Los Angeles County got a chilling glimpse Monday of what awaits if a massive shutdown of health services occurs Oct. 1 because no state or federal money can be shaken loose. Emergency room nurses called in sick at County-USC Medical Center and patients with life-threatening conditions had to be diverted to hospitals that lacked specialized emergency care.
That situation could occur again and again, all over the county, if severe cutbacks in health services cannot be avoided. Emergency patients may have to be shifted to private hospitals. Untreated contagious diseases, such as tuberculosis, will spread. Pregnant women may be at greater risk and more babies may be born with birth defects. The social and economic consequences will be devastating. Gov. Pete Wilson should call a special legislative session.
A DIRE WARNING: We all will be at risk. Age, income and suburban living will provide no protection. As Dr. F. Douglas Scutchfield, head of San Diego State's Graduate School of Public Health, put it, "A bacterium doesn't know if you live in Beverly Hills in a $4-million house or in East L.A."
The same warnings have been heard in Orange County, which has cut numerous services as a result of the bankruptcy it suffered last December. Example: a health clinic that served 3,700 people a year with family planning information, vaccinations and testing for tuberculosis and other diseases.
From the outset of this budget crisis, it was clear that Los Angeles County could not handle the problem without help from both Sacramento and Washington. Without state and federal aid, three-quarters of the county's 45 public health clinics and up to four of the six county hospitals will be closed.
Last Saturday, the Legislature authorized an unprecedented shift of $150 million in transportation funds to ease the hits on county health services, but it also killed a patchwork of measures that would have provided $135 million more for other county needs. The Board of Supervisors had counted on the $135 million. Now it will have to decide on a new round of overall budget cuts at its meeting today. It would be preferable to spare health services further cuts, but that will depend on Washington. The supervisors are awaiting a federal answer to their request for $178 million. County health czar Burt Margolin is to meet with officials in Washington beginning today.
FEDERAL DEMANDS: The county's application for relief has encountered unexpected obstacles. Federal officials want to structure the aid as a loan and are insisting that no federal funds be used for non-emergency treatment of illegal immigrants. They also object to shifting some funds from hospitals to clinics, a crucial element in restructuring the health system. Washington should look on the L.A. situation as a model for switching over to an outpatient clinic system. If the money is denied, the Board of Supervisors will have to further slash the budget--health care and all.
In an unprecedented move, the county board has asked Gov. Wilson to call a special legislative session to help the county. A spokesman indicated Wilson would not agree unless Los Angeles' fractured political leadership could unite behind a common bailout request. Four of the five supervisors are saying they will reject $100 million of transportation money because it has to be paid back. But Sacramento should realize that Los Angeles' problem is unique; after all, it was the governor and Legislature that took away $1 billion in property tax revenues from Los Angeles County to balance the state budget.
The governor has the opportunity now to help manage the problem. He should not abdicate that responsibility.