Before health reform, Los Angeles County clinics served people who had no other options—sick patients with no health insurance. But as 2014 approached, county officials realized that many of their clients would become insured and choose other health care. If they opted out, the entire system –with 19,000 employees and a $4 billion budget would face near collapse.
The Affordable Care Act, with its promise of health care for most Americans, represents a welcome step forward for physicians who have cared for the uninsured.
More than a year after the passage of the Affordable Care Act, nearly three million Californians are newly insured by Medi-Cal, California’s health insurance program for the very poor, but many of them are still struggling to get the care they need.
Nearly 300,000 children in California—more than in any other state— are homeless, or live in cars, garages or crammed into single rooms with their entire families. More than half of those children are younger than 10 years old.
Diabetes afflicts one in 12 Californians. It causes early death and disability for millions and costs the state $27.6 billion annually in health care and related expenses. In 20 years, diabetes rates are expected to double in the United States. But the disease doesn’t have to wreak that kind of havoc. Diabetes can be avoided in many people with intensive diet and exercise counseling, according to a 2002 study by the National Institutes of Health and the Centers for Disease Control and Prevention.
California’s more than 200 non-profit hospitals claim billions of dollars in federal and state tax exemptions annually. In exchange for that tax relief, they’re required to offer free and discounted health care for the poor and benefits like free vaccinations or disease prevention programs for their communities.
Charter schools — public schools run by parents, teachers and others largely free of state and local regulations — were designed to provide competition for traditional public schools, forcing them to improve, or lose students. But the schools’ detractors argue that charters sometimes look better on paper than they are in reality. One complaint: they raise their test scores, and hurt disadvantaged students, by enrolling fewer special education students than they should.
In Los Angeles, several dozen women, who would otherwise be in jail or prison instead receive addiction treatment and counseling at Prototypes, a substance abuse treatment center about 30 miles east of downtown Los Angeles. Their young children are allowed to live there too.
An injunction that will affect 500 alleged gang members is put in place in the Glendale Corridor, including Echo Park and Silver Lake, increasingly trendy and affluent LA neighborhoods. Though crime has been steadily declining in the city, police say the injunction is necessary for public safety.
The Affordable Care Act recognizes drug addiction and alcoholism as chronic diseases that must be covered by health insurance plans, and in so doing marks a major transformation of addiction care.