County-USC: Call In Feds

It’s just an ordinary peacetime day at Los Angeles County-USC Medical Center. Wedged gurney to gurney in hallways, crammed three to a curtained cubicle, more than 150 patients pack a hospital emergency department built for half that many. Feeding the backlog are a flood of ill and injured people, most of them without medical insurance, and a dearth of hospital beds to move them into.

The emergency department’s interim chairman tells of a 40-year-old woman with a blocked artery who waited almost three days for a bed to open in the hospital’s intensive-care unit. Before it did, she suffered cardiac arrest and died.

This and other testimony from the front lines of the county’s flagship public hospital are part of a lawsuit by groups trying to stop the cash-strapped county from cutting 100 of the hospital’s 745 beds. Fewer beds would put even more lives at risk. But the sad truth is that even if the county could find the money to save these beds, conditions at the hospital would remain, as one expert on overcrowding testified, “horrific.”

L.A. County, the poverty capital of the country, is collapsing under the weight of its uninsured. Part of the problem is smaller employers’ reluctance to offer employee health insurance. Part of it is the press of illegal immigration, of people who are not eligible for federally subsidized Medicaid.

A voter-approved property tax increase, a recent $250-million federal infusion and a series of tough cuts have kept the emergency system from shutting down entirely. But a new study by Blue Shield estimates that covering all uninsured Californians would cost nearly $8 billion -- more evidence that state and local governments cannot end this bottleneck alone.

It will take help from Washington every bit as ambitious as the plan that Democratic presidential candidate Rep. Richard A. Gephardt (D-Mo.) detailed Wednesday. Gephardt wants to give employers a tax credit for buying health insurance for employees. He’d allow 55-year-olds to buy into Medicare, expand the Children’s Health Insurance Program to cover parents in working poor families and pay for it all by repealing the Bush tax cut.

A rival plan by another Democratic presidential candidate, former Vermont Gov. Howard Dean, would require states to guarantee insurance for everyone under age 23, add prescription drug coverage to Medicare and use refundable tax credits to cover the uninsured. He too would finance his program by repealing the Bush tax cuts.

The Gephardt and Dean plans aren’t perfect. They would be costly and would, for example, leave in place a patchwork of programs that make enrollment confusing. But they make President Bush’s rob-Peter-to-pay-Paul approach to health-care reform seem pinched by comparison. California’s growing health-care crisis demands bold proposals, the kind that will do something for patients parked for hours in hallways.