The editorial "Humana Hospital Closure Is a Disaster" touches on all aspects of medical care in Orange County as viewed from a hospital emergency room.
In stating that the closure of the hospital was disastrous " . . . for the thousands of poor people in the region who sought medical aid in its emergency room," you arrive at the heart of our problem.
Restoration of the emergency room is the hope of Westminster Mayor Charles V. Smith. Unfortunately, reopening the emergency room would not solve the problem of indigent medical care in Orange County or even in Westminster; on the contrary, it would delay finding a genuine solution.
Indigent care is not efficiently delivered in emergency rooms. You mention that Orange County is at the bottom of the state in funding primary indigent care. The solution is simply stated: We must provide primary, not just emergency room care.
Our county leaders might do well to study Sacramento County in this regard. The population is about one-third that of Orange County but the demographics are quite comparable.
Like Orange County, Sacramento County has no county hospital. Unlike Orange County, Sacramento County contracts with the local University Hospital (UC Davis) and, to a lesser extent, to all but one of the private hospitals for inpatient care for indigents. Moreover, a string of full-time, primary-care offices staffed by full-time physicians, nurses and assistants exists, as well as a full-service pharmacy for indigents.
The cost of delivering care in this comprehensive, planned, rational way is actually less than the cost in our local inefficient, helter-skelter non-system.
The main benefit in providing adequate primary care to indigents outside of hospital emergency rooms, however, is the protection all of us have, indigent or otherwise.
When an emergency room closes for lack of funds, because of having to provide undercompensated care, we all lose.
If Mayor Smith wishes to be helpful, he should lobby the Board of Supervisors to establish sufficient indigent outpatient clinics.
Until this is done, emergency rooms will remain under intolerable financial pressure and we will see more closures.
ROBERT MC CAULEY MD