BY J. THOMAS ROSENTHAL

The Los Angeles County Department of Health Services is like the little boy who cried wolf. Since the early 1990s, the system has been on the brink of collapse several times, yanked out of the crisis by bailouts from the federal government. This time, the wolf really is at the door, and no one with the power to do anything about it appears to be listening to the pleas for help.

If federal officials in Washington, state officials in Sacramento and Los Angeles County administration cannot collaborate to provide substantial financial resources to help reduce the system’s anticipated $300-million deficit next year — accumulating to nearly $800 million over the next five years — the Los Angeles County Board of Supervisors will vote on Oct. 29 to change the public health system in drastic ways. The Board of Supervisors has taken the almost unprecedented step of putting on the November ballot a modest property tax increase to support the Los Angeles County hospital system.

In addition to closing more health clinics and limiting services at others, the supervisors would most likely vote to convert both Harbor/UCLA and Olive View/UCLA hospitals (which are county-run hospitals, not operated by UCLA) into ambulatory care centers. No more trauma center at Harbor, no emergency room at either.

The county hospitals handle approximately half of all trauma cases in Los Angeles County. Harbor/UCLA and Olive View handled close to 100,000 emergency room visits last year. That trauma network is already stretched to the breaking point with ambulances being diverted away from overcrowded emergency rooms now. Where will you go if you or someone in your family is critically injured if the trauma network shrinks substantially? The answer is to crowded, potentially dangerous, non-trauma-ready hospitals.

Make no mistake. The impact on the citizens of Los Angeles County will be profound if this happens. This is not just an issue affecting the poor and uninsured. None of us can know when or where we’ll be if we’re in an accident. Also, the loss of two emergency rooms and one trauma center will have ripple effects throughout the health-care delivery system. If you need more routine hospital care, you may have significant delays because your local hospital is backed up with emergency room cases.

For UCLA, important facilities for medical student and resident training will be lost. Biomedical research will be lost, since faculty at Harbor/UCLA generate more than $64 million in annual research funding. Many of the most productive faculty will choose to or have to leave UCLA.

The early read on whether or not our elected officials will come together to save the system was not good. Fortunately, at a meeting held Oct. 9 in Washington, there was some hope expressed that a solution would be reached. Although a check wasn’t written, the Board of Supervisors was advised to delay its Oct. 29 vote until after the election, with the implication that details of a solution would be forthcoming. Public support of Proposition B, the trauma-system tax, would be an important signal of public support for maintenance of the county health system.

Rosenthal is chief medical officer of the UCLA Medical Center and director and vice provost of UCLA Medical Group.