Windfall Could Cure What Ails Our Health Care

While surfing the Internet for more information on the recent proposal by Orange County to use the county’s tobacco settlement funds for our bankruptcy bailout, a flashing sign on my computer showed a box with the following: “In debt? Need help? Click here.”

If the Board of Supervisors does that with our share of the funds from the historic tobacco settlement, they will follow in the steps of their predecessors and desperately needed funding for health care will go lacking. These are health care funds.

Recently, the Health Alliance to Reinvest the Tobacco Settlement (HARTS) sent county supervisors a position paper calling on them to allocate 100% of the funds to health care programs, as their counterparts in San Diego did earlier this year. HARTS includes health care, nonprofit and private sector representatives, and is urging the county to reinvest this health care money back into the community.

Right now the county easily can leverage the funds for even more special hospital funds for Children’s Hospital and UCI Medical Center. The Legislature is developing additional incentives so counties can receive two or three times their “investment” back if they invest in health care programs. This is a rate of return we can’t pass up.

Why? Because there’s another, unseen side of our community’s health. The April Orange County Health Needs Assessment showed enormous gaps between the needs and the availability of health care for large segments of our population. Nearly 430,000 residents, including 90,000 children, lack any health coverage. While the working poor are disproportionately impacted, so are wealthier residents. Many barriers to health care services impact our elderly, children, mothers/pregnant women, teens and immigrants. The greatest barriers and access issues include:

* Routine preventive dental care is unavailable to 34% of residents. The few dental care programs available are turning away droves of patients for lack of funding.

* The unmet transportation needs. Too many elderly residents and young mothers don’t get health care because there is no convenient transportation. They can’t travel hours on a bus to clinic appointments. Many end up in emergency rooms with medical conditions that easily could have been treated before they reached the critical stage--and much less expensively.

* Insufficient mental health services, especially for the elderly, who voiced concerns about the lack of depression and suicide prevention services.

* The pervasive lack of education. This is how to gain access to available resources and avoid dangerous health habits and unsafe medical practices such as seeking medical care in back rooms similar to those linked to the recent deaths of three Orange County children.

Historically, health care has not been a priority for Orange County (at the bottom in per capita spending among major counties). Bankruptcy, jails, crime, and roads have taken precedence and, oftentimes, understandably so. The county “never had the resources” to adequately fund health care programs. Now we do.

In 1976 when the county hospital was sold to UC Irvine, it meant that health care costs (other than public health) would be borne largely by private sector and nonprofit organizations. As a relatively wealthy (or at least perceived to be) and healthy community, it’s easy to see how other problems took priority.

Just as a lack of attention to infrastructure in roads and buildings leads to a decaying environment, so health care is suffering from potholes and the need to rebuild to meet the needs of the next century.

How serendipitous that the needs assessment coincides with the tobacco settlement money won by a coalition of states that sued the tobacco industry for the billions paid to care for pulmonary, heart and other smoking-related diseases and conditions. Hundreds of millions have been spent by Orange County’s private medical establishment and community-based organizations to absorb these costs and provide health care in lieu of a county hospital since 1976.

You would think the supervisors would be thrilled at the prospect of being able to invest the more than $900 million over the next 25 years in collaborative comprehensive strategies to improve the health of our community. The needs assessment can serve as our strategic road map to decide the best return on this new investment in our future, and not in using the money for funding existing programs.

Which of our supervisors will take the leadership role and convince the others that people matter, our children and their parents and their grandparents need good health care and prevention and education to be productive members of society?

The needs have been demonstrated and documented. And now we have the money. Let’s work together in a collaborative fashion to build a cost effective, user-friendly, caring countywide health care system and not have the state dictate how the money is spent. It’s the right thing to do.