As county officials grapple with how to provide adequate health care in the face of a mammoth budget gap, two reports indicate that private hospitals and physicians cannot be counted on to care for the poor.

One study, conducted in June by the Los Angeles County Department of Health Services, predicted that the closure of High Desert Hospital in Lancaster would create possible life-threatening health care shortages in the remote area.

A second health department report concluded that proposed closures and cutbacks would mean increased waiting times at surviving county hospitals and clinics--including six-month waits at Olive View-UCLA Medical Center in Sylmar, where most of High Desert's patients would be sent.

Health department officials believe that scenario would be repeated throughout the county if one or more of its six public hospitals close.

"In every area, there will be not enough access, not enough people to care for the indigent," said Walter Gray, the health department's assistant director.

As part of an effort to reduce a $655-million deficit in the county health department, High Desert and three other public hospitals are on one proposed closure list, while County-USC Medical Center is on another.

Closing High Desert would save the cash-strapped county $35 million, and eliminate 629 jobs.

Although county Chief Administrative Officer Sally Reed favors closing County-USC, a specially appointed health task force is assessing the situation.

As part of its evaluation, the task force is looking at the health department's High Desert report, which explored whether the area's three private hospitals might pick up the slack if High Desert closed. The three are operating at only about 50% of capacity, a rate typical of many private hospitals in the county.

But all three--Antelope Valley Hospital Medical Center, Lancaster Community Hospital and Desert Palms Community Hospital--said they would not care for the county hospital's poorest patients, except in emergencies, as required by law.

Only Antelope Valley Hospital agreed to accept new Medi-Cal patients--those low-income people covered by the state's public medical insurance. Antelope Valley Hospital is the only one of the three that has a contract with the state to provide Medi-Cal services.

An added problem, the 60-page report noted, is that none of the private hospitals has adequate staffing, space and equipment to offer the level of outpatient services now provided at High Desert.