The Big Raid

Call it what he will, Gov. George Deukmejian’s proposed use of proceeds from the increased tobacco tax, voted in November, violates the language and the intent of Proposition 99 and constitutes a formula for wreaking more damage on health care in the state.

We do not minimize the budget problem that the governor faces in the wake of the passage of Proposition 98, which earmarked specified funding for public education. We are aware of his dogged resistance to adequate taxation, and his determination to restore a $1-billion budget reserve.

But nothing can justify taking the cigarette-tax money, passed with a remarkable 58% yes vote, and diverting it to the precise use forbidden in the initiative. It was to prevent just such a raid that the initiative specified that the increased tobacco-tax revenue was to “supplement existing levels of service and not to fund existing levels of service.”

The governor’s staff insists that he is respecting the law. But no court of law could possibly uphold his budget plan as conforming to the wish of the voters. He proposes cutting $358 million from funding for the medically indigent in major counties, a general-fund obligation assumed by the state when it dumped the program onto counties. Then, to create the illusion of conforming with Proposition 99, he proposes creating a new operation, the California Health Care for Indigents Program (CHIP), with $331 million taken from four separate accounts of the tobacco-tax initiative. He insists that this is not funding an existing service because CHIP is “new.” Nor is that the only raid on tobacco-tax money.

If the governor has his way, at least 70% of the proceeds of the tax initiative would be used to replace general-fund revenue. To make matters worse, his plan would reduce funding for the indigent-care program despite incontrovertible evidence that the program already is desperately underfunded. That underfunding is a major factor in the decline of emergency services, particularly in Los Angeles County.

Indeed, Los Angeles County would face what can only be described as a public-health disaster. The basic budget of the county Department of Health Services is based on tobacco-tax revenue. Even with the promised Proposition 99 funding, the county’s emergency services would continue to unravel unless additional state funding was provided. The downtown emergency rooms, kept open with special supplementary hospital allocations through calendar 1988, are now without any special funding. At least one more emergency room will close in the immediate future, making even worse the pervasive overloading. As matters rest, the caseload is so high in the remaining emergency and trauma centers that as many as seven may be at saturation levels at any given moment--meaning that they must temporarily refuse additional patients.

Given this crisis and the budget pressures created by the education initiative, Proposition 98, the governor owes the people of this state candor --not deceptive bookkeeping. If there is not money enough to meet the basic needs, he must say so. In no case, however, can the budget pressures justify a raid on funds voted and earmarked by the people of the state to address the deterioration of public-health services.

This dispute must not be allowed to divert state officials from the more important challenge of working out an equitable distribution of the more than $600 million that Proposition 99 is expected to generate each year. This is not a pie for the health-care sponsors of that successful proposition to carve up for the benefit of each and every health-care provider. It must be used to address the priorities for which it was intended, to supplement and not to replace the existing resources. To do otherwise would betray the trust of the voters and violate the rule of law.