Wanted: a Little Leadership : Governor’s Vetoes a Ritual, Now He Needs to Show the Way

It was surprising to read last week of Los Angeles County Supervisor Deane Dana’s objections to Gov. George Deukmejian’s budget vetoes. That health-care services should take a sizable hit, and that Los Angeles County should suffer accordingly, should not have shocked and startled Dana, as he says it did.

After all, this sort of thing has achieved the status of a ritual at the California Capitol since Deukmejian first took office in 1983.

Each January the governor presents the Legislature with his proposed budget, which lawmakers then proceed to enlarge and enhance. And each June (or July, if the budget is late) the governor vetoes away most of the additions. And finally, since Democrats have only a simple majority in the Legislature, not the two-thirds needed for overrides, the governor’s vetoes stand.

Things can become more complicated, of course. This year the state unexpectedly took in more money than it could spend under the Gann limit, and the budget became involved in a dispute over who should get the surplus.

But the basic budget pattern remains. Deukmejian annually whacks away that which he hasn’t proposed in the first place. Nobody should be much surprised.

However, there’s still plenty of room for comment, and especially so in the area of health services. It’s here that another aspect of the governor’s behavior is most evident.

Generally speaking, Deukmejian has always attempted to impose spending limits on state government. When he was first elected, the limit was expected income--don’t spend more than current taxes will produce. He couldn’t enforce his limit altogether; he had to raise taxes modestly in 1983. But the goal remained.

Nowadays the Gann limit, which voters approved in 1979, is beginning to take effect, and the governor is determined to enforce its spending limitations.

All of which is fine, except for one thing: Being a leader requires a lot more than simply telling cities, counties and everyone else beneath you to get along on less. Being a leader also requires that the governor use the power that only he possesses to propose and develop new ways of doing things that will allow the limit to be enforced without causing undue harm.

Take, for instance, Los Angeles County and its network of trauma centers, each a sort of glorified emergency room. The system is undoubtedly saving lives. But it is also being undone financially by floods of uninsured patients. Thus the Legislature added $20 million to the governor’s budget to help cover their costs.

The governor vetoed, saying that “the problem of providing funding for medical care for the uninsured, non-indigent population is nationwide in scope and cannot be efficiently and fairly resolved by this sort of piecemeal approach.”

How true. The growing number of uninsured patients is generating an enormous problem, not only for trauma centers but for the entire health-care system as well. And it has been for several years.

It’s also true that the Legislature adopted a piecemeal approach. But what was it supposed to do when the state’s top elected leader has offered no alternatives?

The same pattern appears in the governor’s biggest veto in the health-care field--$69 million for so-called “medically indigent adults,” or the “working poor.” The state used to care for these people, but passed them to the counties in 1982. At the time, the state also promised that support to the counties for this new program would not wane.

Inevitably, though, that support did dwindle, and the Legislature this year added $69 million to Deukmejian’s initial budget to make up for the counties’ loss.

This time the governor looked like a leader, in that his veto message suggested another source for the funds--an $89-million block grant to the counties, which lawmakers also had approved and which he was not vetoing.

What his message failed to note was that the block grant was meant to finance cost-of-living increases for other health-care services provided by the counties. Thus, for instance, if Los Angeles spends its share on the working poor, it won’t have extra money for mental health, social services and so forth.

The governor’s response to this sort of situation has always been, in effect, to shrug his shoulders and tell people “to prioritize,” to decide which programs are more important than others and to use resources accordingly.

But such an approach ignores the possibility of reform, of staying within fiscal limits not by slashing spending everywhere but by requiring that government come up with new and less costly ways of doing things.

In fairness, it ought to be said that reform is usually difficult to achieve. It shakes up the status quo and creates enemies where none existed before. The doctors’ lobby, for instance, doesn’t like competition. But, for a governor, reform comes with the territory, and those who avoid it are doing only half the job.