ORANGE COUNTY PERSPECTIVE : A Matter of Dollars and Health

How can there be an $11.4- million cut in support for Orange County’s Indigent Medical Services program in the 1990-91 fiscal year--and not a reduction in services? That’s a good question, and one the Board of Supervisors should answer.

The board says it doesn’t think that there is a need for hearings on the cuts because, while there was a reduction in the IMS budget, there hasn’t been a traceable reduction in services. Public hearings are triggered under state law when a county plans to reduce medical services.

But local hospital officials make a good point. They say hospitals, which were getting reimbursed 20 cents on the dollar before the cuts, now are getting only 10 cents on the dollar, and about 24,000 poor people receive health care through the program. That’s a shortfall the hospitals cannot continue without drastically reducing services or simply withdrawing from the IMS system. So talk about a reduction in services is semantic.

Like all counties around the state, Orange County was forced to reduce its support for indigent care because of sharp cuts in state funding made last summer by former Gov. George Deukmejian, who was looking for a way to balance a deficit-ridden budget. But such cuts cannot be endured without having a severe impact on health services for the poor. So why take a narrow view?

Recognizing this, the Hospital Council of Southern California and other groups, such as the League of Women Voters, the Orange County Medical Assn. and the United Way Health Care Task Force, say they believe that hearings are needed to assess the damage. In fact, the council cites a court case in San Francisco where, under similar circumstances, a hearing was actually ordered.

Hospital officials have demanded that the board decide by Jan. 18 whether it will hold hearings. They say the county should at least be forced to own up to the impact of the cuts, and explain its health-care priorities. Those are reasonable requests that should be granted soon.