Wednesday, July 25, 2007

If our national conversation is carried out in the media

then I'd say Michael Moore has definitely changed the conversation. From the home page of

Adults with no health insurance face waits up to a year or longer for gallbladder or hernia surgery in Los Angeles County, a backlog that community clinic doctors say has worsened since the county downsized Martin Luther King Jr.-Harbor Hospital last year.

The elimination of most specialty care at King-Harbor, formerly known as King/Drew, has hit Harbor-UCLA Medical Center near Torrance the hardest, the doctors say. As the county-owned hospital closest to King-Harbor, it absorbed the bulk of that facility's displaced patients.

Community clinics rely on five county-owned hospitals to provide virtually all specialty care, including hernia and gallbladder surgery, for their uninsured patients.

With a quarter of the county's adult population lacking insurance, patients have always had to wait a long time. But delays are growing longer as the population ages and suffers complications from such chronic conditions as diabetes and obesity.

Still, clinic doctors were stunned earlier this month when Harbor-UCLA told them not to send any more nonemergency gallstone, hernia, orthopedic or neurosurgery patients until hospital physicians worked through the yearlong backlog for these surgeries.

After a Times reporter asked about the ban on referrals, the medical center sent another notice lifting it. But the backlog remains.
Imagine: a major news story about medical care with absolutely no mention of delays in countries with universal coverage. Will wonders never cease? And in an ironic (perhaps even unintentional) response to President Bush:

"Emergency rooms should be saved for emergencies," she said. "But no one has a better answer."
But wait, it gets better (or worse, actually):

With funding help from the county, 43 nonprofit groups operate 117 community clinics throughout Los Angeles County. The clinics collectively see about 600,000 low-income patients a month for asthma and flu, diabetes and prenatal care, gynecological exams and immunizations.

But people without insurance also get hernias and gallstones, suffer failing hearts and ailing livers that, though not, technically emergencies, are beyond the skills of the clinics' primary care doctors, physician assistants and nurse practitioners.

Gallstones and hernias, for example, can be painful. But unless complications develop, their removal is considered elective surgery — never mind that it's better for the patient and more cost-effective to remove or repair them before they become emergencies.
Better for the patient AND more cost effective! But, of course, such an improvement would steer people away from private insurance....which they don't have anyway. Oh, well; that's what emergency rooms are for, right? Maybe not:

Clinics faced with yearlong delays for specialists will sometimes send patients with inflamed gallbladders or painful hernias to an emergency room, only to have them examined and released because their conditions not a threat to life or limb.
Oops again!

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