Tragedies Cry Out for Medical Care Remedy

Some wrenching questions about life, death and the cost of medical care in America were raised when Stephen Regalado of Mission Viejo died on Oct. 30. Just 23, Regalado was too sick to survive the time it was taking to raise money to pay for a heart transplant at UCI Medical Center.

Now a second patient, Hector Bojado, 29, of Anaheim, is in a deadly waiting game. Like Regalado, Bojado suffers from cardiomyopathy, an irreversible swelling of the heart, and has no health insurance. The financially strapped UCI Medical Center said it will not pay for his heart transplant operation, which it estimates could cost from $70,000 to $150,000. Its fund-raising auxiliary fell short of raising what was needed, collecting only $50,000.

Luckily, UCLA Medical Center has now taken over the care of Bojado, a plastics molder and native of Colima, Mexico. Because UCLA has more experience with heart transplants, its patients qualify for Medi-Cal while UCI’s do not. UCLA doctors will evaluate Bojado on Wednesday to determine whether he is a good candidate for a transplant. If he is, he will go on a list of potential transplant patients that now numbers more than 20.

While Regalado’s death was a tragedy, and Bojado’s situation is desperate, UCI Medical Center cannot be faulted for its decision not to move ahead with the transplants without appropriate funding. The two men help dramatize a crisis at the medical center, which this year began discouraging the admission of impoverished pregnant women at the door, saying it no longer could afford to deliver babies at the current reimbursement rate being paid by government programs. This is a serious problem facing medical care providers all over the country.

It would be a mistake to relegate Regalado and Bojado to the category of oddities. Many families are touched by similar high-cost medical procedures, including dialysis. Nor are they out of the ordinary in being uninsured. Estimates are that the uninsured now number about 500,000 in Orange County, 5 million in California and 37 million nationwide. Even many of those with insurance do not have benefits covering high-cost treatments such as transplants.

The cruel--but not hypothetical--question facing those who provide medical treatment to the poor is this: Which is more important, saving one person’s life through a transplant or in the emergency room? A UCI Medical Center spokesperson pointed out that if a transplant costs even $100,000, that is enough money to pay for 224 emergency room visits or 33 baby deliveries.

There are no easy answers, but what must be clear is that the nation’s medical system is due for a major overhaul. Even the conservative business community now recognizes this. In a reversal of their past stands against governmental interference, four major business groups, including the U.S. Chamber of Commerce and National Assn. of Manufacturers, last week pleaded for help from Congress, saying that soaring health care costs have gone out of control.

Cases such as Regalado’s and Bojado’s force us to give careful thought to the medical funding crisis. It is time to view these dilemmas not just as individual tragedies but as an opportunity to rethink medical care in America.