Knitting health reform into the community

Dr. Ronald Fong

I was privileged and surprised to be invited to Congresswoman Doris Matsui’s inaugural Sacramento Health Care Working Group meeting in early July. Rep. Matsui assembled many of the region’s health care leaders, including Claire Pomeroy, Dean of the School of Medicine at UC Davis; Glennah Trochet, Sacramento County Public Health Officer, CEO’s of medical groups, health directors of community clinics, and others who shape health care delivery in Sacramento.

Rep. Matsui wanted input on how to engage citizens on the implementation of the recently passed federal health reform, known as the Affordable Care Act. During the guest self-introductions, I pondered the weight of my credentials. Immediately, my mind zoomed to the 1992 Vice-Presidential debates where Vice Admiral James Stockdale greeted the American voting public by saying, “Who am I? Why am I here?”

Rep. Matsui promoted constructing a “Sacramento Model” as a paradigm for other cities to institute national policy aligned to local sensibilities. She believed Sacramento’s demographics provided challenges and opportunities that resonate with almost every other region of the country. She cited the 2002 Time Magazine article declaring Sacramento as “America’s Most Diverse City.”

Already, there are institutional responses to the health needs of a varied population. At the UC Davis Medical Center, we have translator services for over 30 languages. The UC Davis School of Medicine sponsors seven student-run clinics that serve communities with histories of limited legislative representation: Paul Hom Asian Clinic [Asian and Pacific Islander]; Clinica Tepati [Latino]; Imani Clinic [African American]; Shifa Clinic [Muslim]; Joan Viteri Memorial Clinic [intravenous drug users, sex workers]; Bayanihan Clinic [World War II veterans and recent immigrants of Filipino descent]; and The Willow Clinic [individuals/families without homes]. The key is how to address diverse health care needs with a coordinated and unified approach.

Rep. Matsui wanted the group to function at the “granular” level, a level where the voices of citizens are the clearest and the loudest. At this point, the clarity of my role and responsibility emerged. My place at the table was due more to my residence than my resume. I grew up in Sacramento and returned to raise my family.

Throughout my childhood, I was the beneficiary of many Sacramentans’ good will, whether it was from neighbors, teachers, or coaches. This social capital was an investment to develop my potential as a future contributor.

My children are experiencing similar blessings from the community. Through her countless hours spent scheduling games, staffing the snack shack and many other duties, fellow Pocket Little League board member Tracy Gee has insured that my sons, along with so many others, will remember their youth baseball experiences fondly.

When the Elk Grove Babe Ruth League was short of managers, they asked Rick Venegas to help. He did so, even though he did not have a son in the league. Rick juggled his schedule and was late for many dinners to teach my son on and off the field and to teach me how to be a better coach.

I thank Howard Liu for his time as principal for the Confucius Chinese School. He provided my children with the skills to help immigrant families find their place in Sacramento, such as my parents did over forty years ago.

I have been witnessing the Sacramento Model in motion for over 40 years. My charge is to weave the Affordable Care Act into the social fabric of the Sacramento community. The Act will be meaningful if it sustains our neighbors’ passions even in the face of illness. While Dr. Fong was invited to the meeting, I believe Coach Ron’s input will be more insightful.

Dr. Fong is director of the UC Davis Family Medicine Residency Network. His opinions are his own and do not represent UC Davis.

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