September 14, 2004
By Peter Micek, NCM, News Analysis

Hospital closures in San Jose, Calif., and Los Angeles recently spurred commentaries in Latino newspapers regretting the drop in local services and possible society-wide effects.

In East Los Angeles and the San Fernando Valley, says Castulo de la Rocha of Alta Med Health Services, a non-profit provider of community health services, two new hospital closures "mark a new low in the race to the bottom for healthcare in low-income communities." His comments appear in the Sept. 9-15 edition of Eastern Group Publications, a chain of newspapers in Los Angeles.

Los Angeles County lost six hospitals in the first eight months of 2004. "For non-profit health centers such as ours, the impact of these closures is tremendous," De La Rocha says in the EGP opinion piece. "Already we serve federally designated 'medically underserved areas' where the ratio of doctors to population is about 1 to 10,000. We have a legal – and moral – obligation to provide primary health services to the uninsured and underinsured, regardless of their ability to pay. Community health centers are especially important to California, since our state has a higher rate of uninsured residents and lower rates of employer-based health insurance coverage compared to the United States overall."

The state is embattled with a budget deficit, owing in part to health care spending. The November ballot will include a measure requiring many employers to provide health care, among other health care-related bills.

In EGP, De la Rocha is quoted as saying the closures put not only Los Angeles residents but society at risk. "Longer commutes to find a 'local' emergency care facility and longer waiting times once you get there are just the beginning," he said. "The serious reduction in Los Angles County’s overall healthcare capacity could make us more vulnerable to the spread of diseases by infected people who have no health insurance."

Also a board member of the National Association of Community Health Centers, De La Rocha asks for federal funds, saying, "billions of dollars in aid flow toward Iraq while we struggle to serve an ever-increasing population of medically disenfranchised people with fewer resources."

He continues, as quoted by EGP, "The federal government has mandated that healthcare organizations provide care without regard for the individual’s ability to pay. Given that our mission and very reason for being is to care for the medically indigent, all we ask of the federal government is to meet their end of this obligation by providing timely funding to cover the high costs of caring for the uninsured."

Meanwhile, an editorial in San Jose, Calif.’s, La Oferta newspaper by Mayor Ron Gonzales analyzes the "sudden" closure of the downtown San José Medical Center.

"As mayor, as a downtown resident, and as an emergency patient myself earlier this year," Gonzales said in the Sept. 10 edition of the bilingual English-Spanish paper, "I know firsthand how important San José Medical Center is to our entire community."

"Quality of life for our growing downtown neighborhood," Gonzales says in La Oferta, "and the availability of medical care - especially emergency care - for our residents, workers, and visitors in the heart of San José," will be affected. "But we are also deeply worried about the patients served by the hospital and the hundreds of its employees who will be losing their jobs, especially during this period of economic downturn in Silicon Valley.

The hospital’s parent company, HCA, made the decision to pull out. "Although we can’t force HCA, as a private business, to change its business decision about closing the medical center," Gonzales is quoted as saying in La Oferta, "we ask them to reconsider it and to keep working with us for solutions to serve our downtown and our entire community." The mayor laments that the county recently spent money on a study of the site.

His La Oferta editorial labels the closure a "wake-up call" for the state’s health care system.