Uram Among Few Speaking Up for Medically Indigent
Congratulations on your excellent, in-depth interview with Thomas Uram (“County’s Health Care Boss Fights a Fund-Short Battle,” Sept. 2). He may be the only official in the county with the credibility and courage to explain to the public what the indifference of our lawmakers to the health-care system has done to the well-being of the poor and to describe the damage to the surviving medical-care resources still available to the not-so-poor.
Uram is the most visible public servant to describe the enormity of the local health-care calamity. But he is not the only Paul Revere. The alarm has been sounded to all the media, to the Board of Supervisors, to the governor, to all who would listen by the shock troops of our medical defense system, the emergency room physicians, and by the Orange County Medical Assn., whose president and Access to Care Committee have for months been screaming a monologue at the deaf.
Doctors are best able to observe how the blight of fiscal drought is withering the infrastructure of all local medical facilities. But when they speak out, they are accused of vested self-interest. It seems that the image of the Mercedes trunk lid closing on a golf bag will never be too hackneyed to be trotted out yet one more time by the politicians.
Cynically, it is argued that doctors want medical care for the poor just so they can receive fat fees. No lawmaker wants to recall that physicians have been serving the needy for little or no fees ever since the sale of the Orange County Hospital years ago freed the county of any fiscal responsibility for its medically indigent.
Legislators know of the crisis, but money is tight, and everyone has “read his lips,” and nobody has the nerve to mention the “T word.”
Besides, the poor are a feeble constituency. They have no powerful citizen groups to argue for them in the Legislature. There are no MADD lobbies for the impoverished, no Gray Panthers battling for the destitute. Each of these lobbies has its own important agenda that it is not willing to share with the medically indigent.
The print media has mentioned the plight of the poor only in the abstract and, until today, without much emotional energy. It is the people--the same ordinary, compassionate citizens who responded to the famine in Ethiopia--who should be appealing to their government for funds for this crisis, but there are no pictures of potbellied children with flies on their eyes dying in the streets of Santa Ana or Laguna Beach to evoke their pity. Not yet.
If doctors are not credible and politicians are afraid to act and the ordinary citizen doesn’t yet realize or care about the magnitude of the problem, where are the clergy? Traditionally, in our culture, when social systems break down, it has been the church and the synagogue that speak for the downtrodden.
Thomas Uram, the compassionate and courageous head of the Orange County Health Care Agency, ably abetted by two Times reporters, has graphically described the future of health care in Orange County as beyond crisis and headed for chaos.
If we, the citizens of this county, don’t force immediate and meaningful governmental action, the legacy of Howard Jarvis and Proposition 13 will be a return to an ice-floe mentality, and we will all be physically more vulnerable and certainly morally bankrupt.
ARTHUR D. SILK MD
Garden Grove