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No Excuse for Health Cuts

June 22, 2003

The cutbacks in Orange County health services stem not just from a bad economy, but from unequal tax distribution at the state level and bad spending priorities by the county. And though the reduced services will be felt soonest and most harshly by poor and sick people, ultimately all residents pay a price in the form of potential health threats.

The cuts probably will mean delays in test results for venereal disease, tuberculosis and other communicable diseases, as well as less tracking of such cases. Families will have to travel long distances, making several bus connections, to get to county-run clinics because their satellite clinics are closed. Some families will no doubt postpone their children's immunizations, or forgo them altogether -- a dangerous situation for those children and for the public.

Yes, the state budget is a disaster, and every county faces cutbacks. But Orange County supervisors committed to budget-busting pension boosts and weren't watching the store when 2% merit bonuses were handed out to 95% of county employees, at $15 million a year. Fifteen million dollars could pay for a lot of vaccinations and TB tests.

This county has a long history of giving low priority to health care, so the current cuts come from a service system that is far from opulent. That historic lack of interest in public health care is part of the reason why this is a "donor county" -- one that collects far more taxes for Sacramento than it gets back in services. When California was figuring out funding formulas in post-Proposition 13 days, it apportioned money according to how much each municipality was spending at the time. Orange County, which in those days sniffed at spending money on social services, came in at the bottom of the allocation heap. That worked as long as the county had few poor people and most employers readily provided good health insurance.

Neither of those is true now, but the same old funding formula remains.

Legislation that would have corrected this sorry situation is stalled in Sacramento. Assembly Bill 1568, sponsored by Lou Correa, would have narrowed the gap so that no county would get less than 15 1/2% of its property taxes. Orange County now gets 7%, the lowest percentage in the state. Legislators, facing ever-growing budget shortfalls, are unlikely to bring it up again soon, but the proposal should not be allowed to die.

Still, the county cannot use this unfair allocation formula as an eternal excuse to endanger public health. Cuts hit every department, but there is no good reason to make it hard to get immunizations, a cheap basic of public health care in any developed nation. Nor should communicable diseases spread for want of tracking and prompt testing. Orange County isn't an impoverished nation, and it shouldn't act like one.

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