16% of People in County Listed as ‘Health Care Deprived’

Orange County, which is among the wealthiest areas in the nation, has a sizable percentage of poor and elderly residents who are not provided adequate health care, a special task force reported Thursday.

The Health Care Task Force, commissioned by the United Way of Orange County to conduct the one-year study, also reported that many other county residents who subsist above the poverty level also receive inadequate health care.

The report estimates that 360,000 people, 16% of the county’s population, make up the “health care deprived.” During illnesses or after minor accidents, these people go without treatment generally available to others.

“It is our finding that, despite the wealth and advantages available in our county, the health care services cannot adequately serve innumerable residents because of social and economic restraints,” said Chauncey A. Alexander, who headed the 28-member panel. “Indeed, we have a health care crisis.”

The report said medical and health services have been “deteriorating rapidly” and estimated that “hundreds of thousands of Orange County residents, even though insured, do not receive the health care they need.”

The task force, which is made up mostly of health care specialists and heads of social service agencies, identified six major problem areas:

- The prevailing drive by private hospitals and clinics to keep their own costs down has resulted in a curtailment of some medical services.

- The costs of health-care services have continued to increase above the inflation rate, while legislators have decreased health care programs.

- Money has been cut back in the federal Medicare and the state MediCal programs.

- The social services system is being pressured to reduce costs have hurt the quality of health care services.

- Coordination and planning of health care services in the county are lacking.

- Broad community participation is absent in efforts to correct health care problems.

Alexander said although the poor and elderly are the groups most affected by health care problems, deficiencies in the present health care system have an impact on “most residents . . . in one way or another.”

The study showed that the reductions in Medicare benefits have forced about half of all senior citizens, an age group that is expected to double within 15 years, to supplement their medical expenses with private insurance coverage.

More than 102,800 persons are eligible each month in Orange County for state MediCal benefits, and another sizable group is cared for under the state-financed, county-administered Indigent Medical Services Program. About half of the people who participate in IMS earn less than $200 a month, the study showed.

The task force said these figures could be “just the tip of the health care service problem” because of incomplete data from both public and private programs.

“Little hard data exists in Orange County regarding those turned away from health services and those who do not seek service for financial or personal reasons,” the report said.

Jon Gilwee, --regional director of the Hospital Council of Southern California, which represents 225 hospitals, including 36 in Orange County--said the findings are not surprising:

“The report demonstrates that the deterioration of government support for the elderly and indigent has now reached down deep into the community. The needs of the poor, the elderly and other persons are being left out by the competition (for health care services).”

Alexander also said the primary reason for the deterioration of health services is the lack of “a coordinated approach to health care in Orange County.”

For example, he said, historical and political considerations are primary reasons Orange County does not receive its fair share of state health funds. The task force estimated that the county gets about $45.7 million a year less than it should because distributions of funds is based on outdated formulas.

Ronald L. La Porte, manager of planning for the County Health Care Agency, said the formula by which state and federal health care funds are distributed must be revamped. However, he said the county traditionally has been remiss in aggressively pursuing state funds for health care.

“Orange County at one time did not move as fast for state funds because it did not want much state assistance. But now it must,” La Porte said. “Another problem is that Orange County is seen (by lawmakers in Sacramento) as affluent, conservative and spoiled.”

Alexander said that the task force will not disband and has been authorized by the United Way to continue its work. He said the panel’s next priority would be to find solutions for the health care problems in the county.

“ ‘What’ was the question now. The next step is to find the ‘how,’ ” he said. “We have established the dimensions of the problems, and the next step is to target some areas.”

Mark Headland--director of human development for the order of Sisters of St. Joseph, which owns and operates St. Joseph Hospital in Orange--is a member of the task force. She said the panel had wanted to study only health care problems of the poor and indigent, but the scope of the study quickly broadened because of the findings.

But Headland said he was not surprised to learn that adequate health care is also a problem for middle-class county residents:

“You have to realize that there are a lot of (middle-class) individuals who do not have health insurance, 22 million in the country. This is a societal issue, not just a county issue. There has been an evolution in that there are now fewer dollars for health care and more competition for those dollars.”

Headland also agreed that coordination in the county was needed to help solve the problem.

“It’s time for everyone to quit pointing fingers and get together and determine what we are going to do. We need to work together because ultimately the patient is the one who bears the brunt of the problem.”