Los Angeles county + USC Medical center is one of the biggest safety-net hospitals in the united States.

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Anyone who has actually watched soap operas in the last 50 years to know Los Angeles county + USC Medical facility as basic Hospital. For decades, the original building graced the soap opera"s opening credits.

Inside, though, there"s no love story between Luke and also Laura.

LAC + USC is what"s known as a safety-net hospital — one of the largest in the unified States. And that provides the fact inside a everyday financial struggle to treatment for every patient that walks through its doors, patients various other hospitals often try to avoid.

One recent week lugged a male who claimed he came to the hospital to "sleep and also eat," a man with dementia whom staff couldn"t identify and a woman found on the street spanned in feces ~ walking the end of a experienced nursing facility. Patients who can only salary a little. Patients that can"t pay at all. Patients with an overwhelming problems.

Few of this patients, if any, have private insurance. And also because the hospital must also find a ar for numerous of them to go once their health improves, physicians say some patients have stayed as long as three years.

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This past year, the nation"s an ext than 300 safety-net hospitals discovered themselves ~ above the former lines of the coronavirus pandemic, i m sorry disproportionately affected the areas that safety-net hospitals are most likely to serve. They took on a greater share of the patience burden, also as various other hospitals emerged from the pandemic with large profits, an investigation by gendergeek.org and also the PBS series Frontline has actually found, more widening the gap between wealthy hospitals and hospitals favor LAC + USC.

"Our expenses went method up, and also revenue walk down," states Brad Spellberg, chief medical officer at LAC + USC. "Unlike a exclusive hospital, we don"t make money from our . Medicaid and also Medicare do not reimburse in ~ a level whereby if you say, if us do an ext things, I"m going come make much more money."

Safety-net hospitals are funded in big part through taxpayers: In this case, LA ar taxpayers, state taxpayers in California and also federal taxpayers, that pay because that Medicaid and also Medicare.

But that taxation money doesn"t salary hospitals practically as lot as personal insurance does.

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It"s just straightforward math. A decade and also a fifty percent ago, exclusive insurance paid around $1.50 for every $1 Medicare payment — because that the same hospital services, follow to a study by the clinical journal Health Affairs. Medicaid paid also less. Through 2018, researches showed exclusive insurance to be paying nearly $2.50 for every $1 that Medicare paid for services. And also researchers say the every time the federal government does covering out a dollar, it"s underpaying for what the solutions actually cost. The $2.50, ~ above the various other hand, is covering things quite well.