Cal Optima

Managed care has its limits, though. CalOPTIMA, initiated in the fall of 1995, is Orange County's ambitious experiment with managed care for hundreds of thousands of poor, elderly and disabled residents. Still, CalOPTIMA will stick with traditional fee-for-service medicine for one group that it's planning to add--the area's uninsured. The uninsured--a population estimated to be as high as 300,000 residents--have enormous, unpredictable needs for health care, say CalOPTIMA officials.

In your Aug. 24 editorial, "It Requires Patients," you outline several of the challenges currently facing the UCI Medical Center and describe several of its attempts to remain viable in a rapidly changing health care industry. As you suggested, community-based solutions to UCIMC's problems are preferable. UCIMC has historically been a valuable part of the safety net in Orange County and has served many of the county's poor and uninsured residents. In the past, the poor had very little choice but UCIMC.

Orange County Board of Supervisors Chairman John Moorlach sought to withhold nearly $54,000 in funding from a doctors group Tuesday because it recently filed a request seeking records from CalOptima, the county's version of the statewide MediCal program. Fellow supervisors balked at his request, with one calling it "antagonistic" and another saying it amounted to retaliation. The funding measure ultimately passed with the doctors' funding intact. The money was part of the Medical Services Initiative, a $70-million program administered by the county that contracts with private medical service providers to care for the poor.

Linda Smith was feeding 5-year-old Michael breakfast through his stomach tube. Eight-year-old Joshua was standing as still as he could while Dick Smith combed the boy's hair, and big sister Rosanna, 12, was finishing up her cereal when the doorbell rang and two neighborhood kids bounded in, ready to carpool to summer school Wednesday.

A free women's health conference with panels discussing domestic violence and cancer will be held from 7:30 a.m. to 2:15 p.m. today at Santa Ana College, 1530 W. 17th St. Other workshop issues include nutrition and exercise, mental and spiritual health, child abuse, prenatal care and communicable diseases.

Veteran hospital executive Richard E. Butler was promoted Monday to head United Western Medical Centers, a local hospital company recently acquired by a nationwide chain. Nashville-based OrNda HealthCorp. said Monday that it named Butler chief executive of United Medical, which includes the 288-bed Western Medical Center-Santa Ana, a 193-bed sister hospital in Anaheim, a skilled nursing facility in Santa Ana, and Tustin Rehabilitation facility. OrNda acquired United Medical last month.

Less than two months after announcing a rare crackdown on Medi-Cal marketing fraud, state regulators have quietly lifted an enrollment ban on a Southland HMO that allegedly offered doctors kickbacks for enrolling Medi-Cal patients. State officials confirmed Tuesday that Universal Care, a Medi-Cal health maintenance organization that serves roughly 80,000 Medi-Cal recipients in Los Angeles, Orange and San Bernardino counties, was permitted to resume enrolling new members as of May 14.

A plan to boost the number of patients at UCI Medical Center--and derail the teaching hospital's controversial proposal to merge with a private health care chain--has been quietly added to the proposed state budget in Sacramento. Not only would the budget proposal stall the university's negotiations with the nation's two largest hospital chains, it also would require changes in how Orange County's Medi-Cal HMO program operates and would mean that other local hospitals would lose patients to UCI.

So it's true. Orange County really is the happiest place on earth. Orange County's Health Care Agency tells us that according to the state's morbidity and mortality statistics, we are the second-healthiest of California's largest counties (Jan. 12). Len Foster, acting public health director, explains that "Orange County is a wealthy community and, as a rule, poverty is associated with adverse health status." In other words, the rich get good health care. This is news? What does the HCA report tell us about those residents who fall outside the parameters of "those with insurance (or)

A state appellate court has dismissed a hospital owner's lawsuit against its former chief of staff, who sent an e-mail to other doctors questioning the company's financial health. The 4th District Court of Appeal concluded in a 21-page opinion published Wednesday that the suit should be dismissed under a state law that prevents use of the legal system to chill criticism, and ordered the company to pay the doctor's legal fees. The suit stemmed from Integrated Healthcare Holdings Inc.'