Dialogue on Health Care Issues

The emphasis in health care in Orange County, as elsewhere, has been on keeping costs down. That’s important. But it pales in comparison with other issues that get far less attention.

There are also ethical, financial and legal considerations that should be explored to help determine how best to spend the limited available funds and provide as many people as possible with the health care they need.

Those decisions are being made constantly, but the priorities are being set almost entirely by doctors, hospital administrators, insurance companies and government officials. Patients, their families and the public in general thus far have had little or no influence in the moral and social implications of life and death decisions such as how new life-prolonging technology should be used and whether more money should be spent to prevent illness or to care for the terminally ill.

That lack of public input could change, however, depending on how Orange County residents respond to a new program, California Health Decisions, that will be launched at 7:30 p.m. Tuesday at a community forum in the Costa Mesa City Council chambers. The project, which seeks to involve residents in health care decisions, is being sponsored by the Orange County Health Planning Council and the Center for Bioethics at the St. Joseph Health System in Orange.

Following a pattern established in Oregon in 1983 and 1984, it will seek from the public, through a series of community meetings, advice on questions such as whether people actually have a right to health care (Oregon residents thought so) and if so, how much. It will explore the ethical principles that the public believes should govern medical choices and ask whether society should prolong life by whatever means is available--and who should draw lines when they must be drawn.

Sponsors believe that Orange County’s reaction could serve as a model for the rest of the state and nation, and spur similar forums elsewhere. The more people who get involved, the better, but any level of involvement would be an improvement on existing conditions and guarantee success for the project. Community response can help expand a dialogue among residents, health professionals and government on health care policies in Orange County that reflect the people’s concerns over medical ethics, treatment and spending priorities. The dialogue itself will make the California Health Decisions project worth the effort.