Protect the Sick at the Economic Bottom

Fans of “ER” or “Chicago Hope” would love Queen of Angels-Hollywood Presbyterian Medical Center. The hard-working medical facility at the corner of Vermont and Fountain in East Hollywood serves a low-income, blue-collar, inner-city community that in one day could provide enough heroic, dramatic, painful stories to cover endless seasons of the two popular television shows.

But the stakes at Queen of Angels are real-life serious. The hospital provides care for a community with few other options. Many of Queen’s patients are the working poor with full-time jobs but no health insurance. Fifty-five percent of the patients served by the hospital are Latino, with Armenian and Asian immigrants forming another significant percentage, along with a large Los Angeles-born Filipino American community as well. As a hospital owned by a Catholic nonprofit, Queen of Angels provides triple the amount of charity medical care of other nonprofit hospitals in the nation. If one includes what are called community benefits, such as preventive care programs, the total was $30 million in 1996.

A pending sale to the nation’s second-largest for-profit hospital chain could threaten all that. Tenet Healthcare Corp. has reached a sales agreement with Queen of Angels and now the decision on whether to approve the deal is in the hands of the state attorney general.

Given the current rapid consolidation and reorganization going on within the health care industry, this proposed takeover is not surprising. The sale of Queen of Angels theoretically could even mean more and better health care for more people--if the sale agreement were structured properly or if Tenet were a trustworthy corporate citizen.

We are very concerned because the terms of the agreement allow Tenet to drastically reduce the hospital’s charity care at a time when County-USC Medical Center is also being dramatically scaled back in size. And, because the agreed-on charity care figure is fixed rather than a percentage of the expected revenue, the amount will never increase. Cardinal Roger Mahony opposes the sale because, he contends, Tenet’s emphasis on profit is incompatible with Queen of Angels’ current emphasis on care for the poor.

A large majority of the hospital’s doctors also voted against selling the hospital, some going as far as filing a lawsuit because they believe the quantity and quality of health care will be compromised.

The deal does not guarantee a continued high level of service, and Tenet’s track record does not inspire confidence about its willingness to meet community needs.

Consider:

* Tenet has only committed to maintain basic emergency services (a primary source of care for the uninsured) and the obstetrics perinatal unit at Queen of Angels for five years after acquiring the hospital. No other services are guaranteed after the sale.

* Since this time last year, Tenet has closed down two Southern California hospitals the chain purchased: Woodruff Community Hospital in Long Beach and Harbor View Medical Center in San Diego. In addition, Tenet immediately announced plans to close all in-patient services at Pioneer Hospital, the only hospital in Artesia, after acquiring it in April 1997. Tenet discontinued obstetric services at Brotman Medical Center in Culver City last year.

* There is nothing in the agreement to protect the jobs of the 1,200 Queen of Angels employees. Tenet has not agreed to continue the existing union contract, the compact that shields health care workers from retaliation if they complain about staffing or other issues that affect the quality of health care.

Tenet has failed to demonstrate a willingness to shoulder the responsibility that Queen of Angels has in the past. The attorney general should deny the sale.