Good Moves on Health

The new state budget worked out by Gov. George Deukmejian and the Legislature makes welcome progress in dealing with two major health-care problems--the care of medically indigent adults and the support of Medi-Cal services in hospitals with a disproportionate number of low-income patients.

All of the $50-million added funding for medically indigent services proposed by the Legislature has been accepted by Deukmejian; a significant improvement in services to the poor will be assured. In Los Angeles County alone the waiting time for clinic visits will be cut in half.

In addition, the governor has approved $2.5 million to improve funding for Medi-Cal services in the hospitals with unusually high levels of low-income patients--a situation that usually results in higher health-care costs. This was but a fraction of what the Legislature had proposed, but the governor indicated that more funds would be provided as he promised “to ensure that disproportionate-provider hospitals are fully compensated for their costs of providing care to Medi-Cal beneficiaries.”

Previously the governor had budgeted $15 million for University of California teaching hospitals at Irvine, Sacramento (Davis) and San Diego, each of which serves in effect as the regional general county hospital with relatively high percentages of low-income patients.

All these budget commitments address the important goal of assuring access to quality medical care for all. The governor and the Legislature have been responsive to that.

There remain serious problems, most of which cannot be solved at this time because they depend on additional federal funding that is not likely during the budget-deficit crisis. Fees for doctors and dentists providing the Medi-Cal services for the poor remain inadequate despite adjustments in the budget. The Legislature is trying to make adjustments to ease some of the more negative situations--among them the unsatisfactorily low use of dental services by children under Medi-Cal.

Budget decisions on health care this year have at least served to continue the process of correcting and compensating for the excessive cuts made when the system in California was turned upside down in 1983, not as part of any carefully planned program for more effective service but in response to a budget emergency. The state surplus this year has been constructively used in Sacramento to continue the process of undoing some of the damage done then.