To cut rising federal medical costs, for example, he severely pruned eligibility lists for Medicaid and Medicare, and he reduced federal reimbursements for home health care and skilled nursing facilities at a time when hospital stays were being dramatically shortened. Health care advocates coined the phrase "quicker and sicker" to describe the plight of many of the patients discharged this way. Reagan also indirectly harmed the health and well-being of many Americans, especially children, by cutting eligibility for food stamps and subsidies to the federal school breakfast and lunch program and by limiting nutrition programs with proven health benefits like the popular Women and Infant Care.

But perhaps the burgeoning AIDS epidemic posed the most defining public health failure of Reagan's administration. Until 1987, six years into the pandemic, Reagan never publicly mentioned AIDS and treated it as a state or local issue. According to his White House physician at the time, Reagan thought of AIDS as a kind of "measles that would go away."

Reagan refused to order or fund preventive education programs and never spoke out against the rampant fear and discrimination many HIV/AIDs patients faced on the job, with insurance companies or at school. Marilyn Moon, a long-time policy analyst at the Urban Institute, told me last month that there was a "great deal of fear that people with AIDS would try and qualify for Medicare or other health programs and a lot of discussion by the administration on how to keep them from bankrupting the medical system."

AIDS activists say Reagan's one concrete proposal was for widespread testing and mandatory identification of people with HIV, with the idea of enforcing a public health quarantine.

In fact, rather than providing for the public welfare, Reagan and his closest advisors effectively muzzled then-Surgeon Gen. C. Everett Koop to stop him from discussing AIDS publicly until midway through Reagan's second term. It took the death of movie star Rock Hudson in 1985 and the Oct. 22, 1986, release of the surgeon general's report on acquired immune deficiency syndrome, which advocated massive public education and a condom distribution program, for Reagan to change his personal views. Even then, his response was at best "halting and ineffective," according to presidential biographer and veteran Washington Post reporter Lou Cannon.

If the UCLA fund-raisers had looked more carefully at Reagan's medical legacy, they would have found that his opposition to health reform dates to the 1950s and 1960s, when as an actor he was hired by the American Medical Assn. in its all-out fight against Medicare.

"We used Reagan, who wasn't getting the best Hollywood roles at the time, to record an album about the dangers of socialized medicine," Jim Stacey, the former AMA national spokesman, told me in 1993. Reagan, of course, came to regret the role he played for the AMA when he ran for governor of California in 1964 and later for president, and voters demanded that he defend his position on medical programs for the aged.

Of course, UCLA would not be the first university to indulge in the well-established tradition of selling parts of itself to large donors. And, certainly it is nice that the medical center is getting a $150-million legacy. But in times as flush as ours, wouldn't it have been better to raise the money some other way? Must a great university like UCLA slap the name of a person on a building who has no proven record or prior commitment to health care for the ordinary Joe?

If UCLA wants to name a football field, or a communications school, or a defense research center after "the Gipper," that's one thing. But a medical center? Say it isn't so.

Copyright 2000 Los Angeles Times

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