle class" abandoned the Hospital. Yet, the L.A. Times who caused to "Killer King" hysteria (and facilitated it's decline running stories that proved to be more the exception of poor care than the rule of poor care) ran an editorial that suggested that the Black middle class in Los Angeles had abandoned the fight to save King by the time the final review had come about. I consider Erin Aubry-Kaplan a respected colleague, and a friend, and I respect her writing. However, for Erin, who is from a middle class background herself: to write this damaging commentary knowing that the Black middle class was amongst the foremost advocates in the fight to save King, is both disingenuous and outrageous. Almost every voice that lent itself to advocating for King, including Erin's father-Lany (also a respected colleague), was of tile Black middle class. The Black middle class didn't turn its back on King. State and federal governmental funders did.
It is ridiculous to suggest that because the Black middle class weren't patients at the hospital, that they somehow contributed to its fall. America's middle-class have health care (most of them) and just like education, where they can pay for a better quality of care (education), they do. King Hospital was a county hospital that was built to provide health care for the community, It was built in the poorest community in Los Angeles County in 1972, Watts, California, as a phoenix that rose from the ashes of poverty and despair, and became a world-class hospital for trauma care and emergency care. They were training doctors at King by the 1990s, because they were the experts in trauma care-s-yet they could never find adequate funding as the number trauma patients rose dramatically as Los Angeles became the murder capital of nation in the 1990s. The neglect began there. The demographic shift, Gloria Molina's "take-over" attempt (to rename King Cesar Chavez' Hospital), high administrative turnover (that caused King to have no real advocate for more dollars or guardian of greater care resources) caused King to be punished fiscally and caused political leaders to keep an arms distance from the political battles that plagued the hospital. By the time political AND community leaders came (late) to rescue King, the hospital's quality of care was already in a free fall and it was already the subject of the L.A. Times' Pulitzer ambitions and the incidents that were called out couldn't be refuted, Yes, the Black middle class got King built, and most that I know defended it to the end (its current state). There is plenty blame to go around on this. Apathy was presented, particularly among the population most impacted by the hospital's reduction in services, the poor and underserved. But nobody turned their back on King, but the policymakers and governmental funders that stripped King of the resources and oversight to accommodate it disproportionate patient load Everybody did "too little, too late." It's sad but true.
King Hospital will be back in a different form (privatized) because it's the only way it will be properly capitalized and staffed. The only thing that is gone is community control. The "community" is bigger than the Black middle class, given that the hospital serves mostly uninsured immigrants now. But we wouldn't dare point the finger at the increased population growth or medical costs tied to treat ing illegal immigrants-probably a bigger factor in King': quality of care issues. It's even sadder that the L.A. Time! 'would continue its "community hunt" by having a respected sister "finger" tile Black middle class, as if tile condition of King Hospital was our fault. It's crazy and consistent with the way the Times points the finger away from the real culprits in a city deep in financial and infra-structure crisis Damn, Erin. Are you that far gone???
Dr. Anthony Asadullah Samad is a national columnist, managing director of the Urban Issues Forum (www.urbanissuesforum.com) and au/he of the upcoming book; "Saving The Race: Empowerment Through Wisdom. " He can be reached at www.AnthonySamad.com
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