Soviet Poet Finds Red Tape at Local Hospital : Health care: Friends of dissident writer say medical center tried to turn him away because he didn’t have enough insurance. The hospital denies it.

When one of the Soviet Union’s leading dissident poets, in the midst of a U.S. tour, fell seriously ill in Los Angeles this week, he was taken to St. Vincent Medical Center.

But friends and supporters say hospital officials tried to turn him away after learning that he had only a small amount of insurance. And, they say, it was only after “international pressure” and a frantic money-raising campaign that Bulat Okudzhava, 67, received an urgently needed--and expensive--double coronary bypass operation.

Hospital officials deny that they ever considered refusing the poet care, saying they routinely attempt to secure prepayment guarantees from foreign patients.

“I can say categorically there was never any question as to Mr. Okudzhava’s receiving care,” Michael Garko, the hospital’s vice president of finance, said Thursday. He attributed the fuss about the financial arrangements to a misunderstanding.

But the poet’s supporters are not convinced.

“I think once they realized they had a world-renowned personality on their hands and not a homeless person they decided they didn’t want the bad publicity,” said one supporter, Si Frumkin.

Okudzhava underwent the five-hour operation, performed by Dr. Taro Yokoyama, the hospital’s chief of cardiovascular surgery, Wednesday afternoon. He was in stable condition in the hospital’s intensive care unit Thursday. A spokeswoman for St. Vincent said he was recovering “very well.”

The poet, singer and novelist, who has suffered from a heart condition for several years, fell ill during a personal appearence tour that included a sold-out concert before an audience of about 1,000, mostly Soviet emigres, in Hollywood on May 18.

After seeing cardiologist Dr. Yuri Busi on Monday, he was admitted to St. Vincent in Los Angeles for further tests early Tuesday. Doctors there decided that the balladeer and folk hero to a generation of post-Stalinist Soviet dissidents needed surgery immediately.

“There was no question that the operation was urgently needed,” Busi said. “It was more or less a textbook case.”

Busi praised the hospital’s handling of the matter, and said that family and friends of his patient “may have let emotions interfere” with their perception of the hospital’s attempts to secure payment.

“There are many hospitals that would not have been as generous, regardless of whether a famous personality was involved, and it is unfortunate that St. Vincent’s motives should even be questioned,” the doctor said.

But after frantic efforts to secure financial pledges from individuals and groups in the United States and Europe to cover the cost of the treatment, friends and family of the poet gave a different account.

Alexander Polovetz of Sherman Oaks said hospital officials at first appeared reluctant to arrange for the operation after it was discovered that the poet had only a $10,000 traveler’s insurance policy.

“They said there was no way to predict the final cost, but that it could be as much as $150,000,” said Polovetz, the publisher of Panorama, a Russian-language news weekly based in Los Angeles.

Hospital officials said Thursday that, barring complications that could cause him to remain hospitalized more than a week, Okudzhava’s medical bills are not likely to exceed $50,000.

Polovetz said he was told Tuesday that the hospital would need a $15,000 cash deposit by the end of the day. When he expressed concern that it might be impossible to raise that much money on such short notice, a hospital official suggested that Okudzhava be transferred to County-USC Medical Center, where charity care is available, he said.

After consulting with the poet’s wife, Olga, and son Bulat, who are traveling with Okudzhava, “we made the decision that we did not want him to be sent to County-USC,” Polovetz said.

Polovetz said that he and others made scores of phone calls “all over the world” Tuesday afternoon and evening, and that the expressions of concern from scholars, artists, political activists and other supporters “was simply overwhelming.”

Polovetz said that Garko, the hospital official, told him Wednesday morning that the hospital had received numerous inquiries about the poet, and that several groups had pledged to cover the medical expenses.

Garko insisted in an interview, however, that the surgery was scheduled “before the first dollar was committed.”

“We’ve done hundreds of charity operations involving international patients over the years,” he said. “Naturally, in a case such as this, we have an interest in being paid, but there was never, ever a question that he was not going to receive care.”

He said that “several” guarantors in the United States and Europe had pledged to cover Okudzhava’s expenses, and that one of them had posted a deposit with the hospital. Garko declined to reveal the amount of the deposit or to identify any of the donors, saying they preferred anonymity.

On Thursday, the poet’s wife and son emerged from a visit with Okudzhava, saying they were pleased with his recovery.

The poet arrived in this country last month for a series of appearances. His wife said he quit his 50-year smoking habit three weeks ago on the advice of a Boston heart specialist.

Observers who attended his musical concert and poetry reading in Hollywood said that even though few in the audience of adoring fans seemed to mind, he appeared tired.

The younger Okudzhava, who is 26, said his father had pushed himself to keep up with the tour, and that he seemed to perk up when in front of an audience.

“We are very grateful for the care he has received, and to the people who (pledged) to pay for it,” he said. “This has been quite a memory for us.”