LAST WEEK NOT ONLY DID THE COUNTY of Los Angeles resolve to close 11 public and four school clinics belonging to its Department of Health Services, reduce beds in one hospital and cut immunizations for more than 80,000 children. It also decided, on grounds that it was improving the urban health environment, to spend DHS money to kill off a long-established seaside colony of stray cats.
Now that's a cheap juxtaposition, isn't it? But this is the kind of idiotic priority setting that has, on many levels, landed our county health services into the mess they are in now. And it's going on, even as our county supervisors are caving in their chests with mighty blows as they wail: This is it, we have no choice but to cut 4,230 jobs by 2006, pile services onto a handful of private clinics and our few remaining public ones. Yet there are enough dollars from someplace, somewhere, to put up as much as a reported $250 per cat for possible extermination of a colony of around 100 felines on a beach near San Pedro. This $25,000 is enough for around 200 potentially life-saving clinic visits for humans or many more immunizations.
The cat enclave has existed unobtrusively on the beach near San Pedro's White Point ever since the Nixon presidency. Local cat lovers have been spaying the cats for years now, adopting out a few, and a year or so ago, Los Angeles Animal Services decided that was good enough. They had plenty to do on a stretched budget without bothering this tiny feline colony.
Then along comes L.A. County lifeguard Kenny Atkins, who reports the colony to DHS, according to the Daily Breeze in Torrance. No human illnesses have been linked to the cats, but the DHS's Joe Ramirez says their fleas could cause something called murine typhus. This disease hits around a dozen people a year nationally. According to one University of Mississippi expert, murine typhus' “symptoms are mild and its mortality is negligible.”
Well, it sure is great to know that DHS can afford to keep Cabrillo cat-free. Even if it must leave 84,000 out of 97,000 eligible children in the county unimmunized. And drop 40 percent of the 88,000 treatments planned for people who already have communicable diseases that are generally more serious than murine typhus. TB treatments are going to be attenuated. Screenings for sexually transmitted diseases are also being cut — bad news for everyone, but especially for people with AIDS, the population most vulnerable to such illnesses.
Usually in the aftermath of such catastrophic cut declarations, the county executive finds funds here and there to ease off the worst effects. It's rare, though, to see what is, under the circumstances, a wanton misappropriation of scarce DHS funds proclaimed on the front page of a local daily paper two days after the cuts. This sort of thing looks bad to the public and anyone in a position perhaps to help out the county.
The immunization cuts already looked suspicious, though. They seemed intended to provoke a response from state or federal authorities, who might think, gosh, L.A. is going to risk a spread of infectious diseases that could move into San Diego or even Arizona. Let's help them out. The immunization cutback — about $9 million out of the $158 million that's supposed to be saved overall — goes directly against the expressed philosophy of DHS Executive Director Dr. Thomas Garthwaite, who's called immunization the cheapest way to keep health costs down. Is it too suspicious to suggest that putting it on the chopping block might just be an example of that very “political gamesmanship” whose presence in this proposal was vigorously denied by county Supervisor Zev Yaroslavsky during last week's board hearing?
But, of course, this is all really a political game. Every cut proposal is a prayer to Sacramento and Washington, entreating the higher powers for the money that would save DHS from a worse round of service deletions that would include closure of both Olive View and Harbor UCLA hospitals. Governor Gray Davis, however, is facing a financial crisis worthy of a Third World nation. And Washington's got a huge deficit and a would-be war president. Tom Scully, Bush's administrator of federal Medicare and Medicaid programs, said on Warren Olney's radio show, Which Way L.A., that he was surprised to discover that DHS had received a billion-dollar boost from the Clinton administration. But the answer is simple, if often forgotten: L.A. County's working immigrant population pays a huge amount of federal taxes and Social Security. But relatively little of this money returns to the county to fund the services immigrants use. It can be said that the 19952001 waiver agreement failed its goal of compelling DHS to re-focus its services. In that it redressed the funding inequity, however, it can't be called unfair.
BUT HOW DOES THE NEW BUSH TEAM see these old realities? Anyone recall Papa Bush's Thousand Points of Light? How about Marvin Olasky's The Tragedy of American Compassion, the 1992 neocon-classic best-seller which concluded that private charity is better than public assistance? What if the Bushies followed their ideological bliss and decided, rather than to help DHS with its shortfall, to let the burden fall onto local private-sector shoulders?
Judy Spiegel, a vice president of the prominent California Community Foundation, notes that local foundations are already involved to the maximum in helping local health-care facilities.
Even if Spiegel's organization switched all of its roughly $9 million annual health-care giving to the DHS shortfall, it could barely pay for those lost immunizations. The two giant statewide health charities — the California Wellness and California Health foundations — with their multibillion-dollar endowments, wouldn't be capable of carrying the county's health deficit, even if they did nothing else.
So it's probably up to the Bush administration to bail out our health services. The only question is: Considering the ideological hurdles and the fact that this is the most Democratic part of a Democratic state, why would it?