January 25, 2002

Commentary

Governor Davis Balances State Budget On Our Backs

James Santiago Grisolía, MD
Chief of Neurology, Scripps-Mercy Hospital
Communications Chair, SD County Medical Society

Our economic recession is anticipated to cause over 12 billion dollars in shortfall in the California state budget. Governor Davis proposes a budget that tries to close the gap with smoke and mirrors, hoping to avoid responsibility for more obvious cuts or tax increases that would damage his chances for re-election.

Most serious is his plan to spend future funds from the tobacco lawsuit settlement to plug the immediate gap in the general budget. This is like putting your mortgage payments on your credit card, putting yourself in a future hole to meet today's basic obligations.

Our county Medical Society President, Rodrigo Muñoz, MD points out that "Every time Californians have voted on what they want done with tobacco settlement revenue, they have said it should be spent on health care, not prisons, roads, or other General Fund items." The proposed budget outlines %2.4 billion in revenues to be raised from the bonds, with $62 million paid back this year, then $190 million yearly for the next 23 years. This will spend 40% of California's tobacco settlement dollars to pay for this year's gap, robbing California health care of the money that was supposed to compensate for the health damage done by tobacco.

Furthermore, the Governor wants to reduce MediCal, the state-federal program that pays for health care for the poor, disabled and children. This includes $186 million in lost dollars to doctors and hospitals, including federal dollars lost because the state will not match them. MediCal already is in the bottom five states in the country in payments, and this cutback will drop them even lower. Doctors' groups and hospitals are already closing in San Diego and across the state, and this cutback will hit hardest the hospitals that provide most care to the poor and disabled.

Furthermore, fewer doctors will be able to afford to treat MediCal patients in their offices, so that the "sickest of the sick" will have fewer options for getting care.

Administrative budgets to the counties will be cut, reducing eligibility workers to help people get on MediCal and other government programs.

According to Dr Muñoz, "The Governor wants to sacrifice health care for the poor in order to keep other programs that are more appealing to the general voters." California is not trailing the other 50 states in transportation, pollution, prisons or education. However, we have been near-last for many years in many important measures of health. We can't afford to lose more ground.

The state budget will not be finalized until late spring or early summer. Contact your state legislators and let them know if you or someone you love will be badly affected by the proposed cuts in health care.

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