Here’s one solution to lengthy waits for health care in our Central Valley
What is the longest you have had to wait to see your doctor?
Not being able to see your doctor when you need to is a serious problem in California, especially in the Central Valley.
In the Health Affairs academic journal, a March 2016 survey of Californians found that 30% could not find a doctor to see them, 35% met resistance because the doctors they found were not taking new patients, 44% found a doctor’s office that did not accept their insurance type, and 67% were unable to find available appointments. Those with the highest likelihood to report problems with access to care were younger, female, Hispanic, low income, and in fair or poor health.
As a practicing registered nurse with over 12 years of experience caring for patients throughout the Central Valley, Sacramento, and Bay Area in California, I have personally witnessed the horrors of untimely follow up. I will never forget a patient who came to me weeks after an occupational accident who suffered permanent blindness because he was not able to see an ophthalmologist soon enough to save his vision.
Despite the grim reality of the current state of healthcare, there is hope on the horizon. Senate Bill 221, in circulation, will force insurance companies to provide timely access to care, even if that means having to pay for doctors outside of their networks. I implore readers to contact state Senators Anna Caballero, Susan Eggman and Andreas Borgeas, and Assemblymen Heath Flora and Adam Gray, to voice support for SB 221, so that all Californians may receive safe and timely care.
Although the Affordable Care Act increased the numbers of persons with insurance, those with public Medi-Cal insurance in the Central Valley are disproportionately suffering delays in access. The Department of Managed Health Care in California is responsible for assuring timely care, yet their Timely Access Report in 2020 details that Health Net members were only able to receive timely care 84% of the time for non-urgent appointments, and 67% of the time for urgent appointments.
For Kaiser Permanente members, non-urgent appointments were timely 91% of the time, but urgent appointments were timely only 77% of the time. This means that all parties are being affected, regardless of public or private insurance status.
Those with mental health and substance-use disorder needs are experiencing even worse delays. An analysis for SB 221 identified a December 2020 survey of clinicians who were part of one of California’s largest health-maintenance organizations. It found that 88% of therapists reported no availability for timely appointments, and over 51% identified more than a four-week waiting period for follow-up care.
Over 13 health care consumer-focused organizations support SB 221, including the National Union of Healthcare Workers, the California State Association of Psychiatrists, and the National Alliance of Mental Illness. Opponents include the Association of California Life and Health Insurance Companies and the California Association of Health Plans, which express concern about meeting demands listed in the bill — to provide adequate and timely care.
While there is a shortage of mental health providers throughout California, technological solutions like telemedicine and telepsychiatry have broadened the reach of providers, especially in the dawn of COVID-19. In turn, these solutions could easily be implemented to improve access to care. It is important to remember that insurance companies are profit-minded businesses, and the financial bottom line is always part of their decision-making process.
Timely access to care in California, especially the Central Valley, has fallen short long enough. We should voice support of SB 221 to our local representatives, demanding that we receive the timely and safe care that we are all entitled to.
This story was originally published May 28, 2021 at 5:00 AM.