Wilson Plan Dismays Health Workers : Finance: They say governor’s proposed funding cut would be disastrous. Budget inaction is squeezing hospital administrators and physicians.

Dr. Brian Johnston’s simmering unhappiness with proposed cuts in state health care funding boiled over last week when he read comments from lawmakers and the governor’s staff about how little protest they had heard from constituents.

He picked up the phone, determined to give someone an earful, but stopped short. Which “someone” in Sacramento should he talk to? How exactly does one get Gov. Pete Wilson on the phone to discuss the impact of $2.2 billion in health and welfare cuts on the sick and poor on the Eastside, where Johnston works as an emergency room physician.

In the end, Johnston said he called the Los Angeles County Medical Assn. to urge the group to “do something. “

It is a route many dismayed health care workers are taking as the state enters its 20th day without a budget: turning to organizations they believe hold far more influence with lawmakers than the doctors, nurses and clinic workers do as constituents.

“The general public, we find, is just incredibly angry and frustrated by this,” said David Langness of the Hospital Council of Southern California. “They are calling us and saying: ‘Look, we think this is a disaster.’ ”

Robert Issai, for one, is fuming. As finance chief for St. Francis Medical Center in Lynwood, he has spent hours on the phone trying to track the fate of health programs key to the hospital’s operations. The lack of consensus in Sacramento has reduced him to picking through rumors for shreds of credible information.

“It changes from hour to hour,” he said. “The programs they are cutting in the morning are not the ones they are cutting in the evening. Try running a business with this uncertainty every day.”

More than half of St. Francis’ business is with the state’s Medi-Cal program, which is paying with IOUs--registered warrants--a currency Issai refers to as “funny money.” The hospital’s bank has pledged to honor them only through July 31.

At least Issai has a bank willing to cash the IOUs St. Francis gets from the state. IOUs worth thousands of dollars are stacked on Dr. Gary Krieger’s desk while he dips into personal cash reserves to keep his San Pedro pediatric office open. His bank has refused to cash the state’s IOUs.

“How long can I afford to do this?” asked Krieger, one of only a handful of private pediatricians in the area who accepts Medi-Cal patients. “I haven’t stopped seeing anybody yet, but if this keeps up a few more weeks, I am going to have to re-evaluate.”

Dr. Lorene Mascola, Los Angeles County’s chief of disease control, is clinging to assurances from top county administrators that programs for children will be preserved, no matter how severe the reduction in state funds. Under Wilson’s proposal to close the state’s $10.7-billion budget gap, the county’s health department could lose $593 million, or 26% of its budget.

She echoed the criticism voiced by three Republican lawmakers last week: that the governor’s proposed cuts in spending for health care could produce higher costs in the long run. Wilson says the cuts are necessary to balance the state budget without raising taxes.

Mascola cited the four-year measles epidemic that struck thousands of unimmunized California preschoolers between 1987 and 1991. In Los Angeles County, 6,600 children fell victim, of whom 39 died and about 2,000 required hospitalization. Their hospital care averaged $7,000 per child, compared to $15.45 per dose of protective vaccine.

“This is the worst time for budget cuts,” Mascola said. “If anything, we should be pushing forward even harder now. Children are being born right now who need these immunizations.”

If doctors and hospital administrators are frustrated by their seeming lack of a voice in Sacramento, lobbyists say they, too, are finding it unusually difficult to influence the budget negotiations.

“More than ever the proposals are being developed very privately and by a very small number of people,” said Wendy Lazarus, policy director for the advocacy group Children NOW. “Many lobbyists, many organizations and even many legislators are finding they can have very little impact on this process.”

Rep. Bruce Bronzan (D-Fresno), a key player in the Assembly on health issues, said the state’s fiscal crisis is to blame, and it has lawmakers frustrated as well.

“Everyone is upset because there are going to be cuts and no one can stop them,” Bronzan said. “It’s not that they cannot voice their disapproval. They are swarming all over here and disapproving until they are blue in the face.”

The frustration has fostered some unusual alliances. The California Medical Assn. is working closely with the Western Center on Law and Poverty to try to dissuade lawmakers from gutting Section 17000 of the state Health and Welfare Code, another Wilson Administration proposal.

Since the 1930s, the law has required California’s counties to provide health care and general assistance to the poor. Advocates for poor patients, such as the Western Center, have used it to win court orders blocking harmful cuts in county health programs.

“It means the collapse of our health care system,” said Melinda Bird, the Western Center’s specialist in health care law. “No one wants that, and (the medical association) is right in there with us.”

Health leaders believe that funding cuts of the magnitude proposed by Wilson coupled with measures to free counties of responsibility for health care to the indigent will cripple the state’s health care system.

“This is one issue that CMA is going to fall on its sword for,” said Dr. Marie G. Kuffner, a board member of the state medical association and president of the Los Angeles affiliate. “We are going to fight it, no holds barred, to the death.”