UC Regents Urged to Put County Poor Before Profits

Arguing that medical care for the poor is bound to suffer, labor and health-care advocates Thursday urged University of California regents to look at alternatives to UCI Medical Center’s proposed affiliation with a for-profit hospital chain.

“We implore you: Do no harm,” said Dennis Clark of the Health Care Council of Orange County, noting that the impact of a public-private partnership on the poor has not yet been analyzed.

The financially troubled UCI Medical Center in Orange has traditionally served a disproportionately large number of poor and uninsured patients in the county.

The medical center, which serves as the teaching hospital for UCI’s College of Medicine, has seen a decline of patients with the growth of managed care. It also has higher costs associated with its teaching mission, and as a stand-alone hospital is unable to compete in the current health-care market, officials have said.

Last year, it lost $8 million. For the current fiscal year, which will end this month, it expects to finish $3.8 million ahead. But because of changing and unpredictable funding, officials expect to post a $12.8-million loss next year.

Last June, UC regents gave the go-ahead for UCI to pursue a private affiliation. Ten health-care organizations applied, and in November the list was whittled to two--Columbia/HCA and Tenet Healthcare, the nation’s two largest hospital chains.

Mark Laret, the medical center’s director, told a committee of the UC regents meeting in Irvine Thursday that he expects to present a recommendation in September.

But opponents to the proposed public-private partnership urged regents to explore other possibilities first, especially the formation of a network made up of all five UC medical centers.

“The regents should look at all other options that would keep public teaching hospitals public,” said Howard Ryan, an organizer for University Professional and Technical Employees. The UC network idea “should be discussed before, not after you contemplate handing over UCI to a for-profit chain.”

After hearing the public comments, Regent Frank W. Clark Jr. suggested that the UC network idea needed further exploration.

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While UCI officials are to be commended for their thorough search for a private affiliation, “I would hope we would do an equally in-depth study of alternative solutions,” added Regent Tirso del Junco.

But when asked if UCI should pursue different options, UC President Richard C. Atkinson responded that he is “in full accord” with the efforts to explore private affiliation.

Representatives of two Orange County hospitals that have been acquired by Columbia and Tenet told regents that that their facilities continue to provide services to the poor.

“The hospital provides care for all who seek it, not just those who can pay for it,” said Art Aviles, formerly on the board of trustees of Columbia Huntington Beach Hospital.

Added Pete Anderson, an emergency physician from Fountain Valley Regional Hospital, a formerly physician-owned facility that is now owned by Tenet: “Not once in the last two years has anyone broached the issue of not providing service” for the indigent.

However, critics said either hospital chain was bound to cut unprofitable services if it affiliates with UCI Medical Center.

“Can the university adopt the kind of rationed care that has curbed treatment for the uninsured and slashed services . . . ? How will physicians be trained in areas not deemed profitable by Columbia or Tenet?” asked Cynthia Hanna, representing the American Federation of State, County and Municipal Employees, including clerical and service employees at the medical center.

She cited news reports of criticism of Columbia’s record for cutting costs and Tenet’s history, which included settling a fraud accusation with the federal government.

“Can you even consider forming an alliance with such riffraff?” she asked regents.