A Health Care System in Trauma : Medicine: Orange County’s ‘hemorrhaging’ medical system affects everyone, not just those who can’t afford its prices, said speakers at a forum attended by hospital officials, insurers and politicians.

Orange County’s health-care system is “hemorrhaging and needs more than a transfusion,” doctors, hospital and insurance executives, elected officials and government workers were told Friday as they struggled with the dilemma of mounting debts for treating the poor.

Speakers at the Showcase of Concern forum expressed frustration with attempts to fix the ailing health-care system and with the growing number of hospitals and trauma care centers closing in the county, state and nation.

But the health-care crisis affects everyone, not just the poor unable to afford care, speakers said.

About 35% of people who suffer from injuries die unnecessarily because trauma-care facilities are not available, said the keynote speaker, Dr. James Henry (Red) Duke Jr., a Houston surgeon who hosts the PBS television series “Bodywatch” and who is health consultant to singer Willie Nelson.

“Everyone is at risk when it comes to being injured. You never know when it is going to happen and if it’s serious, you will need a trauma center,” he said. Through education taxpayers could be persuaded to provide the money for trauma centers, he added.

(During the summer, one of Orange County’s four trauma centers announced it would drop out of the once-renowned emergency medical care system later this year. Fountain Valley Regional Hospital and Medical Center officials cited mounting debts from providing expensive medical treatment to severely injured patients who often are unable to pay.)

Nearly 200 persons attended the meeting held at the conference center of the Orange County Medical Assn. It was coordinated by

County Supervisor Harriett M. Wieder and Dr. Russell C. Ewing II, immediate past president of the Orange County Medical Assn.

Hospitals and physicians are facing increasing costs that are not fully compensated by government health programs, speakers said. Shifting the costs to patients with private insurance is no longer an option as insurance companies struggle to contain their costs, the conference was told.

In 1988 Orange County hospitals and health-care facilities ran up $240 million in unreimbursed expenses for care provided, according to Jon Gilwee of the Hospital Council of Southern California. The state and federal programs often do not pay enough to cover the actual expense of treatment. The shortfalls included $82 million in Medicare, $76 million in Medi-Cal, $22 million in the county’s indigent program and $60 million in patients’ bad debts, he said.

While others used medical terms to describe the health-care crisis, Chauncey A. Alexander, chairman of the health-care task force for United Way of Orange County, compared the situation to the earthquake disaster in the Bay Area. Orange County, he said, has two major faults--”the geological San Andreas fault and the sociological health-care crisis. Both have given us fair warning of the dangers to come.”

He referred to the recent publicity surrounding UCI Medical Center’s decision to direct pregnant women with no history of care there to other hospitals when the maternity ward and emergency room are full, calling the situation a 4.2-magnitude “health quake.” Now, he said, “we are subject to a 5.7 quake with the imminent collapse of the emergency room and trauma centers system.”

Like others who spoke of the problem, Alexander pointed out that fewer and fewer people who have insurance are being asked to pay for more and more who are without insurance. In Orange County alone, officials said, 400,000 residents are uninsured.

But Assemblyman Ross Johnson (R-La Habra) said the issue goes beyond the financing of government health programs.

“We have to answer some very threshold questions. What is the basic level of health care that an individual ought to be entitled to?” Johnson asked. “There is just not enough money in the world to provide the ideal health-care system for all citizens. It doesn’t exist.”

Assemblyman Gil Ferguson (R-Newport Beach) symbolically threw up his hands in frustration when he likened the county’s health-care system to Communism in the Soviet Union. Mikhail S. Gorbachev, he said, was “tinkering around” to try and fix a system that would never work.

“Neither of them work,” Ferguson said. “This (health care) is a screwed-up system that doesn’t work. Most of us don’t believe in the system.” He agreed that simply raising taxes and putting more money into the system will not solve the problems that have led to deteriorating health care and fewer services.

“What we need is a clean sheet of paper,” Ferguson said, hinting that the system should be dismantled and rebuilt. “I’ll join you when you clean off the paper.”

In addition to Ferguson and Johnson, other Assembly members in attendance included Nolan Frizzelle (R-Huntington Beach), Curt Pringle (R-Garden Grove) and Doris Allen (R-Cypress).

Also attending a part of a panel attempting to define the problem was Dr. Charles W. Plows, president-elect of the California Medical Assn.; Joe San Filippo, a vice president of Pacific Mutual Insurance; Jim Muese, director of compensation and benefits for ITT Cannon and president of the county’s Employer’s Health Coalition, and Tom Uram, director of the county’s Health Care Agency.

Supervisor Wieder said that the conference was not designed to find solutions but to put the issues on the table and discuss them. She said many are struggling with questions of whether a national health plan is appropriate and who gets what type of guaranteed health care. She said a permanent committee will be named to conduct an ongoing study of the problem of under-funded hospitals and a shrinking health-care system.

As the beginning of the session, a movie sponsored by the Hospital Council opened with the deep breaths of an expectant mother on her way to the hospital. As they pulled into the hospital entrance in the nick of time, both the pregnant woman and her husband wondered why it was so dark. When they reached the door of the emergency room there was a sign saying, “Sorry we’re closed.”

The film talked about the growing number of hospitals that are closing and the reduction in trauma and emergency services in California and the nation. It was titled “Going, Going, Gone.” It said 700 hospitals have closed in the nation and 50 in California, some of them in rural areas where they were the only health-care facility available.

Alexander said a “shell-game” has been under way for the last 10 years with “everyone shifting costs to someone else.” But there is a bottom line that has to be met. “The major players, the federal government shifted health-care problems and costs to the state and the state to the county and the county to the providers and the consumers in escalating costs to those who could pay.”

Wieder said the first task is to dispel the myth that Orange County is so affluent that it has no problem with providing health care to the less fortunate. She said changes in the health-care system will have to be made without changing it into a welfare system.

Something must be done, and soon, she said.

“The system is hemorrhaging and needs more than a transfusion,” she said.