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A Loud 'Yes' on Health Care

November 11, 2002

Do ordinary people want action on the health-care problems that politicians love to ignore? Resoundingly yes, if the vote for a tax increase to bolster Los Angeles County's trauma-care system is any measure.

For years, the future of the stretched-to-the-limit county health-care system has been up in the air, its problems punted from county supervisors to the governor to Washington. Finally the supervisors, fearing that the health system's mounting deficits would drive the county into bankruptcy, did something most politicians no longer do: They asked for a property tax increase.

County residents approved it with a 73% "yes" vote, an unheard-of margin. The 3-cent-a-square-foot tax is the first direct property tax increase to pass since 1978's tax-slashing Proposition 13. The money will be used to keep countywide trauma centers and emergency departments open and to ready the county to counter any bioterrorism attack.

Voters care about health care. Politicians should too. There is plenty left to do. The root of Los Angeles' still-staggering financial crisis is the number of people the county serves who have no health insurance and can't afford to pay for care.

The uninsured are not confined to Los Angeles County, although their numbers are greater here due to a swelling immigrant population, high poverty rates and a concentration of small-company and service-industry jobs that don't offer insurance. California has the lowest rate of employer-sponsored insurance in the country, according to a 2002 Urban Institute report, but comes in second to President Bush's home state of Texas in the overall uninsured rate, which takes into account both employer- and government-sponsored coverage.

Nationwide, 40 million Americans lack any kind of coverage, public or private.

The insurance crisis is not something that counties, the most cash-strapped of governments, can solve by themselves. The Bush administration's health honcho, Tom Scully, is at least talking with county and state officials. But during his visit last week to county-run Harbor-UCLA Medical Center, he merely urged supervisors to "come up with a responsible fix"; he rejected their plan, one that already has led to clinic closings and other painful cutbacks.

Gov. Gray Davis declined to even talk with the county until shortly before the election, when he promised help and hinted at a special legislative session.

Davis could start with a commitment to up the state's contribution -- among the lowest of such payments in the nation -- to Medi-Cal, the state version of the low- income Medicaid program, which would trigger additional matching federal money. Medi-Cal payments will no doubt be held in temporary thrall to the state's budget problem, but they have to be on the agenda.

If a humbled governor who got only 47% of the statewide vote is looking for a mandate, he will find it in health care.

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