The Agenda, April 24 -39: Real health-care reform!

Plus: Affordable housing, evictions, Airbnb .... and the Leaning Tower of Soma. It's going to be a busy week

A measure that would transform health care in California and set the stage for a profound change nationwide comes before its first committee Wednesday/26.

SB 562, by Sens. Ricardo Lara and Tony Atkins, could be the most important piece of legislation in the state this year.

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It would guarantee free health care to every Californian, replacing the expensive, ineffective current system of private health insurance.

It would be the equivalent in the nation’s biggest state of the Medicare for All proposal touted by Sen. Bernie Sanders in his presidential campaign.

For the millions of people who are either stuck with individual plans under the Affordable Care Act, which are better than nothing but in many cases not affordable, or have no insurance at all, this would of course be a huge benefit.

It would also be a huge help to California businesses. Employee health care is a major cost factor, particularly for smaller companies; eliminate that expense and businesses at every level would become more competitive, able to pay better salaries and to offer products and services for less.

Local governments spend a fortune providing employee health care; the savings would be in the billions of dollars.

Much of the startup money could come from existing programs (assuming, for example, that Washington lets California take over some federal health-care programs). At some point, the Legislature and the new nine-member board that would oversee the program would need to find revenue sources, and that will get tricky – except if we can manage to get the message out that the money businesses save from single-payer, and the money individuals and local governments save from not paying inflated health-care costs to prop up the profits of the insurance industry, will far exceed any new taxes to pay for the program.

Single-payer health care in North America started with one province in Canada in 1947, and spread across that country. The same could happen with California – but we need to make clear that the idea has major popular support. Gov. Jerry Brown is dubious, and even if this clears the Legislature, the governor could be a problem.

Still, in the Age of Trump, this is a remarkable opportunity. The California Nurses Association is leading the fight, and will be holding a rally and march to the state Capitol starting at 11 am. The hearing is at 1:30. Buses will leave San Francisco at 7:50 am, one from the Zoo and one from Civic Center; you can RSVP here.

 

The heated battle over affordable housing in SF is back at the Planning Commission Thursday/27, and it’s pretty clear that the deck has been stacked in favor of the plan favored by Sups. Ahsha Safai and London Breed – and the developers.

The Planning Department staff has already come down on the side of the Safai-Breed plan. But affordable-housing advocates will, I suspect, be at the commission meeting to point out that when you allow higher-priced units to count as “affordable” housing – even when they are targeted at the middle class that so desperately needs places to live – you are doing developers a favor.

And they should pay for more in exchange.

 

It’s going to be a crazy busy day at the Supes Government Audit and Oversight Committee Friday/28. (Interesting that since President London Breed stacked the committees to give power to the more conservative supes, this panel, along with Public Safety and Neighborhood Services, have become the go-to places for interesting and progressive legislation and hearings).

In this case, check out the agenda:

First, Sup. Jane Kim has called for a hearing on the city’s enforcement practices around residential evictions. That’s going to play into her move to ensure more accountability for landlords who do fake owner-move-in evictions – and may be the start of a discussion around the need for more enforcement authority and inspectors at the Rent Board.

Next: Sup. Aaron Peskin wants to look into the funding and oversight of the Fine Arts Museums of San Francisco – which will no doubt bring up some of the issues around former DeYoung honcho Dede Wilsey, whose tenure was marked by all sorts of issues.

Then we are back to the Leaning Tower of Soma, and Peskin’s ongoing efforts to figure out why the city approved and a developer constructed a giant luxury housing tower that is now sinking and keeling over to the side.

This week’s chapter should be good: The full board has accepted Peskin’s request to issue a subpoena to Hardip Pannu, an engineer who was one of those who reviewed the project’s plans. Pannu told the developers that the project needed further review, particularly in terms of its ability to withstand an earthquake. He’s do nothing wrong – in fact, he may be able to explain how this fucked-up building got developed in the first place. But without the subpoena, he was apparently reluctant to talk.

Finally, Peskin will continue his inquiries with a hearing into the city’s (weak) enforcement of short-term rental laws, which will be a chance to review the existing legislation, Airbnb’s efforts to circumvent it, and the city’s inability to stop thousands of housing units from being turned into hotels.

That meeting starts at 10am. It will go on for a while.

46 COMMENTS

  1. Ethnicity matters to a degree in that different ethnicities are predisposed to developing certain genetic illnesses. For example. white people have much higher rates of skin cancer and alcoholism, Ashkenazi Jewish women have the highest rates of breast cancer, and African Americans have higher rates of sickle cell anemia. But if you are talking about insuring a country with many different ethnicities there is no greater cost that comes from having a variety of people from different ethnic backgrounds.
    The concept that immigrants are flooding into the US and driving up health care costs is fallacious. The immigration freak out is largely a byproduct of over population. The US has a population of over 330 million, and can’t welcome as many new people as an underpopulated country like Canada. Health care costs in the US come from the fact that insurance companies have had an oligopoly and have been able to drive up costs to consumers without increasing efficiency.

  2. Well it is not likely to pass so don’t worry about it. If you take a large enough human population to measure risk on an actuarial basis then ethnicity is meaningless. The fact that African Americans have disproportionately high rates of certain illnesses in the United States is not attributed to their genetic makeup. Africans who spend their whole lives in Africa don’t get the same illnesses that African Americans get. That is the whole point of nationalizing healthcare – raising the number of people insured to minimize overall costs.
    Like I said it doesn’t seem realistic that one state would be able to implement single payer in a country with different dysfunctional health care systems. The whole system needs to be overturned and restructured.

  3. The United States has a national health care system that works it is called Medicare. The people who have it are satisfied with it and the medical community is satisfied with it. The question is whether or not one state could implement a national health care system within a country with four different health care systems. I don’t know because it might involve cost shifting across state lines and within systems, ie a company based in California would stop offering insurance to employees in that state but not others. And what would Californians over 65 do, opt for the Medicare or a state system? It might not work.

    France, Japan and the other countries do not have small native populations, the ethnicity of the people insured is irrelevant.

  4. But again, you’re comparing native small populations which are not even as big as CA’s population to CA, which is multi-ethnic in a way that those populations are not, and in fact many are pissed off as H about refugees coming in & using their services. Comparing it to the UK is relevant & the NHS is a huge mess.

  5. All of the countries mentioned in the list of the top life expectancies have national health care systems. You mentioned Sweden, Iceland, South Korea, Luxenberg, Israel, Australia, France, Singapore, italy, Spain , Japan and Hong Kong. Plus they all pay half or less than what we pay in the US for health care. Thank you for proving my point.

    The Canadian polls? Im not sure how much I believe polls anyway these days as the betting odds put Hillary Clinton as a sure win. Pollsters are not as accurate as people think.

  6. Well just 52% of Canadians are satisfied. If you +/- the usual 3% for errors and inaccuracies it could be just 50% or less
    http://www.gallup.com/poll/8056/healthcare-system-ratings-us-great-britain-canada.aspx

    Further
    O’Leary, who is a Canadian Trump person is leading in the race for PM, this is from today, most likely O’Leary will be replacing the really unpopular Trudeau
    http://www.metronews.ca/news/ottawa/2017/01/24/poll-puts-kevin-oleary-in-the-lead.html

    As far as living longer, Canada isn’t even in the top 13
    http://www.independent.co.uk/news/world/the-13-countries-where-people-live-the-longest-in-the-world-a7335321.html

  7. 1. Sally Pipes is one person. There are over 30 million people in Canada and most of them are satisfied with their medical care, or they would vote to change it. In contrast, most Americans are not satisfied with their health care.
    2. This article was published in the NY Post,which is owned by Rupert Murdoch, the owner of Fox News and the Wall Street Journal, a right wing sensationalized rag. Anything you watch on Fox news or read in either of these papers is going to be slanted with his opinion.
    3. Canada does not have socialized medicine. Socialized medicine means the government owns the hospitals and health care workers are government employees. An example of that would be the Veterans Administration in the US, one of the few systems that actually works.
    4. If the care is so bad, why do the Canadians live longer ? They are outliving the Americans by an average of two years.
    5. The US has four health care systems, medicare and medicaid, employer based plans, and the Obamacare plans, and the main problem is the four plans don’t coordinate well with each other . Can one state implement a single payer system in a nation with four different systems? I don’t know but it might be worth a try.

  8. I read it. Scroll down to where it talks about the financial aspect. It is completely pie-in-the-sky Maduro/Chavez type of bs

  9. I read SB 562 in it’s entirety. They will forcibly take every persons medi-cal & medicare from the feds & it will still fall short by billions. And force everyone, even sick people who have doctors all over, to stay within their area. It’s a nightmare.

  10. According to Sally Pipes, a Canadian, she says socialized medicine is not working in Canada

    Single-payer’s cheerleaders cite Canada as proof of the system’s superiority. It’s a foolish fetish: Our northern neighbor’s health-care system is plagued by rationing, long waits, poor-quality care, scarcities of vital medical technologies and unsustainable costs. That’s exactly what’s in store for America if we follow Canada’s lead.

    As a native of Canada, I’ve seen this reality firsthand. To keep a lid on costs, Canadian officials ration care. As a result, the average Canadian has to wait 4½ months between getting a referral from his primary-care physician to a specialist for elective medical treatment — and actually receiving it.

    Mind you, “elective treatment” in Canada doesn’t mean Botox or a tummy tuck. We’re talking about life-or-death procedures like neurosurgery, orthopedic surgery or cardiovascular surgery.


    http://nypost.com/2014/04/16/the-false-promise-of-single-payer-healthcare/

  11. You mean “UNhealthy San Francisco.” I was on it for a while. It is not a great program. It is not even a good program. Getting an appointment when something like this,

    Me: “I need an appointment.”
    Clerk: “The next available will be July, unless it is urgent, in which case we can see you on June 30th.”
    Me.: “I was hoping for something sooner…”
    Clerk: “Do you want July or not?”

    I was very poorly treated. I went for an eye exam, on what was one of the brightest days of the year. They dilated my eyes, and then told me that they didn’t have a doctor available. Going home was excruciating. I couldn’t not even tell which bus was which. I had them arbitrarily decide which drug I could take. I did without my cholesterol medicine for six months because they took me off of the one I was on, and told me I had to take one that I had suffered a bad reaction with. On another occasion, they told me I couldn’t have my blood pressure medicine. Turned out they were insisting I have the BRAND NAME version, instead of the generic, I was never so glad as when I got off of it.

  12. So is SB 562 – which is the one that Tim is talking about, it’s all based on Healthy SF. The PROBLEM is who will foot the bill? Are you ready for sky high taxes ?

  13. Gavin’s plan is based on Healthy SF, which is actually a great program. No problem with that!

  14. There are more effective ways of ensuring quality of care than the state taking over the entire medical system.

  15. You should care because the quality of care in the United States consistently lags other countries which spend approximately half as much. This means even if you have a blue chip insurance policy the odds of a poor outcome from illness or hospitalization are higher than in a country like France or Canada. If you break your leg or develop cancer and are hospitalized in the US you are much more likely to get a secondary infection, a misdiagnosis or even death.
    We are paying twice as much as we need to for suboptimal care. That has been proved over and over again, all you have to do is search under “American hospitals compared to other countries ” or search World Health Organization statistics.

    That is called being ripped off and maybe it doesn’t bother you but I don’t like being ripped off. I don’t like paying $8000 for something that is only worth $4000.

  16. I absolutely can, I’ve spent hours being educated on it. However, I will not waste my time on someone who is just trolling for reactions without any interest in facts.

  17. No, that’s not what I “admitted.” I said I hadn’t read the bill, which is what I meant by saying “up to speed.” I’m responding here to information you and Tim provided above. If you can’t defend what you wrote, maybe you might want to exit the conversation, K?

  18. You’ve already admitted that you’ve not read a thing about the bill, it seems like that should’ve been the end of the discussion from your end, no?

  19. If you’re not going to bother to get up to speed, perhaps it would be best not to participate in a discussion as though you have. We have enough “alternative facts” floating around these days, we don’t need someone spreading misinformation about a bill that has the potential to change the lives of millions of Californians for the better. After all, it’s misunderstandings like these that cause people to vote for/against something that may actually be quite different than what they’ve been told.

  20. Again, why would I enjoy paying 3-5% of payroll tax on my income which exceeds Medi-Cal’s $16,243 annual cap? Right now I pay $140 per month for full coverage for my family through my employer. The system you’re advocating for represents an enormous tax hike for me and most people like me who get medical insurance through their employers – to benefit those who don’t. Stop couching it as better for me than the system we have now, it’s not. It’s a wealth transfer, just be honest and say it.

  21. I know it’s not going to happen, so I’m not going to bother getting up-to-speed on a piece of legislation that has ZERO chance of passing the legislature and even if it did – would meet the governors veto pen. If you think it’s such a great idea, put it on the ballot as an initiative.

  22. Sounds like Vermont has nothing to do with California’s plan then, since the entire plan is a payroll tax of 3-5% and no premiums on top of it.

  23. Again, you’re basing your information on false facts Snaps. The actual plan comes in at 3-5% of a person’s payroll, and only taxes that income which exceeds the current cap for MediCal.

  24. It sounds like you’re basing your rejection of the plan on old information and plans from other states. Do you know the details of SB-562? It actually starts at a substantially lower cost to both the residents of the state and the government itself than our current system and the prices will only fall as the state’s collective bargaining power as the world’s sixth largest economy is able to make its power felt. This isn’t the financial drain that people like to allude to.

  25. I dare them to put it on the ballot. Every time this has been voted on it’s failed once the costs are made clear. Colorado was the latest.

  26. I’m already compensated handsomely and my employer can deduct the cost of health insurance. With this – they’d be prevented from doing so since this is a state and not federal program. How’s that going to help me?

  27. I pay next-to-nothing because my employer picks up the cost. Why in the hell would I want to swap that sweet arrangement for one where I’m paying an extra 10%?

  28. I pay more than 10 percent of my income for health insurance now. Ten percent for health insurance is less than most people pay

  29. That’s some pretty rank anti-Vermont attitude there. Everyone is in favor of single payer – until it comes time to pay for it. As Tim himself said, “that’s the tricky part.” A 10% payroll tax and premiums at 10% of a person’s income are not going to fly – ever. Especially considering CA already has the country’s highest marginal income tax rate at 13.3% – imagine the joy of adding 10% on to that, there goes 1/4 of your paycheck – before the feds or FICA even get their share. I wonder how much of the citizenry would be overjoyed at seeing 55-60% of their paychecks decimated before they arrive in their bank accounts? And wasn’t Tim calling for a city income tax a couple of weeks ago? Imagine that – your take home pay is reduced 75% by the progressive wish list before arriving in your hands.

  30. You’re talking about a state that still hasn’t done anything about the Oroville Dam, the potholes, the water, built new dams & reservoirs, and you want to entrust The State with your life?!

  31. Vermont is a comparatively poor state with a low capita GDP. They don’t have much industry to support their citizens. A few resorts plus Ben and Jerry ice cream can’t support an entire state’s oxycontin addiction.
    California might be the one state big enough and rich enough to pull it off. The world’s eighth largest economy has companies like Google, Apple Computer, Facebook, Intel and the entire entertainment industry. The per capita GDP of California is one of the highest in the country.The problems would occur primarily from cost shifting across state lines, and the necessity of eliminating the payroll tax deduction for health insurance for companies’ employees. Plus, everyone would try to move there if the cost of health care were half as much as everywhere else.
    It works in Canada and Australia and the Netherlands, as well as many of the smaller Asian countries. These countries pay approximately half of what the United states citizens pay per year in health care costs, and they also live longer. There have been myriad studies done on this topic by non partisan groups such as the World Health Organization and the information is readily available to anyone who is interested in researching it.

  32. And yet, the current system is dysfunctional for a significant number, if not all! Does anyone have a plan that isn’t subsidized to some extent or all? And if someone pays cash, there is no pricing plan publicly available.

    The alternative is to set up a separate health care system – with separate facilities, personal, and equipment. That, involves a lot of capital; which is a good question. However, with all the capital floating around, a significant player just might be able to get different capital centers to war (compete) with each otters for a lesser-but-steady return.

    Maybe some pension funds/systems and various private individual (along with “socially conscious” investors) would see this as an opportunity. Lot of ‘set up’ though.

  33. “Free” healthcare doesn’t exist. Someone is going to have to pay and as Tim admits, “that’s where it gets tricky.” Vermont attempted to implement single payer and the plan collapsed when the figures came out – it would have required a payroll tax of 12% and premiums up to 9% of a person’s yearly income to finance itself. We all know that’s not going to happen. This idea is dead in the water and the backing of the radical nurse’s union all but guarantees that.

  34. If Single Payer could produce Single Price, then it might be worth it.

    Currently, price’s are unknown for most medical items, procedures, and drugs.

    Single Price would go a long way to lowering costs – even for multiple payers.

  35. A single payer health care system isn’t really free, it is paid for in taxes but the per capita cost of insurance ends up being approximately half of the cost Americans pay now per capita. The extra money goes to health care instead of health insurance executives. That is the primary difference. It is more efficient, with less bureaucratic overhang and less incentive for insurance companies to deny care based on cost.

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