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Balancing the Budget: A Modest Proposal : State finances: If we punish the poor and ailing, let’s have a swift end to their suffering.

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<i> Dr. Brian D. Johnston is an emergency physician in Los Angeles. </i>

If you have a badly injured horse needing care that you are either unable or unwilling to provide, it is considered right and proper to shoot the animal, rather than allow it to suffer. If you can’t cure the suffering, it’s humane to end it quickly with a bullet.

In Los Angeles, and throughout California, we have a very sick horse. We have the homeless, the children in foster care (30,000 in Los Angeles), the roaming mentally ill, a huge prison population, the medically indigent dependent on a decrepit and overburdened “safety net” of county hospitals, an AIDS epidemic, a tuberculosis epidemic, an epidemic of violence and an education system in trouble.

We also have an $11-billion budget deficit and a governor and Legislature committed to balancing the budget without a tax increase. They reflect the views of a citizenry hostile to the disadvantaged and adamantly opposed to paying any more to anyone to address these problems.

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In response, the governor has proposed repealing the section of the Welfare and Institution Code that requires counties to provide health care and welfare services to the poor. He would cut the state funding to counties and relieve them of the legal requirement to provide “safety net” services. In addition, he would eliminate hospice care and adult dental services through Medi-Cal; Medi-Cal payments to doctors, hospitals and nursing homes would be reduced, nursing homes would not be inspected and the state would refuse to pay for any services for all the illegal aliens among us.

Voila , the budget balances without raising taxes.

The governor should realize, however, that these steps, by themselves, are not enough. Once we have made the proposed cuts, once we have relieved the counties of their burden, we will be faced with a new and more urgent set of problems.

We will have among us uneducated, unimmunized, malnourished, homeless children, not likely to acquire acceptable family values. Our mentally ill will act out even more bizarrely when they can’t get medications at their clinics. Our county hospitals will be overwhelmed. The poor will bear their babies at home or in the street without benefit of prenatal care. AIDS and tuberculosis patients will die for lack of medication, and hospital, nursing home or hospice care. People with acute curable illnesses will suffer and die for lack of services.

This new set of problems will be bad for business, hard on tourism and difficult to explain, even if we do have to balance the budget.

For these reasons, the governor and the Legislature should take a long-range view of the problem. If we truly want to terminate these services, we should consider shooting the poor. If we can predict a slow, painful, inhumane and inevitable death, we should at least be willing to do for our fellow citizens and illegal aliens what we would do for a badly injured horse.

In all probability, it could be done without raising taxes, but our social values would have to change.

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