The Case for Measure H

What does it say about the priorities of three Orange County supervisors and the tax collector when they can stare a frightening local health care crisis in the face and virtually ignore it when they have the means to alleviate it? Worse, what does it say when a solution falls into their laps--money specifically intended to be spent on local health care--and they immediately contrive to funnel that money into a completely bureaucratic black hole?

This is what the opponents of Measure H would like to do with the funds that Orange County will receive--more than $30 million annually--from the settlement of the American Medical Assn.’s lawsuit against the tobacco companies.

If they succeed, thousands of people in Orange County will continue to go without adequate health care.

The opponents’ rationale appears as Measure G, a pernicious and murky proposal that takes money intended to repair a woefully inadequate county health care system and spends it on the county’s bankruptcy. Those who support Measure G evidently believe that the AMA sued the tobacco companies in order to put a gloss on bureaucratic balance sheets. But that was never the intention of the suit. The purpose of the settlement was to punish the tobacco companies for illegally marketing cigarettes to children by funding public health services for smoking-related illnesses.

In 1976, the county sold its hospital to UC Irvine and promised to reimburse the private sector for providing mandated health services. The county has never made good on that promise. Year after year, the private sector absorbs millions of dollars to meet the county’s legal responsibility to provide health services. With the tobacco settlement, the county has an opportunity to set things right. But after 18 months of negotiations, three county supervisors voted to use the funds on the bankruptcy debt.

This is as foolish as it is unconscionable. The supervisors’ vote neatly ignores the fact that there already is a debt-payment plan in place for the county, and that the plan is working.

It ignores the fact that Orange County today spends less on health care per capita than any other of the major counties in California. It ignores the fact that 14 Orange County hospitals have closed within the last 10 years--six had emergency departments. It ignores the facts that more than 400,000 people in the county--100,000 of them children--have no health insurance; that many small businesses can’t afford to offer it; and that working poor families or minimum-wage earners can’t afford to buy it.

But most of all, it ignores the fact that the tobacco settlement dollars are not government dollars and were never supposed to be. They are health care dollars. The settlement is nothing less than a debt to society that must be paid. Three supervisors and the tax collector are calling on voters to renege on that debt.

Measure H was put on the November ballot by 115,000 voters. Those voters--and a long and distinguished list of supporting organizations and individuals that includes Citizens for a Healthy Orange County, Yes on H (a bipartisan coalition of health professionals), and associations of nurses, physicians, religious and community leaders--recognize a hijacking when they see it.

They also know that Measure H (for health) will keep the promise that Measure G (for government) will deny: money for desperately needed services such as senior transportation to medical appointments, keeping hospital emergency departments open, anti-smoking education for youths, and increased access to community clinics--all resulting in lower health care costs for everyone.

Measure G, its backers claim, is simply about good business, government-style; it will enable Orange County to pay down its debt a few years sooner--2019 instead of 2026. Yet it requires 10% of the settlement money for administration alone, creating another needless bureaucracy that would be unaccountable to voters. Measure H funds existing programs. There is no need for yet another bureaucracy.

The voters, faced with bearing the costs and the risks of substandard health care well into the 21st century, know better. The best business always is about people first.

This is why I am supporting a yes on “H,” for health.

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Editor’s Note: Two competing initiatives on the ballot next month would allocate Orange County’s roughly $30 million annually in tobacco settlement money differently. Marian Bergeson makes the case for Measure H, which would give 80% to health care and the rest to public safety. John M.W. Moorlach argues for Measure G, which would give money to those purposes but designate 40% of the total to paying down the county’s bankruptcy debt. The initiative with the highest vote total wins, but if neither gets more than 50%, county supervisors would decide how the money is spent.