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Wednesday, April 6, 2022

Sounds of Silence

Two days ago, an op ed appeared in the LA Times slamming UC Health for not taking Medi-Cal patients. (Medi-Cal is the California version of federal Medicaid.) The authors were Michael Wilkes, a professor of medicine and global health at UC Davis* and David Schriger, a professor emeritus and vice chair of the department of emergency medicine at UCLA.** 

Yours truly assumed there would be a letter to the editor, an op ed, or a news release from UC Health in response. So far, none has appeared. An excerpt of the Wilkes-Schriger op ed is below:

One in three Californians are insured through Medi-Cal — the state’s health insurance program for low-income residents. Yet very few of these patients are able to get care through the University of California’s health systems. Only a tiny fraction of primary care patients seen at UC clinics have Medi-Cal coverage. In some sites, it’s as little as 1% — even in areas with high numbers of Medi-Cal enrollees. The reason for this lack of access, according to UC administrators, is because state reimbursements for Medi-Cal patients don’t cover the cost of treating them. It’s even worse for Medi-Cal patients seeking medical specialists, such as neurologists, orthopedic surgeons and cardiologists. Most UC specialty clinics won’t take Medi-Cal at all...

Since income levels and race are often correlated, this also means that the UCs are disproportionately excluding people of color. How can this de facto racist policy be acceptable?...

What message does this send to taxpayers who fund these medical schools, when a large percentage of them cannot get care at UC-affiliated medical centers? What message does it send to tomorrow’s doctors, nurses and pharmacists? We are teaching them that it is OK to cherry-pick profitable patients and hope others in the community will provide care for the rest.

In the late ’80s, when we were beginning our academic careers in the UC system, it would have been considered highly unprofessional and inappropriate for a physician-in-training or a faculty member to inquire about a patient’s insurance status. Any physician who did this would have received stern counseling from supervisors, but now such a question is common and reflects a culture that accepts profit over compassion.

The UC health leadership has long argued that it wants to treat Medi-Cal patients but cannot negotiate contracts that would cover the cost. They point to UC partnerships with county facilities and free or low-cost clinics to care for these patients. However, these primary care clinics can do only so much without backup from medical specialists...

Full op ed at https://www.latimes.com/opinion/story/2022-04-04/university-of-california-uc-medi-cal-healthcare-insurance.

The most yours truly could find on the UC Health website was some charted information in a release dated June 4, 2021 on hospital revenue and patients:

Source: https://www.ucop.edu/uc-health/_files/uchealth-at-a-glance.pdf.

Note that by law, any hospital with an emergency room must take anybody who appears - regardless of insurance - and provide treatment. However, the op ed refers to clinics rather than hospitals.

Although the Regents Health Services Committee - where the op ed might have been discussed - sometimes meets off-cycle, the committee is not scheduled among the upcoming April off-cycle meetings.

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*https://health.ucdavis.edu/team/internalmedicine/706/michael-wilkes---internal-medicine-sacramento.

**https://www.uclahealth.org/providers/david-schriger.

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