Clinton’s County Health Package

Re “Clinton Delivers on Health Care; Can the Supervisors?” editorial, Sept. 24:

In all the talk about the health care crisis, and the second-guessing about how the L.A. County health care system may be better managed, what is often overlooked is the health care crisis itself.

I have just finished my yearly rotation,spending a month supervising the care of inpatients at County-USC Medical Center. While one can talk about prevention, managed care and a shift to outpatient medicine, what I saw most frequently were the acute and chronic ravages of HIV, drugs, alcohol, tobacco and homelessness. The inpatient hospital system served as a safety net for many of society’s ills that aren’t even discussed in your otherwise thoughtful editorial. How are we going to take these ills into the “downsizing equation,” as everybody pleads for L.A. County to be realistic and to get on with modern times?

FRANCO M. MUGGIA MD

Director, Medical Oncology

Professor of Medicine, USC

* How come the Feds have to bail out Los Angeles County and the great state of California can’t? The last Democratic governor, a so-called flake, left office with a treasury surplus. What this country needs is more flakes in office.

KEN JOHNSON

Pinon Hills

* A double bull’s-eye in Opinion (Sept. 24), with Xandra Kayden’s “Behind the County Health Woes: An Outmoded Government” and your editorial.

Kayden repeatedly hits many targets, but the threshold issue, coming out of both pieces, is whether the supervisors have the political will to exert leadership and take the responsibility of making tough decisions, something they have not wanted to do for a long time. “Politics as usual” is much easier.

What a gift Los Angeles County has been given, in large part as the result of an outsider who in just a short time has made substantial headway in understanding an extraordinarily complex system. Maybe the lesson is to have more outsiders come into county government to get the job done!

In any event, will our so-called leaders take advantage of this gift, or will they lose the important opportunity it provides? A probing press--keeping the supervisors’ feet to the fire--can help answer that question, while also helping the region achieve some measure of success.

LLOYD B. DENNIS

Redondo Beach

* While those who claim fiscal objectivity may decry the federally sponsored $364-million assistance package for the Los Angeles County health system, we would like to point out that this amount is approximately half the cost of a B-2 bomber, a weapon we don’t need and can’t afford. America deserves a new definition of national security.

ROBERT C. WESLEY JR. MD

Co-President, Los Angeles Physicians

for Social Responsibility

* Did anyone bother to ask President Clinton where the $364 million came from?

R. LYLE TALBOT

Lancaster

* You cynically report that the President’s announcement of Los Angeles County’s $364-million health package was “broadcast live on local television in a region crucial to his reelection hopes.” True, but what of it?

Maybe Clinton actually believes--independent of his reelection bid--that delivering the health care package is the right thing to do.

STEVEN M. MONTGOMERY

Valley Village

* The crisis in the delivery of medical services in our county is exactly the kind of situation that would have been avoided if President Clinton’s health care plan, with its employer mandate, had passed last year. According to the UCLA Center for Health Policy Research, 75% of the 2.6 million people in Los Angeles County without health insurance, MediCal or Medicare are employed. We are all participating in the disastrous impact of cost-shifting, in which employers, who should be paying health insurance premiums for their employees as a matter of course, are avoiding their responsibility and throwing the obligation for health care on the public through a strained and unpopular tax system.

Now is the time to revisit the question of an employer mandate. Unfortunately, the bean-counters in the Republican Party who are obsessed with balanced budgets will not only oppose that action, but are now conspiring to dramatically increase the number of people dependent on our county’s vanishing health care system with massive cuts in Medicare and Medicaid.

MICHAEL W. SEVERAL

Los Angeles