Fighting for care
A community group says San Diego Children's Hospital is denying uninsured patients access to so-called "charity care"-need-based free or reduced-cost hospital services for patients who don't qualify for programs like Medi-Cal and Medicaid. In exchange for tax breaks, nonprofit hospitals must provide a certain amount of charity care.
The group, ACORN, protested Friday in front of the hospital. Protestors argued Children's Hospital spends less than half of 1 percent of its revenue on charity care compared to the statewide average of roughly 1 percent.
Children's Hospital spokesperson Tom Hanscom said the population the hospital serves, kids, explains the low spending. Children are more likely to qualify for government programs than adults, he said; therefore, most of the uninsured or underinsured patients in a children's hospital don't need charity care as much as patients in a general hospital.
However, ACORN argues the numbers are low because Children's doesn't post information on charity care so that it's visible to patients' families.
Hanscom said it isn't the hospital's policy to provide patients with payment information upfront, adding that financial advisors are available to help after a patient has been treated. Hanscom emphasized the hospital's primary focus is on providing care.
"Our first concern is to see that they are cared [for], not to open their wallets," he said.
"They say one thing, but we have the people, and it's very different," said ACORN organizer Victoria Samaha.
Judith Ocampo brought two of her children, both with a fever, to the emergency room and was unable to pay the $4,000 bill. She was never offered charity care, she said.
Hospital Chief Operating Officer Chris Abe promised ACORN the hospital would review its policies and meet with the organization.
Doing the county's job
On Tuesday, the San Diego City Council voted to reinstate its needle-exchange program, absent since it lost majority support on the council last year.
Needle-exchange proponents say it's a needed public-health service that slows the spread of blood-borne diseases like HIV and hepatitis C. This year in San Diego County, new cases of hep-C are on track to top last year's numbers. According to the county Health and Human Services Agency, in 2005 there were 3,491 new cases of hep-C; in the first six months of this year, there were 1,980 new cases reported.
So why hasn't the county implemented a needle-exchange program? The reality is that such programs are less about public health and more about politics. Adrian Kwiatkowski, a consultant who's worked with the city of San Diego on its needle-exchange program, pointed out that the county's public-health officer, Dr. Nancy Bowen, has never publicly stated her position on needle exchange. (Bowen was out of town this week and unavailable for comment.) It's likely because her bosses, the county Board of Supervisors, vehemently oppose needle-exchange.
In 1997, they voted on a resolution, authored by Supervisors Dianne Jacob and Bill Horn, to ban needle-exchange programs in the county, arguing such programs facilitate drug use (widespread research has found no evidence of this). The vote came despite a 1994 county Grand Jury report recommending a countywide needle-exchange program. Those same five supervisors are still in office. Only one has changed his position. A spokesperson for Supervisor Ron Roberts said Roberts would support needle exchange as along as it's tied to drug treatment. Treatment referral is a key component of San Diego's program, Kwiatkowski noted.