June 27, 2008

Commentary:

Budget Cuts Put Hospitals and Lives at Risk

By Dr. Arthur A. Gonzalez

Community hospitals in San Diego County provide vital health care services and emergency care to millions of people around-the-clock. But our hospitals – and our lives — are increasingly at risk.

In an effort to solve the unprecedented $17.2 billion state budget deficit, the Governor signed into law in February a 10 percent cut to the Medi-Cal program which serves our most vulnerable patients – the uninsured, underinsured and working poor, the disabled and seniors. Then, in a May budget revision, the Governor proposed additional cuts that will further erode an already chronically under-funded program and this state’s fragile health care system.

California’s community hospitals lost $2.8 billion in 2007 from inadequate payments for care provided to Medi-Cal patients. The program and budgetary cuts currently proposed translate to additional losses estimated at more than $1.5 billion to Medi-Cal services statewide. The total impact to California’s hospitals is an estimated loss of over $750 million annually – nearly $40 million to San Diego and Imperial County hospitals and nearly $4 million to Imperial County hospitals.

Such losses are likely to result in reduced critical emergency and trauma care services throughout the state and in our community. And when health care services are lost, they are lost to all citizens, not just those covered by the Medi-Cal program.

The budget also calls for payment delays to doctors and hospitals in June and August. Such delays could mean laying off health care workers, suspending services and perhaps closing altogether. During the past decade, more than 70 California hospitals and ERs have closed. Nearly half of our state hospitals are operating in the red. This affects our community’s financial health in already uncertain economic times.

Where will patients go when hospitals are forced to close, when physicians are unable to accept Medi-Cal patients and when hospital ERs are backlogged with Medi-Cal patients? It doesn’t matter how good your insurance coverage is when you have nowhere to get treatment. The business community will suffer when employees can’t get care and can’t return to work quickly.

Access to vital health care is at stake for all Californians and we must make sure that lawmakers prioritize budget cuts. The Legislative Analysts’ Office rejects the governor’s budget and says prioritizing cuts is the way to proceed.

As a last resort, a coalition of health care providers including the members of the California Hospital Association recently filed a class-action lawsuit against the state of California to prevent the planned Medi-Cal cuts from taking effect. The Hospital Association of San Diego & Imperial Counties urge lawmakers to take a more balanced, approach to solve our state’s fiscal emergency that secures access to vital health care services for all Californians.

Arthur A. Gonzalez, Dr. P.H., FACHE, President & CEO, Tri-City Medical Center Chairman, Hospital Association of San Diego & Imperial Counties

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