Doctor Shortage in Poor Areas

* “Doctor Shortage Severe in Poor Areas” (April 19) suggests that a cause of severe doctor shortages in indigent neighborhoods is somehow related to the loss of affirmative action. As a physician, I can assure you that the No. 1 reason physicians (regardless of ethnic origin) avoid inner-city practices is because MediCal and Medicaid payments for treating the poor are so abysmal that it is impossible to make a living taking care of poor people. Try encouraging a young, idealistic doctor with $120,000 in student loans to work for $15 an hour seeing indigent people--in the face of rising overhead, employee costs, administrative hassles and malpractice costs.

For example, MediCal pays $42 for a doctor to provide epidural anesthesia to a woman in labor. For this fee, the doctor arrives in the middle of night, places a catheter near a pregnant woman’s spinal cord and assumes all risks and liabilities for injuries, for the mother and baby. To assert that restoring affirmative action will compensate for such unfair reimbursement to doctors is a pipe dream.

AHMED F. GHOURI MD

Assistant Clinical Professor

UC Irvine Medical Center

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The contempt and callousness that this country shows for the poor is well characterized by the severe doctor shortage in poor areas. And this contempt is also evident in the quality of education that the poor receive.

A poverty-stricken nation like Cuba is able to provide a nonprofit, comprehensive and humane health care system. Cuba also provides for its citizens an education system that has eliminated illiteracy. It’s time we dropped the embargo and benefited from the lessons of Cuba.

HANK ALBERTS

San Luis Obispo