Crisis & commitment: 150 years of service by Los Angeles county public hospitals.
The Los Angeles County University of Southern California Medical Center will open soon, replacing the county's current 74-year-old facility with a modern, although smaller, facility. Los Angeles County has provided hospital care to the indigent since 1858, during which time, the operation of public hospitals has shifted from a state-mandated welfare responsibility to a preeminent part of the county's public health mission. As this shift occurred, the financing of Los Angeles County hospitals changed from primarily county support to state and federal government sources, particularly Medicaid. The success of the new hospital will depend on whether government leaders at all levels provide the reforms needed to help the county and its partners stabilize its funding base.
Cousineau
Michael R
MR
Center for Community Health Studies, Department of Family Medicine, Keck School of Medicine, University of Southern California, Alhambra, CA 91803, USA. cousinea@usc.edu
Tranquada
Robert E
RE
D002140:California; D003710:Demography; D004469:Economics, Hospital; D035082:Federal Government; D005380:Financing, Government; D049672:History, 19th Century; D049673:History, 20th Century; D006779:Hospitals, Public / Q000191:economics* / Q000266:history / Q000458:organization & administration*; D006801:Humans; D008484:Medicaid; D008489:Medical Indigency; D013219:State Government