Compromise on Health Funding

The Orange County Board of Supervisors should accept the compromise offered by health care groups asking for a reasonable share of funds from the settlement with tobacco companies. Since the issue almost certainly will be decided by one of two possible initiatives, supervisors, by compromising now, can co-sponsor one agreeing to spend 60% of the funds on health care. Otherwise, they will take their chances opposing one requiring them to spend 80%.

The best estimates are that the county will receive $30 million to $38 million a year for the next 25 years as its share of the tobacco companies’ nationwide settlement of lawsuits. Orange County did not join the lawsuits, which were intended to recover the costs of treating smoking-related illnesses, but the county nevertheless stands to share in the settlement.

For years health care organizations have pleaded with the supervisors for more money. Unlike many other large counties, Orange does not have a public hospital. Doctors and private hospitals complain that as a result they pick up an inordinate share of the cost of treating the sick.

The tobacco settlement should have been an easy solution. However, the supervisors want to use the bulk of the money to pay off debts incurred as a result of the bankruptcy of 1994 and to expand county jails. Those are legitimate needs. But the compromise would still give the supervisors a hefty percentage of the money.

The county chapters of the American Lung Assn., American Heart Assn., state medical association and other groups last week presented a proposal in which they would receive 60% of the tobacco money and the county would use 40% for other purposes. If the supervisors reject the deal, the health groups have enough signatures for a November ballot initiative requiring that 80% of the funds be spent on health care.

There’s no way to predict how the initiative would fare, but betting against health would not be smart. Yet that’s what the supervisors will do if they reject the offer at their meeting today.

The supervisors have offered to spend perhaps 20% to 25% a year in settlement proceeds for health care, in addition to normal funding, which in the next fiscal year probably will be $40 million. But the county should spend more for anti-smoking programs, additional community clinics and programs to reach the large number of residents without health insurance. Those programs should receive more than one-quarter of the settlement funds.

The health care groups have done their share, negotiating with the county for months and cutting their target from 80% of the funds to 60%. The county too should compromise.