Concerns Raised About Access to Primary Care in Sacramento County

Health care advocates say Sacramento County's primary care network for low-income or uninsured residents is inadequate, the Sacramento Bee reports.

Primary Care Lacking

The county once operated six public clinics for low-income or uninsured patients, but now it operates only one. In addition, the county does not have many not-for-profit community clinics, which provide crucial health care services for low-income residents.

As a result, the estimated 444,000 Sacramento residents who are uninsured or who are Medi-Cal beneficiaries often seek care in emergency departments. Medi-Cal is California's Medicaid program.

According to a recent analysis by research firm Valley Vision, Sacramento County's physician deficit for low-income patients leaves 113,000 to 142,000 residents with no physician to serve them.

Jonathan Porteus -- CEO of The Effort, a growing chain of not-for-profit clinics -- said, "Things are uniquely bad in Sacramento County compared to other counties in the state."

Mary Keale -- executive director of the Capitol Community Health Network -- said that strong hospital systems "dominate" the county and make it "one of the best places ... in the country for health care if you've got employer-provided insurance." She added, "I'd say it's the opposite end of the scale" for residents without private insurance, noting, "It's one of the worst."

Potential Improvements

The federal health reform law will expand insurance to an estimated 167,000 Sacramento County residents by 2014, prompting lawmakers and health care administrators to take note of the demand.

Now, some local clinics are expanding. The Effort has grown to five full-service health centers and plans to add four more by the middle of next year. Four other clinics have earned a federal status that allows them to draw higher Medi-Cal payment rates.

In addition, the Sierra Health Foundation has coordinated local groups to assess Sacramento County's health care needs and devise a strategy to address them.

Ted Wolter -- chief of staff to county Supervisor Roberta MacGlashan -- said there is fresh interest among officials to develop new strategies for providing health care to low-income residents since the closures of the county clinics. He said members of MacGlashan's staff have been meeting with local health care providers to develop ways to improve the Medi-Cal system (Rubenstein, Sacramento Bee, 5/8).

Sandra Kelly
I am between 55 and 65 and have lost my job in this recession. I have no health benefits and am forced to buy high-cost individual insurance with a very high deductible. I have made no inordinate claims over a 4 year period. I have claimed annual checkups and flu visits - all which cost I paid out of pocket since my deductible is too high. Even so my insurer has raised my rates 7 times in 4 years and now, for the same coverage, I am paying more than DOUBLE the original cost when I joined only 4 years ago. Are Ted Wolter and Supervisor MacGlashan expending any time investigating this travesty? More and more of us are being forced into individual insurance where we are literally at the mercy of Insurers who are allowed to raise our rates with impunity. Luckily, I'm a very healthy 59. But I am being penalized by rate hikes that are triggered by those who don't exercise, are obese, smoke and take mind altering drugs, etc. We promote survival of the weakest these days.

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