Shortchanging Medical Care

It seems almost paradoxical, but in affluent Orange County, the UCI Medical Center is losing more money than any of the other UC hospitals because it treats so many poor people.

UCIMC in fact treats more indigent patients than do any of the other four hospitals in the University of California system or any of the other hospitals in Orange County. Because it does, it will be $5 million in the red at the end of the current fiscal year on June 30. And without help, it will finish next year with an estimated deficit of $11 million.

Those grim figures were presented to the university’s Board of Regents last week in a special meeting called to study the growing losses of the university’s hospital system, which existsto serve the poor and train new doctors.

The biggest problem facing the hospitals is the shortage of reimbursement funds from the state and county. The UCI Medical Center receives only about two-thirds of what it costs to treat each indigent patient. That shortfall, compounded by the growing number of poor people seeking medical care and the fact that medical costs have risen nearly four times more than state reimbursements in the last five years, has led to $35 million in underpayments at UCI, with $11 million of the shortage attributable to the shortage of county reimbursements.

The state and the county should be making more realistic payments to the medical center. The university and the county are now renegotiating the contract that covers county reimbursements for medical care for the poor. The county is proposing to give the present $8.4-million block grant that now goes to the university to the Southern California Council of Hospitals for distribution to about 30 hospitals in the county that are under contract to treat the poor.

If that happens, UCI’s shortfall from the county could be even greater. The university, instead of receiving the full $8.4 million that it now gets each year, would no doubt get only a portion of it--despite the fact that it treats 35% of the poor, with the remainder being cared for by the 30 other hospitals.

If the county insists on putting the grant funds into the hospital council pool, it should substantially increase its annual contribution.

Of all the major counties in California, Orange County provides the least amount of money to care for its poor. Orange County currently ranks 56th out of the state’s 58 counties in per-capita health-care expenditures. The county board can’t keep shortchanging UCI and other hospitals like that. Neither can the state.

Without that adequate public funding now, UCI and other hospitals treating indigent patients may be forced either to close their emergency rooms or to cut back on the number of patients they admit, providing only life-saving emergency treatment. That could seriously reduce health care--not only for the poor but for all county residents as well.