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As the up/down, "deem" or damned health care bill lurches to some sort of ending, meet a man who talks a lot of sense about our health care crisis.
He's a Canadian cardiologist who works in America's busiest ER ...
LA County USC.
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As the up/down, "deem" or damned health care bill lurches to some sort of ending, meet a man who talks a lot of sense about our health care crisis.
He's a Canadian cardiologist who works in America's busiest ER ...
LA County USC.
Mike Tharp
It's where the Navy sends its officers and corpsmen to train before they go to Iraq or Afghanistan. Sixty-eight emergency residents treat 450 patients a day. They give free care in return for, say, training as a brain surgeon. It's a one-word badge of honor, like the Marines, to say you trained at "County."
The sense-talker is Ed Newton, professor and chairman of the Department of Emergency Medicine at the sprawling complex east of downtown L.A. The 60-ish gray-goateed doctor grew up in Montreal and came to L.A. for training. In a sense, he's never left.
His ideas about problems and solutions to health care in this country come from his experiences living in two drastically distinct societies separated by a 3,145-mile border. He witnessed Canada moving from a minimalist health care system to one where half its people have their own family doctor.
A system where health care is a birthright, and prescriptions are free or cheap.
And he's watched for years as Angelenos -- 77 percent of them nowadays uninsured -- have staggered from 70 ambulances a day to his ER with gunshot wounds, heart attacks, freeway injuries and hypertension.
All that gives him a unique platform from which to diagnose, prescribe and treat.
Let's start with his solutions:
any U.S. national health plan should not be linked to insurance companies and employers;
funding should be provided for EMTLA, the 1986 federal law that prohibits any emergency department from turning away anybody based on insurance status;
increase in-patient psychiatric and convalescent hospital bed capacity;
every hospital should have a "surge capacity" plan that involves the whole institution (in case of a huge natural or man-made disaster);
primary care capability should be built up;
entice more nurses by increasing wages, benefits and training;
mandate participation in emergency department on-call service as a condition for medical staff privileges;
legislate gun control, violence intervention and rehab programs.
By now those of you who believe in "death squads" will be calling for Dr. Newton's scalp -- or his stethoscope.
More reasonable folks might pay attention because this man, this physician, has seen it all, from both sides of the border. He's been bloodied by sucking chest wounds from tattooed gangbangers.
His ideas are based on experience ranging from when he broke his hand as a boy and went without a cast for two weeks because his poor father couldn't afford it (in the days before Canada's present health care system); to dealing with 16 gunshot wounds a day on average at County in 1988 at the depth of the gang/crack epidemic; to this February when he flew to Haiti and had to decide which victims would die -- even with care and those he should try to save.
Life or death. The man knows what he's talking aboot.
Of our system today he says, "It's a weird way to deliver health care to a large population: The healthiest people have access to health insurance, and the sickest people don't have insurance."
At County, even if there were no federal law, "we can't turn 'em away -- we have no place to turn 'em away to."
And, contrary to what many of us might think, most of the increase in the number of patients to visit emergency rooms -- 114 million a year from 1993 to 2003 -- comes from insured patients.
