By Rickey M. Gelb Emergency rooms across the county are closing as costs skyrocket and an overburdened system can no longer cope. The region’s remaining emergency rooms are overcrowded, with patients being forced to wait for as long as eight hours. Our healthcare system is not far from a meltdown. People with life-threatening emergencies are dying unattended while onlookers do nothing and orderlies clean up blood and vomit around them. It appears that Los Angeles has become a place where minimum wage jobs are plentiful, the homeless roam freely, and if you are critically injured or sick there is a good chance that you may not be able to obtain medical assistance. Just a few years ago, we just voted for a tax increase to support trauma/emergency services, an increase which generates hundreds of millions of dollars annually to prevent, or at least begin correcting, this intolerable situation. Our property tax bills show we are paying for trauma center program expansion, so we know the government is collecting the tax. Where is all this money? We have all seen hospitals and trauma centers closing but do any of us remember hearing of any new ones opening or existing hospitals receiving the financial assistance for which we are paying? What we have seen are years of studies, environmental impact reports, and countless bureaucratic consultants burning up millions of tax dollars. It is fair to wonder if there will be any money left over to open or build new trauma centers. We can assume that all of these consultants have concluded that more trauma centers are needed in the underserved areas (i.e., Los Angeles’ densely populated, economically disadvantaged communities). Why doesn’t the city put those funds to use right now in areas where the emergency rooms already have long lines and longer waiting periods? Our government bureaucrats must believe they still need additional consulting time to prepare additional reports and studies. It’s time to wake up our County Supervisors and new Chief Administrative Officer and find out exactly how much trauma/emergency services property tax money has been collected over the last three years, and how it has been spent. We were promised that these funds were to be earmarked for opening new trauma centers and upgrading existing ones to meet federal standards. This is what we voted for. Let’s just hope all this new tax money is not being dumped into the general budget, being poured into the consultant money pit, or used to pay for the same trauma expenses that had been budgeted in prior years. These tax dollars were to be used for new and improved trauma centers. While the consultants are still consulting, the county should open managed urgent care centers in vacant or boarded-up buildings in the proximity of fire stations and/or police stations. These small urgent care centers can be staffed with a doctor, nurses, medical interns and volunteers. These facilities would be much more cost-effective and could provide emergency medical care to thousands of patients with non-life-threatening medical issues, who otherwise would be waiting hours in one of the fast-shrinking number of emergency rooms. The lion’s share of demands at emergency rooms are not life threatening and can be served by new county urgent care centers. Most patients can probably be served with cold packs, a stitch or two, bandages, band-aids, aspirin, and assurances that the problem is minor and will resolve itself in a few days. For more serious matters, patients can be stabilized and transferred to an emergency room by an ambulance. While in route, the emergency room would be notified of a pending arrival of a real emergency situation. By opening up urgent care centers in underserved areas, the influx of additional people into the area will entice entrepreneurs and developers to open new businesses nearby (i.e., pharmacies, restaurants, and of course, a Starbucks.) In the long run, this will generate additional tax revenues for the community. Many emergency rooms are handling more than 35,000 patients a year with a large percentage of the visits being of an urgent care nature. The cost of medical attention in a hospital or trauma center is very expensive compared to the cost of a neighborhood urgent care center. With less non-emergency patients going to the emergency room, the efficiency and quality of care would improve drastically. The cost savings and the improved focus on actual emergencies would be extensive and many lives would be saved as a result. And then there’s the additional benefit of our tax dollars being spent as we voted to have them spent. Rickey M. Gelb is managing partner of the Gelb Group A Family of Companies.
