Adrift in a Sea ofJargon : Public often is exploited in the state’s Medi-Cal changeover

When a large corporation sets out to cut its health insurance costs, one economy option is “managed care.” A deal is struck with a medical organization that agrees to provide a given level of care to the corporation’s employees for a given price.

What does the State of California do when it decides to cut its health insurance costs by transferring Californians from Medi-Cal to private managed care? Instead of striking a deal with a set of providers and then informing the Medi-Cal recipients of the change--and of their options--the state turns the sales forces of the competing private organizations loose to chase down Medi-Cal recipients and persuade them to choose managed care of their own volition.

In health care as in perhaps no other area of the economy it takes extraordinary smarts to be a smart shopper. Not only is the medical product intimidatingly high-tech, the billing bureaucracy is a thicket of fine print. The consumer needs not only to understand English but also to have mastered the jargon of medical records.

For this reason, the state has done Medi-Cal recipients a cruelly illusory favor by permitting them the “freedom” to make this choice themselves. As Times staff writer Clare Spiegel reported recently, Latino Medi-Cal recipients in particular are easy prey for rapacious peddlers of cut-rate health care.

What is disturbing is not so much that such hustlers are at large but that they were set loose to spare the state the political inconvenience of telling the truth. If Medi-Cal is history, doomed to be replaced by something cheaper, then state leaders should say so and take whatever heat results. Even cut-rate care, if expertly chosen, is something. But quietly standing by while the sick and needy sell themselves down the river is worse than nothing.