John Gonzales's blog

Forty-seven California counties have provided health care to more than 335,000 people through the “Bridge to Reform” program.  San Luis Obispo is a case study in one county that has decided not to participate.

We have reported on the Bridge to Reform, also known as the Low Income Health Program, or the Health Care Coverage Initiative, since its early phases. I was the reporter of our first piece, which looked at Kern County’s efforts to build the bridge. A follow-up examined the challenges of implementing the program in the far reaches of rural California.

I am waiting for the metal jailhouse door to open. The woman whose profile will be the last chapter in a five-part series on frequent users of the emergency room is about to emerge from behind it.

Her name is Joan Kloh.  And she has generously allowed us to make her the embodiment of a government/nonprofit effort to reduce taxpayer costs generated by frequent use. Almost as an aside, I wrote in the story, the effort will try to extract her from a life of substance abuse and homeless. 

While in the San Diego-based program dubbed Project 25, she was arrested on a drunk and disorderly charge. She had relapsed after eight months of sobriety, eight months of program involvement that reduced her taxpayer bill by more than 50 percent, even with the relapse.

Sometimes when a reporter listens in on a panel discussion, the eyes glaze over and the journalistic instincts shift into cruise control. That’s particularly true on a topic like health care reform, which our CHCF Center for Health Reporting has covered from its passage, to its currently tenuous fate before the U.S. Supreme Court.

We’ve reported what the law means to people with pre-existing medical conditions, what it means to medically isolated rural communities and what it will do to the health insurance landscape statewide. It’s sometimes easy to think that we’ve run out of things to write – particularly as the law winds toward an uncertain future.

I have been spending the last few reporting months with men and women in pressing need of comprehensive mental health services. Arguably, for their own safety, they should have an alternative -- the type of locked facilities that are no longer part of California's institutional landscape.

One man sees a bridge spanning a sun-splashed bay, and suicidal ideation, or threats of jumping off it, become part of the interview. Another offers detailed accounts of combat in Southeast Asia, but the Veteran's Administration finds nothing of the sort in service records that show a five-month stint ending with a medical discharge.

Their stories will be part of an upcoming project that I won't detail here as we work to meet deadlines with our reporting partner.

Medicare spends $8.6 billion annually to care for a profoundly ill segment of the American population: kidney patients receiving the life-sustaining treatment of dialysis.

I have yet to meet a dialysis patient who is not thankful for this 38-year-old, taxpayer-funded life bridge. Their anguish comes by way of a harsh reality: the treatment can also be life-threatening.