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Board of Supervisors' Role in Medical Care for Poor

March 20, 1988

Every month hundreds of good and substantial residents of Orange County become victims of catastrophic disease or trauma--events that they could not foresee and for which they are unable to budget.

They become what the elected officials of this county have chosen to label Medically Indigent Adults. But no matter what the name, the sad fact is that the Board of Supervisors is turning its back on these desperately sick and injured folks by letting the program go broke.

Who are these unfortunates who failed to prepare for a rainy day with prudent insurance or savings? They are, but for the grace of God, you or I, our wives and children.

They are people who work but have no health or accident insurance. They are working people whose group insurance is tied to their jobs but who happen to be out of work when medical disaster strikes. They are illegal immigrants who get sick or hurt just as you and I do.

The most familiar scenario is that the medically indigent person postpones, delays or avoids care until a catastrophe--a stroke, diabetic coma, seizure or car wreck--compels a call to 911. The familiar county hospital that used to serve as a substitute for the family doctor has been sold. Orange County has had no county hospital for a dozen years.

The county-funded paramedics perform in their always splendid fashion, bringing the victim to a trauma center or other hospital-based emergency care facility that is not funded by the county. And if the bills are not paid, the hospital goes out of business.

The medically indigent are arriving--without money, Medicare or insurance--at local hospitals in far greater numbers than ever before. The simple truth is that care programs for the poor are facing collapse. Such a collapse would affect all of us. (Trauma centers in half a dozen hospitals in Los Angeles have already shut down; those centers are closed to everyone, not just the poor.)

Cynics say that politicians have little concern for the poor because they represent few voters and that the majority of voters are in no mood to contribute to the care of the indigent. I find it difficult to believe that people who have contributed millions of dollars to aid the starving in Ethiopia are unwilling to come to aid of their neighbors.

The residents of this county must find some way to let their elected representatives know that they do care about the way we treat our less fortunate neighbors. We do not want a reduction in the emergency medical services that any of us may someday need.

ARTHUR D. SILK, M.D.

Garden Grove

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