California Counties are Critical in Expanding and Improving Healthcare Access
By Kathleen Clanon, MD
With the Supreme Court ruling largely upholding the Affordable Care Act, the legal battle over health care reform may be over, but the political debate is only getting started this election year.
Despite the contentious politics surrounding health care reform, everyone agrees that our country’s health care system is too expensive and leaves too many people falling through the cracks—getting sick, dying earlier, and going bankrupt for lack of access to medical care and insurance.
In the two years since the Affordable Care Act was passed, California and many of its counties have moved ahead with major changes to expand health care coverage and improve the way patients receive care.
Through the “Bridge to Reform,” an agreement between the state and the federal government to allow California to begin implementing health care reform early, counties have enrolled over 370,000 uninsured residents into health coverage, many for the first time. Alameda County is leading the way in getting patients enrolled, through partnerships between community organizations, public institutions, and philanthropists.
One such partnership, a neighborhood-based initiative called East Oakland Building Healthy Communities, is engaged in an innovative, collaborative effort to reach out to eligible low-income residents and enroll them in health coverage and public benefits. These individuals are already enjoying the improved financial security and improved access to health care that come with health insurance. Millions more will experience those benefits in 2014 when the other parts of health care reform “go live.”
Increased health insurance coverage is only one of the benefits of health care reform in California so far. The Bridge to Reform has also spurred counties and safety-net health care organizations to make changes that improve health care services for low-income residents. New resources are allowing us to better coordinate clinics and hospitals, to measure our effectiveness, and to design innovative programs that promote prevention and empower patients to understand and manage their own health.
These better-coordinated services help people to better prevent and manage chronic diseases. There are many stories, but one example is Ms. L, a woman in her 50s. With expanded services and a coordinated care approach, providers at Alameda County Medical Center detected un-diagnosed diabetes during an eye exam offered through newly-available optometry services, and got her into care.
With the help of state and federal dollars, and the promise that more patients will be coming into care with insurance, HealthPac (Alameda County’s program for uninsured residents) and its partners are upgrading technology and skills of providers to offer pro-active care—working to get the highest-risk patients into primary care and reducing unnecessary hospital admissions.
We who are providing care at the local level need the ongoing support of the state and federal government to build upon the work that has already been done. We all must re-commit to expanding access to healthcare and improving the health care system no matter who wins the next election.
Too much is at stake not to succeed.
Kathleen Clanon is the Medical Director of the Health Program of Alameda County, also known as HealthPAC.