PROVIDING health care for those who can't afford it is one of the most perplexing problems facing the public and private health systems. Yet while legislators pound out an increasing succession of bills seeking to address the issue, one of the most obvious solutions would cost taxpayers and businesses next to nothing.

An estimated 7.3 million California residents do not have health insurance. A huge portion, perhaps as many as half, of those people live in Los Angeles County, thanks to its large immigrant and low-wage population. As county Health Services Department chief Mark Finucane says, the problem has gone from a public health crisis to a public safety crisis, because these uninsured residents are flooding hospital emergency rooms and overwhelming the emergency response system.

To their credit, legislators are now paying more attention to the problem than they have in the past. During the final hours of the past legislative session, state lawmakers passed a bill to extend the government-sponsored Healthy Families program to 600,000 low-income parents, about 10 percent of the uninsured adults in the state. It was an admirable move, if an uncertain one; it still hasn't been determined where the state's share of $128 million a year to fund the expanded program would come from.

Yet while spending the budget surplus or tobacco settlement money to provide health care for the uninsured is a wise decision, there are much less expensive solutions.

Studies show there are as many as 639,000 children in California who are eligible for the Healthy Families program, but not enrolled. Further, a recent report from the UCLA Center for Health Policy Research estimated that there are 830,000 children eligible for Medi-Cal but not enrolled. Rather than paying for a host of new programs, it seems far more logical to work harder on signing people up for the programs that exist -- particularly because the lion's share of these programs are paid for by the federal government. In a state that has to bear the burden of extremely high immigration, it seems only fair for the feds to shoulder as much of the bill as possible.

A few tentative steps are just now being made to address this situation, but a good deal more can be done.

The California Association of Health Plans and state Assemblyman Gil Cedillo, D-Los Angeles, have spearheaded a drive to enroll more low-income families in Medi-Cal and Healthy Families. They have organized a health fair taking place Oct. 7 at Roosevelt High School intended to educate parents about these programs. With the cooperation of the L.A. Unified School District, thousands of flyers were mailed out to parents of students at Roosevelt and surrounding schools, informing them about the event.

No one is entirely certain why participation in government health care programs is so poor, but most observers attribute it to two factors: people either don't know the programs exist or are afraid to enroll because they or their family members are in the country illegally and fear they'll be deported if they sign up. The latter is simply a matter of perception - these programs do not report members to immigration authorities.

The solution to both problems, clearly, is greater outreach and education. And that's what makes programs like Cedillo's so critical.

Organizers see the Oct. 7 event as something of a test case. If it is successful in signing people up, the California Association of Health Plans intends to get involved in other, similar activities. Other public and private organizations would do well to imitate it.

Making sure L.A. is populated with healthy families is a fundamental prerequisite to having a productive workforce and vibrant economy.

COPYRIGHT 2000 CBJ, L.P.
COPYRIGHT 2000 Gale Group