California's Emergency and Trauma Services Crumbling With More Than $400 Million in Losses

    SACRAMENTO, Calif., Jan. 18 /PRNewswire/ -- The California Medical
 Association and two state senators today announced legislation that would
 avert the collapse of the emergency care system in California, which lost
 $400 million providing uncompensated care in fiscal 1999.
     The two measures introduced today by Senators Joe Dunn (D-Santa Ana) and
 Jackie Speier (D-Hillsborough) would end a real threat to every Californian
 and preserve life-saving patient care by allocating an additional $300 million
 to the emergency medical system, while streamlining both the way emergency
 funds and emergency care are distributed.
     "Right now, our state is facing a critical power shortage because
 California ignored the warning signs. We mustn't make the same mistake with
 our emergency medical system," said Marie Kuffner, M.D., president of the
 California Medical Association. "We need to save the system now."
     Why do the financial losses matter? Since 1990, 12 percent of the
 emergency departments in the state have closed, while in the remaining
 355 emergency rooms patients wait longer. Fewer doctors, nurses and
 technicians are available to provide lifesaving care.
     To support the legislation and highlight the growing problem, CMA released
 a white paper that found a startling 80 percent of the hospital emergency
 rooms lost money in fiscal 1999. More than 9 million patients were treated
 that year in emergency rooms at an average loss of $46 per visit. Hospitals
 statewide lost $317 million in their emergency departments. Emergency
 physicians provided an additional $100 million in uncompensated care.
     These losses are widespread, occurring in every area of the state, with
 30 percent of those deficits occurring in Los Angeles County in fiscal 1999.
 The hospital emergency rooms in Alameda County reported $20 million in losses.
 So did the hospitals in San Diego and San Bernardino counties. Orange County
 hospitals lost $16 million, and in San Francisco $10 million. (So reporters
 can localize these figures, the report breaks them down by county and by
 individual hospital. To access the report, go to CMA's web site at:
 www.cmanet.org).
     At simultaneous press conferences in UCLA Medical Center in Los Angeles
 and at the State House in Sacramento, physicians, members of the AARP and
 legislators decried this statewide problem, and declared it a threat to
 Californians' fundamental expectation of immediate access to competent medical
 care for critical injuries and sudden severe illnesses.
     The physicians also released statistics detailing the dwindling of
 emergency care in the past decade:
 
     -- In 1999-2000, nine emergency departments closed in this state.
     -- Since 1995, 19 have closed.
     -- Since 1990, 50 have closed.
     -- By the end of 2000, at the state's 568 acute care hospitals, just
        355 still had emergency rooms; 285 of these lost money.
 
     The report also describes ways to improve and update the emergency medical
 system, which is administered at the county level using state funds.
     "Seriously injured patients will have nowhere to turn if we allow our
 emergency care system to collapse," said Sen. Dunn, who authored one of the
 bills. "We cannot let that happen. We need action now."
     Dunn's bill would declare trauma and emergency care as an essential public
 service and create a statewide Essential Emergency Service Facility Fund of
 $200 million to support local hospitals. The money would be allocated to
 existing county emergency medical services agencies with 40 percent
 apportioned to all counties and the rest by population. The existing agencies
 would distribute the money within their counties or regions and set priorities
 within their jurisdictions. An additional $100 million would be allotted to
 the existing Maddy Emergency Medical Services Fund for physicians caring for
 uninsured patients.
     Sen. Speier's bill would require HMOs to directly pay doctors and
 hospitals for emergency services. Under the current system, responsibility for
 these payments is delegated by health plans, and it can take months for these
 bills to be paid, if they are paid at all.
 
 

SOURCE  California Medical Association