A Shrill Cry on AIDS

The words, “The Noblest Motive Is the Public Good,” frame the seal of the County of San Diego and serve as the motto of county government.

The “public good” is many things to many people, and the diversity of services performed by the county employees bears that out. Nowhere is this more apparent than within the varied programs of the Departments of Health Services and Social Services. Care of the indigent, the aged, the young and the mentally ill; prevention of the spread of contagious diseases; prenatal care; and medical services for the homeless--all of these services operate for the public good and all, taken together, speak to a sense of balance within the spheres of public health and social services.

One of the tenets of vibrant, workable public health and social service programs is to achieve a balanced delivery system. Balanced programs allow services for the many, not just the few. But it is a fact that we live in a world of scarce resources. In order to guarantee that the noblest motive continues to be served, those scarce resources must be allocated and administered in a conscientious and beneficial manner.

To short change one segment at the expense of another is both shortsighted and irresponsible. Yet, the shrill cry from the uninformed is to do just that--focus limited resources into a single health issue, AIDS, a viral disease without a cure and without an agent to render those infected, non-infectious.

Acquired immune deficiency syndrome is a major nationwide problem. It is a devastating disease with an apparent 100% death rate over time; but it is a disease that must be addressed with many others, such as cancer, polio, diphtheria, tuberculosis, leprosy and gonorrhea. The public good is best served when public health deals with all of society’s major health issues and does not make the mistake of playing them off against each other.

But unfortunately, San Diego County currently ranks 57th out of the state’s 58 counties in receiving funding for services for its residents. The travesty is that the county receives $132 million less than what would be considered an equitable distribution of resources to provide services.

A regional conference on this fiscal crisis is being called on April 26 by the Board of Supervisors in order to define the problems more clearly, to outline options, and to solicit countywide help. The clarion call during this fiscal crunch should not be to divert existing scarce resources into a single health issue, but rather it ought to be a loud, clear plea for the state to provide the county its fair share of funding for health and social service programs. A fair share will help assure that the county can strike a balance of services, thus ensuring that the public good is accomplished.

DR. J. WILLIAM COX

Director

Department of Health Services