Deaf to Health Fund Crisis

Faced with a $24-billion state deficit, a budget stalemate and a reelection campaign, it’s easy to understand why Gov. Gray Davis doesn’t want to hear about Los Angeles County’s $800-million health-care deficit right now. Understandable, however, isn’t the same as excusable. This is a crisis that affects a third of California’s population.

The governor’s hands-off approach is particularly galling now that state officials have started second-guessing the county’s own efforts to deal with the deficit. State health officials screamed when L.A. County supervisors recently voted to close 11 clinics and end inpatient services at an Antelope Valley hospital.

The cuts are alarming. But if the governor was so concerned about health care for the poor, surely he wouldn’t be trying to balance his own budget by slashing state matching funds for Medi-Cal to the lowest in the nation, in turn reducing the amount the federal government pitches in. Surely he wouldn’t be reinstating cumbersome paperwork that discourages the poor from using cost-effective services, or postponing innovations that would have expanded insurance coverage.

No, we suspect that what caught the determinedly deaf Davis’ ear were complaints from organized labor, a key constituent, about lost jobs. No one wants to see jobs--and their accompanying medical benefits--lost. But the recently announced cuts shave just $150 million from the looming deficit, which will reach almost $1 billion in three years as a federal subsidy is phased out. Supervisors warn of even more dire cuts and job losses to come unless the county gets some help.

Here’s the catch: Unlike the Clinton administration, which was willing to negotiate directly with Los Angeles County supervisors, the Bush administration says it wants to work with the state and its largest county together. But the state is refusing to even forward the supervisors’ new bailout proposal unless they undo their recent cuts--cuts that would cost jobs for Davis’ supporters.

Meanwhile, conditions in the county are building toward the health-care equivalent of a perfect storm. The region’s vast number of immigrants, both legal and illegal, and the profusion of jobs that offer no medical insurance combine to leave more than 2 million people without any health insurance. County government cannot by itself keep up with the costs of caring for this ever-increasing population. Closing county hospitals and clinics would overwhelm private hospitals and undermine the already fragile trauma-care system. Everyone in the county, rich or poor, with or without insurance, would suffer the effects.

Figuring out how to pay ever-rising medical costs for an ever-growing uninsured population is a difficult, complex undertaking. It’s understandable that politicians across the country spend more time trying to avoid the problem than solve it. But it’s not excusable. California can do far better than point out the problems in Los Angeles County. It can join in finding ways to fix them.