Indigents Have Been Left Out in Vasquez’s Leaner County

I am writing to you after reading the column “Lean Times Demand More Efficient Leadership” (March 27) by Supervisor Gaddi H. Vasquez.

I find myself in the involuntary role of contributing to the “leaner, more efficient way . . . “ the county is doing business.

I don’t doubt that some of the measures to streamline health care have resulted in “one of the lowest county employee-to-citizen ratios among major counties in America. . . .” The elimination of the county hospital certainly reduced the number of county employees involved in health care.

Unfortunately, it did not address the underlying problem of disease in the economically disadvantaged. It merely deflected their health-care needs into the private sector, dispersing the impact and blunting the focus. Now the Board of Supervisors need not defend substandard care at “their county hospital,” nor experience the focused pressure to bring care to the indigent equal to community standards. It’s someone else’s responsibility and someone else’s failure because of streamlined efficiency.

The absence of committed leadership on the part of the supervisors in the area of health care has led to efforts on the part of community agencies ranging from the United Way Health Care Task Force, California Health Decisions, the Orange County Medical Assn., the California Hospital Assn. and the Orange County Grand Jury to address the shortfall in quality, accessibility and funding for health-care services.

For a long time, America’s citizens have enjoyed a stuporous euphoria of credit-card psychology, geometric multiplication of the national debt and blithe indifference to the coming day of reckoning. Personal responsibility has been transmuted into “a thousand points of light.”

The “leadership” Vasquez alludes to in his article stresses a series of edifices, airports, jails and environmental landfills. Nowhere in this article are health-care needs mentioned. Can this be because Vasquez has abandoned his position of leadership to the more politically expedient role of weather vane and anemometer?

To talk of efficient leadership and ignore the problem of the decade is to feed the self-satisfaction and complacency that insulate us from the challenge of the ‘90s. I don’t expect the supervisors to solve the problem all by themselves, just to recognize its existence so that constructive steps may be taken on federal, state, county, public and private levels.

To impress the private sector into public service, scatter stardust from a magic wand like the fairy godmother in a Disney fantasy, label this a “thousand points of light” and then brag about “efficient leadership” is to hold the electorate in contempt. When the narcotic wears off, the withdrawal will be most unpleasant.

LAURENCE LEWIN, M.D., Garden Grove