Picking Patients by Coverage

As a health care professional and administrator, I read with horror about this now infamous incident at Northridge Medical Center. My experience, however, has shown that this situation is neither isolated nor rare. During a graduate residency in administration at a major Los Angeles hospital, I watched in amazement as the lead anesthesiologist of the day picked his or her cases. The daily surgical schedule was written on a large chalkboard, with columns describing the patients’ names, diagnoses, surgical procedures and insurance coverage.

Patients were classified as “M-Care,” “M-Cal,” or “M&M;,” also known as “Medi-Medi.” These fortunate patients, with both Medi-Cal and Medicare, were chosen first, due to their superior insurance coverage. The Medicare patients were taken second and the Medi-Cal patients were taken third, and often reluctantly.

This situation depicts a system with many serious flaws, too numerous to be addressed here. Foremost in my mind is our nation’s continual denial of the issue of national health insurance coverage. As the only industrialized nation to ignore this urgent human need, how can we react with surprise when such “aberrations” occur?

VICTOR ELEFTHERAKIS

Los Angeles