With the recent Supreme Court ruling largely upholding theAffordable Care Act, the legal battle over health care reform may beover, but the political debate is only getting started this electionyear.
Despite the contentious politics surrounding health care reform,everyone agrees that the country's health care system is tooexpensive and leaves too many people falling through the cracks --getting sick, dying earlier and going bankrupt for lack of access tomedical care and insurance.
In the two years since the Affordable Care Act was passed,California and many of its counties have moved ahead with majorchanges to expand health care coverage and improve the way patientsreceive care.
Through the 'Bridge to Reform,' an agreement between the stateand the federal governments to allow California to beginimplementing health care reform early, counties have enrolled morethan 370,000 uninsured residents into health coverage, many for thefirst time.
Alameda County is leading the way in getting patients enrolledthrough partnerships between community organizations, publicinstitutions and philanthropists.
One such partnership, a neighborhood-based initiative called EastOakland Building Healthy Communities, is engaged in an innovative,collaborative effort to reach out to eligible low-income residentsand enroll them in health coverage and public benefits.
These individuals are already enjoying the improved financialsecurity and improved access to health care that comes with healthinsurance. Millions more will experience those benefits in 2014 whenthe other parts of health care reform 'go live.'
Increased health insurance coverage is only one of the benefitsof health care reform in California so far.
The Bridge to Reform has also spurred counties and safety-nethealth care organizations to make changes that improve health careservices for low-income residents.
New resources are allowing us to better coordinate clinics andhospitals, to measure our effectiveness and to design innovativeprograms that promote prevention and empower patients to understandand manage their own health.
These better-coordinated services help people to better preventand manage chronic diseases.
There are many stories, but one example is a local a woman in her50s. With expanded services and a coordinated care approach,providers at Alameda County Medical Center detected undiagnoseddiabetes during an eye exam offered through newly-availableoptometry services, and got her into care.
With the help of state and federal dollars, and the promise thatmore patients will be coming into care with insurance, HealthPAC(Alameda County's program for uninsured residents) and its partnersare upgrading technology and skills of providers to offer proactivecare -- working to get the highest-risk patients into primary careand reducing unnecessary hospital admissions.
We who are providing care at the local level need the ongoingsupport of the state and federal governments to build upon the workthat has already been done.
We all must recommit to expanding access to health care andimproving the health care system no matter who wins the nextelection.
Too much is at stake not to succeed.
Kathleen Clanon is medical director of HealthPAC, the HealthProgram of Alameda County.
