UCI Sends a Clear Message
No one in the county would disagree with UCI Medical Center’s years-long complaint: It has been saddled with trying to heal too many of the county’s poor people. Others have to help more. This situation will have to end at some point.
But Orange County and the medical community never stepped forward to help. So the situation is ending at this point, with the medical center refusing to treat new uninsured patients unless they’re emergency cases or live within a few miles of the hospital or its clinics.
The victims are the working people who fall ill. They will be turned away from one more place and forced to search for treatment that should be readily available.
UCI’s message is clear and fair: It no longer will shoulder a disproportionately huge caseload among Orange County’s 20,000 medically indigent residents. A better-managed system is needed. With health costs rising for everyone, government at all levels must put more money toward medical care for these people. Their care is both a moral and legal obligation.
Yes, UCI also is sending other messages. Chief Executive Ralph Cygan would like to fashion his medical center into the premier range of such teaching and research hospitals as UCSF and Stanford University. And, with occupancy rates rising, the hospital can improve its bottom line by filling beds with insured patients.
UCI bought the hospital in Orange from the county 25 years ago, but it has never thrown off the image of a public hospital. Poor people have continued to flock to its doors and, for the most part, found treatment.
Problem solved, the rest of the county thought. Doctors regularly refer the working poor to UCI Medical Center even when the patients live much closer to other hospitals. The medical center in one recent year provided 29% of inpatient services for these patients, even though 24 other hospitals are supposed to be providing care.
UCI’s not-gonna-take-it-anymore stance should finally galvanize bureaucrats and politicians, who have known that UCI would take this action but have been molasses-slow to cure their own program for the medically indigent. One important move forward: County administrators will pre-approve treatment so all healers know what costs will be reimbursed.
But the county still runs an underfunded and inefficient system that emphasizes care for only the most urgently ill. The county’s contracts with hospitals don’t extend to primary-care physicians. The county needs to nail those down quickly, actively recruit more doctors and streamline reimbursement and manage care so the system intervenes before treatment grows more serious and more expensive.
Until then, what will happen to people toiling for low pay at jobs with no benefits when they get sick? If they’re from the wrong ZIP Code, UCI will direct them to the county. An overwhelmed civil servant will try to track down a willing doctor. More often, the patients will line up at the county’s already burdened community clinics--or delay care until their condition becomes life-threatening. At that point, hospitals will have to treat them.
