Medical Center Is Off Course With Plan to Help the Indigent

I read with dismay the article on UCI Medical Center’s plan to use $740,000 to set up an information and referral system (“UCI Agrees to Share Indigent-Care Funds,” June 12). I can understand the university’s desire to spread out the burden of medical care for indigents to other providers, but question if this is an appropriate use of such desperately needed money.

The County Board of Supervisors took an unprecedented step--using county general fund money to fund indigent medical care--by granting UCI $3 million to make up for some of its shortfall. Those of us who have been calling on the county for years to take more direct responsibility for medical care for the poor were heartened by this first step toward their acceptance of this long-ignored responsibility mandated under State Code 17000.

Our cheers have turned to chagrin when we learn that almost 25% of the grant will not be used for direct service but for a referral system and the hiring of an expensive consultant.

Those of us who have been around Orange County for a long time have seen this scenario played out time and again. The consultant does an extensive needs assessment (for the umpteenth time) and comes up with a responsive plan. But the crucial bottom line is always the same--where will these people in need of services be referred?

In this case, how many physicians are willing to serve Medi-Cal and IMS patients? How many will serve the uninsured or under-insured? How many hospitals will admit uninsured patients without prepayment unless it’s a life-threatening emergency? The answer, unfortunately, is precious few.

What happens now is that these unwanted patients are referred to free and community clinics for care, where a few selfless physicians, medical professionals and others donate their time (or are paid token salaries) to give as good care as they can.

These clinics scrounge for donations, spend days and sometimes weeks trying to obtain needed surgeries, special treatments, and hospitalization when needed. They provide a small but sturdy patch in a safety net full of holes.

I fear that this new study system will come up merely with an even more effective way of referring those not served to these already overburdened clinics.

Our medical system nationwide needs a complete overhaul. Orange County does not need an exorbitantly expensive referral system until there’s a valid network of providers willing to accept and respond to those referred.

JEAN FORBATH, Costa Mesa