Public Health Care in Jeopardy, Report Says : Medicine: UCLA study’s bleak findings about L.A. County system overshadow first summit meeting of normally contentious factions.

Sobered by a new UCLA study declaring that taxpayer-financed health programs in Los Angeles County are “in danger of collapse,” an unusual collection of normally contentious factions in the health community held their first summit meeting Friday.

The study, prepared by the UCLA Center for Health Policy Research and released at the start of the meeting, represents the most comprehensive profile yet of the county’s massive health care delivery system.

The UCLA researchers examined data, some of which has been published before and some of which is new, from documents, public records and vital statistics for the county and previous studies.

Its bleak findings:

* Between 1988 and 1992, the county’s non-elderly population increased by 7%, but the number of uninsured people increased by 32%; those on Medi-Cal, a subsidized health program for the poor, grew by 46%. These disparities reflected high unemployment and bad economic conditions.

* Only about 60% of the county’s 2-year-olds are adequately immunized, well below the 90% goal set by county health officials. The numbers are even worse for African American children, 25% of whom were fully immunized, and Latino children, 45% of whom received the full slate of recommended vaccines.

* More than one-quarter, or 28%, of the non-elderly population in Los Angeles County reported having no regular doctor, a key indicator of poor access to health care services.

* About 15% of the 22,000 inmates in county-operated jails at any given time are considered to be mentally ill, with 8% considered severely mentally ill.

* The health system is about $425 million short of meeting its public health care needs, a shortfall that could lead to the closing of hospitals or health centers.

* The county’s diversity offers numerous health challenges. The study said breast cancer was the leading cause of death among women in the county; complications from AIDS is the leading cause of death among men between 25 and 44; African Americans suffered higher than average rates of infant mortality and deaths from heart disease, cancer, stroke and homicides.

Almost as eye-catching as the report’s findings was the makeup of the coalition of health care policy-makers who gathered in a conference hall at USC: county, state and federal elected officials, hospital administrators, county health providers, Skid Row health workers and academic researchers.

The gathering was described by most of those present as “a first step” that could ultimately lead to a statewide ballot proposition or at least a more formal response to some of the changes being proposed by others in the health care system.

The more than two dozen members of the coalition represent, for the most part, a solid wall of opposition to two propositions on the Nov. 8 ballot. One, Proposition 186, would radically reform the health care system by implementing a single-payer health care arrangement that calls for the state to replace private health insurance companies. The other, Proposition 187, the anti-illegal immigrant measure, would cut off all non-emergency health care to undocumented residents.

On another front, most of the coalition members said they are feeling pinched by the state’s efforts to move welfare recipients into managed care programs, which threatens to turn county health programs topsy-turvy by changing traditional methods of health care financing.

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“Two years ago this meeting wouldn’t have been possible,” said David Langness, a spokesman for the Hospital Council of Southern California, which sponsored the event. “What this summit does is start the process toward a plan that everybody in the health care field can agree upon. We have had so much infighting in the past that we could never have been able to agree on which direction we should go.”

Sparks flew at times during the daylong meeting, but the somewhat shaky coalition seemed to hold. Money, usually the source of most problems in health care turf wars, once again was at the root of friction at the conference.

Complaining that California is being shortchanged in federal Medicaid payments, Robert Gates, director of the county Department of Health Services, distributed charts showing that New Hampshire is receiving $7,767 per Medicaid recipient, New York $3,699, while California is dead last at $1,301 per recipient.

Gates blamed the state for not being aggressive enough in pursuing federal Medicaid dollars. Other local health officials criticized California members of Congress for not keeping up with other states.

Rep. Xavier Becerra (D-Los Angeles), in turn, said he would like to see some creative local proposals that would raise funds to correct some of the problems.

“You can’t just go to Congress and the Legislature and say, ‘These are the facts. Give us the money,’ ” Becerra said. “We want to know how are we going to come up with the money? How are we going to cut down on the bureaucracy?”

But Becerra said he thought the meeting was worthwhile.

“It’s always productive when you get the different players in the same room,” he said. “We all agree on one thing: We must come up with a way to solve the looming crisis for health care in Los Angeles County.”