russia is christine legarde first stop on a mission to the world's up and coming the natural. course. of the super rich russians at legal loggerheads as allied to shown on the shady business dealings of the past a billion dollars at stake. and now when our team why it's commonplace in los angeles when you call an ambulance to end up with a fire crew giving you first state a special report is next. for . there's. a part of. her on the way are you are you with her now. ok is she conscious. and.

let me warn you that there's a bit longer. than. that. i am wearing i cannot family for you. want to. hear. it is not.

god let's do everything we can to help b.m.s. thirteen standards. today is the parade thoughts christmas parade ten

o'clock or so goes till about well thirty three engine six five and rescue two six by. three for the good of you guys that know you got. the better going on. i know you got it all right but it may take you so much to me and when you are not right and i'm going right you don't even know what i'm going to. there are aware of. this merger of the amateur radio on the way. just tell me off the roof. it's about a twenty five foot tall. i can see where that thing that there's

a god i think. that's neat and we'll see about the attorneys on the floor. particularly your children as the whole thing ok. let's get. lucky. you know we don't act fast enough to get into the silly season and get in there fast and. take a deep breath. to get. my first computer four years ago we were averaging nine fifty a day. we're averaging over twelve hundred thirty eight hundred calls a lot of runs a day i could well have first. got yes. we handle six hundred thousand

americans see calls a year but the calls are on the m.s.i. there's been an explosion in call well it's about eighty two percent of what we do the fire departments medical. roger or i'll. just get rid of everything now is the address of your emergency is there any please is there bleeding. and i just don't believe you are the strong one year deal kay i want your time her rescue operations for me is that i want to have a rest are you there with the right now your ok listen very carefully and it's already on the way what i need to find out from you right now is she conscious conscious beings awake the rising demand for a my services increasing every year are you nuts runs are going up two percent and hospitals are closing in the last four years or that ten hospitals close so it's less and less hospitals thruster take our five hundred seventeen patients every day the rest you get there to evaluate your situation has been referred to as a perfect storm in the county of los angeles just getting bigger and bigger in this

there's no. no relief in sight if you're having a health crisis you'd like to think you can count on getting quick treatment in a hospital emergency room across the country today many emergency rooms were packed e.r. visits have grown thirty two percent in the last decade but there are seven percent fewer emergency rooms from los angeles to chicago to birmingham twenty trauma centers have closed since two thousand severe if you know what's happening in the city of los angeles and in southern california is ground zero for what we're seeing nationwide with the crisis with emergency services. the inpatient beds for capital lois in the country and what we've seen recently is the only real health care system that we have in the city of los angeles is the los angeles fire department and because we become the de facto health care system this is the canary in the morning of health care throughout the united states that outstanding

thank you bye. bye bye. orly statistical to me this is a big step for here oh you. mr tabor you miss the city. service. eight hundred twenty seven. joined. with the rule. is that the sure this is the case if the school really breathing from those the number one called the. station sixty five is in the south los angeles area of our city. they actually have two paramedic rescues down there one of our busiest engine companies we have in the city of los angeles and unfortunately can't keep personnel that long there are they come there they grab a lot of experience in a relatively short period of time and they want to go on to

a better place. people will. still be a. thief three see. firefighters at first were even e.m.t. things and then they became e m t's and for my understanding that a lot of firefighters pocket that they want to do any e.m.'s in fact when i started my venture is a firefighter i didn't want to be a mass and i started out i want to just do firefighting and be told this could be true mt license i said i can't hear you and you're doing and i took an e.m.t.

course and i thought all right i'll do it took the class just to get the license to try to get hired it was only thing i was planning on doing it was just using the license to get high and it turned out that i truly enjoyed eunice aspect of it as well my job where it was that it started with any company making just five bucks an hour for about four years five years which a lot of us had to do. our fire code has played an important role in driving down the volume and spirit of fires and because that is the reality what we need is more ambulances. ten years ago with half the evidence is that we have now now we have all of them see medical services in the city of los angeles. from the time you dial nine one one here in our dispatch center tell the time you get to the hospital it's one service the one you want to family member to come with you to the hospital we want him to step. down here.

and. here. you go see this. lady and you know this. urgent soon is very important. we see about three thousand patients a month through demurred city park but. we had a day the other day where we saw hundred ten in one day and it was exciting and your name is stephanie said just reach your sorry buddy the lady you looking for the thing on her mind hump a lot ok i've had a lot of pain and it's laying where my legs get now in the news bulletins and

you're in a doctor's office today and she was concerned he had blood finally he had one before when you're pregnant there's pressure right now this morning we're increasing staff feeding and trying to find room where there's never been room like you know closets hallways things like that. sorry to see every in the hallways because about three times it's. discourteous the problem is not enough in-patient beds not enough urgency department beds and not enough nurses to man those best to take care of all the people who are here. we may have a hospital full of patients no beds upstairs were all patients in our yard because there's no beds upstairs and we do the best we can where we can't turn them away. and we have a federal law that mandates that you can't turn no one away who seeks care in an

emergency room. the reality is that these people don't have primary care physicians that they can call so you're going to end up in the emergency room and i think that if we had a system where everyone had access to care they would. this would not be happening because they would they would call their doctor. rose crazy things are easier to rescue. my person or. rather. right right from. wrong. in season way too much this year. what's worse i know that should read just me.

to spank really. you can play it just me which different or whatever see your way or the grunting with your heart just go right right now let's do it with your rhythm i want to make sure. we question but never take any sex lately and see the last twenty four hours that in. terms of believing that it's really. not just on a more clear you know we're going to start ok high that sequence number on the spacious b. as in boy you two six six five four four six five he is now adamantly refusing the hospital there were rising on the wrists complication up to and including down i'm . willing to accept those responsibilities. and i'm so the hospital i want to speak with you. know the team by the on talk to.

yeah. yeah there were. some people are just like that they're you know they get the dream and then they don't want to they don't want to go yeah we're locked up on that as a boy and. as precious but. a lot of times they don't have the medicine they can't get the. medicine they can afford the medicine or they sell it for the us. this is it up and take it back to the doctor. so because of that a lot of them tend to use more for primary care than fresh somebody sees. for individuals don't have access to health care or ambulance to show up with our paramedics on there and that's it that's the closest thing those people see a doctor over here so we're actually a doctor in a box if you will and i remember the service. there are there are. not really gross. make sure

everybody stops and starts. to want to be more. just resigned they were going to hear martin luther king ok that's the way. you should go we're strongly recommending it we can't force you to go one have a good healthy baby right. let's go to hospital maybe you know fifty. only you. will only go under who's a month and that where you are as a family what you're going to have. let me do this is for first time bring him home with crack and yet she could meet contracting and just. as a young man to do this it was that i have an old you know great listen if she doesn't want to go with us well the worst possible case scenario is the baby can come out good and that's just being we're not going to sugarcoat it it's just being blunt i mean i'm going to have a look around her leaders have you had three and i pass it off so i'm not next

project that you have i'm not. if you think that i have a woman think once you stand up and try to walk forth. like we can do that. blood pressure already. or you feel standing. clearly. they're not telling you not to run the sweetie. so you need to do the right thing for your baby that's less you can also look. ok ok ok we're going to go to martin luther king ok ok ok ok all right the king is the greatest hospital shortly right yes or they say i mean are babies like they are really really good. this is because they were picked up on was found was county supervisor. that opens the door a. little monday morning at eight o'clock this hospital be open to the

patients. watson would welcome the south central area of los angeles county. was put on the map not only in california but the but the mission to the world. in one thousand six hundred five because of the riots six days of rioting in a negro section of los angeles left behind scenes reminiscent of war torn city much of south central los angeles seemed to be on fire up the fire killing five by unemployment or education and things like the lack of health care as you. might call commission said that the county must build a hospital. just think that we had a section of los angeles county. over a third of a million citizens without adequate hospital care. when i transferred in on m.l.k. more use of. true hospital was the e.r.

facility it was a hospital it was a trauma hospital trauma it was open which was actually a pretty state of the art trauma and. i believe we were saying to him fifty. maybe even closer to fifty five fifty seven thousand a year in the main much the department a lot of times we would get the diabetic and coma who knew something was wrong but didn't have the means to go to the doctor's office. again that goes to the problem that there are no primary care facilities in that area. a few years ago the county last year said a lot of clinics are awful people could go walk in off the street and see clinics when the county had a few bad budget years a few years ago they closed those clinics private clinics are going to open up and take under insured patients who can't pay.

and you don't have papers yes you have papers just permission how is your sugar level it's one hundred twenty eight. no it's four hundred that's very bad for your diabetes. so i can see that you had an appointment with the pharmacy a week ago why didn't you go. i did go. this is a free clinic the medicine is free you see me for free so why didn't you come this costs money. a lot of the patients here are not implying they don't want to structure their never raise with structure they want the school you know never stuck with a layer. so check your sugar two to three times a week don't use more not every day this is very expensive to not have insurance but this is where the money needs to go because if you've treated primary care why

in this diabetic you prevent from getting you know feel your heart attacks leg cut off you know because if you want to don't we see them on the streets and then two years later he ends up at l.a. county hospital you've got to treat it as if it cost five hundred thousand dollars . if you miss your next appointment or any other appointment you can find a new clinic oh yes if i miss the appointment i can come back you know when. primary care nationally is a problem when it is and especially a problem here in los angeles county where do you go for primary care physicians first of all the country is not training enough for them.

so we have a possible candidate for the program. mr mayor has been identified as every one user she's been to. at least six times within the one year period we want to care for also the care management part of it in order to maybe help her keep her on it that you aren't having to come in ok the same mrs romero come to see my name is. i work with a program called road to house and to help the patient understand better how to use the medical system settings them out maybe. but they're even going to have

a caseworker who is going to communicate with you often and they. use them as though you were telling me a how sometimes you have difficulty making appointments see ok so we're going to help you a little bit with that. oh my you know how can i help you know maybe if they didn't give me this mattson you do have to educate and empower patients to learn how to access care quickly and at the same time you can't do that if the system is not set up to be accessible if you're educating the patient to go down a road where the bridge is out and there's a fork in the road there's three different ways going you know which way to go that's not going to be very helpful. our vision is to improve access to care we want to give people access to the right care at the right time at the right place we need to incentivize financially our primary care providers our physicians this is your family medicine doctor that you go see for a cold but also the person who's most likely to diagnose you if you have cancer.

and you know you have refills you know but they told me i shouldn't come back without to prescription why. they wouldn't salad to me that's one thing we need to explain to the feet and i don't know the field. yes five she's telling me that she gets it that's when i maybe seem to get it you don't need a pharmacy. be sure be sure going for wellness will get together later for a lot of. thought there's got to. give a good thing for the market right now. this year it's. there right now we have twenty eight. under labor's lead in ok you guys are doing much better you're just about reach but margery's goal of what he wanted to have been a last resource on scene within six minutes you guys are holding down seven minutes

flat however the best it's ever been and it was six point four. zero zero zero zero zero zero zero zero zero the super necessary just give you the facts. i had a doctor call me from a hospital but we rescued get there but no and he called me one evening any tells me that they couldn't take any more patients and their merger. so i asked him to explain exactly what he meant and he says we need to free our beds for our people and i said i will which people are your people. the people that we're bringing them from these lower income areas are paying they don't have insurance they got to get treated they got to be seen. throughout paying you can't function as a hospital and that's why we've lost so many hospitals an aryan. in los angeles cold. just over five years we've had

a love in emergency rooms close and in most cases entire hospitals. if you give a map of the city and you put a little dot where the hospitals are and you put a dog or the yards and. a mission. critic a should be free. for charges free arrangement free. three stooges free. old free broadcast television videos for your media projects a free media dog darty dot com. the close up team has been to the region where technological breakthroughs save

human lives. now are she goes to the sea. where unusual ways to protect nature. where farming pioneers place local cuisine to the highest pitch. and where future developments depends on the way. russia's black sea coast should close up on our.

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