As president of the West San Fernando Valley District of the Los Angeles County Medical Assn., I would like to set the record straight with respect to allegations made at the Jan. 14 public hearing for the state's Expanded Choice pilot in the San Fernando Valley ("Doctor Questions List of Peers Signed Up for Medi-Cal Pilot Project," by Lynn O'Shaughnessy).
This project, you will recall, proposes to delegate the medical care of 87,000 elderly, poor and disabled individuals to what is a wholly inadequate and fiscally unjustified "test" program, in the opinion of a broad-based coalition comprised of beneficiaries and their advocates, health care providers (including physicians), most state legislators in the Valley, and the mayor.
In this program the provision of health care will be the responsibility of seven health maintenance organizations. Although the HMOs which have thus far been selected are very reputable, they have, to date, provided no convincing evidence that they have the medical, geographic or administrative capability of providing care for 87,000 relatively immobile individuals dispersed throughout the San Fernando Valley.
At the Jan. 14 meeting, it was asserted that LACMA's opposition to this program was based entirely upon financial self-interest, because physicians in private practice would no longer be able to see these patients and, therefore, would lose fee-for-service income. In fact, the administrators of the pilot project have repeatedly attempted to assure us that this would not be the case. We have been told that all physicians wishing to participate in the program are free to do so and, therefore, can continue to see their patients through an administrative relationship with the HMOs. Since these physicians will continue to be compensated for their services in this setting, the allegation makes no sense.
