PLATFORM : How Many Bake Sales Will It Take to Replace County Clinics?

MARY L. RAINWATER, executive director of the Los Angeles Free Clinic, is concerned about the proposed shift of medical care to charities. She told The Times:

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The Los Angeles Free Clinic handles about 60,000 patient visits a year. We must turn away twice that number. We can only help about one out of every three sick people who come to us. And we are one of the larger social service agencies around.

The call for privatization of social services could not come at a worse time for social service agencies, especially in Los Angeles. Having suffered through years of recession, our donors are writing smaller checks. And government funding at all levels is drying up.

At the same time, the good people on whom we rely to donate and volunteer are getting burned out. They’re overwhelmed by the enormity and the endlessness of the need, and they hear their own government blame poor people for their poverty. Especially as their own financial pressures mount, it’s tempting to call for family caps and two-year limits for benefits and demand that poor people clean up their acts.

Those of us who have worked directly with the poor know it’s not that simple. Poor people are just as complex as the rest of us, and the reasons for their poverty are as complicated as the reasons why I went into social work or Newt Gingrich went into politics.

The Los Angeles Free Clinic is eager to step up to the bat in the county health care crisis. We’re willing to see if we can treat more indigent patients, either at our own clinic or at one of the clinics the county will close. We see it as the heart of our mission. That’s what we do. But we can’t do it alone.

We can’t wave a magic wand and make our strapped donors write big checks all of a sudden. We can’t just hold a silent auction or write a grant application and come up with enough money. We barely manage to provide 60,000 visits, and the county estimates that 1.3 million people will be left without medical care when the county clinics close.

We can only function effectively as part of a public-private partnership that allows us to leverage every government dollar with private donations and volunteer help. That way we can provide services much more cheaply to many more people than the government can alone.

It is folly to suggest that private non-profits alone can do what our massive government bureaucracy was created to do. We can help, and we can provide the models for new alternatives, but there aren’t enough bake sales and Monte Carlo nights in the world to allow us to do what Los Angeles County used to do.