Close to Home: Access to health insurance saves lives

Imagine a hardworking 53-year-old Santa Rosa resident with chronic and disabling abdominal pain, regularly cries himself to sleep. He has not responded to three courses of treatment for the bacteria that commonly causes stomach ulcers. He dreams of a life without constant distress. Without health insurance, he cannot afford the appropriate testing and treatment that could allow for a cure for his nightly agony.

Lack of insurance coverage and unaffordable health care are major barriers to well-being for more than 25,000 Sonoma County residents, who disproportionately utilize hospitals and die. As a family doctor practicing in Santa Rosa for 20 years, I have witnessed how insurance coverage brings stability and vitality to patients. But our fragmented employer-based system of insurance coverage leaves people vulnerable, and many of them die because they cannot access health care.

Having spent more than 1,000 hours teaching UC San Francisco-affiliated resident doctors population health, I believe we all do better when we all do better.

Insurance coverage saves lives. The best way to protect people living with diabetes and high blood pressure from heart attacks and strokes is to get them health insurance. The best way to increase cancer screening rates is to remove financial barriers to obtaining health insurance. In addition to prevention, insurance allows for greater access to medications and specialist referrals.

Insurance coverage saves money. The Council of Economic Advisers reports that expanding coverage to the uninsured would be an economic stimulus without negative impacts on state budgets. California’s Office of Health Care Affordability will work to reduce costs and increase transparency within the health care system, including developing cost targets and implementing new investments to reduce health insurance premiums.

Insurance coverage narrows health inequities. Where we are born, live, learn, work and play all have a profound effect on health. The 2021 update of the Portrait of Sonoma County showed the number of residents without insurance declined from 15% in 2014 to 6% in 2021.

Inequities in insurance coverage are driven mostly by employment status, which has long disadvantaged people of color. Increasing coverage would especially improve outcomes for those in the poorest health and for the most historically disadvantaged in terms of access to care.

Some may be concerned about the cost of expanding insurance coverage for everyone, but an ounce of prevention is worth a pound of cure. Access to health, like universal access to a K-12 education, fire departments and interstate highways is indispensable for all Californians.

Our country was founded by immigrants seeking better lives. Our melting pot prospers when we have social cohesion: a rising tide of expanded insurance coverage lifts all boats.

Insurance coverage for all Californians is within reach. Beginning May 1, the Older Adult Expansion gave full scope Medi-Cal coverage to all adults 50 years of age or older. Immigration status does not matter, though all other Medi-Cal eligibility rules, including income limits, still apply. Overnight, thousands of patients at Santa Rosa Community Health could become insured. Please direct people without insurance to certified enrollment counselors at sonomacounty.ca.gov.

Building on previously approved expansions, Gov. Gavin Newsom proposes to expand full scope Medi-Cal coverage to income eligible, undocumented residents aged 26 through 49, beginning no sooner than Jan. 1, 2024. Please reach out to state legislators on the budget committees to help pass these elements as part of the 2022-23 budget, which is due by June 15. You can find the members at assembly.ca.gov and senate.ca.gov.

Because everyone deserves life, liberty and the pursuit of happiness, getting all uninsured Sonoma County residents health insurance is essential.

Dr. Danny Toub is an associate clinical professor at UC San Francisco, a faculty member for the Sutter Santa Rosa Family Medicine Residency and a lead clinician at Santa Rosa Community Health.

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