Op-Ed; What Really Drove COVID in South L.A.
September 09, 2021
By Dr. Elaine Batchlor
In January, I became one of more than 1,500 MLK Community Healthcare staff and physicians to receive both doses of the COVID-19 vaccine. The vaccines were administered in an atmosphere of great joy and relief in our hospital’s cafeteria. We know how important this is. Upstairs, our hospital beds were filled with COVID patients.
Over the last three months, South Los Angeles has endured a surge of COVID unlike any other. Our small community hospital had more COVID patients than hospitals three to four times our size.
I’m proud of how our team adapted to take care of so many patients. We converted an entire floor of the hospital into an intensive care unit. We never ran out of supplies; when we needed more oxygen, a staff member drove hours to get it. We provided free and fast telemedicine and education to our community.
I’m most proud of the compassion and commitment our nurses and doctors displayed throughout the surge. We cheered when patients left our hospital. We cried with family members when they did not.
We also spoke out. The surge drew national and global media attention. We used this as an opportunity to talk about the real reason COVID hit South L.A. so hard: this community’s decades-long lack of access to quality health care, compounded by other social determinants of health.
Even before COVID, our community had an epidemic of chronic disease. Conditions like diabetes, heart disease, and obesity make COVID outcomes worse. Eighty-two percent of our hospitalized COVID patients had one of these conditions, and 56% suffered from two or more.
South L.A. is sick because we have a shortage of 1,200 doctors, or 10 times fewer doctors than the average community. The doctor shortage has everything to do with the way our separate and unequal health care system pays them. Specifically, the public insurance our community largely relies on pays a fraction of what commercial insurance pays. So providers can’t afford to work here.
We need to use COVID-19 to urge our policymakers to address these systemic inequities. We don’t want our community to be the epicenter of the next pandemic because we failed to act on the lessons of this one.
First, we need to attract health care providers to South L.A. That means policy changes that correct the imbalance in the way care is paid for in underserved communities.
Consider that imbalance: For an emergency visit today, private insurance pays $2,000 on average. Medicare pays $650. But Medi-Cal - which is the insurance that most of our patients use - pays $150 for the same visit and the same care.
Medi-Cal pays providers even worse for care that takes place outside of a hospital. A primary care doctor who works to prevent and improve the chronic illnesses that drive COVID can’t make ends meet here.
California needs to bring Medi-Cal reimbursements up to par with Medicare. This will make it possible for more providers to practice in communities like ours.
Secondly, we need a system that invests more in community-based care. Right now, the healthcare system spends enough on hospital care and not enough on outpatient prevention and disease management-- health screenings and maintenance with primary care doctors and disease management with specialists. To improve the health of our community, we need investment in community-based care.
At MLK Community Healthcare, we’ve started a medical group that provides high quality preventive and specialty care. But, we can’t sustain it within the current payment system. Our investments must be matched by adequate reimbursement for services.
Finally, we need medical residency programs and education, especially for doctors of color. Physicians who look like us and understand us can go a long way toward overcoming mistrust and bringing better care to our community.
We need all this because COVID will likely not be the last pandemic we see. It may be the first, however, to truly illustrate how interconnected we are.
COVID has demonstrated that we are all impacted by diseases that disproportionately attack our most vulnerable. South L.A. is home to our essential workers - grocery store clerks, bus and truck drivers, security guards, electricians and construction workers, nurses and home care providers. They are critical to the food everyone eats, the services everyone receives, and the work we all do. These community members can’t “shelter in place” - too many people depend on them. And we all come in contact with them.
So if our community is sick, it is a problem for our entire society.
In the short term, we should all get vaccinated. I’ve reviewed the research and I believe the Pfizer and Moderna vaccines are safe and effective. Please visit our website - www.mlkch.org - to find out more about the vaccines and where to go to get one.
In the longer term, we need to roll up our sleeves and advocate for our communities. Talk with your friends and family about the need for better healthcare and how we can get there. Write your representatives. Speak out on the need for health equity.
We are all connected. Working together, we can emerge from this pandemic as a powerful force for change and improve the health of South L.A.