South Los Angeles residents face difficulties receiving medical care for variety of reasons

A shortage of primary care physicians and low Medi-Cal reimbursement rates have made South Los Angeles "one of the most difficult places in the nation to both receive and give medical care," the New York Times reports.

Medi-Cal is California's Medicaid program. According to the Times, "[T]he woes of South Los Angeles mirror other poor urban health systems," such as those in Philadelphia; Washington, D.C.; and Cleveland, which "have closed or fallen into bankruptcy in recent years, leaving patients scrambling." However, "the situation in South Los Angeles is particularly grave" because Medi-Cal offers the lowest Medicaid reimbursement rate per capita nationwide, which has made recruiting new physicians difficult, according to recruiters.

Nationwide, a decrease in employer-sponsored insurance and Medicaid reductions have contributed to more than 2.2 million U.S. residents becoming uninsured between 2005 and 2006, the Times reports. Nearly one in three patients who visits a Los Angeles emergency department is uninsured, and the number of uninsured patients and those on Medi-Cal in South Los Angeles has increased by more than 38% since 2000. Adding to those problems, Gov. Arnold Schwarzenegger (R) also has proposed a 10% cut for Medi-Cal, which combined with Congress' proposed reductions to Medicaid programs nationwide could mean $240 million less for Los Angeles over the next year, the Times reports.

In addition, since 2000, 15 general acute care hospitals in Los Angeles have closed. The Los Angeles County Department of Health Services, which "is sagging under its own budget woes," has adopted complex patient transfer policies that have shifted a number of its low-income patients to private hospitals, which have similar financial problems. Nine area clinics that have attempted to absorb uninsured patients since Martin Luther King Jr.-Harbor Hospital closed in 2007, have seen a 157% increase in patient visits, according to Jim Mangia, who runs the consortium of clinics. Jim Lott, vice president of the Hospital Association of Southern California, said, "We have less than one hospital bed per 1,000 residents here compared to 4.3 per 1,000 in the U.S."

Carol Meyer, director of governmental relations for the county health department, said, "We have an all-out crisis here," adding, "In terms of lack of access to care, emergency room overcrowding and total underfunding of the health care system" (Steinhauer, New York Times, 6/5).