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A Warning to Heed

August 28, 1986

Sacramento has several opportunities to improve the prospects that women who are poor will have healthy babies.

As a result of a study showing that other health costs of raising children go down when women get good prenatal care, Gov. George Deukmejian already has signed a bill to raise the level of prenatal care starting July 1 for women under the Medi-Cal program. Now the Legislature wants a task force to make a similar survey of costs and benefits for women who are poor but not poor enough to be covered by Medi-Cal.

The Department of Health Services opposes the bill--AB 4241, sponsored by Assemblywoman Teresa Hughes (D-Los Angeles)--saying that a state board already provides advice about prenatal care and that it should finish its own survey sometime this fall. The Legislature is right to want something more specific on this important question, and Deukmejian should sign the bill.

The same department proposes, however, to pay obstetricians who see Medi-Cal patients an additional fee of $150 if they will provide earlier and more frequent prenatal care. Current payments are too low. The Legislature had increased the budget to cover higher fees, but the governor vetoed most of the money, saying that increases could be granted administratively. The department should take him up on that.

Prenatal care for pregnant women is also threatened by the veto of $50 million for health services for the poor in general, of which $20 million was to go to Los Angeles County. The Legislature must restore the money this week. Veto victims would include not only pregnant women but also people with heart disease, hypertension, cancer and other ailments--some contagious.

Consider the effect on one group alone: Dr. Steven Golde of the Women's Hospital at Los Angeles County-USC Medical Center points out that pregnant women who have undetected or untreated diabetes lose their babies 20% to 30% of the time. Those deaths can be prevented by monitoring the fetus and providing better insulin treatment. But the obstetrical clinic at Women's Hospital is operating at maximum capacity, and could not do its job if budget cuts were severe. Cuts would not just mean longer spells in the waiting rooms, Golde says. "Pregnant women cannot have their care deferred."

That is a warning that Sacramento should heed throughout the state.

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