‘County’s Medical System for Poor’

Thank goodness for telling it like it is! The Legal Aid Foundation of Los Angeles report (“Study Assails County’s Medical System for Poor,” June 26) pinpoints where the problems truly exist in county health care.

Indigent patients for years have been the backbone of the county hospital system--a system whose providers are highly dedicated and professional in delivering their medical services. However, they are being asked to deliver health care within a system which is too large and inefficient.

As a previous provider at the LAC/USC Medical Center, I experienced much of the same frustrations and patient care delays cited in the report. No emergency room in this or any county should have to see 1,000 patients a day. This type of work load, no matter how hard providers work, will break down.

Some may ask, “How can these consumers of health care tolerate such a system of care?” The answer is simple. Our indigent population is socially and politically inept and powerless. This system is their last and only hope in order to receive medical services. Naturally, few if any are going to complain.

The director of health services for the county needs to closely scrutinize this report and ask the county hospital commission to set up a task force to shift some of the patient care workload over to the private sector. If private hospitals and physicians are adequately reimbursed financially for indigent care, there would be no reason why they would refuse this added business. Especially with most private hospitals running at 40-50% occupancy rates.

If each surrounding private hospital took a 5-10% increase of indigent care patients, our county health care system could run more efficiently. In the area of obstetrics some of this is already being done. But there are significant problems with the way the system is set up which causes many private hospitals and physicians to be reluctant to participate.

Another possibility is that rather than have the county comprehensive health centers admit patients to the county hospital, they should be admitted directly to local private hospitals. This again would reduce the workload at county hospitals.

It is time for county health care providers and private health care providers to work together.

After all, illness affects everyone! The difference between recovery and death for many common illnesses is the system in which one receives health care.

ROBERT A. BELTRAN, M.D.

Los Angeles