What I’ve witnessed inside our clinics doesn’t always match that founding purpose. Money meant to support patients doesn’t always make it to the front lines, and the people who pay the price are the patients themselves.

I see it constantly. Families wait months just to get an appointment. Others can’t keep up with the cost of their prescriptions, or they abandon treatment altogether after an insurance change pushes the price out of reach.

That’s why, as someone who works in this system every day, I’m supporting Proposition 44 this fall — the Clinic Funding Accountability and Transparency Act. The measure would require community clinics to direct at least 90% of their revenue toward patient care and the services that support it, while publicly disclosing how the rest of their money is spent. Under the proposal, no more than 10% of clinic revenue could go toward executive salaries, administrative costs and overhead.

This isn’t about restricting care. It’s about accountability — making sure clinics that receive public healthcare dollars are transparent about where that money actually goes, and ensuring patients and taxpayers can see it for themselves.

Prop. 44 doesn’t cut what clinics can spend on care. It does the opposite: it protects that spending. Patients walk through our doors because they trust that we’ll have what we need to treat them properly. We owe them the staffing, equipment and resources to make that trust worth something.

That obligation becomes especially critical in emergencies. I’ve stood in a room where a patient’s heart had stopped and staff scrambled to locate a working defibrillator. In situations like that, seconds decide outcomes. No patient’s life should hinge on whether working equipment can be found fast enough.

Community clinics statewide receive billions of dollars annually to serve some of the most vulnerable Californians. Yet some spend as little as half of that funding on direct patient care, while a significant share goes toward high executive salaries and expenses unrelated to the person sitting in the exam room.

When I think about moments like the one with that defibrillator, that’s exactly the kind of funding gap that comes to mind.

The stakes are only growing. California could lose as much as $30 billion annually in healthcare funding because of federal cuts moving through Congress. Clinics are already shutting their doors across the state, and more than a million Californians are at risk of losing coverage. In this climate, every dollar clinics receive needs to reach the patients who depend on them.

This issue is personal for me. My sister has cerebral palsy, and because my mother didn’t speak English, I was interpreting for my family by the time I was six years old, just so my sister could get proper medical care. For families like mine, interpretation and language access aren’t optional extras — they’re essential to getting treated at all. Prop. 44 would help safeguard funding for those exact kinds of services.

This measure wouldn’t take a single dollar away from community clinics. It would simply ensure the money already flowing into these clinics ends up where it’s supposed to: with patients. At a time when California’s healthcare system is under so much strain, that kind of accountability matters more than ever.

I hope the people leading our clinics remember why they got into this work to begin with. Healthcare was never supposed to be about inflated executive pay or shiny new facilities. It’s about the person sitting across from us, trusting that we’ll show up for them when it counts.

That’s the standard our community clinics should be held to — and it’s the standard every patient in California deserves.

Original source: CalMatters

The post Proposition 44 Aims to Keep Patient Care Ahead of Executive Pay at California Community Clinics appeared first on The Hemet & San Jacinto Chronicle.

Family physicians like myself work inside California’s community health clinics every day, delivering care to patients who often have nowhere else to turn. Prop. 44 puts that work — and the clinics themselves — in serious jeopardy.

The problem lies in how the measure is written. Its spending rules are so rigid that, by some estimates, roughly 91 percent of the state’s health centers would fail to meet them. An independent analysis commissioned by the California Primary Care Association found that clinics could collectively face as much as $1.7 billion in penalties in just the first year, with continuing costs in the years after. That’s money that currently keeps clinic doors open and supports the kind of comprehensive, community-based care that has made these centers a trusted resource for millions of Californians.

The financial fallout could be severe. Recent data suggests that the vast majority of clinics statewide are already operating on thin margins. A sudden wave of penalties tied to Prop. 44 could push most of them into the red, forcing painful decisions about which services to cut just to stay afloat.

If that happens, some clinics may be forced to shut down entirely — eliminating safety-net care for the very communities that depend on it most. Each year, California’s community clinics serve more than 7 million patients, including children, working families, uninsured residents, seniors, veterans, and roughly one in three Medi-Cal enrollees. Prop. 44 threatens the funding base that keeps this system functioning.

Beyond the financial risk, the measure is poorly constructed and legally murky. Clinics could be penalized simply for spending money on the things that keep them running — new medical equipment, technology upgrades, disaster preparedness, or reserve funds set aside for emergencies. Under the initiative’s language, even responsible financial planning could trigger steep penalties.

Anyone who has spent time inside a community clinic understands that health care extends well beyond the exam room. Programs that provide patients with transportation to appointments, telehealth options for those who can’t make it in person, and enrollment assistance to help people access insurance they qualify for are not extras — they are essential parts of keeping people healthy and connected to care. Prop. 44 puts all of that at risk.

Perhaps the most troubling piece of this measure is what it does to the relationship between doctors and patients. Prop. 44 would give the state Attorney General — an elected official without medical training — significant influence over which services clinics are able to offer. If recent years have taught us anything, it’s that political figures should not be inserting themselves into decisions about a patient’s care.

Our health care system is already stretched thin. Costs continue to climb, wait times for primary care and specialist appointments keep growing, and emergency rooms are routinely overwhelmed. If Prop. 44 leads to clinic closures or reduced services, patients won’t simply stop needing care — they’ll delay treatment until conditions worsen, often ending up in emergency rooms for issues that should have been handled through routine, preventive visits. That shift would only add more strain to hospitals, lengthen wait times, and drive health care costs even higher.

Opposition to Prop. 44 spans a wide and politically diverse coalition — not just physicians, but many others who understand what’s at stake for the patients who rely on these clinics every day. Millions of Californians are counting on voters to get this one right.

Original source: CalMatters

The post Proposition 44 Would Inject Politics Into California Patient Care appeared first on The Hemet & San Jacinto Chronicle.