Want Government-Run Health Care?

HEALTH care is in the spotlight again, with the state of Massachusetts switching over to a mandatory universal single-payer program. But also sharing center stage are the same controversies that have bedeviled government's involvement in anything that demands excellence--as Angelenos know well.

The basic question is whether we want a political system to manage doctors, hospitals, and patients. What is the history of government's accomplishments? Are politicians and bureaucrats known to he pillars of efficiency, impartiality, and competence? Or will government's escalating foray into medicine turn into a Laurel and Hardy comedy with the catchphrase: "Well, here's another nice mess you've gotten us into."

A glimpse of that mess became visceral in Los Angeles in recent months. Angelenos know the story: A very ill woman. Edith Rodriguez. on May 9 entered the government-operated Martin Luther King-Harbor Hospital in dire need of medical assistance. She was ignored. Rodriguez collapsed and lay on the floor for 45 minutes, unattended, screaming for help and throwing up blood. The security camera videotape shows that the hospital staff was indifferent to her plight. As she pleaded for help, a janitor was shown mopping around her writhing body. Rodriguez died on that floor. Her husband called 911 for help, but was told that since his wife was already at a hospital, they could not send help.

The hospital, of course, lost its federal funding a few weeks ago and began its shutdown. Still, one would expect that the staff would have been severely reprimanded or fired for gross negligence. But King-Harbor Hospital was a county-operated facility accountable only to the political establishment, not to consumers. In fact, hospital patients cannot sue for damages unless the Los Angeles Supervisors agree to the lawsuit.

So what happened? The medical staff responsible got "letters of expectation" that explained how to treat patients in tile future. The director of Islamic Project HOPE, Najec Ali, was incensed and regarded the hospital's reply as a "slap in the face for the whole family, a slap in the face for the community and it shows the devaluing of Latinos and blacks ... "

'Killer King'

Known by the locals as "Killer King" for decades, the hospital had a long history of harming and killing patients that it was meant to serve. In 2000, a 9-year-old patient died after coming to the same hospital with two broken teeth. One investigation discovered that a man with a serious brain tumor was left untreated in the emergency room for four days before relatives transferred him to another hospital so that he could get a life-saving operation.

Dozens of other cases of incompetence, poor management, bureaucratic indifference, and lapses in care were found. So many violations were revealed that the U.S. Center for Medicare and Medicaid Services recently filed a report that not only condemned the hospital for "substandard care" but declared that "patients at King-Harbor in Willowbrook were in immediate jeopardy of harm or death."

But surely, this county-operated hospital must be underfunded! Not according to the Los Angeles Times' five-part investigative series that included the headline, "Underfunding Is a Myth, hut the Squandering Is Real." The report said that King-Harbor hospital "spent more per patient than 75 percent of the public and leaching hospitals in California. according to a 2002 state audit thai looked at fiscal year 2000." In other words. King-Harbor county hospital could have been considered overfunded compared to most other hospitals.

According to the World Health Organization, the United States' "overall performance" in health care is supposedly 37th in the world. But in the "patient satisfaction category," America ranks No. 1, and it's No. 2 for the shortest waiting time for nonemergency surgery. This is an amazing statistic, since more than 50 percent of every U.S. medical dollar spent is controlled by local, state or federal agencies.

Everyone wants better and more affordable services. But the issue of health care or any service boils down to choice. To the more libertarian-minded among us, the greatest way to bring down prices and raise quality is to let people make their own decisions. Without choice, a system can easily morph into a stagnant monopoly where politics determine who gets which doctor, what medical procedures are appropriate, and how much quality is affordable. Any other way but choice makes a mockery of free institutions.

In the case of Edith Rodriguez's experience with government medicine, the outcome was a tragedy, of unimaginable incompetence. This might he our fate if government completely invades the medical field. In that scenario, health care may be "free." but it will surely cost us a lot.

L.K. Samuels is a Realtor who is a contributing writer to the Libertarian Perspective. He also is editor and contributing author of "Facets of Liberty," an anthology of political, economic and sociological essays. He lives in Cannel Valley.