Closure of King Harbor Hospital

Friday's announcement that Martin Luther King Jr. Harbor Hospital will close after losing $200 million of federal funding, after it failed a second CMS inspection, highlights yet another problem caused by having high numbers of uninsured residents.

King Harbor is one of the lowest-income areas of L.A., meaning most likely a large number of patients visiting the hospital for care would be uninsured or on Medicaid. Either way, the hospital was probably operating on larger debt than most other hospitals in higher income areas. While I'm sure all the hospital's problems cannot be blamed on funding (I really hate it when government entities blame all problems on inadequate funds -- **cough cough** -- FDA), I think it's safe to say that the hospital would have been able to hire more knowledgeable staff and run the place more efficiently with more funds from the very beginning.

In short, what I'm trying to say is that a vicious cycle exists within our current health care system:

• Uninsured/underinsured residents are less likely to receive care because they can't pay the bills;
• Hospitals that serve large numbers of uninsured/underinsured can't collect enough funds when they're patients can't pay, thus making it difficult to hire competent staff;
• Without competent staff, the hospital can't offer care worth paying for, and might end up the way of King Harbor, and the community loses access to care all over again.

I think that single-payer systems have a lot of problems, but I think in this situation they offer a benefit. When the government is paying for care, and the wealth of the patient is no longer a factor, all patients have a better shot at receiving high quality care. Our system simply reinforces an existing socioeconomic divide. Will there still be a divide under a single-payer system? Of course. There's no way of convincing a doctor to practice at a hospital if he or she is concerned about being shot driving to and from work. Same idea for rural areas. But at least wealth is taken out of the equation.

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Last week, the Philadelphia Inquirer had a great opinion piece about health as a public good, as opposed to a private good, that I think relates to the problems with King Harbor. Columnist Chris Satullo writes,

Health care is a classic public good that should be supported by a social compact: The healthy should pay into the system to underwrite care for those who need it now, both as a matter of civic morality and self-interest. They need to support the system now so that it'll be there come the inevitable day when they'll need it.

...

The goal shouldn't be for government to supplant the private health-care market, but to tame it. States have tried, but only the feds can really do what's needed: Organize the market rationally so it covers all at a basic level, wastes less, and offers consumers intelligible, workable choices.

For more coverage about King Harbor, see here, here and here.