By Tali Woodward

The San Francisco Department of Public Health is considering shutting down the inpatient pediatric ward at San Francisco General Hospital and ending all-day treatment programs for mentally ill adults. Or so its representatives said at the Feb. 5 meeting of the city's Health Commission, where the proposed 2002-03 budget was unveiled.

Hundreds of people swarmed City Hall – enough to fill the Board of Supervisors' chamber and another, equally large hall set up with closed-circuit TV – to lambaste the proposed cuts, stretching the meeting out for more than five hours.

But something fairly significant went unmentioned during the marathon session: the Department of Public Health doesn't expect to make those cuts.

"The mayor and every member of the [Board of Supervisors] I've spoken with have said they don't want to cut services," DPH director Dr. Mitchell Katz later told the Bay Guardian. If the most dire economic predictions stand, Katz said, the city might still avoid cuts by finding more ways to generate revenue within the department, possibly through fees.

The mayor has asked all city departments to identify ways to trim 10 percent of their General Fund money for the coming fiscal year, and DPH was one of the first departments to release its suggestions. But as one DPH official emphasized to us, the department submitted two entirely separate budget proposals: one with the 10 percent reductions, one without.

The smaller budget would eliminate entire classes of mental health care – such as all adult day treatment and transitional residential programs – as well as shut down 30 beds at the Mental Health Rehabilitation Facility. Three of the city's most renowned community health clinics – the Haight Ashbury Free Medical Clinic, Lyon-Martin Women's Health Services, and the Mission Neighborhood Health Center – would lose their only city funding (about $250,000 annually). And DPH would be forced to close the Inpatient Pediatric Ward at S.F. General, slash services in city jails, and reduce capacity at primary care sites.

There's plenty of speculation that the department has intentionally proposed drastic cuts. Wade Crowfoot, aide to Sup. Aaron Peskin, said that among all city departments "one traditional strategy that's been used is to offer up cuts that elected officials could never make in a million years."

But Katz said that the proposals are neither "underplayed nor exaggerated" and pointed out that the department wasn't able to meet its full goal of $30 million worth of cuts.

Even if there are no political motives involved, one has to wonder about the usefulness of considering a budget that DPH isn't even taking seriously. In the end, it amounts to another distraction from DPH's very real budget woes. Hundreds of people line up to praise specific threatened programs, but the truly desperate conditions at most of the city's health organizations aren't addressed. No one makes more than passing reference to ever-shrinking state and federal health funding – or the fact that DPH hasn't gotten money for cost-of-living increases since 1998 (meaning it has to cut positions to cover salaries).

Health care advocates from around the state gathered in Oakland last week to dissect dozens of proposals for a universal health insurance system in the state. Hollywood is even playing to the widespread anger over our health care system's inadequacies – in the new movie John Q., Denzel Washington takes an emergency room hostage in order to get a heart transplant for his son. But in San Francisco hundreds of people waited in line to criticize proposals that are basically mythical.