WE LIKE TO GO AHEAD AND START
THE HEARING.
WE LIKE TO GO AHEAD GET STARTED
IF YOU GUYS COULD.
.
HAVE A SEAT NOW. WILL GET GOING
HERE SO FIRST OFF THANK YOU VERY
MUCH FOR FOR BEING HERE. AYE WE
ARE GOING TO HAVE OUR FIRST
PANEL COME UP IN AND MASS OF SO
THAT WILL BE.
MISTER LIGHTLY.
DOCTOR POLLAND.
MISTER FOUNTAIN AND DR TWO
ZEMSKY OF YOU ALL COME UP HERE
THAT IT WAS OUR FIRST PANEL THIS
MORNING.
AND WE'LL START WITH SOME
OPENING REMARKS AND THEN WE'LL
MOVE RIGHT IN RIGHT INTO THE
PANEL SO I'M.
SO GOOD MORNING AND. WELCOME TO
THE LAST SCHEDULED HEARING OF
THE SELECT COMMITTEE.
FOLLOWING THIS HEARING WILL
BEGIN THE WORK OF DEVELOPING OUR
REPORT.
WHICH WILL INCLUDE ACTIONABLE
RECOMMENDATIONS.
WE MAY NEED TO RECONVENE
ADDITIONAL HEARINGS AS WE WORK
THROUGH THAT PROCESS BUT HOPE TO
COMPLETE OUR REPORT BY EARLY
SPRING.
JUST LAST SEPTEMBER.
SENATOR BERNIE SANDERS
INTRODUCED AS MEDICARE FOR ALL
BILL ON THE SENATE FLOOR AND
SAID THIS.
QUOTE THE TRUTH IS.
EMBARRASSINGLY THAT ON THIS
ENORMOUSLY IMPORTANT ISSUE THERE
IS NOT BEEN THE KIND OF RESEARCH
AND STUDY WEENIE. AND QUOTE.
JUST YESTERDAY THE UNITED STATES
OF CARE WAS ANNOUNCED.
THIS NEW NONPARTISAN NONPROFIT
HEADED BY ANY SLAP IT WHO SERVED
AS THE ACTING ADMINISTRATOR FOR
THE CENTERS FOR MEDICARE AND
MEDICAID SERVICE IN THE OBAMA
ADMINISTRATION. HAS CONVENED A
HIGH PROFILE GROUP A PUBLIC
HEALTH FIGURES TO RESHAPE HEALTH
KICK HEALTH HEALTH CARE.
IT'S ONE OF THE MANY DIFFERENT
GROUPS BUILDING AND MOBILIZING A
MOVEMENT TO ACHIEVE LONG LASTING
SOLUTIONS TO ASSURE ENSURE THAT
EVERY AMERICAN. HAS ACCESS TO
HIGH QUALITY AFFORDABLE HEALTH
CARE. REGARDLESS OF HEALTH
STATUS
SOCIAL NEED OR INCOME.
AMAZON RATTLED THE HEALTH CARE
MARKET A COUPLE WEEKS AGO. WHEN
IT ANNOUNCED A PARTNERSHIP WITH
BERKSHIRE HATHAWAY. JP MORGAN
CHASE.
TO CREATE A NONPROFIT HEALTH
CARE COMPASS COMPANY FOCUSING ON
COST REDUCTION.
INCREASE TRANSPARENCY.
AND USER SATISFACTION.
ALTHOUGH NO DETAILS HAVE REAP
HAVE BEEN REVEALED. IT WILL BE A
FORCE TO BE RECKONED WITH.
HERE IN OUR STATE MANY
ORGANIZATIONS HAVE BEEN
ADVOCATING FOR CHANGES ON TO THE
HEALTHCARE SYSTEM.
HEALTHY CALIFORNIA. A VERY
PASSIONATE GROUP OF ADVOCATES
ALONG WITH CNN CALIFORNIA NURSES
ASSOCIATION.
HAS RAISE THE AWARENESS AND
CERTAINLY THE DECIBELS OF THIS
ISSUE ON BEHALF. OF ALL
CALIFORNIANS.
AND WE ABSOLUTELY NEED TO THANK
THEM FOR THAT.
THE ANSWER SHOULD NOT BE IN
POLITICS BUT IN BRINGING
TOGETHER EVERYONE WITH ONE GOAL.
I CAN ASSURE YOU THAT MICHAEL
HAS ALWAYS BEEN TO FIND A
CONSTRUCTIVE.
AFFORDABLE AND LASTING APPROACH.
AS I'VE SAID MANY TIMES I MAKE
NO APOLOGIES FOR THE AMOUNT OF
TIME WE HAVE SPENT ON THIS
COMPLEX ISSUE.
WE SPENT MORE THAN TEN TIMES THE
HOURS USUALLY AFFORDED THE
TYPICAL BILL AND A REGULAR
REGULAR ASSEMBLY HEALTH
COMMITTEE HEARING.
TWENTY EIGHT A HALF HOURS AND
COUNTING TODAY.
OUR WORK HAS BEEN COMPREHENSIVE
AND THOROUGH. WE MUST ENSURE
THAT ANY SIGNIFICANT CHANGES TO
OUR HEALTH CARE SYSTEM WORKS FOR
ALL CALIFORNIANS.
YOU MUST BE AFFORDABLE.
YOU MUST BE QUALITY.
THEY MUST BE SUSTAINABLE.
NO MISTAKES
NO EMPTY PROMISES.
ON MONDAY.
WE LEARNED ABOUT THE MANY
CHALLENGES WE FACE IN
IMPLEMENTING SIGNIFICANT CHANGES
TO OUR SYSTEM.
AND ALTHOUGH THEY ARE NOT
INSURMOUNTABLE THEY WILL TAKE
TIME.
AND MORE THAN THAT
WE'LL TAKE A CHANGE IN THE
BALANCE OF POWER IN CONGRESS TO
GET THE CHANGES IN FEDERAL LAW
THAT WE NEED.
TODAY'S HEARING WILL FOCUS OF
PROVIDE THE OPPORTUNITY FOR A
NUMBER OF ORGANIZATIONS TO
PRESENT THEIR PLANS FOR
ACHIEVING UNIVERSAL HEALTH
COVERAGE. INCLUDING THE
CALIFORNIA NURSES ASSOCIATION.
THE CALIFORNIA PHYSICIANS
ALLIANCE.
HEALTHAXIS CALIFORNIA.
THE CALIFORNIA IN IMMIGRANT
POLICY CENTER.
THE CALIFORNIA LABOR FEDERATION
AND SMALL BUSINESS MAJORITY.
I WANNA THANK ALL THE COMMITTEE
MEMBERS FOR THEIR ACTIVE
PARTICIPATION OVER THE PAST
SEVERAL MONTHS.
AS WE CLOSE IN ON A PATHWAY TO A
HEALTH CARE SOLUTION FOR
EVERYONE WHO CALLS CALIFORNIA
HOME.
A AND NOW I WOULD LIKE TO ASK MY
CO CHAIR DOCTOR JOAQUIN ARAMBULA
TO MAKE HIS OPENING REMARKS.
THANK YOU.
I'D LIKE TO THANK EVERYONE WHO
IS HERE TODAY ESPECIALLY THANK
THOSE IN THE AUDIENCE WHO HAVE
ATTENDED OR WHO HAVE WATCHED ALL
SIX DAYS OF OUR HEARINGS.
I AM PARTICULARLY COGNIZANT OF
OUR ADVOCATES AND APPRECIATE
YOUR DEDICATION TO THIS CAUSE.
KNOWING THAT IT CAN BE DIFFICULT
FOR MANY OF YOU TO ATTEND ALL
THE HEARINGS IN PERSON DUE TO
OTHER OBLIGATIONS.
AS A PUBLIC SERVANT IT'S OUR
DUTY TO BE A VOICE FOR THE
VOICELESS.
AND I'M AWARE THAT SO MANY FROM
MY COMMUNITY COULD NOT BE HERE
TODAY.
I WILL DO MY BEST TO BE THEIR
REPRESENTATIVE.
TODAY'S HEARING WILL FOCUS ON
PROPOSALS THAT CAN IMPROVE OUR
STATE HEALTHCARE SYSTEM.
WE WILL HEAR FROM A BROAD RANGE
OF INTEREST GROUPS THAT HAVE
IDEAS ON HOW WE CAN PROVIDE
BETTER ACCESS AND BETTER CARE.
THIS COMMITTEE'S CHARGE IS
DEFINED WORKABLE SOLUTIONS THAT
WILL EXPAND HEALTH CARE COVERAGE
AND INCREASE ACCESS TO ALL
CALIFORNIANS.
A BETTER ORGANIZED SYSTEM
COVERING EVERY CALIFORNIAN WOULD
ALMOST CERTAINLY CUT OUR HEALTH
CARE COSTS.
EVERY OTHER DEVELOPED NATIONS
SPENDS LESS ON THEIR HEALTHCARE
THAN WE DO. AND WITH BETTER
HEALTH CARE RESULTS.
WE HOPE TO FIND A SYSTEM OR
SYSTEMS THAT WILL PROVIDE
COVERAGE TO ALL. BY EXAMINING
THE EFFICIENCIES AND COST
CONTROL MECHANISMS.
TODAY WE WILL HEAR ABOUT
OPPORTUNITIES TO MAKE OUR SYSTEM
MORE EFFICIENT.
WE KNOW THATPEOPLE WITHOUT
INSURANCE ARE LESS LIKELY TO GET
THE MEDICAL CARE THEY NEED.
THE FEDERAL INSTITUTE OF
MEDICINE PUT IT SUCCINCTLY.
UNINSURED PEOPLE ARE MORE LIKELY
TO RECEIVE TOO LITTLE MEDICAL
CARE AND RECEIVE IT TOO LATE.
AS A RESULT THEY ARE SECKER AND
DIE SOONER.
I AM CONVINCED WE CAN IMPROVE
OUR STATE'S HEALTH CARE SYSTEM.
I BELIEVE THAT HEALTH CARE IS A
HUMAN RIGHT AND I BELIEVE
CALIFORNIA CAN AND MUST DO
BETTER. FOR ALL ITS RESIDENTS.
AT THE CONCLUSION OF THIS
HEARING WE WILL HAVE A BETTER
UNDERSTANDING OF THE VARIOUS
PATHWAYS WE CAN PURSUE. TO
ACHIEVE UNIVERSAL COVERAGE.
AND AS AN ASSEMBLY MEMBER AND AS
A CO CHAIR OF THIS COMMITTEE I
REMAINED COMMITTED TO HELPING
PEOPLE IN THE CENTRAL VALLEY AND
THROUGHOUT CALIFORNIA ACHIEVE
THIS.
WITH ALL OF THE CONTROVERSY
SURROUNDING HEALTH CARE AND WHAT
TRUMP ADMINISTRATION AND
CONGRESS ARE PROPOSING AND
THREATENING TO DO. CALIFORNIANS
ARE RIGHTFULLY CONCERNED ABOUT
WHETHER THEY CAN GET AND KEEP
AFFORDABLE HEALTH INSURANCE. AND
WHETHER THEY WILL BE DOCTORS AND
OTHER PROFESSIONALS TO CARE FOR
THEM.
THE WORK WE HAVE DONE SO FAR HAS
ALLOWED US TOGETHER ALL OF THE
FACTS
ABOUT HEALTHCARE INSURANCE IN
CALIFORNIA. AND WILL PROVIDE US
THE OPTIONS THAT ARE AVAILABLE
TO US NOW.
I WOULD LIKE TO WELCOME THE
OTHER COMMITTEE MEMBERS WHO ARE
HERE TO SEE IF THEY HAVE OPENING
STATEMENTS. BEFORE I PASS THAT
ON TO THEM. I WANTED TO SAY THAT
WE WILL HAVE TWO PANELS TODAY.
WITH THREE PRISONERS IN EACH
PANELAND FOLLOWING EACH PANEL
MEMBERS WILL HAVE THE
OPPORTUNITY TO ASK QUESTIONS.
WE ARE SCHEDULED FOR A BREAK FOR
LUNCH FROM TWELVE THIRTY TO ONE
THIRTY.
THE FOLLOWING THE FINAL
PRESENTATION OF PANEL TO WILL
PROVIDE TIME FOR PUBLIC COMMENT.
OUR GOAL IS TO ENSURE WE ALLOWS
MANY PEOPLE TO SPEAK AS POSSIBLE.
PLEASE BE RESPECTFUL AND LIMIT
YOUR COMMENTS TO TWO MINUTE IF
POSS.
WHEN YOU HAVE EXCEEDED THE TWO
MINUTES WE PLAN TO TURN THE
MICROPHONE OFF.
ONLY SO THAT WE CAN MAKE SURE TO
ALLOW AS MANY PEOPLE TO SPEAK AS
POSSIBLE.
MORE DETAILED WRITTEN COMMENTS
ARE ALWAYS WELCOME AND CAN BE
SUBMITTED TO THE COMMITTEE.
WITH THAT I'D LIKE TO TURN THIS
TO THE OTHER MEMBERS ON OUR
COMMITTEE TO SEE IF THEY HAVE
OPENING STATEMENTS.
THANK YOU MISTER CO CHAIRS AND
COMMITTEE.
AND TO EVERYONE THAT IS HERE
THIS IS A BIG ISSUE.
I WON'T. BELABOR THE POINT IT
IS ARM BASICALLY THECOMMITTEE
WHERE ROBERT HITS THE ROAD I
THINK IN YOU KNOW EVERY QUESTION
THAT NEEDS TO BE HONEST.
WELL WE ASKED AND THE.
I LOOK FORWARD TO OUR DISCUSSION.
SIMILARLY I LIKETO THINK I
DOCTOR WOULD IN A STAFF FOR ALL
THEIR HARD WORK AND BRING SO
MANY DIFFERENT STAKEHOLDERS
TOGETHER FOR. THESE INCREDIBLY
IMPORTANT HEARINGS I'D LIKE TO
THINK DOCTOR ARAMBULA AND
MEMBERS OF THE COMMITTEE I
APPRECIATE THE DEDICATION I KNOW
THIS IS T. IT'S.
WE'VE BEEN DISCUSSING THIS FOR
HOURS UPON HOURS AND THERE'S
NEVER GOING TO BE ENOUGH HOURS
TO REALLY HOW THIS CONVERSATION
BUT. IT'S AN IMPORTANT
CONVERSATION AND I AM I
APPRECIATE YOUR INSIGHT TO WILL
BUT A LOT OF THESE ISSUES.
I ALSO WOULD LIKE TO THINK EVERY
PERSON WHO HAS COME OUT FOR
EVERY SELECT HEARING A SELECT
COMMITTEE HEARING.
THOSE AT A PROVIDE THEIR
EXPERTISE IN THOSE WHO HAVE JUST
SPOKEN AND SHARE THEIR STORIES.
AS WE'VE LEARNED OVER THE LAST
COUPLE OF MONTHS NOTHING IS MORE
IMPORTANT THAN FINDING A PATH TO
COMPLETE COVERAGE FOR ALL
CALIFORNIANS. ESPECIALLY OUR
MOST VULNERABLE POPULATIONS.
AND THAT COMPREHENSIVE PLAN MUST
PROVIDE BETTER OUTCOMES THAN OUR
CURRENT SYSTEM IS PROVIDING.
WHEN IT COMES TO WHEN WE COME TO
AN AGREEMENT WHICH I BELIEVE WE
WILL. IT WILL TAKE MONTHS AND
YEARS TO IMPLEMENT AND I
PERJURED TESTIMONY.
AND I'VE HEARD SO MANY OF YOU
TALK ABOUT PEOPLE ARE SICK AND
PEOPLE ARE DYING NOW.
I AM DEEPLY CONCERNED ABOUT
THOSE WHO NEED ARSES SINCE TODAY.
AND OF THOSE WHO ARE CURRENTLY
UNDER INSURED WHICH WE HAVE
LEARNED SO MUCH ABOUT HERE IN
THIS COMMITTEE.
I BELIEVE IT'S IMPERATIVE THAT
WE FIND BOTH SHORT TERM AND LONG
TERM SOLUTIONS.
I I KNOW THAT EVEN IF WE PASS
SOMETHING IMMEDIATELY AND IT WAS
SIGNED FOR SIGN FOR URGENCY IT.
IT WILL STILL TAKE US TIME TO
IMPLEMENT.
AND SO I'D LIKE TO THINK CNN ALL
THE ATTENDEES WHO HAVE SHOWN UP
FOR THE HEARINGS MAJOR CALLS
WRITTEN YOUR LETTERS KNOCKED ON
DOORS.
A I APPRECIATE YOU BRINGING THIS
CONVERSATION TO THE FOREFRONT
IT'S IMPORTANT TO ME PERSONALLY
I HAVE BEEN IN UNINSURED PERSON.
AND I'VE BEEN A SICK UNINSURED
PERSON SO AS I THINK ON THIS
COMMITTEE THERE'S PROBABLY NO
ONE THAT IS MORE PERSONAL TO. SO
I REALLY DO I THINK YOU FOR YOUR
COMMITMENT I THINK YOU FOR YOUR
DRIVE I THINK YOU FOR BRINGING
THIS TO THE FOREFRONT. AND ON
AND I DO THINK YOU ARE COMMITTEE
MEMBERS AND AND THOSE WHO HAVE
SPOKEN AND EDUCATED US ON YOUR
TIME AND YOUR EFFORT.
HER FIRST PRESENTERS TODAY WILL
BE THE CALIFORNIA NURSES
ASSOCIATION MICHAEL LIGHTY
DIRECTOR OF PUBLIC POLICY FOR
CMA.
RIGHT DOCTOR PAUL AND PROFESSOR
OF ECONOMICS AT UNIVERSITY OF
AMHERST.
AND STEPHANIE ROBERSON WITH C.
N. AS WELL.
WHAT'S THAT. YOU'RE GOOD OKAY SO
MY NAME'S MICHAEL LADY I'M HERE
ON BEHALF OF THE. OVER A HUNDRED
THOUSAND MEMBERS OF THE
CALIFORNIA NURSES ASSOCIATION
TO PRESENT OUR PROPOSAL FOR
GUARANTEED HEALTHCARE. WE ARE
NOT PRESENTING AN OPTION FOR
UNIVERSAL COVERAGE
COVERAGE IS NOT CARE ACCESS IS
NOT HERE.
THIS IS ARE PROPOSAL FOR
GUARANTEED HEALTHCARE BECAUSE IT
ADDRESSES THE NUMBER ONE PROBLEM
FACING CALIFORNIANS WILL WE BE
ABLE TO GET THE HEALTH CARE WE
NEED WHEN WE NEED IT OR WILL
THERE BE BARRIERS IN OUR WAY. S.
B. FIVE SIX TO ELIMINATES THOSE
BARRIERS IT IS GUARANTEED
HEALTHCARE IT IS NOT COVERAGE.
AND THE REASON WE TAKE THE
SCIENCE BECAUSE THE HEALTHCARE
SYSTEMS BECOME AN INDUSTRY WHERE
MONEY IS THE METRIC OF GOOD
MEDICINE.
THE CAREGIVING PROFESSION THAT
THE MEMBERS HAVE SEEN ES WERE
EDUCATED TO DO HAS BEEN OVERRUN
BY THE PROFIT MOTIVE.
THIS HAS RESULTED IN HUGE OUT OF
POCKET COSTS THIRTY SIX PERCENT
OF CALIFORNIANS.
FACE AN UNDER INSURANCE
EPIDEMIC FIFTEEN MILLION
CALIFORNIANS ARE EITHER
UNINSURED OR UNDERINSURED.
IF YOU HAVE A MEDICAL EXPENSE OF
OVER A THOUSAND DOLLARS THIRTY
AYE PERCENT OF US CAN'T AFFORD
IT.
THE INDIVIDUAL PREMIUM.
IS A MAN'S BUT IT'S SUBSIDIZED
BY TAXES ARE TAXPAYER DOLLARS
ARE GOING TO SUBSIDIZE THE
FAILED BUSINESS MODEL OF THE
INSURANCE INDUSTRY AND WHAT THEY
DO. IS THEY ORGANIZE THE SYSTEM
AS AN INDUSTRY THEY RESTRICT
ACCESS AND THEY USE THAT TO
PROFIT BASED UPON CLAIM DENIALS
AND OTHER PRACTICES.
WHAT DO PEOPLE CARE ABOUT THEY
CARE ABOUT JUST WHAT YOU'RE
SAYING ASSEMBLY MEMBER BURKE
WILL WE GET THE HEALTH CARE WE
NEED IT IS TO MOST INTIMATE
EXPERIENCE OF OUR LIVES WERE
PUBLIC POLICY MEETS?
OUR EVERYDAY REALITY AND YET WE
OUR SUBJECT TO THE PRACTICES OF
THE INSURANCE COMPANY WE DO NOT
CONTROL OUR OWN CARE. THEY
DEDUCTIBLES ANOTHER CARSHARING
ARE INCREASING CAN PEOPLE GO TO
THE DOCTOR THAT THEY NEED TO OR
IS THAT DR OUT OF NETWORK WILL
THEY HAVE HIGH FEES THESE OF THE
PROBLEMS S. B. FIVE SIX TWO
ADDRESSES. AND THAT SIMPLY
PROVIDING INSURANCE TO EVERYONE
WILL NOT ADDRESS WILL NOT SOLVE.
LOOK AT THE DEDUCTIBILITY THREE
PERCENT OF AMERICANS SAY THEY
HAVE TROUBLE PAYING THEIR
DEDUCTIBLE THAT'S NEARLY HALF.
AND HERE IS WE GET TO THE CRUX
OF IT WITH THE INSURERS DENIAL
OF CLAIMS IS THEIR BUSINESS
MODEL IN TWO THOUSAND. NINE
ELEVEN WE DID A STUDY AND THEN
BY THE TIME WE COMPLETED THAT
STUDY THEY'VE NOW CLOSED OFF
ACCESS TO DATA ON CLAIMS DENIALS
SO WE HAVE TO LOOK AT THE
INDEPENDENT MEDICAL REVIEW
PROCESS. TO SEE HOW THEY'RE
DOING CLAIMS BACK IN IN TWENTY
ELEVEN WE SAW TWENTY FOUR
PERCENT OF ALL CLAIMS WERE READ
REJECTED.
THEY'RE DOING THAT BECAUSE THEY
NEED THE PROFIT.
NOW WE LOOK IT INDEPENDENT
MEDICAL REVIEW TO GET A SENSE OF
CLAIM DIALS NOW.
LOOK AT THAT US ALMOST SIXTY
PERCENT CARE TONIGHT IS NOT
MEDICALLY NECESSARY BUT
ULTIMATELY. MOST OF THAT THAT
SIXTY PERCENT RATHER WAS IN FACT
OVERTURNED BECAUSE THOSE CARE
DENIALS WERE ILLEGITIMATE
PAYMENT DENIED AGAIN. MOSTLY
OVERTURNED ILLEGITIMATE TO NILES
THESE INSURERS IN CALIFORNIA
HAVE MADE TWENTY SEVEN BILLION
DOLLARS IN PROFITS NET INCOME
WHY ARE CALIFORNIAN WORKERS AND
BUSINESSES PAIN FOR THE PROFITS.
OF THE INSURANCE COMPANY WHEN
THEY ADD NO VALUE AND DENIES
CARE. AND THE PENALTIES THAT
HAVE BEEN ASSESSED OR FRACTION
OF WHAT THEY'VE ACTUALLY.
ENCOURAGES PROFIT LOOK AT THE
PROFIT PAROLEES ANTHEM HUNDRED
SEVENTY.
FIVE DOLLARS PER IN ROWLEY IN
PROFIT IN PROFIT NO THAT IS
DOLLARS NOT SPENT ON CARE. THIS
IS REALLY THE TIP OF THE ICEBERG
THIS DENIAL MODEL.
IN HERE WE HAVE THE BASIC POINT
UNIVERSAL COVERAGE IS NOT
GUARANTEED HEALTHCARE AND IF WE
CONTINUE TO ENABLE CARE DENIALS
AND USE OUR TAX DOLLARS TO
SUBSIDIZE.
FAIL BUSINESS MODEL OF THE
INSURERS WE ARE WASTING MONEY
SIMILARLY IT DOES NOT MAKE SENSE
TO TO SUBSIDIZE THE PURCHASE A
PRIVATE INSURANCE IF THAT IS NOT
GOING TO ENABLE FOLKS TO GET THE
CARE WE NEED.
UNIVERSAL COVERAGE IS NOT A
SOLUTION.
IF WE UNDER FUNDING LIMIT THE
SCOPE OF SAFETY NET PROGRAMS
LIKE MEDICARE ALL THAT FAILS US
POLICY AND ETHICALLY.
SO WE WANT TO TURN TO. SP FIVE
SIX TWO IT'S A MODEL OF SOCIAL
INSURANCE WHERE EVERYBODY'S IN
NOBODY'S COVERED WE REPLACED
THOSE RISING PREMIUMS WITH. WITH
PUBLIC FINANCING WE WERE
ELIMINATE DEDUCTIBLES AND CO
PAYS ONLY OUT OF POCKET COSTS
ARE NO LONGER A BARRIER TO CARE
PROVIDING INSURANCE WILL DO THAT.
PLEASE CHOICE OF PROVIDER
COMPREHENSIVE BENEFITS
NO COST TO ACCESS CARE NO
FINANCIAL BARRIER TO CARE IT'S A
PUBLIC SOLUTION ENROLLMENTS
AUTOMATIC EVERYBODY AND NOBODY
OUT. AND OF COURSE THERE'S A
ROLE FOR SUPPLEMENTAL BENEFIT
PROGRAMS.
IF WE LOOK AT.
EIGHT. A HEALTHY CALIFORNIA.
THE HEALTHY CALIFORNIA ACT
SPECIFICALLY.
WE SEE THEY GUARANTEES
HEALTHCARE TO ALL CALIFORNIANS
ALL RESIDENTS OF CALIFORNIA
REGARDLESS OF IMMIGRATION STATUS.
WE'D THEIR NUMBER REASONS TO DO
THAT BUT THE MOST IMPORTANT
REASON IS WE NEED TO ESTABLISH A
SINGLE STANDARD OF SAFE
THERAPEUTIC CARE.
THAT IS THE ONLY WAY TO
INITIALLY ADDRESS HEALTH CARE
DISPARITIES
BECAUSE IN THE CURRENT SYSTEM
THE KIND OF HEALTH INSURANCE
PLAN YOU HAVE.
THE KIND OF BENEFITS YOU GET
WEATHER TO PLATINUM PLAN OR
EMPLOYER PLAN DETERMINE THE
STANDARD OF CARE YOU RECEIVE IN
CALIFORNIA HOSPITALS. THAT NOT
ONLY IS THE YOUR BENEFITS BASED
ON ABILITYTO PAY BUT THE ACTUAL
STANDARD OF CARE YOU RECEIVE THE
ONLY WAY TO ELIMINATE THE HEALTH
DISPARITIES BASED ON RACE.
GENDER AND INCOME THAT EXIST IS
TO ESTABLISH A SINGLE STANDARD
SAFE THERE APPEAR CARE BY
INCLUDING EVERYONE.
WE ELIMINATE BUREAUCRATIC WASTE
INEFFICIENCY IN MARKETING COSTS.
WE GO TO THE DOCTOR AND PROVIDER
OF OUR CHOICE
THAT'S A FUNDAMENTAL PRINCIPLE
NO OTHER REFORM THIS INSURANCE
BASS CAN DO THAT. BECAUSE THEY
ALWAYS HAVE NETWORKS OF
PROVIDERS THAT'S HEALTHY MONEY
IS THE CONTRACT WITH PROVIDERS
AT A LOWER RATE IN LIMIT PEOPLE
ABILITY TO GO TO ALTERNATIVES
AND WHEN YOU DO GO AT A NETWORK
IT'S FORTY PERCENT MORE
EXPENSIVE. SO WE ELIMINATE ALL
THAT AND IN STILL COMPLETE
PROVIDER CHOICE WE WANT DOCTORS
AND NURSES AND CLINICIANS IN
CHARGE WERE HEALTH CARE NOT
INSURANCE COMPANY BUREAUCRATS.
S. B. FIVE SIX TWO DOES THAT.
WE ESTABLISHED PROGRESSIVE
PAYROLL IN INCOME PREMIUMS
CALLING TAXES CALL THEM FEES
DOCTOR PULL THEM WILL DISCUSS
THAT AND WE SET UP AN
INDEPENDENT HEALTH. AUTHORITY
THAT IS THE CALIFORNIA HEALTHY
CALIFORNIA TRUST FUND AND THAT
TRUST FUND IS WHAT PAYS
PROVIDERS. AND WERE ABLE TO POOL
ALL THE MONIES WE CAN GET INTO
THIS QUESTION OF OF FEDERAL
WAIVERS AND SO FORTH. AND THEN
WERE ABLE TO PAY PROVIDERS BASED
UPON MEDICARE RATES
THAT IS A SUBSTANTIAL SAVINGS
AND A SEAMLESS INTEGRATION WITH
MEDICARE. AND THAT INDEPENDENT
PUBLIC HEALTH AUTHORITY THEN
PAYS THOSE DOCTORS CLINICIANS
WHO ARE IN CHARGE OF HEALTH CARE
SERVICES BECAUSE THERE ARE
SPECIFIC PROVISIONS IN THE BILL.
THAT PREVENT.
PROFESSIONAL CLINICAL JUDGMENT
FROM BEING OVERRIDDEN BY
TECHNOLOGY OR STANDARDIZED
PROTOCOLS.
SO IMAGINE I HEALTHCARE SYSTEM
WHERE DOCTORS AND NURSES AND
CLINICIANS ARE IN CHARGE. IT
SAVES BUSINESSES AND INDIVIDUALS
BILLIONS OF DOLLARS TO PROVIDE
COMPREHENSIVE BENEFITS
TO EVERYONE REGARDLESS OF
ABILITY TO PAY THAT'S GUARANTEED
HEALTHCARE IT'S NOT UNIVERSAL
COVERAGE. FOR LABOR THAT MEANS
THAT WORKERS CAN CHANGE JOBS
WITHOUT LOSING INSURANCE IT
MEANS THAT.
WE CAN HAVE COMPREHENSIVE
BENEFITS WITHOUT HAVING A TWO
THOUSAND DOLLAR DEDUCTIBLE OR
FOURTEEN HUNDRED DOLLAR
DEDUCTIBLE THAT'S THE AVERAGE
DEDUCTIBLE. IN LARGE EMPLOYER
PLANS.
THIRTY NINE PERCENT OF
CALIFORNIANS DO NOT HAVE A
THOUSAND DOLLARS IN THE BANK FOR
A MEDICAL EMERGENCY AND YET WERE
EXPECTING THEM TO PAY A FOURTEEN
HUNDRED DOLLAR DEDUCTIBLE
THERE'S NO WHETHER PROPOSAL ON
THE TABLE. ELIMINATES
DEDUCTIBLES AND CO PAYS.
YOU HAVE MONEY SAVED FROM LOWER
HEALTHCARE COSTS TO GO TO WAGES
WE CAN INCORPORATE RETIREE
HEALTH BENEFITS INTO THIS
PROGRAM THAT'S VOLUNTARY. A
PROCESS UNDER S. B. FIVE SIX TWO
BUT WE WOULD BE ABLE TO
ELIMINATE THE STATE'S. I'M
FUNDED RETIREE HEALTH LIABILITY
THAT EXCEEDS EIGHTY BILLION
DOLLARS WE CAN TAKE THAT OVER
WITH FIVE SIX TWO.
THE CURRENT SYSTEM FOR BUSINESS
IS UNSUSTAINABLE THERE IN THE
HEALTHCARE BUSINESS WHEN THE
HEALTHCARE INSURANCE INDUSTRY
PROVIDES NO BENEFIT TO THEIR
BOTTOM LINE. SO THEY WOULD. VERY
MUCH DESIRE TO GET OUT OF THAT
BUSINESS.
WE ESTIMATE AS A DOCTOR POLL OF
ALL TALK ABOUT THIS A THIRD TO A
HALF.
A REDUCTION IN COST TO EMPLOYERS.
THAT THE EMPLOYER'S PREMIUM
PAYMENT COLLEGE ATTACKS COLOR TO
FEED WILL FOR HEALTHY CALIFORNIA
IS RELATIVE TO THE SCALE THE
ENTERPRISE NO LONGER DO SMALL
BUSINESSES GET* TO SPEND
TWENTY THOUSAND DOLLARS A YEAR
ON INSURANCE PREMIUMS.
REGARDLESS OF THEIR ABILITY TO
AFFORD IT WITHIN THEIR BUSINESS
MODEL NOW WE'RE GOING TO BE ABLE
TO HAVE THEM PAY FOR HEALTH
BENEFITS ACCORDING TO THE SCALE
OF THEIR ENTERPRISE SO IT'S
RELATIVE. TO THE REVENUE OR TO
THEIR PAYROLL.
IT'S MUCH MORE FAIR AND
EQUITABLE IN COURSE REAL
HEALTHCARE COST CONTROL MEANS
VALUE FOR BUSINESSES SO THEY CAN
INNOVATE AND GROW THAT'S WATER
HEALTHCARE SYSTEM CURRENTLY
PREVENTS IS THAT BASICALLY. THAT
REALLY STRENGTH OF THE
CALIFORNIA ECONOMY IS UNDERMINED
BY HOW WE PAY FOR HEALTH CARE.
WE TALK ABOUT GUARANTEED
HEALTHCARE IT'S IMPORTANT THAT
WE UNDERSTAND. WHAT PROVISIONS
OF THE BILL EXIST EVERY RESIDENT
THE STATE SHOULD BE ELIGIBLE
ENTITLED TO ENROLL? SETS A
SINGLE STANDARD OF SAFE THERAPY
TO CARE FOR ALL RESIDENTS THAT'S
THE PRIMARY PROGRAM STANDARD IN
THE LAW.
THE PROHIBITION ON OVERRIDING
CLINICIANS
PROFESSIONAL JUDGMENT IS
ENSHRINED IN LAW. IF WEAKER
COMMITTED TO MAKING HEALTH CARE
HUMAN RIGHT THAT WE CAN'T LET
THAT BE CONDITIONED BY INSURANCE
COMPANY DENIALS BY ABILITY TO
PAY. OR BY LIMITATIONS ON WHAT
PROVIDERS CONSIDER MEDICALLY
NECESSARY TREATMENT THAT'S THE
ONLY WAY TO ESTABLISH HEALTH
GUARANTEE IT FOR ALL. AND NOT
ESTABLISH THOSE BARRIERS.
SO WE ELIMINATE THOSE PREMIUMS.
COPAYS AND DEDUCTIBLES.
WE ALSO HAVE A PROVISION THAT
DOCTOR POLL TALK ABOUT OF
ALTERNATIVE.
FUNDING MECHANISMS.
WE TALKED ABOUT GOING TO THE
PROVIDER. OF YOUR CHOICE WE'RE
TALKING ABOUT.
THIS BEING.
.
ALSO CARE DELIVERED IN THE MOST
CLINICALLY APPROPRIATE SETTING
THAT IS NOT THE BASIS IN THE
CURRENT SYSTEM THE CURRENT
SYSTEM IS WILL PROVIDE CARE IN
THE LEAST EXPENSIVE CLINICAL
SETTING. BUT DOCTORS AND NURSES
KNOW THAT THERE'S A DIFFERENCE
BETWEEN WHAT MIGHT SAVE THE
HOSPITAL CORPORATION MONEY AND
WHAT'S IN THE BEST INTEREST OF
THE PATIENT.
SO WILL REQUIRE AS A MATTER OF
DUTY FOR PHYSICIANS AND OTHERS
PATIENT ADVOCACY SO ANY OF THE
FINANCIAL INTEREST THEY MAY HAVE
IN A SAY IN OUTPATIENT SURGERY
CENTER. CANNOT OVERRIDE THEIR
DUTY TO.
ADVOCATE ON BEHALF OF THEIR
PATIENTS.
AS THEY SAY IT'S THE INTENT OF
THE LEGISLATURE THAT WE CANNOT
OVERRIDE THE EFFECTIVE JUDGMENT
OF CLINICIANS.
THE LIST OF THE COMPREHENSIVE
BENEFITS THAT INCLUDES
REPRODUCTIVE HEALTH SERVICES
YOU'LL NOTICE IT INCLUDES. SOME
LONG TERM CARE SERVICES THAT
WILL NO LONGER BE MEANS TESTED
UNDER S. B. FIVE SIX TWO.
THAT IT'S DENTAL AND VISION THIS
IS MORE COMPREHENSIVE THAN ANY
OF THE PLANS OUT THERE NOW AND
AT LOWER COST AS DOCTOR PULL
THEM WILL SHOW.
THIS IS AN INDEPENDENT HEALTH
CARE A SORTIE AS I SAID THE
TRUST FUND IS CREATED AND
ESTABLISHED BY THE BOARD AND IT
WILL BE.
MANDATED TO HAVE A A PRUDENT
RESERVE YOU ASKED US TO ADDRESS
GOVERNMENT'S THIS IS THE
GOVERNANCE STRUCTURE FOR THE
BOARD NINE MEMBERS FOR FROM THE
GOVERNOR TO FROM THE SENATE. AND
ASSEMBLY WITH THE SECRETARY OF
HEALTH AND HUMAN SERVICES
SERVING AS A.
X. OFFICIO AND HAVE TO HAVE
DEMONSTRATED EXPERTISE IN HEALTH
CARE.
ESSENTIALLY WHAT WE'RE DOING
WITH THIS PROCESS IS FOR
CREATING A SINGLE PIPE WE TAKE
ALL THE REVENUE FROM FEDERAL.
EXISTING FEDERAL AND STATE
SOURCES
PUT IT THROUGH A SINGLE PIPE OR
CHANNEL AND THEN WERE ABLE TO.
PAY PROVIDERS BASED ON ON THAT
POOLED RESOURCE.
WE ELIMINATE CARE DONE I'LL SEND
AND RESTRICTIONS THERE'S A BEEN
A QUESTION HOW DO YOU ENSURE
THAT SERVICE DELIVERY WILL OCCUR.
OVERDOING IS FOR STOPPING THOSE
DENIALS EMERIL ELIMINATING
GATEKEEPING A NARROW NETWORKS
AND THE FINANCIAL BARRIERS TO
CARE. BUT IT'S A MIXED PAYMENT
SYSTEM SO SOME PROVIDERS BE PAID
ON FEE FOR SERVICE SOME WILL BE
PAID ON A PER CAPITA BASIS SOME
WILL BE PAID ANA OPERATING
BUDGET BASIS.
AND WE LEAVING THAT UP TO THE
BOARD FOR FLEXIBILITY DETERMINE
THE MOST EFFICIENT WAY TO DO
THAT.
BUT WHEN DOING SO WE'RE ABLE TO
BECAUSE EVERYONE'S IN ONE SYSTEM
HAVE DATA COLLECTED BASED UPON
OUTCOMES AND PROCEDURES AND
PRACTICES.
AND USE THAT DATA SO WE DON'T
HAVE TO DENY PEOPLE CARE UP
FRONT WE CAN REVIEW. PRACTICES
IDENTIFY OUT LIARS IDENTIFY
FRAUD AND AFTER THE FACT AND
CORRECTED GOING FORWARD WE THINK
THAT'S A MORE EFFICIENT WAY.
HAVING SAVE MONEY UP FRONT BY
PUBLIC FINANCING AND EVERYBODY
IN ONE POOL WITHIN ARE ABLE TO
REVIEW QUALITY CARE THROUGH THE
SYSTEMATIC DATA COLLECTION THAT
WE HAVE ESTABLISHED IN THE BILL.
AND ENSURE THAT THERE IS NO
BARRIER TO ACCESS.
WE DO SAID MEDICARE RATES AS
PRESUMPTIVELY REASONABLE AND WE
NEGOTIATE FROM THERE SO FOR ALL
SERVICES THAT MEDICARE COVERS
THOSE RATES WILL BE THE SAME.
AS.
IN CALIFORNIA AS IN MEDICARE.
BAND THAT THEY AS I MENTIONED
CAN BE ON A DIFFERENT.
PAYMENT METHODOLOGY BASIS WE
HAVE TO ENSURE ADEQUATE SUPPLY
OF PHYSICIANS REMEMBER WE HAVE A
PHYSICIAN'S SHORTAGE REGARDLESS
OF WHAT SYSTEM WE GO TO.
THIS SYSTEM IMPROVES THE
PRACTICE ENVIRONMENT STABILIZES
REIMBURSEMENT ENDS ALL THE
HASSLES THAT. DOCTORS EXPERIENCE
AND GUARANTEES REASONABLE PAY IN
AN EFFICIENT AND TIMELY MANNER
SO IT'S A. MUCH IMPROVED SYSTEM
THE PATIENT ADVOCACY DUTY I
MENTIONED WE PRESERVE A ROLE
FIRST HAVE PARTLY TRUST. AS PART
OF OUR APPROACH TO CARE
COORDINATION WHICH THE COMMITTEE
ASKED WE HAVE AN EXTENSIVE.
ABILITY TO NAVIGATE THROUGH THE
SYSTEM THROUGH EXISTING
RELATIONSHIPS BETWEEN PATIENTS
AND PROVIDERS.
SURFER IN A COUNTY SYSTEM NOW
THAT COUNTY SYSTEM CAN BE A CARE
COORDINATOR UNDER HEALTHY
CALIFORNIA THEY CAN HELP YOU
NAVIGATE THE SYSTEM THEY CAN
TRACK YOUR MEDICAL RECORDS. SO
FACILITATE THE EFFICIENT
ADMINISTRATION OF HEALTHY
CALIFORNIA. AND THE TAP PARTLY
TRUSTS ARE ONE OF THOSE ENTITIES
THAT CAN DO THAT.
WE CONSOLIDATE ALL STATE DRUG
PURCHASING WE WILL APPLY FOR
WAIVERS WE HAVE A PROCEDURE BOTH
TO GET THOSE WAIVERS AND IN THE
EVENTUALITY WE DON'T.
TO MAKE SURE THAT EVERY DOLLAR
THAT CALIFORNIA'S ENTITLED TO
FROM THE FEDERAL GOVERNMENT WE
RECEIVE IT'S.
ASSEMBLY QUESTION OF HOW WE
CHANNEL THAT.
WE DO HAVE A TRUST JUST
TRANSITION FOR DISPLACED WORKERS
AS WELL WHO MAY BE.
LOOSE WORKER TRANSITION TO
ANOTHER JOB.
I'M GONNA LEAVE IT THERE ON TIME
WHAT I WANNA.
LEAVE IT WITH IS WE HAVE AN
OPPORTUNITY TO PROVIDE REAL
HEALTH SECURITY AND GUARANTEED
HEALTHCARE.
MOST IMPORTANTLY PEACE OF MIND
FOR CALIFORNIANS THAT'S WHAT S.
B. FIVE SIX TWO PROMISES.
PEACE OF MIND THANK YOU.
CORRECT.
REGISTERED.
OKAY.
I'M OF ROBERT POLAND AND I'M A.
.
DISTINGUISHED PROFESSOR OF
ECONOMICS AND CO DIRECTOR OF THE
POLITICAL ECONOMY RESEARCH
INSTITUTE AT THE UNIVERSITY OF
MASSACHUSETTS AMHERST NOT
UNIVERSITY OF AMHERST.
I WE'RE VERY SENSITIVE ON SUCH
THINGS NAM.
I AM ALSO.
FORMER PROFESSOR OF ECONOMICS
AT UNIVERSITY OF CALIFORNIA
RIVERSIDE.
WHERE I LIVED IN RIVERSIDE
RAISE MY TWO CHILDREN WITH MY
WIFE AND RIVERSIDE AND HAVE?
VERY STRONG CONNECTIONS AND
FEELINGS CONTINUE TO.
WITH RIVERSIDE WHAT I'M GONNA
DO IS SUMMARIZE.
OUT RIGHT NOW SOME OF THE MAIN
FINDINGS OF THE STUDY. I CO
AUTHORED.
WITH OTHER.
UMASS FACULTY MEMBERS.
THAT WAS PUT OUT IN MAY TWO
THOUSAND SEVENTEEN AND IN THE
INTERESTS OF DISCIPLINE IN TIME
I'M BASICALLY GONNA READ.
THIS SUMMARY. THE FUNDAMENTAL
PURPOSE OF HEALTHY CALIFORNIA IS
SIMPLE.
TO CREATE A HEALTHCARE SYSTEM
FOR THE STATE THAT ENABLES ALL
CALIFORNIA RESIDENTS TO ENJOY
DECENT HEALTHCARE AS A RIGHT.
THIS IS CERTAINLY A LAUDABLE
GOAL BUT WE STILL NEED TO ASK
SOME HARD QUESTIONS
IS IT REALISTIC TO BE ABLE TO
PROVIDE DECENT HEALTHCARE TO
EVERYONE IN CALIFORNIA AND MORE
SPECIFICALLY.
IS THE HEALTHY CALIFORNIA
PROPOSAL A WORKABLE VEHICLE FOR
ACHIEVING THIS GOAL.
MY SHORT ANSWERS ARE YES AND YES.
PROVIDING UNIVERSAL DECENT
HEALTHCARE IS WITHIN REACH AND
CALIFORNIA AND FOR THAT MATTER
IN THE U. S. OVERALL.
AND YES HEALTHY CALIFORNIA DOES
PROVIDE A VIABLE FRAMEWORK FOR
ACHIEVING THIS GOAL. LOTS OF
DETAILS WILL NEED TO BE FILLED
IN TO MAKE THE PROPOSAL FULLY
WORKABLE BUT IN MY VIEW THE
BASIC APPROACH IS SOUND.
IN THESE REMARKS I'M GOING TO
TOUCH ON FOUR KEY ISSUES.
COSTS OF UNIVERSAL COVERAGE
RELATIVE TO THE EXISTING SYSTEM.
TENCHI OFFER COST SAVINGS UNDER
HEALTHY CALIFORNIA. HOW TO FUND
HEALTHY CALIFORNIA AND WHAT THE
IMPACT WILL BE ON FUNDING
HEALTHY CALIFORNIA ON THE
STATE'S HOUSEHOLDS AND
BUSINESSES RELATIVE TO WHAT
EVERYONE IS PAYING NOW FOR
HEALTHCARE?
NOW BEFORE GOING INTO THESE
ISSUES I WANTED TO START BY
RECOGNIZING.
TWO RECENT REPORTS PROVIDED ON
THE ISSUE BY STAFF MEMBERS AT
BOTH THE SENATE COMMITTEE ON
APPROPRIATIONS TO RELEASE A
REPORT. AND APRIL.
TWO THOUSAND SEVENTEEN AND THE
LEGISLATIVE ANALYST'S OFFICE
WHOSE REPORT JUST CAME OUT TWO
DAYS AGO.
THESE ARE BOTH USEFUL REPORTS IN
MY VIEW.
I SPOKE WITH THE AUTHORS OF THE
FIRST REPORT LED BY MISTER
BRANDON MCCARTHY BEFORE IT WAS
RELEASED.
I AGREE WITH ABOUT SEVENTY
PERCENT OF WHAT'S IN BOTH
REPORTS
THAT'S NOT TOTALLY SURPRISING
THAT I WOULD AGREE IT SO HAPPENS.
THAT ONE OF MY BEST STUDENTS
FROM UC RIVERSIDE MR ROBERT
ENGINEERED ó PARTICIPATED IN
PREPARING AT LEAST ONE OF THEM.
NOW THE MOST SIGNIFICANT
DIFFERENCE I HAVE WITH THESE
REPORTS AS I WILL ADDRESS BELOW.
IS I BELIEVE THERE ARE LARGE
AREAS OF POTENTIAL COST SAVINGS
THAT ARE ATTAINABLE THROUGH
HEALTHY CALIFORNIA RELATIVE TO
OUR CURRENT SYSTEM.
I REACHED THIS CONCLUSION NOT ON
MY OWN BUT THROUGH ASSESSING THE
RELEVANT RESEARCH LITERATURE ON
THESE MATTERS INDEED AND WORKING
WITH THIS RESEARCH LITERATURE.
OVERALL WE SET OUR ESTIMATES OF
COST SAVINGS THROUGH HEALTHY
CALIFORNIA. ON THE CONSERVATIVE
SIDE OF WHAT THE LITERATURE
THINKS IS REASONABLE.
OKAY CURRENT HEALTHCARE SYSTEM
COSTS.
FOR TWO THOUSAND SEVENTEEN
OVERALL HEALTHCARE COSTS IN
CALIFORNIA WERE ABOUT THREE
HUNDRED AND SEVENTY BILLION
DOLLARS.
THIS WAS ABOUT FOURTEEN PERCENT
OF THE STATE'S TWO THOUSAND
SEVENTEEN GTPASE.
HEALTHCARE COSTS IN CALIFORNIA
ARE LOWER AS A SHARE OF GDP THAN
IN THE U. S. OVER ALL IN WHICH
HE SHARES ABOUT EIGHTEEN PERCENT
OF GDP.
AT THE SAME TIME HEALTHCARE
COSTS AND ALL OTHER ADVANCED
INDUSTRIALIZED COUNTRIES RANGE
BETWEEN NINE AND ELEVEN PERCENT
OF GDP THIS INCLUDES GERMANY
FRANCE THE UK JAPAN AND CANADA.
OVERALL HEALTHCARE OUTCOMES IN
THESE OTHER COUNTRIES ARE ALL
SUPERIOR TO THOSE IN CALIFORNIA
AND THE U. S. GENERALLY.
AT PRESENT ABOUT THIRTY THREE
MILLION PEOPLE IN CALIFORNIA
NINETY TWO POINT FIVE PERCENT
ARE COVERED BY SOME FORM OF
HEALTH INSURANCE.
WHY TWO WHILE TWO POINT SEVEN
MILLION? A SEVEN POINT FIVE
PERCENT ARE UNINSURED ONE OF THE
GOALS OF HEALTHY CALIFORNIA IS
THEREFORE TO PROVIDE DECENT
COVERAGE TO THE TWO POINT SEVEN
MILLION WHO ARE PRESENTLY
UNINSURED THESE FIGURES OF
COURSE REFLECT. ANYTHING BEFORE
THE REPEAL OF THE HEALTH CARE
MANDATE AT THE FEDERAL LEVEL.
BUT IN ADDITION TO THE UNINSURED
THEIR ROUGHLY ANOTHER THIRTY
THREE THIRTY FOUR PERCENT WHO
ARE WHAT WE COULD CALL UNINSURED.
THERE'S NO SINGLE PRECISE
DEFINITION OF ON DURING OF
UNDERINSURED.
IN OUR STUDY WE TOOK AN
EXPANSIVE DEFINITION WORKING
FROM A SURVEY CONDUCTED BY THE
COMMONWEALTH FUND AN OUTSTANDING
RESEARCH ORGANIZATION.
THIS SURVEY FOUND THAT FOR THE
U. S. OVER ALL ABOUT THIRTY SIX
PERCENT OF THE POPULATION WENT
WITHOUT NEEDED CARE BECAUSE OF
COST CONSIDERATIONS.
THE FIGURE IS MODESTLY LOWER FOR
CALIFORNIA THESE PEOPLE ONE DID
NOT FILL A PRESCRIPTION TO SKIP
TO RECOMMENDED TESTER TREATMENT
THREE DID NOT VISIT A DOCTOR
EVEN WHILE HAVING A HEALTH
PROBLEM OR FOR DID NOT GET
NEEDED SPECIALIZED CARE.
THIS IS OUR WORKING DEFINITION
OF THE UNDER INSURED POPULATION
THERE OTHER DEFINITIONS AND WE
CAN GO THROUGH THEM AS YOU WISH
LATER.
OKAY WHAT OF THE COST OF
PROVIDING DECENT CARE FOR
EVERYONE WITH IN THE EXISTING
SYSTEM.
OKAY WE ESTIMATE THAT TO PROVIDE
DECENT CARE FOR EVERYONE UNDER
THE EXISTING SYSTEM AND NOW I'M
GOING TO INCLUDE THE SEVEN POINT
FIVE PERCENT WHO ARE UNINSURED
AND THE THIRTY FIVE PERCENT WHO
ARE UNDERINSURED.
UNDER THE EXISTING SYSTEM WHERE
WE'RE NOW SPENDING THREE HUNDRED
AND SEVENTY BILLION WE ESTIMATE
THAT WE'D REYES COST BY ABOUT
TEN PERCENT TO PROVIDE DECENT.
CARE FOR EVERYONE THAT IS THE
OVERALL SYSTEM COSTS WOULD RISE.
TRUE ABOUT FOUR HUNDRED BILLION
FROM THE EXISTING THREE HUNDRED
AND SEVENTY BILLION JUST TO
EMPHASIZE SINCE AGAIN.
WE ARE NOT GOING FROM ZERO TO
FOUR HUNDRED BILLION WE ARE
GOING FROM THREE SEVENTY TO FOUR
HUNDRED UNDER THE EXISTING
SYSTEM. NOTE THAT HERE THAT OUR
ESTIMATE IS VIRTUALLY IDENTICAL
TO THAT OF THE APPROPRIATIONS
COMMITTEE REPORT AND THE STATE
LEGISLATIVE ANALYST'S OFFICE.
NOW
ATTENTION FOR COST SAVINGS.
WORKING AGAIN FROM THE EXISTING
LITERATURE AND MAKING
CONSERVATIVE ASSUMPTIONS WITHIN
THAT LITERATURE. WE HAVE
ESTIMATED THAT HEALTHY
CALIFORNIA COULD GENERATE A
TOTAL OF ABOUT EIGHTEEN PERCENT
IN SAVINGS RELATIVE TO THE
EXISTING SYSTEM HERE IS HOW WE
GET THERE.
WE ESTIMATE SIX POINT SIX
PERCENT SAVINGS ON
ADMINISTRATION SYSTEM WIDE.
THREE POINT FOUR PERCENT SAVINGS
ON LOWERING PHARMACEUTICAL COSTS
SYSTEM WIDE.
THREE PERCENT SAVINGS ON
ESTABLISHING MEDICARE RATES FOR
HEALTH CARE PROVIDERS ACROSS THE
BOARD AS MICHAEL JUST REFERRED
TO. AND FIVE PERCENT SAVINGS
THROUGH REDUCING UNNECESSARY
TREATMENTS.
SPENDING PREVENTIVE CARE AND
CUTTING BACK ON FRAUD AND ABUSE.
OKAY THAT'S HOW YOU GET EIGHTEEN
PERCENT SAVINGS
THUS.
THE WHEN WE COVER EVERYBODY
WITHIN THE SYSTEM. UNDER THE
EXISTING SYSTEM BEFORE SAVINGS
WE GO FROM THREE SEVENTY BILLION
TO FOUR HUNDRED BILLION.
WHEN WE INCORPORATE THE SAVINGS
LITERATE SHIVA BOWL WITH THEM
CONSERVATIVELY ACHIEVABLE WITHIN
HEALTHY CALIFORNIA TOTAL SYSTEM
COSTS WILL GO DOWN TO THREE
HUNDRED AND THIRTY BILLION OR
THEREABOUTS.
TOTAL SYSTEM COSTS WILL GO DOWN
FROM THE EXISTING THREE SEVENTY
BILLION TO THREE HUNDRED AND
THIRTY BILLION AND UNDER THE
THREE HUNDRED AND THIRTY BILLION
WITH HEALTHY CALIFORNIA
EVERYBODY GETS DECENT HEALTHCARE.
NOW HOW DO WE FINANCE THREE
HUNDRED THIRTY BILLION.
EXISTING PUBLIC FUNDS RIGHT NOW
FEDERAL STATE AND MUNICIPAL
FINANCING COVERS ABOUT SEVENTY
PERCENT OF ALL HEALTHCARE
EXPENDITURES IN CALIFORNIA.
EXISTING FEDERAL LAW REQUIRES
THAT THE FEDERAL GOVERNMENT
CONTINUE PROVIDING THIS CURRENT
LEVEL OF SPENDING. IF A STATE
ORGANIZES ITS OWN HEALTH CARE
SYSTEM DIFFERENTLY THAN THE
PREVAILING SYSTEM AS LONG AS THE
STATE RUN SYSTEM PROVIDES ITS
RESIDENTS WITH AT LEAST THE SAME
QUALITY OF CARE AS THE
PREVAILING SYSTEM.
THIS IS THE FEDERAL LAW PASSED
ON TO THE AFFORDABLE CARE ACT
SECTION ONE THREE THREE TWO
WHICH PROVIDES WAIVERS IN STATES
THAT DEVELOPED INNOVATIVE
HEALTHCARE SYSTEM.
UNDER THIS LAW EXISTING PUBLIC
FUNDING WILL COVER ABOUT TWO
HUNDRED AND TWENTY FIVE BILLION
OF THE TOTAL THREE HUNDRED AND
THIRTY BILLION.
WE NEED AN ADDITIONAL HUNDRED
AND FIVE BILLION.
IN OUR STUDY WE OFFERED TWO SETS
OF PROPOSALS FOR GETTING THE
ADDITIONAL HUNDRED AND FIVE
BILLION.
IN THE FIRST THE STATE
ESTABLISHES A GROSS RECEIPTS FEE
OR TAX.
TWO POINT THREE PERCENT ON
BUSINESSES WITH AN EXEMPTION FOR
THE FIRST TWO MILLION DOLLARS IN
REVENUES FOR ALL BUSINESSES.
THREE THIS EXEMPTION ABOUT
EIGHTY PERCENT OF BUSINESSES IN
CALIFORNIA THE SMALLER FIRMS
WOULD PAY NOTHING IN GROSS
RECEIPTS FEE. AND MEDIUM SIZED
BUSINESSES WOULD PAY AN ATTACK
AFFECTIVE RATE OF LESS THAN ONE
PERCENT THAT WOULD STILL REYES
NINETY TWO BILLION DOLLARS.
THE STATE COULD ALSO INSTITUTE A
SALES FEE OR TAX INCREASE OF TWO
POINT THREE PERCENT.
THIS WOULD EXEMPT HOUSING
UTILITIES FOOD PURCHASE FOR HOME
AND A RANGE OF SERVICES.
AND WE INCLUDE A TAX CREDIT FOR
LOW INCOME FAMILIES AT TWO
PERCENT THAT WOULD RAISE THE
ADDITIONAL FOURTEEN BILLION.
OTHER OPTIONS ARE OF COURSE
POSSIBLE.
AND WE'VE EXPLORED ONE OF THESE
IN DETAIL IN OUR STUDY THAT IS
TO SUBSTITUTE A PAYROLL FEE OR
TAX FOR THE GROSS RECEIPTS
MEASURE.
THE PAYROLL FEE TO GENERATE THE
SAME NINETY TWO BILLION DOLLARS.
THE TAX RATE WOULD HAVE TO BE
SIX POINT SIX PERCENT ON ALL
BUSINESSES
NOW WHAT IF WE WANTED EXEMPTS
SMALL BUSINESSES AGAIN.
CAN BE DONE.
YOU EXEMPT THE FIRST TWO HUNDRED
THOUSAND DOLLARS IN PAYROLL FOR
ALL BUSINESSES AGAIN ABOUT
EIGHTY PERCENT OF ALL BUSINESSES
IN CALIFORNIA WOULD PAY NO
PAYROLL TAX OR FEE. TO MAKE UP
FOR THE LOST REVENUE THE RATE
WOULD HAVE TO RISE TO A MAXIMUM
OF SEVEN POINT EIGHT PERCENT FOR
THE TWENTY PERCENT OF LARGER
BUSINESSES.
WHAT IF WE LOWERED THE EXEMPTION
THRESHOLD TWO HUNDRED THOUSAND
AS OPPOSED TO TWO HUNDRED
THOUSAND?
THE AVERAGE SMALL BUSINESS WOULD
NOW PAY A FEE OR TAX AT TWO
PERCENT
WHILE LARGE BUSINESSES WOULD PAY
UP TO SEVEN POINT TWO PERCENT.
OUR APPROACH IN PROPOSING THESE
VARIOUS TAX MEASURES IS BASED ON
THE STANDARD GOAL WITH TAXATION
POLICY. TO HAVE RATES SET LOW
ENOUGH AS TO MINIMIZE
DISTORTIONS AND HERE I WANT TO
HIGHLIGHT AN AREA WHERE I AGREE
FULLY. WITH THE A LEGISLATIVE
ANALYST'S OFFICE BECAUSE THEY
HIGHLIGHT THIS EXACT POINT ON
PAGE SEVENTEEN.
ECONOMISTS TEND TO PREFER TAXES
WITH BROAD BASES AND LOW RATES
BECAUSE THEY MINIMIZE ECONOMIC
DISTORTIONS THAT IS WHEN
INDIVIDUALS AND FIRMS MAKE LESS
EFFICIENT DECISIONS AND THEY
WOULD HAVE MADE WITHOUT THE TAX
SO. WE HAVE DELIBERATELY
DESIGNED THIS SUCH THAT THE TAX
RATES ARE CAPPED RELATIVELY LOW
WE GENERATE THE NECESSARY
REVENUE AT LOW RATES THAT'S
CRITICAL.
NOW WHAT ABOUT THE IMPACT ON
HOUSEHOLDS AND BUSINESSES.
RELATIVE TO THEIR CURRENT
HEALTHCARE COSTS MOST
CALIFORNIAN FAMILIES WILL END UP
SPENDING LESS EVEN WITH THE NEW
TAXES AND SOMEONE JOINT LARGE
GAINS.
WORKING WITH THE GROSS RECEIPTS
SALES TAX SCENARIO MOST
HEALTHCARE SPENDING FOR MIDDLE
INCOME FAMILIES WOULD FALL BY
BETWEEN TWO POINT SIX AND NINE
PERCENT OF INCOME.
MOST BUSINESSES WOULD ALSO SEE A
DROP IN SPENDING.
SMALL FIRMS THAT HAVE BEEN
PROVIDING HEALTH INSURANCE FOR
THEIR WORKERS WILL SEAT COSTS
FALL AS A WINDFALL BY TWENTY TWO
PERCENT AS A SHARE OF PAYROLL.
FOR MEDIUM SIZE FIRMS COSTS WILL
FALL BY AN AVERAGE OF BETWEEN
SIX POINT EIGHT AND THIRTEEN
POINT FOUR PERCENT AS A SHARE OF
PAYROLL. EVEN MOST LARGE FIRMS
WILL SEE COSTS FALL BY AN
AVERAGE OF BETWEEN ZERO POINT
SIX AND FIVE PERCENT.
THIS PROPOSAL IS THE US
ESPECIALLY FAVORABLE ESPECIALLY
FAVORABLE FOR MEDIUM SIZE
BUSINESSES AND MIDDLE CLASS
HOUSEHOLDS RELATIVE TO THE
EXISTING SYSTEM THEY WILL
BENEFIT IN FINANCIAL TERMS.
OUR RESULTS ARE FULLY CONSISTENT
WITH A MORE DETAILED ANALYSIS
THAT I WANTED SITE BY PROFESSOR
A GYMKHANA AT UC SAN FRANCISCO
AND COLLEAGUES. WHO HAVE
DEVELOPED THEIR WHAT THEY CALL
HEALTHY? HEALTH CARE COST
CALCULATOR WE CAN GO THROUGH
SOME DETAILS OF THAT BUT AT WHAT
THEY DO RISK IS. GET MORE
PRECISE BRAKE PADS OF DIFFERENT
FAMILY TYPES FACING DIFFERENT
KINDS OF HEALTH CARE COSTS.
OUR OVER ARCHING CONCLUSION IS
THAT HEALTHY CALIFORNIA IS
CAPABLE OF GENERATING
SUBSTANTIAL SAVINGS FOR FAMILIES
AND MOST INCOME LEVELS AND
BUSINESSES OF MOST SIZES. THIS
WILL BE TRUE THROUGH A RANGE OF
ALTERNATIVE FINANCING APPROACHES
INCLUDING USING A PAYROLL ARE
GROSS RECEIPTS FEE OR TAX AS THE
PRIMARY SOURCE OF FUNDING.
THESE SAVINGS ARE IN ADDITION TO
THE BENEFITS THE FUNDAMENTAL
BENEFITS OF THE MEASURE.
WHICH IS THAT THE RESIDENTS OF
CALIFORNIA WILL HAVE ACCESSALL
RESIDENTS WILL HAVE ACCESS TO
DECENT HEALTHCARE THANK YOU
.
NEXT WILL WE WILL HAVE DALE
FOUNTAIN CHAIRPERSON AND CEO OF
ENACT UNIVERSAL HEALTH CARE FOR
CALIFORNIA.
AND IF I MAY JUST EXTEND MY
APOLOGIES TO DOCTOR POLLAND FOR
GETTING THE SCHOOL.
GOOD MORNING ASSEMBLYMEMBERS.
GLENDALE FOUNTAIN CHAIRPERSON
CBO CONNECT UNIVERSAL HEALTH
CARE FOR CALIFORNIA. THINKS OR
HAVING ME HERE TO TALK ABOUT THE
CALIFORNIA HEALTH CARE ROADBLOCK
MOVE LACKED. Y. A CONSTITUTIONAL
AMENDMENT IS NEEDED TO ALLOW
HEALTHCARE FUNDING.
THE AUDIENCE FOR THIS
PRESENTATION ISN'T JUST ENTIRE
LEGISLATURE BUT THE GENERAL
PUBLIC.
THE LEGISLATURE'S INTIMATELY
FAMILIAR WITH PROP FOR AND PROP
NINETY EIGHT IN ALL THE BUDGET
CALCULATIONS EACH YEAR.
WHILE THE GENERAL PUBLIC HAS ALL
BUT COMPLETELY FORGOTTEN.
MY PRESENTATION WILL GO ON OF
WILL BUILD ON THE TESTIMONY
GIVEN TO THE SAME COMMITTEE ON
MONDAY FEBRUARY FIFTH. SO PLEASE
GO AHEAD AND POSITS SPEED YOU IF
YOU'RE WATCHING HOME WATCH THAT
WHEN WE COME BACK.
SO A LITTLE ABOUT WHAT WE'RE
DOING.
ENACT UNIVERSAL HEALTH CARE FOR
CALIFORNIA SPONSORING ABOUT
PROPOSITION FOR TWENTY EIGHTEEN.
THE CALIFORNIA HEALTH CARE
ROADBLOCK MOVE LACKED OR SHARE A
SELECTIVE COLLEGE.
IT WILL NOT BY ITSELF IMPLEMENT
UNIVERSAL HEALTH CARE. BUT IT
WILL ENABLE. ANY FUTURE HEALTH
CARE LEGISLATIONIN THE STATE
WITHOUT HAVING TO GO TO THE
BALLOT EACH TIME.
HERE'S AN EXAMPLE OF HOW OUR
CONSTITUTION WOULD APPLY NOT
ONLY TO UNIVERSAL HEALTHCARE
WHERE INCREMENTAL WHICH
LEGISLATION.
BUT TO ANY COST CONTROLS SUCH AS
GLOBAL BUDGETING OR STATEWIDE
BUYING COOL FOR FORMA.
TOTAL HEALTHCARE SPENDING IN
CALIFORNIA IS FOUR HUNDRED
BILLION DOLLARS.
AND IF THE STATE SIMPLY HELD
THAT AND PAID IT BACK OUT. TWO
HUNDRED BILLION DOLLARS WOULD
AUTOMATICALLY BE SENT TO
EDUCATION VIA PROP NINETY EIGHT.
PROP FOR WOULD REBATE HUNDRED
EIGHTY EIGHT BILLION DOLLARS
FROM THE OTHER HALF BACK TO THE
TAXPAYERS.
HEALTH CARE WOULD BE LEFT WITH
ALMOST NOTHING.
SHARE IT COSTS NOTHING ITSELF IN
SPECIFICALLY WRITTEN THAT WAY.
EVEN THE LEGISLATIVE ANALYST'S
OFFICE FOUND IT WILL HAVE NO
DIRECT FISCAL IMPACT.
IF PASSED THE LEGISLATURE CAN
THEN PASS AN ENTIRE HEALTHCARE
SYSTEM. WORKING DO INCREMENTALLY.
HAVING TO GO TO THE BALLOT WILL
NO LONGER BE AN EXCUSE FOR
INACTION.
SHARE EXEMPTS HEALTH CARE
FUNDING FOR PROP NINETY EIGHT
THE MINIMUM FUNDING GUARANTEE
FOR EDUCATION.
AND PROP FOR STATE SPENDING CAPS
AKB CAN LIMIT.
BUT OTHERWISE LEAVES THESE
RESTRICTIONS INTACT.
ALRIGHT SO LET'S GET INTO A
LITTLE HISTORY.
THE PICTURE ON THE LEFT IS
HOWARD JARVIS AND GOVERNOR JERRY
BROWN.
THE PICTURE ON THE RIGHT IS PAUL
CAN.
IN THE NINETEEN SEVENTIES
CALIFORNIA HOMEOWNERS WE'RE
SEEING THEIR PROPERTY VALUE
SEWER. RIGHT ALONG WITH THEIR
PROPERTY TAXES.
SO WE'RE GETTING TAXED OUT OF
THEIR OWN HOMES
CALIFORNIANS WERE BAKING A
LEGISLATURE FOR RELIEF.
IN NINETEEN SEVENTY SEVEN THERE
WERE A FEW PROPOSALS BOUNCED
AROUND THE LEGISLATURE BUT
NOTHING PASSED.
HOWARD JARVIS AND PAUL GANN CAME
UP WITH THEIR OWN PLAN AND GOT
ON THE BALLOT AS PROPOSITION
THIRTEEN.
IT'S A LEGISLATURE IN NINETEEN
SEVENTY EIGHT HAD SIMPLY PASSED
ANYTHING TO LOWER PROPERTY TAXES.
PROP THIRTEEN WOULD NOT OF GOT
MOMENTUM.
ALL HELL BROKE LOOSE WHEN PEOPLE
FOUND OUT THE PROPERTY TAXES FOR
INCREASING THAT YEAR SOME BY ONE
HUNDRED PERCENT OR MORE.
PROP THIRTEEN PASSED IN A
LANDSLIDE.
I INITIALLY GOVERNOR BROWN WAS
SUPPOSED TO PROP THIRTEEN.
THEN IT PASSED.
AT THAT POINT HE BECAME IN HIS
OWN WORDS A BORN AGAIN TAX
CUTTER.
IN NINETEEN SEVENTY NINE
GOVERNOR BROWN TEAMED UP WITH
JARVIS AND CAN TO PUT A SPENDING
CAP ON THE BALLOT.
WHICH BECAME KNOWN AS
PROPOSITION FOR.
KK THE GAMUT.
THE FALLOUT FROM PROP THIRTEEN
WAS IMMEDIATE.
SCHOOL DISTRICTS LOST FIVE
BILLION DOLLARS IN TAX REVENUE
WHICH A STATE DEPLETED ITS OWN
RESERVE TO BACK FILL.
BUT WITH THE STATE TAKING GUT
PUNCH WITH PROP FOR. TAXES COULD
NOT BE RAISED WITH OTHER METHODS.
IN THE NINETEEN EIGHTIES MANY
SCHOOLS CLOSED CONSOLIDATED AND
CUT PROGRAMS.
INFRASTRUCTURE PROJECTS SUCH IS
FREEWAYS WERE PUT ON HOLD OR
CANCELLED ENTIRELY.
FACT
IF A DISTRICT I GREW UP IN. CITY
OF GLENDALE ASSEMBLY MEMBER FREE
VERSIONS DISTRICT SHE SHOULD
REMEMBER THIS CARD JUNIOR HIGH
CLOSED AND TWO FREEWAY PROJECT.
EYES LEFT UNFINISHED TO THIS
VERY DAY.
IN NINETEEN EIGHTY SEVEN DUE TO
PROP FOR.
AND DESPITE THE ONGOING FUNDING
CRISIS HE ONE BILLION DOLLAR
SURPLUS WAS REBATED TO THE
TAXPAYERS.
HE DIDN'T TAKE LONG FOR THE CTA
PER PROP NINETY EIGHT TO
EDUCATION FUNDING GUARANTEE ONTO
THE BALLOT.
THE POINT BEING HOW THE
LEGISLATURE LISTEN TO THE PEOPLE
WHO ARE CRYING OUT FOR RELIEF.
NONE OF THIS WOULD HAPPEN.
ALRIGHT.
FOR THOSE WHO DON'T KNOW IT THE
GAMMA. HERE'S A SIMPLE DIAGRAM
PLEASE DON'T STARE AT IT TOO
LONG.
ACCORDING TO THE LA ONLY HAVE
ABOUT TWELVE BILLION DOLLARS IN
ROOM AS OF LAST MONTH.
HERE'S ONE OF THE FIGURES FROM
THE PROP NINETY EIGHT HAND OUT
THAT LA O. GIVES TO NEW
LEGISLATORS.
MINIMUM FINDINGS BASED ON A
FORMULA THAT CAN GO NO LONGER NO
LOWER THAN THIRTY NINE PERCENT
OF THE BUDGET.
RIGHT NOW WE'RE AROUND FIFTY
PERCENT CURRENT CASE IN FOURTEEN
FUNDING TOTAL SEVENTY FIVE
BILLION DOLLARS.
AS YOU CAN SEE IT'S NOT UNUSUAL
FOR PROP FOR AN PROP NINETY
EIGHT TO BE OVERRIDDEN BY THE
VOTERS FOR EXEMPTIONS.
WE HAD TO ON THE BALLOT IN
TWENTY SIXTEEN THAT PASSED.
AND IF YOU NOTICE THERE SO PROP
NINETY EIGHT PROPERLY EVAN WAS
THESE.
WAS A TRANSPORTATION FUNDING
WHICH IS ACTUALLY A.
IN DISGUISE.
IT WAS ACTUALLY A MODIFICATION
TO THE CAMERA AND PROP NINETY
EIGHT.
A PROP TENDS NOT A CHILDREN'S
FIRST FIVE. OF PROP ONE A IS THE
LOCAL TAXES GO TO LOCAL.
AUTHORITIES.
PROP FIFTY TWO IS A WHICH WAS
JUST.
IN TWENTY SIXTEEN THAT PASSED BY
SEVENTY PERCENT NET WAS THE
HOSPITAL TAX.
ARE AND THAT WAS ANOTHER
EXEMPTION OF PROP FIFTY SIX.
I IS A I. IS ANOTHER TOBACCO TAX.
ALRIGHT NOW TALKER COUNTER
ARGUMENTS TO THE BALLOT MEASURE
THAT I'VE ENCOUNTERED.
OTHER THAN THE PEOPLE WHO DENY
PROP FOR IMPROPER NINETY EIGHT
EXIST.
HERE THE POPULAR ARGUMENTS.
ARE. WE CAN JUST IGNORE AGAIN IN
PROP NINETY EIGHT AND.
WELL I COULD LOOK AT THE LAWSUIT
BY HOWARD JARVIS TAXPAYERS
FOUNDATION AND THE CTA.
I GOVERNOR BROWN HIMSELF LAST
YEAR OF AYE HE TRIED TO SAY HEY
WE CAN JUST DO SOMETHING WITH NO
WHERE MONEY.
AND KEEP BACK DOWN WHEN HOWARD
JARVIS.
WAS GONNA SUE AND FACT IT'S
KIND OF WEIRD WHEN YOU'RE THE
ONE WHO PUT IT ON THE BALLOT AND
YOUR ARE GOING TO IGNORE IT.
.
SO THE NEXT ONE IS JUST PUT
GANON PROP NINETY EIGHT
EXCLUSIONS INTO A LEGISLATIVE
BILL.
.
IT IS WEIRD TO HEAR PEOPLE NOT
UNDERSTANDING CIVICS.
I IT NEEDS TO EITHER TO BE A
BALLOT PROPOSITIONS ARE WITH
THAT PETITIONS.
SIGNATURES COLLECTED AND THEN
GO ON THE BALLOT. OR A TWO
THIRDS MAJORITY THROUGH THE
LEGISLATURE AND THEN GO ON THE
BALLOT EACH TIME I HAVE TO. GO
TO THE PEOPLE.
ARE THE NEXT RISE A LITTLE BIT
ARE. TOO LITTLE BIT IN THERE
LOOK T MORE WANT KEY IT'S
PREMIUMS ARE LIKE SNICKERS BARS.
OR THE USER FEES
OUR USER FEES MUST BUY TO CANCEL
SERVICE SUCH AS BRIDGE TOWER
VEHICLE LICENSE FEE.
DRIVER'S LICENSE.
I ETCETERA.
YET.
EIGHT AND INSURANCE PREMIUM IS
NOT A USER FEE.
IN FACT.
.
YOU CAN YOU CAN PAY INTO
INSURANCE ALL YOU WANT AND NEVER
GET ANYTHING BACK FROM IT. OF
HOW HOW DOES THAT EVEN WORK I
EVEN RAN THIS BY JUDGE FRIEND OF
MINE HE JUST LAUGHED AT IT HE
SAID YOU.
SHE WOULDN'T BELIEVE THAT
SOMEBODY WOULD ACTUALLY BRING
THAT UP TO HIM.
.
SO TO FURTHER DISTINCTION PART
OF IT IS INTENT OF THE
CONSTITUTION ITSELF.
ARTICLE THIRTEEN GAVE WHICH IS
THE CAMERA IN SECTIONS EIGHT A.
I EXPLICITLY.
EXPLICITLY.
EXEMPTS DISABILITY PREMIUMS.
AND THAT'S ANOTHER HEALTH
INSURANCE
THERE.
OKAY. SO THIS IS A WALL OF TEXT
I I APOLOGIZE. SADDAM.
THIS IS.
.
THIS IS FROM.
.
BAN ADS EVER SERVED.
WHO WROTE AN ARTICLE ON THIS
JUST THIS LAST MONTH?
I HOW THE CANON INTERACTS WITH
CAP AND TRADE.
I IT WAS FEATURED IN SCOPE OF
BLOG.
IT'S A VERY GOOD QUESTION
BECAUSE CAP AND TRADE A IS NOT
SUBJECT TO THE GAMUT.
I AND.
THE ONLY REASON IT'S NOT OR THE
SHORT ANSWER.
THAT ALL THIS LEADS TO IS THAT
CABIN TRADE IS AN AUCTION.
IT'S NOT MANDATORY THAT YOU
PARTICIPATE IN THE AUCTION.
AND IS THEREFORE NOT ATTACKS.
A FURY GOING TO CLAIM SOMETHING
LIKE WELL THEY'RE SELL THE STATE
IS SELLING SOMETHING. THAT IS
ALSO EXCLUDED.
LIKE A STATE ASSET IS ALSO
EXCLUDED IN.
IN CALCULATIONS FOR THE CAMERA
I'VE WOULDN'T CONSIDER INSURANCE
AS.
STATE ACID AND I DOUBT ANYONE
HERE WANTS TO RUN HEALTHCARE
SYSTEM AS AN OPTION.
.
OKAY.
DOCTOR GRAVES.
HE WAS HERE MONDAY THAT'S WHY
ASK PEOPLE TO TUNE INTO THAT.
I HE ALSO WROTE AN ARTICLE IN
THE CALIFORNIA BUDGET AND POLICY
CENTER LAST YEAR IN JULY.
AND THIS IS BASICALLY HIS
CONCLUSION
IN SHORT RATHER THAN TRYING TO
DEVISE A CLEVER AND LIKELY
COUNTERPRODUCTIVE WAY TO AVOID
GOING TO THE BALLOT. SINGLE
PAYER ADVOCATES WOULD BE WELL
ADVISED AS CALIFORNIA VOTERS TO
REMOVE THE KEY CONSTITUTIONAL
OBSTACLES TO THE IMPLEMENTATION.
OF A SINGLE PAYER SYSTEM.
I HOPE HE GOES INTO A LOT MORE
DETAILS.
BEGAN WHEN IT CAN'T BE GOTTEN
AROUND. THERE ARE.
THERE ARE INSTANCES WHERE.
PROP NINETY EIGHT I HAD BEEN
IGNORED BUT IS FORSMALL
INCREASES LIKE SMALL INCREASES
TO A LOCAL.
STE.
A LOCAL SALES TAX.
BUT NOTHING IS HUGE AS SAY
HUNDRED FIVE BILLION DOLLARS.
IN TAXES THAT WE WE NEED TO DO.
IN ORDER TO SAVE FOR S. B. FIVE
SIX TWO.
EVEN THOUGH THAT'S NOT ON TOP
OF ANYTHING SAYS JUST A SHIFT IN
REVENUES THAT'S STILL. SOMETHING
THAT THE STATE SAYS IS.
MA PROCEEDS OF TAXES.
I'M SO WEAK WE WOULDN'T BE ABLE
TO DO ANYTHING ABOUT THAT.
I SAW THAT UP PRETTY MUCH ENDS
MY PRESENTATION.
THANK YOU VERY MUCH.
NEXT A PET DOCTOR DOZENS CAN YOU.
TO PRESENT FROM THE CALIFORNIA
PHYSICIANS ALLIANCE.
NEXT WE HAVE DOCTOR TURDS IN SKI
FROM THE CALIFORNIA PHYSICIANS
ALLIANCE.
THANK YOU UM. I BEEN ACCUSED OF
MANY THINGS IN MY LIFE BUT NEVER
SELF PROMOTION BUT I'M GOING TO
PROMOTE MYSELF RIGHT NOW I
MEASURE THE PRESIDENT.
I'M NOT THE VICE PRESIDENT OF
THE SAYS ON YOUR AGENDA.
.
I'D LIKE TO THANK THE SELECT
COMMITTEE FOR INVITING
CALIFORNIA PHYSICIANS ALLIANCE
OR CAPITA TO PRESENT TESTIMONY.
AND TO ASSIST THE COMMITTEE IN
ITS WORK.
MY NAME IS STEVEN TARZAN SKIN
AYE AYE AND THE PRESIDENT OF
CALIFORNIA PHYSICIANS ALLIANCE.
THE LEAD ARTICLE. IN THE JANUARY
TWENTY FIFTH ISSUE OF THE NEW
ENGLAND JOURNAL OF MEDICINE.
WHICH ADDRESSED PHYSICIAN
BURNOUT.
STATED THAT OUR FOR ETHICAL
PRINCIPLES THAT GUIDE PHYSICIANS
IN THEIR WORK.
A COMMITMENT TO OUR PATIENTS TO
BENEFITING OUR PATIENTS.
AVOIDING HARM TO THEM.
RESPECTING PATIENT AUTONOMY AND
STRIVING FOR HEALTH CARE JUSTICE.
JUSTICE AND HEALTH CARE.
THE ARTICLE NOTED IT IS THESE
VALUES THAT AFFIRM THE MORAL
FOUNDATION AND DEEP MEANING
UNDERLYING PHYSICIANS IT IS THE FOURTH VALUE STRIVING
FOR JUSTICE AND HEALTH CARE THAT
I WILL FOCUS MY REMARKS TODAY.
LET ME BEGIN BY TELLING YOU WHO
WE ARE CALIFORNIA POSITIONS
ALLIANCE CAP WAS FOUNDED IN
NINETEEN EIGHTY SEVEN IS A
PHYSICIAN ORGANIZATION DEDICATED
TO ADVANCING HEALTH CARE REFORM.
WITH THE GOAL OF ESTABLISHING A
SINGLE PAYER SYSTEM.
WE SAW SINGLE PAYER AS THE BEST
OPTION BECAUSE IT OFFERED
SECURITY CHOICE AND SIMPLICITY
AS A PUBLICLY FINANCED NONPROFIT
INSURANCE. AND MAINTAINED ARE
MAINLY PRIVATE HEALTH CARE
SYSTEM.
IN OUR CURRENT ERA IT ALSO
OFFERS COST CONTAINMENT WITHOUT
COMPROMISING ACCESS TO QUALITY
CARE.
KAPPA WORKS TO DEVELOP A
HEALTHCARE SYSTEM BOTH IN OUR
STATE AND OUR NATION THAT
EMBODIES. CAPAS FIVE CORE VALUES
SLIDE PLEASE.
NO I HAVEN'T SORRY.
I MEAN TO SOMEONE ELSE DOING IT
FOR ME.
YEAH VERSUS.
EXACTLY. AND THANK YOU.
GOOD I GOOD ONE OKAY ARE YEAH.
.
THESE VALUES THE THE FIVE CORE
VALUES GUARANTEED UNIVERSAL.
COMPREHENSIVE HIGH QUALITY AND
AFFORDABLE.
THESE VALUES ARE BASED ON OUR
BELIEF THAT HEALTHCARE IS A
HUMAN RIGHT.
OUR MISSION IS TO EDUCATE AN
ADVOCATE FOR HEALTHCARE SYSTEM
THAT IS GROUNDED IN CAPAS FIVE
CORE VALUES.
WE ARE AN ORGANIZATION OF OVER
SEVEN THOUSAND MEMBERS AND
SUPPORTERS MOSTLY PHYSICIANS BUT
ALSO HEALTH PROFESSIONALS OTHER
HEALTH PROFESSIONALS PUBLIC
HEALTH SCHOLARS. POLICY EXPERTS
ANOTHER CALIFORNIA RESIDENTS WE
ALSO HAVE A STUDENT FEEL YET THE
CALIFORNIA HEALTH PROFESSIONAL
STUDENT ALLIANCE CAPS ON. WHICH
A SEVERAL THOUSAND MEMBERS AND
MANY YOUNG ACTIVISTS.
I MEMBERS AND BOARD. AND OUR
BOARD CONTINUE TO DEVOTE
THOUSANDS OF VOLUNTEER HOURS TO
THE WORK OF THE ORGANIZATION AND
OUR STAFF HOPES GUIDED
COORDINATE THIS WORK.
WE ALSO KNOWLEDGE THE VITAL
SUPPORT OF THE WELLNESS
FOUNDATION THE CALIFORNIA
HEALTHCARE FOUNDATION THE
CALIFORNIA ENDOWMENT.
CAP HAS A THREE PRONGED APPROACH.
WE WORK TO HELP PEOPLE GET
COVERAGE NOW.
WE WORK ON MEDIUM TERM HEALTH
REFORMS THAT ARE CONSISTENT WITH
OUR VALUES AND WE WORK TO
ADVANCE TO A SYSTEM THAT WILL
EMBODY THOSE FIVE VALUES.
ONE EXAMPLE OF OUR WORK TO
IMPROVE THE LIVES OF PEOPLE NOW
IS OUR STUDENT PROGRAM CALLED
PROJECT WHITE COAT.
WHICH TODAY HAS AND ROLL OVER
FIVE HUNDRED FAMILIES IN THE
COVER CALIFORNIA AND MEDICARE.
OVER THE YEARS CAP HAS WORKED IN
A VARIETY OF INCREMENTAL STATE
LEGISLATION TO EXPAND COVERAGE
AND BENEFITS FOR VARIOUS GROUPS
OF CALIFORNIANS.
SOME OF THE LEGISLATION CAP AS A
INCLUDED S. B. EIGHT TEN THE
SINGLE PAYER BILL AUTHORED BY
THEN STATE SENATOR SHEILA CURE
ALL. THAT PASSED A STATE
LEGISLATOR* LEGISLATURE
TWICE IT WAS VETOED TWICE BY
THEN GOVERNOR SCHWARZENEGGER.
AB SEVENTY TWO WHICH ALLOWS
CONSUMERS TO ONLY BE RESPONSIBLE
FOR THEIR IN NETWORK COSTS.
PREVENTING UNANTICIPATED BILLS
FOR MEDICAL PROVIDERS AND
SERVICES THEY DIDN'T CHOOSE OVER
WHICH THEY DID NOT HAVE CONTROL.
AND THE ONE THAT CAP IS MOST
PROUD OF SINCE WE WORKED HARD
WITH OTHERS TO GET THIS PASSED
S. B. SEVENTY FIVE HEALTH FOR
ALL KIDS.
EXPANDED MEDICAL COVERAGE TO ALL
CHILDREN CALIFORNIA REGARDLESS
OF IMMIGRATION STATUS.
KAPPA CURRENTLY SUPPORTS THE
PASSAGE OF A NUMBER OF OTHER
BILLS CURRENTLY IN THE
LEGISLATIVE PROCESS.
THAT WOULD FURTHER EXPAND
COVERAGE AND PROTECT PATIENTS.
KAPPA SUPPORTS THE AFFORDABLE
CARE ACT.
WHICH WASN'T IMPORTANT HISTORIC
STEP FORWARD AND STRUGGLE TO
ACHIEVE HEALTH CARE FOR ALL.
I STATED CAP A PLEA AN IMPORTANT
ROLE IN INCLUDING STATE
UNDOCUMENTED CHILDREN THE MEDI
CAL SYSTEM. WE ALSO WORK TO
SUCCESSFULLY PASS STATE
LEGISLATION FOR FEDERAL WAIVER
THAT WOULD PERMITTED
UNDOCUMENTED ADULTS.
TO PURCHASE HEALTH INSURANCE AT
THEIR OWN EXPENSE IT COVERED
HAVE CALIFORNIA.
GIVEN THE VIRULENT ANTI
IMMIGRATION POSITION OF THE
CURRENT ADMINISTRATION IN
WASHINGTON.
STATE WITHDREW ITS REQUEST FOR A
WAIVER. AND ALTHOUGH THIS WAIVER
REQUEST WAS A VERY SMALL STEP.
IT DID ESTABLISH THE PRINCIPLE
THAT UNDOCUMENTED ADULTS SHOULD
BE INCLUDED IN THE STATE'S
HEALTH CARE SYSTEM AND THIS AND
OF IN OF ITSELF WAS AN IMPORTANT
POLICY MILESTONE.
AS FOR MY PERSONAL HISTORY VERY
BRIEFLY I AM A BOARD CERTIFIED
GENERAL PEDIATRICIAN A FELLOW OF
THE AMERICAN ACADEMY OF
PEDIATRICS.
I GRADUATED FROM MUCH MEDICAL
COLLEGE AND DID MY INTERNSHIP
AND RESIDENCY IN PEDIATRICS THE
LOS ANGELES COUNTY USC MEDICAL
CENTER.
ON JANUARY FIRST. I RETIRED
AFTER FORTY YEARS OF FULL TIME
PRACTICE.
WHICH HAS ALSO INCLUDED
INTERNATIONAL WORK TEACHING AND
MEDICAL GROUP LEADERSHIP.
THE LAST THIRTY THREE YEARS
SPENT AS A PRACTICING PHYSICIAN
AND PARTNER IN THE SOUTHERN
CALIFORNIA PERMANENTE MEDICAL
GROUP PROVIDING MEDICAL CARE TO
THE MEMBERS OF THE KAISER
PERMANENTE MEDICAL CARE PROGRAM.
I WILL CONTINUE WORKING PART
TIME AS A PER DIEM POSITION IN
THAT ORGANIZATION.
I DO WANT TO BE CLEAR THAT MY
REMARKS HERE TODAY ARE MY OWN AS
A PRIVATE CITIZEN AND CAPITA
PRESIDENT DO NOT REPRESENT THE
POSITION OF KAISER PERMANENTE A.
I.
YET.
YEAH.
I'M TALKING TO THEM.
.
FOR THE PAST FORTY FIVE YEARS
THAT IS ALMOST MY WHOLE ADULT
LIFE I'VE BEEN DEEPLY ENGAGED IN
ADVOCACY POLICY DEVELOPMENT
CRASS GRASSROOTS ORGANIZING AND
ORGANIZATIONAL LEADERSHIP TO
ADVANCE HEALTHCARE REFORM. AND
TO ACHIEVE A SINGLE PAYER SYSTEM
IN OUR COUNTRY.
WHY HAS THE UNITED STATES LAGGED
OTHER WEALTHY NATIONS AND FAILED
TO ACHIEVE TRUE UNIVERSAL
COVERAGE?
IT CERTAINLY HAS NOT BEEN FOR
LACK OF TRYING.
RATHER THE REASON LIES IN THE
STRUGGLE OVER THE ROLE OF
GOVERNMENT IN MEDICAL CARE
THAT'S BEEN GOING ON SINCE THE
VERY FOUNDING OF OUR REPUBLIC.
THE EFFORT TO INCREASE THE
GOVERNMENT ROLE IN MEDICAL CARE
HAS ALWAYS BEEN CONTENTIOUS AND
FRAUGHT.
FROM SEVENTEEN NINETY EIGHT WHEN
PRESIDENT JOHN ADAMS SIGNED AN
ACT FOR THE RELIEF OF SICK AND
DISABLED SEAMEN.
TO THE NINETEENTH CENTURY SAW
GREAT ADVANCES IN PUBLIC HEALTH
TO THE TWENTIETH CENTURY WITH
THE FAILURE TO PASS TO SHEPARD
TOWNER ACT.
TO THE SUCCESSFUL EFFORT TO PASS
MEDICARE AND MEDICAID. INTO THE
RECENT EFFORT TO PASS AND NOW
PROTECT THE ACA.
SOME PEOPLE HAVE NEVER ACCEPTED
THE IDEA THE GOVERNMENT SHOULD
USE ITS POWER TO IMPROVE
CITIZENS PHYSICAL WELL BEING.
THIS OPPOSITION TO GOVERNMENT
REGULATED MEDICAL CARE IS
PARTIALLY BASED ON THE VIEW THAT
GOVERNMENT GOVERNS BEST WHICH
GOVERNS LEAST.
LIBERTY MEANS AN UNCONTROLLED
FREE MARKET AND THE INDIVIDUAL
PURSUIT OF SELF INTEREST.
HUMAN EXISTENCE ITSELF IS VIEWED
AS A ZERO SUM GAME WHERE THERE
CAN ONLY BE WINNERS AND LOSERS.
TODAY WE HEAR COSTA BRING BACK
POLICY FROM SEVENTEENTH CENTURY
ENGLAND'S ELIZABETHAN POOR LAWS.
WHEN THERE'S TALK ABOUT LOW
INCOME ABLE BODIED ADULTS NEEDED
TO WORK TO DESERVE HEALTH
INSURANCE.
WE HAVE SEEN THIS IN THE PAST
FEW MONTHS REPEAT BUT UP
REPEATED ATTEMPTS TO GOT ALL
MEDICAID FUNDING TO THE STATES.
GIVE THEM THE OPTION TO PLACE A
WORK REQUIREMENT BEFORE SO
CALLED ABLE BODIED ADULTS CAN
DESERVE HEALTH INSURANCE.
SEVERAL STATES ARE ACTIVELY
CONSIDERING AND MOVING TOWARD
SUCH MEASURES.
NO OTHER CIVILIZED NATION MAKE
SUCH A DEMAND ON ITS PEOPLE.
FROM MY DECADES OF EXPERIENCE AS
A DOCTOR.
IT SEEMS TO ME THAT NO MARKET
DRIVEN HEALTHCARE SYSTEM CAN
SIMULTANEOUSLY LIMIT COSTS.
GUARANTEED UNIVERSAL COVERAGE
AND DELIVER DESIRED OUTCOMES.
OVERWHELMING EVIDENCE
DEMONSTRATES THAT THE BEST WAYS
TO REDUCE COSTS AND GUARANTEE
HEALTHCARE TO EVERYONE IS TO
HAVE THE LARGEST RISK POOL THAT
IS THE ENTIRE NATION.
THESE FACTS COMPEL THE UNITED
STATES OF AMERICA TO MOVE TO A
SINGLE PAYER SYSTEM GUIDED BY
COMPARISONS WITH OTHER COUNTRIES
EXPERIENCES AND BY OUR OWN
AMERICAN SUCCESS AS SUCH AS
MEDICARE AND MEDICAID.
HOWEVER GIVEN THE CURRENT
CONTOURS OF THE POLITICAL
TERRAIN IN WASHINGTON.
THE CURRENT CONGRESSIONAL LINE
THE FORCES AND THE CURRENT
OCCUPANT OF THE WHITE HOUSE.
IT'S RATHER UNLIKELY FOR THE
MOMENT THE WE CAN MAKE THE
ENTIRE NATION THE RISK POOL.
WE NEED IT ME INSTEAD ME TO LOOK
TO THE LARGE THE NEXT LARGEST
RISK POOL WHICH WOULD BE A VERY
LARGE STATE.
WITH ELECTED LEADERSHIP THAT HAS
COMMITTED ITSELF TO NOT BEING
AFRAID OF USING GOVERNMENT.
DO NOT BE AFRAID USING
GOVERNMENT TO ADVANCE THE
UNIVERSAL COVERAGE.
THE STATE THAT HAS AN ECONOMY
THE SIZE OF FRANCE THAT HAVE A
POPULATION LARGER THAN CANADA.
AND IS THE WORLD'S SIXTH LARGEST
ECONOMY BEST STATE AS WE ALL
KNOW IS OUR STATE CALIFORNIA.
CAPA ALONG WITH MANY OTHERS
INCLUDING THOSE WHO ARE
TESTIFYING IN ATTENDANCE HERE
TODAY BELIEVE THE CALIFORNIA CAN
AND MUST TAKE THE LEAD. THIS
BELIEF IS GROUNDED IN THE
HISTORY OF THE GOLDEN STATE AS A
LEADER AND SOCIAL PROGRESS ARTS
AND CULTURE. BUSINESS TECHNOLOGY
PUBLIC INFRASTRUCTURE EDUCATION
AND OTHER INNOVATION.
WITH RESPECT TO UNIVERSAL
COVERAGE UNIVERSAL COVERAGE IS A
TERM THAT IS USED BY EVERYONE.
UNIVERSAL COVERAGE IS LIKE MOM
AND APPLE PIE WHO COULD POSSIBLY
BE AGAINST IT.
BUT THIS TERM IS ALSO USED BY
INTEREST WITH VARYING MOTIVES.
SOME BEHAVE AS ENTRENCHED
INTEREST TO PROFIT FROM THE
CURRENT SYSTEM AND SEE AN
OPPORTUNITY TO FURTHER INCREASE
THEIR MARGINS. AND THEIR VERSION
OF UNIVERSAL COVERAGE.
BUT UNIVERSAL COVERAGE IS NOT
ENOUGH.
CAP IS GOAL IS INDEED COVERING
EVERYONE LIVING IN CALIFORNIA
BUT IN A HEALTH CARE SYSTEM THAT
IS AFFORDABLE. NOT WASTEFUL OF
HIGH QUALITY AND SOCIALLY JUST
AND EQUITABLE.
NO ONE SHOULD GO BANKRUPT
BECAUSE OF MEDICAL BILLS OR GO
WITHOUT NEEDED CARE BECAUSE IT
IT IS ON AFFORDABLE. EVERYBODY
AND NOBODY OUT THAT IS A
CALIFORNIA VALUE.
IN CALIFORNIA WE'VE TAKEN BOLD
STEPS TOWARD UNIVERSAL COVERAGE
USING THE OPENING CREATED BY THE
ACA TO BRING AS MANY INDIVIDUALS
INTO OUR SYSTEMS POP.
OUR STATE LEADERS AND MANY
OTHERS HAVE WORK TO MAKE COVERED
CALIFORNIA MARKETPLACES AS
EFFECTIVE AND INCLUSIVE AS
POSSIBLE EVEN DEFINE THE CURRENT
NATIONAL MINISTRATION IN ITS
ATTEMPTS TO GUT THE ANNUAL
ENROLLMENT PROCESS.
MEDICAID OR MEDICARE EXPANSION A
CALIFORNIA HAS ACHIEVED
IMPRESSIVE RESULTS INCLUDING AS
I KNOW TO THE BOB THE IMPORTANT
STEP OF PROTECTING ALL
UNDOCUMENTED CHILDREN.
YET DESPITE ALL THIS OUTSTANDING
A STORK WORK THE GOAL OF
UNIVERSAL COVERAGE FRAME BY CAPS
FIVE CORE VALUES CONTINUES TO
ELUDE US OFF. IT IS TO ACHIEVE
THIS GOAL NOW THAT I WISH TO
RETURN MY REMARKS.
CAPITA PERSPECTIVE IS THAT AS
LONG AS COVERAGE IS TIED TO
EMPLOYMENT.
INHERENTLY WASTEFUL FOR PROFIT
INSURANCE COMPANIES ARE IN THE
SYSTEM. AND PRICES ARE NOT
EFFECTIVELY CONTROLLED WE WILL
NEVER ACHIEVE HEALTH CARE REFORM
GROUNDED ON OUR FIVE CORE VALUES.
CAPITA FRO APPROACH IS ALSO
FRAMED BY THE REALITY OF WHAT
CALIFORNIA CAN AND CANNOT DO IN
THE CURRENT PERIOD.
AND THAT CERTAINLY BEGS THE
QUESTION OF THE FEASIBILITY OF
SOME TYPE OF SINGLE PAYER SYSTEM.
ANY STATE LEVEL APPROACH TO SOME
TYPE OF A SINGLE PAYER SYSTEM
REQUIRES CAPTURE A FEDERAL
FUNDING FOR MEDICARE AND OTHER
PROGRAMS.
THIS CAPTURE RETURN REQUIRES NEW
FEDERAL WAIVER LEGISLATION.
YET IN THE CURRENT POLITICAL
REALITY UNFORTUNATELY WE CANNOT
EXPECT THESE WAIVERS FOR AT
LEAST THREE YEARS. AND THAT IS
HAVE WE ARE VERY LUCKY.
WORKABLE MAJORITIES IN THE HOUSE
AND SENATE WILL BE TO APPROVE
AND A PRESIDENT WILLING TO SIGN
SUCH WAIVERS MUST EXIST.
SO THAT GIVES CALIFORNIA AT
MINIMUM A THREE YEAR PERIOD IN
WHICH TO PREPARE TO TRANSITION
TO SOME TYPE OF SINGLE PAYER
SYSTEM.
KAPPA BELIEVES THAT ONE WAY
FORWARD MAYBE A STEP BY STEP
PROCESS DID BILLS THE BROADEST
CONSENSUS POSSIBLE AMONG ALL
STAKEHOLDERS
AND THAT ALSO SURE THAT WE WILL
NOT GET STUCK IN A TRANSITION
PHASE AND FAILED TO ACHIEVE OUR
GOAL.
CAPITA REALIZES THAT IT ALONE
CANNOT DEVELOP DETAILED POLICY
PROPOSAL THE CAN BE TRANSLATED
TO LEGISLATION THAT WILL BE
REQUIRED TO ACHIEVE SUCH A TRIP
MAJOR TRANSITION.
YET WE CAN DO IS BRING TOGETHER
THE EXPERTISE OF WILL DEVELOP
THAT POLICY PROPOSAL.
SO CAP HAS LAUNCHED.
WHAT WE CALL A ROADMAP TO SINGLE
PAYER IN CALIFORNIA?
THE ROADMAP PROCESS THROUGH A
SERIES OF STATEWIDE MEETINGS AND
WORKING GROUP'S HAS BEEN
BRINGING TOGETHER OVER ONE
HUNDRED EXPERTS ACROSS A VARIETY
OF DISCIPLINES
INCLUDING PRACTICING PHYSICIANS.
NURSES OTHER ALLIED HEALTH
PROFESSIONALS HEALTH POLICY
EXPERTS HEALTH ECONOMISTS PUBLIC
HEALTH SPA SCHOLARS EXPERTS IN
TECH. EXPERTS AND HEALTHCARE
SYSTEMS ENGINEERING A QUALITY
IMPROVEMENT LEGISLATORS
ORGANIZED LABOR. LEADING AND A
LEADING HEALTH CARE REFORM
ACTIVISTS AND OTHERS TO WORK
TOGETHER TO DEVELOP A REALISTIC
PATHWAY TO SINGLE PAYER.
THE GOAL OF CAMPUS ROADMAP
MEETINGS IS TO DEVELOP A
DOCUMENT BUT LAKES BY LATE
SPRING THIS YEAR DOUBLE SERVICE
A TEMPLATE FOR LEGISLATION. TO
ACHIEVE THE GOAL OF UNIVERSAL
COVERAGE IN OUR STATE BASED ON
OUR FIVE CORE VALUES.
TWO VERY SUCCESSFUL STATEWIDE
MEETINGS HAVE SO FAR BEEN HELD
IN LOS ANGELES IN SACRAMENTO.
AND.
DOCTOR WOULD WAS AT THE SECOND
ONE. THE ROADMAP PROCESS
CONTINUES.
THE SAME TIME CAPITA REALIZES
THAT A CRAFTING LEGISLATION FOR
A BETTER STATE HEALTHCARE SYSTEM.
IT IS ESSENTIAL AND THAT
COMMITTEE AND SKI PARTLY AT THE
SAME TIME CAPITA REALIZES THAT
CRAFTING LEGISLATION FOR BETTER
STATE HEALTHCARE SYSTEM. AND IS
ESSENTIAL IN THAT THE COMMITTEE
HAS INVITED CAP HERE TO ADDRESS
THIS.
WE ARE AWARE FROM MEETINGS WITH
SELECT COMMITTEE MEMBERS THERE
ARE SPECIFIC CONCERNS WITH
RESPECT TO LACK OF COVERAGE IN
SERVICES IN RURAL AREAS AND THAT
OF THE DEVASTATING IMPACT OF THE
OPIOID EPIDEMIC WE SHARE THAT AS
WELL.
I'M NOT ROADMAP PROCESS IS
ONGOING AND IT HAS SO FAR
IDENTIFIED A FEW BROAD POLICY
AREAS THAT WILL BE NEED TO BE
ADDRESSED IN A MAJOR TRANSITION
AND THESE AREAS ARE LISTED ON
THE NEXT SLIDE.
YEAH SORRY.
SHAME ON ME OKAY.
ALRIGHT.
WE CAN CERTAINLY THAT THE SOME
OF THE AREAS ARE YOU TO YOUR
SAVINGS AND REVENUE
AFFORDABILITY DELIVERY SYSTEM
REFORM WORKFORCE. COVERAGE
INSURE THE UNINSURED AND BENEFIT
PACKAGE PRICE CONTROL GOVERNANCE
HEALTH INFORMATION TECHNOLOGY
MEDI CAL IMPROVEMENT PUBLIC
AUCTION AND THERE WILL BE OTHERS.
IT'S REALLY GOING TO LITTLE BIT
MORE DETAIL ON THE QUESTIONS.
CAP ENVISIONS CALLING OUR
IMPROVE NEW STATE HEALTHCARE
SYSTEM GOLDEN STATE CARE.
MY CREDIT FORMER DIRECT OF LOS
ANGELES COUNTY HEALTH. SERVICES
DOCTOR MITCHELL CAPS FOR
ADJUSTING THE NAME.
GOLDEN STATE CARE WILL BE ROLLED
OUT IN TWO PHASES.
PHASE ONE WOULD OCCUR OVER THE
THREE TO FOUR YEARS WHILE WE
ALSO WORK HARD TO CREATE THE
CONDITIONS FROM FEDERAL WAIVERS
THAT WILL LEAD TO THE
ESTABLISHMENT OF A STATEWIDE ALL
PAYER SYSTEM.
ALL PAYER SYSTEM.
THIS THAT IS FEASIBLE AT THE
STATE LEVEL WITHOUT FEDERAL
WAIVERS FOR PERMISSION.
THE COMMITTEE HAS ALREADY
RECEIVED TESTIMONY ON COUNTRIES
WITH ALL PAYER SYSTEMS IN OUR
WEB AND IN OTHER WEALTHY NATIONS
AS WELL AS FOR STATES HAVE TRIED
TO DO THIS.
FACE TO WITHIN MOVE TO SOME TYPE
OF SINGLE PAYER SYSTEM WANTS TO
REQUIRE CHANGES AT THE FEDERAL
LEVEL WOULD OCCUR.
AS THE COMMITTEE HAS ALREADY
HEARD THERE ARE MANY TYPES OF SO
CALLED SINGLE PAYER SYSTEMS
AROUND THE WORLD HAVE ACHIEVE
UNIVERSAL COVERAGE.
CALIFORNIA NATION CAN LEARN FROM
THESE EXAMPLES BUT ULTIMATELY.
WE MUST DEVELOP OUR OWN SYSTEM.
WE BELIEVE THAT FACING IN
SIGNIFICANT CHANGES AND
FINANCING DELIVERY OF CARE WOULD
HELP MITIGATE THE MASSIVE
DISRUPTIONS AND DISLOCATIONS AND
BLOWBACK. THAT COULD OTHERWISE
OCCUR FROM TO SUDDEN OVERNIGHT
CHANGE.
THE TIME FOR COULD HELP MINIMIZE
THE RISK AVERSION OR FEAR OF
MILLIONS OF CALIFORNIANS WHO
SATISFIED WITH THEIR CURRENT
COVERAGE WILL BE AFRAID TO LOSE
IT IN AN OVERNIGHT PROCESS.
OPPONENTS OF SINGLE PAYER WILL
CERTAINLY EXPLOIT THIS FEAR.
MOREOVER PUBLIC FINANCING WILL
BE ESSENTIAL IN THIS PROCESS AND
CALIFORNIANS HAVE SHOWN THAT
THEY ARE UNUSUALLY GENEROUS AND
TAXING THEMSELVES YET THERE'S IS
STILL A QUESTION OF HOW FAR.
TAXPAYERS ARE WILLING TO GO.
BASICALLY REFORMER STILL FACE
THE CHALLENGE OF THE PUBLIC'S
NEGATIVE PERCEPTION OF TAXES AND
GOVERNMENT.
THE ROADMAP PROCESS IS ALREADY
ADDRESSING THIS CHALLENGE.
IT IS KEY TO UNDERSTAND THAT ANY
NEW TAXES WOULD ACTUALLY
SUBSTITUTE FOR THE COST OF KERN
INSURANCE BEINGS THEY WILL
LIKELY BE LOWER THAN THOSE
PREMIUMS AND THAT'S A BETTER
DEAL FOR THE AVERAGE CALIFORNIA
TAXPAYERS.
BEFORE LEAVING THE ISSUE
FINANCING AFFORDABILITY I WOULD
LIKE TO EMPHASIZE ONE IMPORTANT
POINT FOR THE WORKING
CLINICIAN'S POINT OF VIEW.
WE KNOW THAT PAYING DOCTORS IS
ABOUT TWENTY THREE PERCENT OF
ALL HEALTH COSTS.
IT PHYSICIAN REIMBURSEMENT WERE
CUT BY TWENTY PERCENT WOULD
RESULT IN LESS IN A FIVE PERCENT
DECREASE IN OVERALL HEALTH COSTS.
BUT WOULD VERY DEEPLY IMPACT
PROFESSION ALREADY SADDLED WITH
TWICE THE BURNOUT RATE.
NOW REACHING FIFTY FOUR PERCENT.
ANOTHER PROFESSIONS AND A HIGHER
RATE OF SUBSTANCE ABUSE
DEPRESSION AND SUICIDE.
AND ATTEMPT TO CUT COSTS IN THIS
MANNER WOULD MAKE TO PEOPLE WHO
CARE FOR EVERYONE IN THIS ROOM
EVEN FURTHER DEMORALIZED THAN
THEY ALREADY ARE WHILE DEALING
EVERY DAY WITH TIME WASTING
PAPERWORK AND DOCUMENTATION. TO
TAKE AWAY FROM CARING FOR
PATIENTS WHICH IS ALL THE REALLY
SIGNED UP FOR.
CONVERSELY INCREASING PHYSICIAN
REIMBURSEMENT MEDICARE OUT BY
TWENTY PERCENT OR EVEN JUST A
MEDICARE RATES. MIGHT ONLY
INCREASE HEALTHCARE COSTS BY
LESS THAN FIVE PERCENT BUT
VASTLY OPEN ACCESS TO PRIMARY
CARE AND SPECIALTY CARE AND
RESULT IN INDIVIDUAL DECREASES
IN OVERALL HEALTH COSTS
ESPECIALLY IN THE CONTEXT OF
UNIVERSAL COVERAGE.
SIMILAR BURNOUT RATES EXISTS
WITHIN THE NURSING PROFESSION.
THAT'S NOT CONTINUE TO TRY THE
PROP SOLVE THE PROBLEM
AFFORDABLE HEALTH CARE ON THE
BACKS OF OUR PHYSICIANS AND OUR
NURSES
THIS HAS BEEN GOING ON FAR TOO
LONG.
I WOULD REFLECT THE COMMON A BIT
FURTHER ABOUT THE CURRENT SINGLE
PAYER BILL S. B. FIVE SIX TWO.
LET ME FIRSTLY VERY CLEAR THE
CAP IS IN SOLIDARITY WITH THE
GOAL VESTBY FIVE SIX TO A SYSTEM
THAT WOULD EMBODY CAPAS FIVE
CORE VALUES.
SIR S. B. FIVE SIX TO SUPPORTERS
ARE TO BE COMMENDED FOR THE
VITAL ROLE THEY ARE PLAYING AND
BUILDING SUPPORT FOR SINGLE
PAYER. AND EDUCATING THE PUBLIC
ABOUT IT AND FOR MOVING THE
CALIFORNIA SENATE AND ASSEMBLY
FORWARD IN YOUR CONSIDERATION OF
THE CONCEPT.
THE BACKERS OF ALSO PLAYED AN
IMPORTANT CATALYST ROLE.
CAPITA RESPECT THE ADVOCATES AND
SUPPORTERS OF S. B. FIVE SIX TWO.
AT THE SAME TIME WE FEAR THAT
THE BILL ITSELF AS LANGUAGE AND
OF NOT SUBSTANTIALLY AMENDED
WILL PREVENT ITS PASSAGE.
THE CONCERNS ABOUT THE BILL'S
LANGUAGE HAVE BEEN ELABORATED BY
OTHERS AND I WILL NOT REPEAT
THEM HERE.
CAPITA HOPES THAT S. B. FIVE SIX
TWO CAN BE AMENDED TO PRESENT A
MORE REALISTIC TRANSITION ALONG
THE LINES I'VE LAID OUT.
WE ARE VERY WILLING TO WORK WITH
THE BILL'S AUTHORS AND IT'S KEY
SUPPORTERS TO THAT AND.
AND MOST IMPORTANTLY KAPPA
STRONGLY BELIEVES THAT ALL
STAKEHOLDERS SHOULD COME
TOGETHER IN A USEFUL
CONSTRUCTIVE AND TRULY
COLLABORATIVE PROCESS.
BASED ON CAMPUS FIVE CORE VALUES.
SOME OF CRITICIZED APPROACH IS
INCREMENTALISM BUT WE AND CAPITA
CALL THAT STRATEGIC PLANNING.
THERE THREE TAKEN POINTS TO
REMEMBER FIRST THE STRATEGIC
TRANSITION INTO PHASES AS
NECESSARY AND MUST ENGAGE OFFICE
KEY STAKEHOLDERS.
THE STARTING POINT FOR THIS
PROCESS SHOULD BE AGREEMENT ON
THE THE GOAL OF HEALTH CARE
SYSTEM BASED ON OUR FIVE CORE
VALUES.
SECOND NEW FEDERAL WAIVER
LEGISLATION IS NEEDED. AND THIRD.
THE WORK OF DEVELOPING THIS
PHASE STRATEGIC TRANSITION PLAN
IS BEING DONE BY CAP AND OTHERS
IN THE ROADMAP PROCESS.
LAST SLIDE PLEASE.
THAT'S FOR.
YEAH.
I'M REALLY TALK TO MAKE.
YEAH THAT'S RIGHT.
THAT'S WHAT HAPPENED YOU HAVE
MAYBE PEOPLE FOR THIRTY THREE
YEARS.
I OUTLINED I'VE TRIED OUTLINED
VALUES VISION BASED ON THOSE
VALUES A STRATEGY A PROCESS AND
A GOAL.
IT CLOSING MANY JUST LEAVE
EVERYONE WITH SOME NUMBERS.
WE NO THAT MEDICARE THE CLOSEST
THING WE HAVE TO SINGLE PAYER
SYSTEM IN THIS COUNTRY IN WHICH
ENJOYS WIDESPREAD SUPPORT AS AN
OVER HEAD OF ABOUT TWO PERCENT.
WHILE PRIVATE FOR PROFIT
INSURANCE CAN RANGE ANYTHING.
MANY WERE DEPENDING ON THE STUDY
FROM TEN PERCENT TO TWENTY FIVE
PERCENT.
IN OTHER WORDS GOVERNMENT IS
MORE EFFICIENT PAY FOR MEDICAL
CARE IN A PREDOMINATELY PRIVATE
RUN HEALTH CARE'S DELIVERY
SYSTEM BY A FACTOR OF FIVE TO
TWELVE TIMES. IN THE PRIVATE FOR
PROFIT INSURANCE INDUSTRY.
GOVERNMENT DOESN'T HAVE TO PAY
INVESTORS.
PAY EXECUTIVE STOPWATCH STOCK
OPTIONS BILL HUGE SKYSCRAPERS OR
FIGURE OUT HOW TO NOT PAY FOR
NEEDED MEDICAL CARE TO MAXIMIZE
SHAREHOLDER VALUE
IN FROM SEVERAL STUDIES WE KNOW
THAT FOR EACH ONE MILLION
UNINSURED ONE THOUSAND PEOPLE
DIE A PREMATURE DEATH EVERY YEAR
DUE TO LACK OF INSURANCE.
IN CANADA THE UNITED KINGDOM
FRANCE AUSTRALIA JAPAN GERMANY
AND OTHER WEALTHY NATIONS THAT
NUMBER ZERO.
THANKS TO THE ACA AND EXPANSIONS
IN MEDICAID AND MEDICARE ALL
TENS OF THOUSANDS OF LIVES HAVE
BEEN SAVED.
BUT THE JOB ISN'T FINISHED.
RIGHT NOW ALMOST THREE THOUSAND
CALIFORNIANS ARE STILL DYING
EVERY YEAR JUST BECAUSE THEY
DON'T HAVE HEALTH INSURANCE
THAT'S EIGHT PEOPLE A DAY ONE
EVERY THREE HOURS.
HOW MANY MORE MUST DIE BEFORE WE
ACHIEVE A CALIFORNIA HEALTHCARE
SYSTEM THAT IS UNIVERSAL
GUARANTEED? COMPREHENSIVE HIGH
QUALITY AND AFFORDABLE GETTING
TWO ZERO IS UP TO ALL OF US.
THANK YOU FOR INVITING US TO
PRESENT TESTIMONY TO THE SECT
COMMITTEE. REVIEW THE CHARGE AND
WORK OF THIS SELECT COMMITTEE A
SERIOUS AND MEANINGFUL WE ARE
READY AND WILLING TO CONTINUE
CYST YOU IN YOUR EFFORTS.
IF THERE'S TIME I'LL ASK MY
COLLEAGUE IN KAPPA BOARD MEMBER
DR ARTHUR CHEN TO MAKE SOME
BRIEF REMARKS.
HE'S A MUCH SMARTER THAN ME CAN
ANSWER ALL THE QUESTIONS.
BUT I ALSO FAILED IN MY ROLE AS
HIS SLIDE CHANGER AND SO.
IF.
GOOD AFTERNOON AN THANK YOU AND
I WILL BE VERY BRIEF BECAUSE OF
THE MAIN POINT OF MY BEING HERE
IS TO ASSIST WITH ANY QUESTIONS
THAT YOU MIGHT HAVE. MY NAME IS
DOCTOR ARE THE CHEN I AM A
PRACTICING FAMILY PHYSICIAN FOR
THE LAST THIRTY FOUR YEARS. AT
ASIAN HEALTH SERVICES IN OAKLAND
CALIFORNIA WHICH IS A FEDERALLY
QUALIFIED HEALTH CENTER THAT IS
IN THE SAFETY NET FOR ALAMEDA
COUNTY. I'VE ALSO HAD THE
PRIVILEGE OF WORKING ON SINGLE
PAYER FOR THE LAST TWENTY FIVE
YEARS SINCE THE ORIGINAL
CAMPAIGN FOR PROP ONE EIGHTY SIX
ARE STARTING CALIFORNIA. I HAVE
ALSO HAD THE PRIVILEGE OF BEING
A PUBLIC HEALTH OFFICER FOR
ALAMEDA COUNTY IN PUBLIC HEALTH.
AND ALSO A CHIEF MEDICAL OFFICER
FOR MEDI CAL MANAGED CARE. PLAN
WHICH IS THE ALAMEDA LIGHTS FOR
HELP BACK IN ITS EARLIER DAYS.
I'VE HAD AN ADDITIONAL
PRIVILEGE.
AND VANTAGE POINT OF BEING THE
BOARD CHAIR FOR THE CALIFORNIA
ENDOWMENT.
A HEALTHCARE FOUNDATION THAT
YOU'RE VERY FAMILIAR WITH THAT
IS SUPPORTED MANY THE
PROGRESSIVE CHANGES THAT WE'RE
TRYING TO SEE AN IMPROVING THE
HEALTH OF OUR COMMUNITIES.
IT'S WITH THESE DIFFERENT
VANTAGE POINTS THAT HAS INFORMED
ME ABOUT OUR HEALTHCARE CRISIS
THEY WERE IN AND HOW WE'RE
APPROACHING IT AND SOME OF THE
SOLUTIONS THAT ARE OUT THERE
THAT ARE NOT. THEORETICAL BUT
ARE ACTUALLY VERY PRACTICAL
MODELS THAT HAVE AMAZING TRACK
RECORDS HAS BEEN MENTIONED BY
OUR PREVIOUS SPEAKERS. THAT ARE
ACTUALLY ACHIEVING UNIVERSAL
HEALTH CARE AND THAT ARE
ACTUALLY DOING IT IN A VERY COST
EFFECTIVE WAY. AND ARE DOING IT
IN A WAY THAT IMPROVES QUALITY
AND GENERATES OUTCOMES.
AND I'M JUST TAKING ONE STEP
BACK AND LISTENING TO THE
TESTIMONY TODAY AND THINKING OF
WHERE WE ARE. AND I CAN'T HELP
BUT THANK YOU. ARE SPECIFICALLY
CHAIRMAN WOULD AND AND ALSO
CHAIRMAN ARAMBULA. FORT DELVING
THIS DEEPLY INTO THIS ISSUE IT
TRULY IS HISTORIC AND IT WAS
LONG OVERDUE. AND I WANT TO
THANK THE CALIFORNIA NURSES
ASSOCIATION AS WELL AS WELL AS
SINGLE PAYER NOW HEALTH CARE FOR
ALL A NUMBER OF THESE VERY
DEDICATED. AND PASSIONATE.
PEOPLE WHO CARE SO DEEPLY ABOUT
THE HEALTH STATUS OF OUR
COMMUNITIES THAT THEY ARE
WILLING TO PUT IN THEIR TIME.
AND SHOW THEIR PASSION.
AND YOU KNOW WHAT I MEAN WHEN I
SAY SHOW THEIR PASSION. AN
HOPEFULLY.
HOPEFULLY
ALL OF YOU CAN TAKE THAT NOT A
PERSONAL ATTACK LEVEL.
BUT TAKE IT AS A SIGN OF HOW BAD
THINGS HAVE GOTTEN. AND HOW THEY
ARE TAKING AND WE ARE TAKING
OWNERSHIP
FOR THIS PROBLEM. WE'RE TAKING
OWNERSHIP IN THE ONLY WAY THAT
WE CAN AS PRIVATE CITIZENS AND
ORGANIZATIONS BY EXPRESSING
PUBLIC WILL. IT EVEN THOUGH IT
MAY BE IN A VERY FORTHRIGHT WAY
THAT MAY HAVE SOME ABRASIVE
EDGES TO IT. IT'S BECAUSE OF
THAT CONCERN THAT YOU HAVE AS
WELL AND THAT YOU'RE TAKING
OWNERSHIP OF THIS AND THE FACT
THAT WE'RE DOING IT TOGETHER
RIGHT NOW I THINK FROM MICE FROM
MY VANTAGE POINT OF BEING. THE
HEALTH CARE PHYSICIAN FOR THE
LAST THIRTY FIVE YEARS IS JUST
INCREDIBLE.
AND I WANT TO JUST THANK
EVERYBODY FOR THAT CONTRIBUTION.
HYPE A LOOK AT S. B. FIVE SIXTY
TWO AND I AND I WENT THROUGH IT
AGAIN LAST NIGHT I HAD PRESENTED
IT TO THE NORTH CALIFORNIAN
NEUROLOGIC SOCIETY. AND I TOOK A
LOT OF HEAT A AMONG PHYSICIANS
GROUPS BECAUSE THERE'S A LOT OF
CONCERN AND THERE'S LOT OF FEAR.
BUT I WANT TO SAY ALSO THAT
WHEN I LOOK AT THIS FROM THE
CONTEXT OF A PUBLIC HEALTH
PERSPECTIVE. OF A PRACTICING
FAMILY PHYSICIAN AS SOMEONE IS
REALLY CONCERNED AS YOU ALL ARE.
WE HAVE SOME INCREDIBLE ELEMENTS
IN THIS PROPOSAL THAT SHOULD
ALWAYS BE PART OF A PIECE OF
LEGISLATION NO MATTER WHAT YOU
DECIDE TO DO. WELL IN TRYING TO
ADVANCE UNIVERSAL CARE I WANT TO
POINT OUT THAT THIS CARE THIS.
AVOIDS THE SEPARATION OF HIGHS
AND MOUTH AND HEAD FROM OUR BODY.
THAT IT INTEGRATES CARE THAT IT
PUTS VISION CARE AND IT PUTS YOU
KNOW ORAL CARE ALL UNDER.
THE HEALTH COVERAGE.
HOW? COMPLEX AN IDEA IS THAT
THAT WE HAVE GOTTEN TO THE POINT
RIVER SO FRAGMENTED WE DON'T
ADDRESS THAT SO THANK YOU FOR
PUTTING THAT IN THE PROPOSAL.
SENIORS AND DISABILITY.
FOR THOSE OF YOU THAT HAVEN'T
READ THIS IT PROVIDES FOR ADULT
DAYCARE AND IN HOME CARE.
WHERE IT'S CRITICALLY NEEDED
ANYONE WHO HAS BEEN TAKING CARE
OF HER AGING PARENTS OR IS GOING
THROUGH THIS YOURSELF?
AS THE SENIOR THIS IS CRITICAL
AND VERY MUCH A PART OF QUALITY
OF CARE IN ENABLING CULT QUALITY
OF CARE. WHERE DID AND I COULD
GO ON? BUT THE THE.
IN A PERIOD WHERE WE ARE DEALING
WITH IMMIGRATION AS A BIG ISSUE.
THIS IS IMMIGRANT FRIENDLY.
THIS IS VERY IMMIGRANT FRIENDLY.
THERE ARE PROVISIONS IN HERE
THAT ACTUALLY ARE IN SYNC WITH
OUR SANCTUARY STATE. LAWS THAT
ACTUALLY KEEP INFORMATION ON
IMMIGRATION STATUS PRIVATE.
AND NOT DISPOSABLE TO ANYONE
WHO'S LOOKING FOR THAT
INFORMATION
AND SO THERE'S A LOT OF THOUGHT
THAT WENT INTO THIS THERE'S ALSO
ITS CULTURAL COMPETENCE AND THEY
ALSO TALK ABOUT FROM ANNA. FROM
A MINORITY HEALTH STANDPOINT AND
SOME OF THE BIGGEST CHALLENGES
WE SEE WITHIN OUR NORMAL
MINORITY COMMUNITIES AROUND
HEALTH DISPARITIES. THEY OPENLY
DECLARED THAT WE NEED TO SEEK
THE ELIMINATION OF HEALTH
DISPARITIES.
CURRENT PROVIDE CARE AND
ADDRESSED CULTURAL AND
LINGUISTIC BARRIERS.
SO IN SUMMARY I JUST WANT TO
SUGGEST.
THAT GET PAST ALL THE ALL THE
ISSUES THAT ARE COMING AT YOU
FROM UP PUBLIC WILL STAND POINT.
AND PLEASE DON'T IGNORE THE
CONTENT OF THIS BILL. WHO ARE
THE THE VALUE THAT'S THERE? TRY
TO AMEND IT HAS ADS ARE
POSITIONING KAPPA IS WE SUPPORT
AB FIVE SICK AS S. B. FIVE SIXTY
TWO IF AMENDED TO ADDRESS SOME
OF THE POINTS THAT DOCTOR TEARS
INSKEEP BROUGHT UP. AND WE STAND
WITH THEM IN SOLIDARITY IN
TRYING TO ACCOMPLISH THAT
BECAUSE WE THINK THE MOTIVATIONS.
THE MOTIVATIONS ARE VERY REAL
AND VERY SINCERE AND ABSOLUTELY
NECESSARY AT THIS POINT IN TIME
THANK YOU VERY MUCH.
THANK YOU ALL FOR YOUR TESTIMONY.
WITH THAT WE WILL BRING IT BACK
UP TO THE DYESS FOR ANY
QUESTIONS THAT THE COMMITTEE MAY
HAVE.
ASSEMBLYMEMBER FIGURE.
THANK YOU.
THINKS FOR ALL OF YOU FOR
COMING TODAY ESPECIALLY FROM
MASSACHUSETTS.
WE A BETTER WEATHER.
SO MAYBE THAT'S
I DRAW.
.
BECAUSE I HAVE LOTS OF QUESTIONS
I'M NOT EVEN SURE WHERE TO START.
I DON'T KNOW IF YOU'VE ALL HAD
THE CHANCE TO WATCH THE OTHER
PRESENTATIONS THAT WE GOT.
I AND LET ME ALSO SAY YOU KNOW.
HARM.
I CAME INTO THIS.
AS A HEALTHCARE USER. BUT NOT A
HEALTHCARE EXPERT I'M NOT A
PHYSICIAN I DON'T PLAY ONE ON TV.
AND SO THIS IS BEEN A REAL HARM
EDUCATION TO MAYOR REAL DEEP
DIVE.
AND I KNOW THAT IT'S FRUSTRATING
TO A LOT OF THE ADVOCATES WHO
KNOW A LOT ABOUT HEALTHCARE.
THAT WE ALL HAVE GONE THROUGH
THIS BUT FOR THOSE OF US WHO
HAVE TO MAKE POLICY IT'S REALLY
IMPORTANT THAT WE UNDERSTAND.
THE BACKGROUND ALL OF THE
DIMENSIONS OF THIS.
AND.
EVEN THOUGH WE SAT THROUGH MANY
MANY HOURS OF HEARINGS THERE SO
THEY WERE SO DANCE.
THAT.
FOR ME I WOULD NEED TO YOU KNOW
PROBABLY TAKE A COURSE FOR MANY
YEARS TO REALLY BE ABLE TO
ABSORB. ALL THE INFORMATION THAT
WE'VE BEEN GIVEN I'M THROUGH THE
COURSE OF ALL THE HEARINGS BUT
I'M STARTING TO GET YOU KNOW
MUCH MORE OF AN UNDERSTANDING SO.
I HAVE SOME QUESTIONS FIRST FOUR
PROFESSOR PAUL ONE. AND AGAIN
THANKS AGAIN FOR COMING.
SO.
.
MY FIRST QUESTION IS ABOUT.
THE.
.
THE FEE ON BUSINESSES THAT YOU
MENTIONED THAT YOU DID YOUR
ANALYSIS ON I THINK IT WAS YOU
IT I TALKEDABOUT A COUPLE OF
DIFFERENT PROPOSALS THAT YOU
LOOKED AT.
TO COME UP WITH YOUR
ASSUMPTIONS ABOUT THE AMOUNT OF
MONEY THAT'S AVAILABLE BECAUSE
IT'S BEING SPENT NOW.
AND YEAH THE FEW THAT YOU
RECOMMENDED IN YOUR ANALYSIS TO
COME UP WITH THE COST
BUT THE THE.
OF HOW TO PAY FOR THE COST OF
THE PLAN I THINK WAS A TO
PERCENT AROUND A TWO PERCENT
PAYROLL TAX.
.
GROSS RECEIPTS TAX
BUT DO YOU HAVE A SENSE RIGHT
NOW OF COMPANIES THAT ARE PAIN
FOR. PRIVATE HEALTH INSURANCE
THEY'RE PAYING MUCH MORE OF THAT
RIGHT NOW THAN TWO PERCENT.
SO YOU KNOW WHAT ONE OF THE THE
SPEAKERS THAT WE HAD WAS OUR
MIKE.
GOVERNOR OF.
.
VERMONT WHO SAID THAT ONE OF THE
MISTAKES THEY MADE WHEN THEY
TRIED TO PROPOSED SINGLE PAYER
IN VERMONT WAS NOT CLEARLY
EXPLAINING TO THE PUBLIC WHAT
THEY'RE PAYING NOW.
SO THOSE COMPANIES ARE PAYING
MUCH MORE. OPEN WHAT WHAT WAS
YOUR.
SORT OF GENERAL ASSUMPTION OF
WHAT THE AVERAGE COMPANY THAT
PROVIDES PRIVATE INSURANCE IS
PAIN.
THANK YOU VERY MUCH FOR THE
QUESTION.
YEAH SO FIRST OF ALL AS I AS I
SAID IN MY OVERALL REMARKS.
VERY IMPORTANT CONSIDERATION.
IN THE WAY WE DESIGN ARE
PROPOSAL. WAS PRECISELY.
TO REMAIN WITHIN. THE FRAMEWORK
AS ARTICULATED IN THE
LEGISLATIVE ANALYST'S OFFICE
WHICH IS TO.
PREFERRED TAXES WITH BROAD BASES
AND LOW RIGHT.
AND THE MISTAKE THAT WAS MADE
AND PER MONTH WAS THAT THEY
DIDN'T DO THAT.
THEY COULD HAVE DONE THAT THEY
DIDN'T AYE AS IT HAPPENS I'VE
HAD EXTENSIVE CONVERSATIONS WITH
THE AUTHOR. OF THE STUDY FOR
VERMONT. WHO IN MY OPINION IS
THE MOST EMINENT?
ECONOMIST WORKING ON SINGLE
PAYER HEALTHCARE AND RELATED
ISSUES IN THE WORLD. A DOCTOR
WILLIAM SHALL OF HARVARD
UNIVERSITY
HE HIMSELF TOLD ME THAT THEY
MADE THAT MISTAKE.
THAT THEY DID NOT. ADHERE TO
THIS PRINCIPLE SO THAT THEY THE.
PROPOSAL WAS FOR A VERY HIGH
RATE THAT GOT PEOPLE WORRY. NOW
SO EXACTLY WHAT WE WERE REALLY
FOCUSED ON WAS.
DESIGNING A SYSTEM THROUGH
WHICH THE RATES OBVIOUSLY WE
HAVE TO RAISE THE MONEY. THAT
THE RATES ARE NOT SO HIGH AS
THAT THEY WOULD COST DISTORTIONS
AND ECONOMIC ACTIVITY SO.
YEAH SO IN OUR STUDY WE HAVE.
IF WE TAKE IT AS AN EXAMPLE.
MEDIUM SIZE BUSINESSES AND
WE'VE LOOKED AT TWO KINDS OF
MEDIUM SIZE BUSINESSES WITH TEN
TO NINE. ATTENDED NINETEEN
EMPLOYEES OVER TWENTY TO NINETY
NINE EMPLOYEES SO.
RIGHT NOW.
.
ATTENDED NINE EMPLOYEES
ARE SPENDING HUNDRED AND EIGHT
THOUSAND DOLLARS.
ON HEALTH CARE PER YEAR AND
WHAT THEY WOULD PAY BY THROUGH
THE GROSS RECEIPTS TAX
SCENARIO WOULD BE.
TWENTY FIVE THOUSAND.
SO THE GROSS RECEIPTS TAX.
PROPOSAL.
WOULD LOWER WOULD LOWER THEIR
HEALTHCARE SPENDING BY THIRTEEN
POINT FOUR PERCENT AS I SAID
THIS IS A MAJOR BENEFIT.
FOR MEDIUM SIZE FIRMS THAT'S NOT
QUITE AS BIG FOR TWENTY TO
NINETY NINE EMPLOYEES. BUT IN
THAT CASE ARE RIGHT NOW WORST
SHOWING TOTAL HEALTHCARE
SPENDING IS THREE HUNDRED AND
FIFTEEN THOUSAND.
EIGHT HUNDRED FORTY DOLLARS THE
GROSS RECEIPTS TAX THEY PAY A
HUNDRED AND EIGHTY FOUR THOUSAND
DOLLARS SO THEY WOULD LOWER
THEIR HEALTHCARE SPENDING AS A
SHARE OF PAYROLL BY SIX POINT
EIGHT PERCENT.
SO.
CONSISTENTLY YEAH EXCEPT ARE IN
SOME CASES FOR CERTAIN KINDS OF
VERY LARGE FIRMS HEALTHCARE
COSTS FOR BUSINESSES.
GO DOWN.
AND YOU KNOW THE GROSS RECEIPTS
TAX IS ONE EXAMPLE I KNOW
THERE'S SOME CONCERN AND I READ
THE. THE LEGISLATIVE ANALYST'S
OFFICE CONCERNED ABOUT THE GROSS
RECEIPTS TAX THAT'S FAIR.
THE PUSH YOU GONNA BE CONCERNED
ABOUT ANY.
FEE OR TAX AND ON THE OTHER
HAND VERY LARGE STATES OPERATE
WITH THESE THIS IS NOT A BIG
SECRET PROPOSAL. WE HAVE TEXAS
WE HAVE THE STATE OF WASHINGTON
WE HAVE THE STATE OF DELAWARE WE
HAD THE STATE OF OHIO THAT
DEPEND HEAVILY.
ON UTILIZING THIS MEASURE SO WE
CAN DO IT ON THE OTHER HAND IF
YOU WANTED TO GO WITH THE. OF
EXTENDING THE EXISTING PAYROLL
TAX.
UP IT'S IT'S CERTAINLY DOABLE AS
I SAID IT WOULD BE SIX POINT SIX
PERCENT TO RAISE THE SAME AMOUNT
OF REVENUE. AS YOU WOULD GET
FROM OUR TWO POINT THREE PERCENT.
GROSS RECEIPTS FEET SO.
IT YOU CAN DO IT.
AND TO NOTE SIX POINT SIX
PERCENT IS HIGHER THAN TWO POINT
THREE PERCENT BUT IT IS STILL.
WITHIN RANGE OF SOMETHING THAT
WOULD NOT BE ONEROUS HAS WAS THE.
THE MEASURE AND AND VERMONT.
WHICH WAS IT'S UNFORTUNATE IN
VERMONT BECAUSE OTHERWISE THE
RESEARCH DONE THE PROPOSAL IN MY
OPINION. WAS OUTSTANDING.
THE WORK DONE BY PROFESSOR SHALL
OUTSTANDING IN MANY WAYS I
MODELED OUR STUDY ON HIS.
HE THEY HAD THAT ONE ISSUE THAT
YOU YOUR THE CHIEF HIGHLIGHTED
WHICH I THINK THEY COULD HAVE
DONE A LOT BETTER.
NOW YOU I'M YOU USE THE.
PHRASE SEVERAL TIMES HE SAID
DECENT INSURANCE.
SO WHAT ASSUMPTIONS WERE YOU
USING YOUR ANALYSIS ABOUT THE
TYPE OF INSURANCE THAT PEOPLE
THAT THIS WOULD PAY FOR BECAUSE
THIS A BIG RANGE OF INSURANCE
THAT'S OFFERED BY. YOU KNOW FROM
FROM PRIVATE INSURANCE FRANCE
INTO SOME COMPANIES OR. GIVING.
PLATINUM PLANS TO THEIR
EMPLOYEES YOU KNOW ALL THE WAY
TO PEOPLE UNCOVER CALIFORNIA
BUYING
YOU KNOW HIGHER DEDUCTIBLE. I
TYPE POLICIES TO WHAT'S IN THEM
FIVE SIX TWO WHICH YOU KNOW
SEEMS TO BE WRITTEN IS. IS MUCH
MORE LIKE ALONG THE PLATINUM IF
NOT HIGHER.
TYPE OF ANALYSIS SO WHAT WE DID
YOU.
DID YOU ENVISION ANY PARTICULAR
COST FOUR TYPE OF INSURANCE OR.
R. YOU SORT OF SPREADING THE
RANGE AND FINDING AN AVERAGE AND
USING THAT AS SORT OF YOUR COST
ASSUMPTION.
SO WHAT DOES THAT MATTER WHEN
YOU DO IT SO NOW IT'S LIKE SAID
THAT WELL ALL OF COURSE ALL
THESE THINGS MATTER AND OF
COURSE WHEN YOU DO.
STUDY OF SUCH BIG SYSTEM WE HAVE
TO WORK WITH AVERAGES AND WE
THINK THAT RANGES WITHIN AVERAGE
JUST. SO YOU KNOW THE BASIC
APPROACH WAS TO SAY LET'S LOOK
AT EXISTING COVERAGE.
AND.
WITHIN THE EXISTING COVERAGE
YOU KNOW WE FIND ABOUT.
FORTY FIVE PERCENT OF PEOPLE.
EITHER UNINSURED. ARE
UNDERINSURED. AND AGAIN IF YOU
WANT I CAN GO THROUGH OTHER
DEFINITIONS OF UNDER IN CHECKING
THE THINGS VERY VERY IMPORTANT
THAT WE UNDERSTAND HOW SEVERE
THAT PROBLEM.
AND THEN WHAT WE SAID WAS LET'S
BRING EVERYBODY WHO IS EITHER
UNINSURED.
OR UNDER INSURED. UP TO.
FULLY INSURED SUCH THAT.
THEY DO NOT FACE THESE KINDS OF
PROBLEMS THAT THEY CAN'T THEY
FEEL LIKE THEY CAN'T. SEE A
PHYSICIAN OR THAT THEY FACE
BANKRUPTCY.
SO BRING EVERYBODY UP.
FOR THAT LEVEL AND THAT WHAT WE
SAID TO DO THAT WOULD ENTAIL.
COSTS YEAH GOING UP.
.
BY BY TEN PERCENT WITHIN THE
EXISTING SYSTEM FLOW FROM THREE
HUNDRED AND SEVENTY BILLION.
TWO FOUR HUNDRED BILLION WITHIN
THE EXISTING SYSTEM BUT THEN
THAT THE SINGLE PAYER SYSTEM.
WOULD ACHIEVE COST SAVINGS
SUCH THAT WE THEN GET.
EVERYBODY AT DECENT COVERAGE AT
THREE HUNDRED AND THIRTY BILLION
SO WOULD BE A NET.
REDUCTION IN COSTS IN THE RANGE
OF EIGHT OR NINE PERCENT WITH
EVERYBODY GETTING RIGHT BUT ARE
YOU WERE YOU ANTICIPATING THE
TYPE OF COVERAGE THAT THE BILL
CALLS FOR. PODIATRY.
LONG TERM CARE YEAH YEAH ALL OF
THAT REAL ISSUE IS ALSO IN THERE
OKAY. NO AND THEN WILL YOU ALSO
ANTICIPATING ADDITIONAL TYPES OF
COST SAVINGS.
BEING MORE REGULATION I MEAN
CLEARLY YOU'RE YOU'RE TAKING OUT
A FOR PROFIT INSURANCE INDUSTRY.
SIPHONING OFF OF MONEY GOING TO
SHAREHOLDERS CORRECTING YOUR
ASSUMPTIONS. AND ALSO THE
ABILITY OF THE STATEMENTS
NEGOTIATE DIRECTLY OR REGULATE
WITH PHARMA ALL OF THAT SO
THAT'S WERE SO YOU HAVE COST
CONTAINMENT BUILT INTO YOUR
MODELING THAT IS WELL. ON.
OKAY.
GOOD.
NATIONAL TURN THANK.
AND THEN DID YOU ALSO MAKE
ASSUMPTIONS THAN ABOUT A
FLATTENING OF.
SORT OF.
.
I DID YOU DID YOU MAKE
ASSUMPTIONS ABOUT FEE FOR
SERVICE VERSES.
YOU KNOW MORE AND I KNOW WHAT
THE FREEZES FOR WHEN YOU'RE JUST
DOING AB FLAT SORT OF
CONTRACTING WITH A DOCTOR WITH
DOCTORS. WELTER OF MEN YOU KNOW
AS YOU KNOW IN MY READING OF THE
MEASURE.
THERE THAT THOSE OPTIONS ARE
STILL. ON THE TABLE AND IN MY
OPINION.
WHAT WE NEED IS SOME
COMBINATION AND I YOU KNOW IF IF
I TURN TO?
?
OUR STUDY WE ACTUALLY QUOTE FROM
THE.
THE BILL ITSELF.
SAID THE BILL ITSELF.
TALKS ABOUT SIMPLIFICATION
TRANSPARENCY STANDARDS SHALL
INCLUDE BUT NOT BE LIMITED TO.
IT FAIRNESS AND HEALTH CARE
CREDENTIALING PARTICIPATION
HEALTH CARE AND REFERRALS OF
THEIRS.
SO THEY AND I MY VIEW THE TO
THE. LEFT OF THE LANGUAGE IN THE
DRAFT LEGISLATION BROADLY
MANDATES THE BOARD TO DEVELOP
SINGLE PAYER AS AN INTEGRATED
SYSTEM NOW. WHAT EXACTLY DO WE
MEAN BY AN INTEGRATED?
AND YOU KNOW THEIR VARIOUS WAYS
TO DO THAT.
SOME OF WHICH COULD INCLUDE FEE
FOR SERVICE.
ON SOME CONTACTS WITHIN A
BROADER FRAMEWORK OF SOME KIND
OF GLOBAL BUDGETING.
SO THAT'S WHAT I THINK THAT'S I
THINK WHERE WE WILL INVOLVE.
I'M AND WE HAVE PIECES OF THAT.
IN.
ALREADY IN OPERATION IN
DIFFERENT PARTS OF THE COUNTRY
FOR EXAMPLE IN THE STATE OF
MARYLAND THEY ARE HAVE GLOBAL
BUDGETING.
THERE THEY ARE INVOLVING IT IN
A POSITIVE WAY. BUT IT HAS TO BE
DONE.
WITHIN A CONTEXT WHICH IT'S NOT
ENTIRELY DONE NOW IN WHICH WE
GUARANTEE DECENT CARE SO.
THAT IS A LEVEL OF DETAIL THAT
IN MY VIEW IS NOT FULLY WORKED
OUT. IN THE.
BILL THUS FAR AND SHOULDN'T BE
BECAUSE IT IS A MATTER OF YOU
KNOW A LOT OF STUDY IN DETAIL
AND UNDERSTANDING A LOT. OF THE.
MODELS THAT ARE OUT THERE AND
MAKING THEM WORK IN THE MOST
EFFECTIVE WAY.
MEN HAVE YOU EVALUATED SINGLE
PAYER SYSTEMS VERSUS A VERY
HIGHLY REGULATED NONPROFIT MULTI
PAYER SYSTEM LIKE THEY HAVE IN
GERMANY AND SOME OF THE OTHER
COUNTRIES YOU HAVE ANY THOUGHTS
ABOUT THAT.
WELL YOU KNOW I THINK THAT.
.
IN THE UNITED STATES.
WE'VE EVOLVED INTO A SYSTEM AND
WHICH.
WE ARE HEAVILY DEPENDENT ON
PRIVATE HEALTH INSURANCE
COMPANIES THAT THEY HAVE
ENORMOUS MARKET POWER.
AND THAT IS A MAJOR FACTOR
HOLDING BACK THE. CREATION OF A
UNIVERSAL COVERAGE SYSTEM.
AND THAT THEREFORE.
WHAT IS REALLY MOST CRITICAL IN
MY VIEW?
IS THE TRANSITION INTO A SIMPLE
SYSTEM OUR A GOVERNMENT RUN
SYSTEM.
AND I YOU KNOW WE'VE HAD WE HAVE
EXPERIENCES.
WITH FOR EXAMPLE MEDICARE.
WHICH HAS A LOT OF FAVORABLE
OUTCOMES BUT IS ENORMOUSLY
COSTLY. I WE DON'T HAVE ANY KIND
OF COST CONTROLS WITHIN IT ARE A
LOT OF THE REASON IS BECAUSE OF
THE INTERACTION BETWEEN THE.
RIDERS INSURANCE COMPANIES AND
THE STATE SO I THINK IN ORDER TO
ACHIEVE A SYSTEM THAT THAT
ACCOMPLISHES THE COST SAVINGS
THAT WE NEED.
.
I DON'T THINK WE CAN RUN IT OUR
SYSTEM LIKE GERMANY'S I THINK WE
NEED TO MOVE TO A SIMPLE SYSTEM
WITH MINIMAL. UP DUROCHER SEE
AND MINIMUM AMBIGUITY
AND LASTLY IS THERE ANY CREDIBLE
ECONOMIST THAT YOU KNOW OF. WHO
THINKS THAT OUR CURRENT SYSTEM?
ARE UNREGULATED.
CURRENT SYSTEM.
WHERE? INSURANCE COMPANIES.
A WHERE WE HAVE SUCH A LACK OF
REGULATION.
AND. FOR CITIZENS TO.
FIVE FROM COMPETING.
INSURANCE POLICIES WITH VERY
LITTLE CARE. ABOUT WHETHER OR
NOT THEY ACTUALLY CAN AFFORD.
WHAT THEY'RE ABLE TO GET THIS OR
ANY ECONOMIST WHO THINKS THAT
THIS IS WORKING I THINK THAT'S A
LOADED QUESTION? YEAH JUST
SAYING NO.
NO.
OKAY.
THANK YOU.
NEXT.
NEXT WE WILL HAVE ASSEMBLY
MEMBER WALDRON.
IF YOU MISTER CHAIR.
.
THERE'S THERE'S A LOT HERE AND I
KNOW EVERYONE WANTS TO GET
THE BEST.
SOLUTION FOR THE PATIENT I'M
ALWAYS CONCERNED ABOUT ACCESS
PATIENT.
AND I'VE RUN UP AGAINST YOU
KNOW ISSUES WITH.
APPROPRIATIONS TRYING TO GET
BETTER OUTCOMES THROUGH SITS
LEMONADE EXCEPT THERAPIES
GETTING PHYSICIANS TO ACTUALLY
BE ABLE TO GET THE TREATMENT
THEY WANT TO THEIR PATIENTS
WITHOUT ALL THE RED TAPE.
SO I'M VERY INTERESTED IN IT.
I'M GONNA PLAY A LITTLE BIT OF
A DEVIL'S ADVOCATE HERE BECAUSE
YOU KNOW WHERE AT THE END OF THE
ROLE.
AS FAR AS A LOT OF OUR
INFORMATIONAL HEARINGS.
AND I THINK SOME OF THESE
QUESTIONS NEED TO BE ASKED OF
NINE.
ASKING THEM BECAUSE I REALLY
WANT TO KNOW.
IT'S NOT YOU KNOW. ANYTHING
OTHER THAN THAT.
.
ONE OF THE THINGS WE WANT UP
AGAINST AS LEGISLATORS OF ONE
WE'VE TRIED TO ONE BILLS IN
APPROPRIATIONS.
WE TRY TO SET UP A PROGRAM OR
SYSTEM IN THIS ALWAYS THOSE
INITIAL ONE TIME COSTS THAT COME
INTO PLAY.
BEFORE WE ACTUALLY THEN YOU
DON'T GET INTO THE NITTY GRITTY
OF WHAT THE.
THE OUTCOME WILL BE FOR THE
PROGRAM.
WHAT WOULD BE THE ONE TIME COSTS?
A LOT TO THE STATE'S GENERAL
FUND OR OTHER SOURCES OF GETTING
A SINGLE PAYER SYSTEM OFF THE
GROUND.
HOME AND HOW WILL I BE PAID I
MEAN I KNOW WE'RE TALKING ABOUT
THE FOUR HUNDRED BILLION PRETTY
MUCH STATIC OPERATIONAL COSTS
BUT WHAT WHAT DO YOU SEE AS A.
SET UP ON THIS.
FOR ME. ARVIN WHOEVER I MEAN FOR
THE ECONOMY.
BECAUSE WELL THEY DEFINITELY ARE
TRANSITIONAL COSTS.
AND I THINK IT'S FAIR TO SAY
THAT OUR STUDY.
AB VERSION CAME OUT AND MADE
DOES NOT COVER THOSE.
AND THAT IS IT WOULD BE A FAIR
CRITICISM OF OUR STUDY BUT IT
REALLY WAS JUST A MATTER OF
DOING WHAT I COULD AND THE TIME
FOR.
SUBSEQUENTLY WE HAVE LOOKED IN
IN SOME DETAIL.
ARE WITH RESPECTED TRANSITIONAL
COSTS.
FOR PEOPLE NOW EMPLOYED.
AND THE PRIVATE HEALTH INSURANCE
INDUSTRY
BECAUSE A LOT OF THE WAYS WE'RE
GONNA CHIEF COST SAVING IN THE
SYSTEM THROUGH IT LOWERING
ADMINISTRATIVE COSTS. MEANS
LET'S FACE IT PEOPLE WILL NOT BE
NEEDED TO DO THEIR JOBS AND
PRIVATE HEALTH INSURANCE SO WHAT
WE'VE ESTIMATED.
IS A FAIR TRANSITION
TO MOVE PEOPLE WHO ARE EMPLOYED.
AB CURRENTLY IN PRIVATE HEALTH
INSURANCE IN OUR CALIFORNIAN
THAT'S ABOUT A HUNDRED AND FIFTY
THOUSAND PEOPLE HUNDRED FORTY
SEVEN THOUSAND.
AND AND WHAT IT ENTAILS.
ARE FIRST OF ALL THE PEOPLE WHO
ARE NEAR RETIREMENT MOVING THEM
INTO.
RETIREMENT.
VOLUNTARY RETIREMENT.
THROUGH.
A GLIDE PATH TO MAINTAIN THEIR
WAGES AND PENSION FUNDS.
SECONDLY.
THE PEOPLE WHO ARE NOT. NEAR
RETIREMENT.
SO THAT IS GOING TO BE.
ABOUT A HUNDRED AND TWNTY FIVE
THOUSAND PEOPLE WE ESTIMATE THAT
ABOUT SEVENTY FIVE THOUSAND WILL
STILL BE NEEDED.
TO MOVE INTO THE PUBLIC SYSTEM
BUT THAT STILL LEAVES US WITH
ABOUT SEVENTY THOUSAND WHO WON'T.
SO WHAT WE.
HAVE LOOKED INTO IS THE RATE AT
WHICH.
RETIREMENTS OCCUR IN OF PUBLIC
EMPLOYMENT IN THE STATE OF
CALIFORNIA NOT IN HEALTHCARE BUT
IN COMPARABLE POSITIONS AND THEY
RATE AT WHICH NEW OPENINGS.
WOULD WOULD EMERGE THROUGH
WHICH THESE PEOPLE COULD MOVE
INTO AND WE ESTIMATE THAT WOULD
TAKE ABOUT THREE YEARS WORTH OF
NORMAL RATES OF RETIREMENT.
TO GET PEOPLE INTO EMPLOYMENT
IF THEY WANTED THAT EMPLOYMENT
BUT WE'VE ALSO LOOKED AT WAYS OF.
POSITIONS FOR.
WAGE REPLACEMENT FOR TWO YEARS
FOR PEOPLE THAT DON'T TAKE THOSE
JOBS WE'VE LOOKED AT JOB
TRAINING AND.
RELOCATION COSTS AND ROUGHLY
WHAT WE'RE TALKING ABOUT IS I
THINK IT COST. AT AN INCREMENTAL
INCREASE ON TOP OF THE THREE
HUNDRED AND THIRTY BILLION AN
INCREMENTAL INCREASE OF AROUND
ONE PERCENT OF SYSTEM COSTS FOR
THREE YEARS.
TO GET PEOPLE INTO AYE AYE A
GOOD TRANSITIONAL SITUATION SO
THE COSTS ARE REAL AND WE MAY WE
CAN'T IGNORE THEM. UP BUT THEY
ARE MANAGEABLE.
THERE'S CERTAINLY MANAGEABLE
AND AND AND WHEN WE FINISH THIS
LATEST VERSION OF WHAT WE'RE
DOING I WILL BE ABLE TO SHOW
THAT.
DO YOU AND USED TO AND MENTIONED
ABOUT ALSO RESPONDED THAT. JUST
FROM A POSITION AND PUBLIC
HEALTH STANDPOINT.
THERE'S.
PART OF WHAT AND I DON'T HAVE
ALL THE RESEARCH BEHIND THIS BUT
IT'S AN IDEA THAT. MIGHT BE
STUDY.
PART OF THE CHAIN.
THAT BUT ALSO GENERATE COSTS IS
SHIFTING TO AN ENTIRE NEW.
SYSTEM OUR ENTIRE NEW ROCKETS
THE NINE ENTIRE NEW AGENCY AND
SOMEONE TO BE ABLE TO CARRY OUT.
WE WE LEARNED THIS SOMEWHAT FROM
COVERED CALIFORNIA BECOMING A
NEW ENTITY AND HAVING TO STAFF
UP.
SO THE QUESTION REALLY FOR US.
IS TO FIGURE OUT HOW MUCH CAN
WE PARLAY WHAT ALREADY EXISTS
AND MAY AT MASSIVELY IMPROVE IT
AND AYE MP AYE EMPHASIZE
MASSIVELY BECAUSE IF WE THINK OF
WHAT INFRASTRUCTURE WE ALREADY
HAVE.
WE HAVE AN INFRASTRUCTURE IN
CALIFORNIA.
IT'S CALLED MEDICARE.
AND IT PROVIDES A LOT OF ALL
THE DIFFERENT ASPECTS OF WHAT'S
NEEDED IN HEALTHCARE AND AT
DIFFERENT TIMES IS PROVIDED THAT
COMPREHENSIVE CARE AND ACTUALLY
INCLUDED PODIATRY.
AND THINGS LIKE THAT.
BUT IT NEEDS MAJOR MAJOR
OVERHAUL.
BUT IT'S DIFFERENT THAN HAVING
TO RECONSTRUCT AN ENTIRE AGENCY
THAT'S ONE ISSUE AND THEN THE
OTHER THING IS IN THE COURSE OF
TRANSITION OF COURSE DOLLARS ARE
REAL IMPORTANT. BUT DON'T FORGET
ABOUT BENEFITS THAT OCCUR
BECAUSE IN THAT TRANSITION FOR
EXAMPLE I CAN TELL YOU FROM A
POSITION OFFICE STANDPOINT.
INCREDIBLE YOU KNOW NARROWING
DOWN AND SIMPLIFYING OF WHAT ARE
VERY COMPLEX AND RIGOROUS AND
LABRYS AND YOU KNOW ACTIVITIES.
THAT ARE COSTLY AS FAR AS
HAVING STAFF TO BE ABLE TO DEAL
WITH. OF DIFFERENT FORMS IN
DIFFERENT POLICIES AND DIFFERENT
CONTRACTS AND ALL THESE
DIFFERENT PAIRS SO DON'T
OVERLOOK THAT ASPECT OF WHAT WE
WHAT WE ACTUALLY IMPROVING THE
EFFICIENCIES. ARE AND CUT DOWN
ON THE COSTS
BUT UNNECESSARY OVERHEAD FOR
MANY MANY PHYSICIANS OFFICES AND
MEDICAL GROUPS IN MANY
PHYSICIANS SPEND TWENTY HOURS A
WEEK ON THIS AND. IT'S EIGHTY
THREE THOUSAND DOLLARS PER U. S.
POSITION. COSTS IF YOU GOT A
GROUP PRACTICE OF FOR BURKE
TWENTY OR FIFTY YOU CAN THINK
ABOUT WHAT THE COSTS ARE JUST TO
BE ADMINISTRATION. AND ALL THOSE
THE OUR SAVINGS THERE IN THERE
ALSO I THINK SAVINGS WE CAN LOOK
AT FOR STREAMLINING AND. THE
IMPROVING MEDI CAL AS YOU KNOW
DOCTOR CHEN ALLUDED TO AND FOR
INSTANCE DO WE REALLY NEED FIFTY
ELIGIBILITY CODES FOR MEDI CAL.
SERIOUSLY.
JUST A COUPLE OF FOLLOW UPS ON
THAT SO.
THE PRIVATE.
PARENTS
DURING THE TRANSITION.
.
WHAT WHAT WORLD YOU SEE FOR THEM
I MEAN WILL THEY BE?
PART OF THIS YOU KNOW TRYING
MAYBE DOING THE BILLING MAYBE
DOING ARE THEY GONNA BE SOMEHOW
INVOLVED IN THE TRANSITION OR
WILL THEY JUST BE.
KIND OF ON THE WAY OUT.
WELL THE LANGUAGE OF OF S. B.
FIVE SIX TWO.
THE LANGUAGE OF S. B. FIVE SIX
TWO PROVIDES THAT THE PROGRAM IS
NOT A FULLY OPERATIONAL UNTIL
THE FEDERAL MONIES HAVE BEEN.
RECEIVED AND SO THERE IS THAT
PERIODOF TIME POTENTIALLY WHERE.
WE ARE.
TRANSITION IN THE PROGRAMMING
THAT'SWHAT DOCTOR POLAND'S NEXT
STUDIES GOING TO REVIEW THE
SPECIFIC SEVEN CLEARLY THE
CAPPER PROJECT AS WELL. BUT I'M.
IT IS CERTAINLY POSSIBLE THAT WE
WERE THERE WILL BE PROVIDED
PRIVATE INSURANCE DURING THAT
TRANSITION PERIOD IT'S ALSO
POSSIBLE THE INSURERS WILL. YOU
KNOW DECIDE THAT THEY WANT TO
PACK UP AND GO HOME AND SO I TO
FIND ALTERNATIVE MEANS OF
COVERAGE.
A I THINK THAT THAT THE REALITY
IS IS THAT THE.
.
COVERAGE
THAT FOLKS CURRENTLY GET IS HERE
AS WE MENTIONED EARLIER SEVENTY
PERCENT PUBLICLY FUNDED AND SO
WE'RE GOING TO HAVE THOSE PUBLIC
RESOURCES THAT WE MAY BE ABLE TO
REALLOCATE DURING THAT
TRANSITION PERIOD AS WELL. AT
LEAST ON THE STATE LEVEL
SO THAT'S WE ANTICIPATE.
.
WHAT LEVEL OF RESERVES WOULD BE
NEEDED?
QUESTION THE IMPACT OF LARGE
COST JOBS OR REVENUE DECLINES
WHICH.
WE SEE ALL THE TIME YOU KNOW IN
ANY BUDGET. YOU KNOW.
AND WELL YEAH THAT'S ANOTHER
THING THAT'S A GREAT QUESTIONS
ANOTHER ONE THAT IS NOT IN OUR
STUDY VOTE WE'VE WE'VE WE'VE
WORKED THROUGH IT AND. I'LL BE
ABLE TO SEND YOU SOME DRIVERS
ALSO ON THAT.
BUT LET'S JUST THINK ABOUT IT.
IN IN THE BASICS.
HOW WE'VE LOOKED AT A FOR
EXAMPLE THE PAYING THE PAYROLL
TAX OPTION WHICH I UNDERSTAND
PEOPLE ARE VERY INTERESTED IN
THAT?
THE GROSS RECEIPTS WOULD BE ON
YOU KNOW.
SIMILAR SO WHAT WE'VE LOOKED AT
IS THE.
THE RANGE.
OF JUMPING UP AND DOWN.
AND YOU KNOW FOR THOSE EITHER A
MEMBER.
YEARS STATISTICS.
THE STANDARD DEVIATION AROUND
THE AVERAGE.
HAS ABOUT FOUR POINT FIVE
PERCENT MEANING SO THAT IF IF WE
WE'VE GOT A GIVEN AMOUNT. OF
REVENUE A YEAR.
SOME YEARS IT'LL GO UP BY FOUR
POINT FIVE PERCENT SOME YEARS
AND THEN IN THE MAXIMUM CUT DOWN
BY FOUR POINT FIVE PERCENT. SO
THAT THE BASIC PRINCIPLE FOR
CREATING RESERVE FUND IS
INSTRUCTORS QUITE
STRAIGHTFORWARD ONCE YOU. KNOW
WHAT THE LONG TERM AVERAGES.
THEN WHAT YOU'RE ABLE TO OBSERVE.
IS YOU KNOW.
THE JUMPS UP AND THE JOHN STEM.
AND WHAT YOU HAVE TO THEIR FOUR
DO IS A INCORPORATE A PROVISION
THROUGH WHICH WHEN YOU HAVE A
GOOD YEAR I JUMP UP.
YOU DON'T SPEND THAT MONEY YOU
PUT IT IN THE RESERVE FUND.
AND THAT IS THAT EXACTLY GOING
TO BE MATCHED.
BY THE YEARS WHEN YOU GO DOWN
BY FOUR POINT FIVE PERCENT YOU
WILL HAVE THE MONEY IN RESERVE
FROM THE UP. SO.
IT IT'S NOT HARD TO DESIGN A
RESERVE FUND THAT WILL BE VIABLE
WHAT WOULD BE A BIT OF A
CHALLENGES YOU KNOW FOR THE
FIRST COUPLE YEARS UNTIL YOU
HAVE YOUR FIRST UP YEAR. HAD YOU
COVER THAT SO FOR THE FIRST FOR
THE INITIALLY YOU WOULD HAVE TO
START PUTTING IN THE RESERVE
FUND.
.
AS AN ADDITIONAL INCREMENT FOR
THE FIRST YEAR FINANCING BUT
AFTER THAT.
IT'S REALLY NOT A VERY HARD
PROBLEM.
GIVEN WHAT YOU KNOW ALL YOU
HAVE TO DO IS OBSERVE THEIR
RANGE OF VARIATION AROUND THE
LONG TERM AVERAGE AMOUNT OF
FUNDING COMING IN.
CAN I RESPOND ALSO JUST.
AND IT SOMEWHAT RELATES TO THE
PREVIOUS QUESTION AROUND THE
ROLE OF PRIVATE INSURANCE. THIS
IS WHY IN THE SINGLE PAYER MODEL
WE REALLY HAVE TO. HAVE IT AS
PUBLICLY FINANCED.
AND.
FOR LEASE FOR A MINIMUM BENEFIT
PACKAGE
A MINUTE BEEN BASELINE YOU KNOW
BENEFIT PACKAGE THAT EVERYONE.
CAN CAN YOU KNOW FEEL COVERED BY
AND.
AS A RESULT OF THAT IMPORTANCE
OF THE ACTUARIAL SPREAD BECAUSE
TO AVOID THE DOWN YEARS.
TO AVOID THE DOWNED SWINGS AND
THE REVENUE THAT COMES FROM THIS
YOU HAVE TO HAVE THE ACTUARIAL
SPREAD OF HEALTHY. WORKING
PEOPLE AND HEALTHY CHILDREN AND
SO ON THAT ARE STILL. PART OF
THAT TAX BASE.
AND SO IF THAT'S SIPHONED OFF
BECAUSE OF HAVING A LARGE ROLL
OF.
OF PRIVATE INSURERS THEN WE
LOSE THAT BENEFIT COME THE ROLE
IN COUNTRIES THAT HAVE SINGLE
PAYER AS WELL AS OTHER MULTI
PAIRS DISTANCE. THERE'S STILL A
ROLE FOR PRIVATE INSURANCE
AND THAT IS REALLY ONCE WE
ESTABLISH THE FOR
FLOOR AND THE BASIC MINIMUM
BENEFITS PACKAGE.
IF PEOPLE WANT SOMETHING MORE
THAN THAT THERE'S AN OPTION TO
BE ABLE TO GO PRIVATE INSURANCE
AND DO THAT.
WHAT YOU'LL SEE OVER THE NEXT
FEW YEARS BECAUSE INSURANCE
COMPANIES ARE VERY KEEN ON THEIR
PROFIT MARGIN? IS A LOT OF THE
COMPANIES THAT HAVE MULTIPLE
PRODUCT LINES UMD AND YOU LIFE
INSURANCE FOR EXAMPLE. THEY'RE
THEY'RE GETTING THEY'RE. GETTING
SECOND GUESSES ABOUT STAYING IN
THE MARKET.
AND PART OF IT IS BECAUSE THE
MARGIN FOR THEM DESPITE THE FACT
THAT IT'S BILLIONS OF DOLLARS
HUNDREDS OF BILLIONS OF DOLLARS.
AS INDIVIDUAL COMPANIES JUST
STARTING TO NARROW DOWN AND AND
NOT SURPRISING BECAUSE OF THE
CRISIS THAT WE'RE IN WITH OUR
FRAGMENTATION. AND A LOT OF THE
CHALLENGES THAT WE HAVE RIGHT
NOW NURSES.
WHICH IS WHY S. B. FIVE SIX TWO
MOVES EXPEDITIOUSLY TO
TRANSITION FROM THE INSURANCE
BASED SYSTEM TO. S. INTO HEALTHY
CALIFORNIA AND I AND I AND I
THINK THAT. CERTAINLY THIS AS A
MINIMUM BENEFIT PACKAGE IS NOT A
CONCEPT IN S. B. FIVE SIX TO THE
COMPREHENSIVE BENEFITS.
ARE THE PACKAGE BECAUSE THE
BIGGER THE ROLE FOR. THE GOOD OF
THE ROLE FOR THE PRIVATE ENSURES.
LESS EFFICIENT AND LESS SAVINGS
AND MORE WASTE THERE IS IN THE
SYSTEM SO WE THAT'S WHY WE'VE.
AFFORD A VERY COMPREHENSIVE.
BENEFIT PACKAGE TO REDUCE THE
ROLE OF PRIVATE INSURANCE TO
SUPPLEMENTAL BENEFITS OKAY SO LET'S GET INTO SOME OF
THE CHARTS CRIME.
DARPA DOT TO POLAND.
ON TABLE NINE.
YOU YOU'RE OUTLINING SOME OF
THE OVERALL COST SAVINGS THROUGH
A. CALIFORNIA SINGLE PAYER
SYSTEM.
ESTIMATES OBVIOUSLY.
.
SO YOU'RE ESTIMATING HEALTH
SPENDING WILL BE REDUCED BY
ABOUT FIVE PERCENT.
AS A RESULT OF REDUCTIONS IN
UNNECESSARY SERVICES.
REDUCED FRAUD OTHER EFFICIENCIES.
WHAT IS THE BASIS FOR THIS
ESTIMATE IS ARE THERE SOME
CONCRETE FIGURES OR STUDIES THAT
HAVE BEEN DONE THAT COULD POINT
TO?
A YOU KNOW. AND THAT'S KIND OF A
BROAD THING UNNECESSARY SERVICES
AND I TOTALLY AGREE WITH WHAT'S
BEEN SAID ABOUT A LOT OF THE
THINGS WITH.
.
STEPPED THERAPIES OPINION ON
DIALS ON ALL THOSE COSTS THAT GO
INTO ALL OF THAT. NAVIGATING A
VERY.
YOU KNOW BROADSYSTEM.
HOW HOW DID YOU COME UP WITH THE
FIVE PERCENT?
?
DIDN'T THINK SANTA SOME CARE
BEING PROVIDED TODAY IS NOT HIGH
VALUE CARE.
WHY SHOULD WE BELIEVE THAT THIS
WOULD CHANGE HONOR FULLY?
PUBLICLY FINANCED SYSTEM.
THANKS VERY MUCH IT'S A GREAT
QUESTION.
.
THE FIGURES HERE LIKE ALL OF THE
FIGURES ON COST SAVINGS COME
FROM THE RESEARCH LITERATURE.
OTHER FEE FOR IS THE STARTING
POINT FOR OUR ESTIMATE OF THE
FIVE PERCENT.
IS FROM A TWO THOUSAND AND TEN
STUDY BY THE U. S. INSTITUTE OF
MEDICINE WHICH IS THE.
MEDICAL BRANCH OF THE NATIONAL
ACADEMY OF SCIENCES.
THE TWO THAT TWO THOUSAND AND
TEN STUDY.
ESTIMATED THAT WASTE OF NOT
TOTAL WASTE BUT WASTE IN THESE
FOUR CATEGORIES UNNECESSARY
SERVICES INSUFFICIENTLY
DELIVERED SERVICES MISS
PREVENTION OPPORTUNITIES AND
FRAUD. WAS NOT FIVE PERCENT WAS
NINETEEN PERCENT.
OKAY NINETEEN PERCENT NOW ARE AS
WE GO THROUGH IN OUR STUDY.
THAT WAS A TWO THOUSAND AND TEN
STUDY AND AS WE GO THROUGH THERE
IS.
MORE RECENT RESEARCH.
THAT AFFIRMS THAT.
BASIC FINDING AREACTUALLY A
SUGGEST THAT THE NUMBER IS.
TOO LOW.
NOW THERE ARE PEOPLE THAT SAY
THAT OKAY THAT'S NOT REALISTIC.
THAT YES THERE'S ALL THIS WASTE.
BUT
WE DON'T KNOW HOW TO GET AT IT.
THERE IS NO WAY TO GET AT IT SO
THERE'S NO POTENTIAL SAVINGS
I'VE I'VE RECEIVE THAT CRITICISM
FROM OUR ON OUR REPORT FROM
PEOPLE I RESPECT.
I DISAGREE WITH THAT BECAUSE.
IF YOU CANNOT GET AT IT IN
ANYWAY EVEN UNDER A TOTALLY
REORGANIZED ADMINISTRATIVE
STRUCTURE THEN ACTUALLY IT'S NOT
WASTE.
IT'S PART OF HOW THE SYSTEM
OPERATES.
SO A. LOT WHAT WE'VE SUGGESTED
THE FIVE PERCENT IS ACTUALLY A
VERY LOW FIGURE.
RELATIVE TO THE SERIOUS RESEARCH
LITERATURE INCLUDING.
THE WORK OF.
THE PERSON WHO WAS THE.
THE HEAD OF THE OF THE.
SEE A MASS UNDER PRESIDENT
OBAMA.
.
FOR SOME TIME AT HOME WHO HAS
READ OUR STUDY AND ACTUALLY SAID
YOUR NUMBERS ACTUALLY.
LOW.
SO WE THINK THAT'S IT AYE
CONSERVATIVE ESTIMATE OF THE
POTENTIAL SAVINGS IN THIS AREA
AND. PART OF WHAT GETS US THE
SAVINGS IS A THROUGH INSTITUTING
A SOME KIND OF A GLOBAL
BUDGETING SYSTEM. AND.
AND THEN ALSO INCLUDING WITH
THAT THE.
.
THE TYPES OF.
COMMITMENTS TOOK.
TO CARE AND TO.
THE.
THE THE.
BOARD THAT IS PROPOSED THAT IS
GOING TO PROVIDE OVERSIGHT INTO
THESE AREAS SO WE HAVE THE THE
COST CONTAINMENT WE HAVE THE.
SYSTEM OF REVIEW AND.
WE SHOULD BE ABLE TO GET.
SOMEWHERE IN THE RANGE OF FIVE
PERCENT OUT OF THE ROUGHLY
TWENTY PERCENT. THAT THE
RESEARCH LITERATURE SAYS EXISTS
AND IN THE AREAS OF WASTE AND BY
THE WAY THIS FIVE PERCENT FIGURE.
OUT THE STUDY FOR VERMONT THAT
WAS REFERRED TO BEFORE.
THEY SAY IT'S TWENTY PERCENT.
A SO MY NUMBER IS ACTUALLY QUITE
LOW RELATIVE TO WHAT'S OUT THERE.
AND IT WOULD BE
BETTER TO BE LOW BECAUSE IF YOU
EXPERIENCE BETTER SAVINGS THAN
BUT SOLD BETTER HOW ARE YA
ENSURE. THAT BUT WHAT WE WE
DIDN'T WE DEFINITELY DIDN'T WANT
TO GET A PRESENT YOU ALL OF YOU
DECISION MAKERS. WITH
UNREALISTIC FIGURES.
SO I THOUGHT YOU KNOW OUR STUDY
NATURALLY EVERY STUDY IS
CRITICIZED.
AND A LOT OF THE CRITICISMS
HAVE OF VALUE NO DOUBT SOME OF
THEM DON'T BOOK OKAY.
BUT THAT THE POINT IS THAT WHAT
WOULD WHEN WE GOT THAT THE MAIN
AREA OF FOCUS OF CRITICISMS WAS
AROUND THIS ISSUE OF COST
SAVINGS. BUT IF YOU LOOK AT THE
NET. YOU KNOW THE DEBATE THAT'S
GONE ON A LOT OF THE CRITICISMS
KIND OF CANCEL EACH OTHER OUT
SOME PEOPLE SAY WE ARE TOO LOW
AND OUR ESTIMATE OF
ADMINISTRATIVE SAVINGS. SOME
PEOPLE SAY THAT WE ARE TOO HIGH
ON THIS FIVE PERCENT TO FIVE
PERCENT A YEAR AGO RELATIVE TO
THE TWENTY PERCENT THAT THE
RESEARCH LITERATURE SAYS IS
WASTE.
OVERALL I THINK OUR OVERALL
ESTIMATE OF EIGHTEEN PERCENT
SAVINGS
IS A CONSERVATIVE NUMBER AT AN
ATTAINABLE AND ATTAINABLE NUMBER
REALISTIC.
ON ONE OF THE THINGS THAT I
ALWAYS INCORPORATED INTO ON
THEIR SERVERS SERVICES WAS ALL.
AND IT ON TESTING.
YOU HAVE THIS TEST YOU NEED THAT
HAS TO AND I THINK IT'S PART OF
THAT IS. BASED ON THE CONCERN OF
MALPRACTICE AND LAWSUITS AND YOU
KNOW IT GOT TO A POINT WHERE.
YOU KNOW I HAVE MY BROTHER'S A
POSITION.
MALPRACTICE JUST.
COVERAGE YOU KNOW HOW TO AND
HE'S NOT IN CALIFORNIA'S AND NEW
YORK SO THEY DON'T HAVE THE
PROTECTIONS THAT WE HAVE EVEN
HAVE HERE.
THAT IS A BIG DEAL I THINK THOSE
LAWSUITS.
IS THAT ADDRESSED IN SOME OF
THIS UNNECESSARY SERVICES
BECAUSE I THINK THE RESULT OF
LAWSUITS IS EXTRA TESTING.
YEAH I MEAN SO THERE WE TO DO WE
DISCUSS IN THE AND THE STUDIES
WHAT IS CALLED IN THE LITERATURE
PHYSICIAN INDUCED DEMAND.
WHERE PHYSICIANS EITHER? ARE
SUGGESTING EXCESSIVE TESTING
BECAUSE THEIR FEES THAT THEY CAN
A GENERATOR OR BECAUSE THEY'RE
AFRAID OF LOS.
AND SO ONE WHEN YOU MOVED TO A
SINGLE PAYER SYSTEM WITH A
SIMPLE ADMINISTRATIVE STRUCTURE
AND CLEAR GUIDELINES.
WITH THE INTEGRATED CARE OF
GLOBAL BUDGETING.
THOSE KIND THEY THE THE
POSSIBILITIES FOR THESE KINDS OF
PROBLEMS.
IT'S NOT THAT THEY'RE GONNA GO
AWAY ENTIRELY THEY'RE GOING TO
BE DIMINISHED
AND THAT'S HOW WE GET THE
SAVINGS.
I THINK THERE'S ALSO SOME
OPPORTUNITIES FOR.
THAT IN IN TRANSITIONING TO
ANOTHER SYSTEM LIKE THIS THERE
ARE. OPPORTUNITIES TO CHANGE A
REFORMER IMPROVE THE DELIVERY OF
DELIVERY SYSTEMS.
AND WE NEED TO LOOK AT THAT YOU
KNOW WE'RE ALREADY DOING THE
MOVING FROM VOLUME BASED.
PAYMENT TO A VALUE BASED.
AND LOOKING AT.
EVIDENCE BASIS WHAT TYPES OF
MODELS OF CARE WORK BETTER IN A
FEE FOR SERVICE VERY INEFFICIENT
VERY VOLUME BASED. A NONPROFIT
INTEGRATED DELIVERY SYSTEMS.
YOU KNOW EVIDENCE SPACES FOR
THAT IS OF IS GOOD SO I THINK WE
THAT THERE ARE OPPORTUNITIES.
IN DOING THIS BESIDES SAVING
MONEY.
IMMEDIATELY OR THE LONG RUN TO
REFORM HOW MEDICAL CARE IS
DELIVERED. IN AND USING THE
EVIDENCE BASIS THAT MAKES IT YOU
KNOW MORE EFFICIENT.
I AND.
EVAN SPACES FOR APPROPRIATE
CARE.
QUALITY REPORTING.
OF ALL THOSE KINDS OF THINGS
PERFORMANCE YOU KNOW ACCESS
SERVICE QUALITY.
WHEN WE BELIEVE THAT S. B. FIVE
SIX TWO DOES THAT IN A BETTER
WAY. THEN THE KIND OF PRACTICES
THAT ARE USE NOW.
TO THE VALUE OF PAIN FOR VALUE
OVER VOLUME HAS NOT SAVE MONEY
IN THE U. S. HEALTHCARE SYSTEM
THAT IS A.
MANDATE UNDER THE AFFORDABLE
CARE ACT THAT HAS NOT YET PROVEN
ITS EFFICACY AND IN FACT RECENT.
STUDIES HAVE SHOWN THAT THOSE
MODELS INHERENTLY DISCRIMINATED
AGAINST POOR PEOPLE AND PEOPLE
OF COLOR. SO WE WOULD OBJECT TO
THE APPLICATION OF THE DOCTOR
TURNS IN SKI SPEAKING OF. IN THE
INTERIM WHERE INSURANCE
COMPANIES ARE STILL IN CHARGE
THERE'S NO CONTROL OVER COSTS OR
PRICES AND IN THAT ENVIRONMENT
THERE'S EVERY INCENTIVE. TO
REDUCE CARE IN ORDER TO FURTHER
THE BOTTOM LINE THE BEST EXAMPLE
OF THAT KIND OF SYSTEM NOW
COURSES KAISER PERMANENTE A.
THEY MAKE A BILLION DOLLARS
EVERY QUARTER.
A BILLION DOLLARS EVERY QUARTER.
WE DON'T THINK THAT'S JUSTIFIED.
.
THIS ONE TO DEVIATE REALLY QUICK
ANA TO SCHOOL SIDEBAR BEFORE
AGAIN INTO MY NEXT FINANCE
QUESTION. ONE OF THE THINGS WE
HEARD IN ONE OF OUR PREVIOUS
HEARINGS WHEN WE LOOKED AT
INTERNATIONAL NAM APPLICATIONS
OF. EITHER ATTEMPTS THAT SINGLE
PAYER OR AT LEAST UNIVERSAL
COVERAGE WITH MULTIPLE PAYING
SYSTEMS.
ONE OF THE THINGS THAT HELPED.
DELIVERY OF SERVICE ACTUALLY
CARED OF THE PATIENT WHICH IS
THE BIG DEAL IF THEY'RE ACTUALLY
GETTING CARE. WAS THIS SOCIAL
SERVICE NETWORK THAT WAS AROUND
THEM.
AND I'M LOOKING AT THE. YOU KNOW
HERE WE HAVE.
THE COMPREHENSIVE BENEFITS WE
SAW THAT SLIDE. AND HAS A LOT OF
THINGS TO DO WITH ACTUAL.
PROCEDURES OR YOU KNOW TESTING
AND THINGS LIKE THAT BUT.
IS THERE OF PLACE OR IS IT
INCLUDED TO INCREASE THE SOCIAL
SERVICE NETWORK AROUND.
THE WHOLE TREATMENT OF THE
PATIENT.
THAT'S REALLY WHAT THE CARE
COORDINATOR PROGRAM IS DESIGNED
TO DO UNDER S. B. FIVE SIX TWO
WHERE EVERY EVERY MEMBER EVERY
CALIFORNIAN EVERY RESIDENT WILL
HAVE A MEDICAL HOME. A PLACE
WHERE THEY CAN GO TO GET
ASSISTANCE NAVIGATING THE SYSTEM
WHERE THERE ADMINISTRATIVE
TRACKING WILL BE WHERE THEY CAN
HAVE.
MEDICAL RECORDS ACCESSIBLE SO
IT TO US THAT REALLY DOES
FULFILL THAT FUNCTION OF OF
CREATING A SUPPORT.
SORT OF SUPPORT SERVICES AROUND
THOSE AND THEN WE ELIMINATE THE
MEANS TESTING THE CURRENTLY
EXISTING MEDI CAL FOR THOSE IN
HOME SUPPORT SERVICES.
SO WE ALSO EXPAND.
.
THAT PEOPLE'S ABILITY TO HEALTH
CARE OR GET THOSE SERVICES THAT
ARE CURRENTLY GETTING ONLY FOR
LOW INCOME FOLKS EVERY
CALIFORNIA WOULD HAVE ACCESS TO.
SO WE DO THINK THAT WE CAN
ACHIEVE SOME OF THAT.
SOME OF THOSE.
ANCILLARY. SERVICES AND
EFFICIENT SPENDING ON THE
SERVICES THROUGH OUR CARE
COORDINATOR PROGRAM.
AND THAT'S INCLUDED IN THAT'S
INCLUDED IT.
CAN I HAVE CAN I ADD TO THAT.
SO THAT SO THAT'S DEFINITELY A
BIG INVESTMENT AND A QUALITY
THAT IS VERY STRONG.
IN THIS PROPOSAL.
AND THE FIELD IS RAPIDLY
EVOLVING RIGHT NOW AS WE SPEAK
IN CALIFORNIA YOU MAY BE
FAMILIAR WITH THE WHOLE PERSON
CARE INITIATIVE IN TAKING A LOOK
AT HOW WE SPEND OUR MEDICAID
DOLLARS.
AND REALIZING THAT MANY OF THE
AFFLICTIONS.
GOV ARE CHRONICALLY ILL
PATIENTS THAT WE'RE DEALING WITH
AND CONFRONTED WITH. ARE ROOTED
IN SOCIAL DETERMINANTS OF HEALTH.
AND SO THAT PUTS A NEW.
ADVANTAGE TO HAVING A SINGLE
PAYER SYSTEM BECAUSE WE'RE GOING
TO HAVE TO RAPIDLY THINK ABOUT
HOW OUR HEALTHCARE SYSTEM.
INTERACTS WITH OUR HOUSING
SYSTEM THAT INTERACTS WITH ARE.
MENTAL HEALTH SYSTEM AND
INTERACTS WITH OUR
TRANSPORTATION SYSTEM AS AN
EXAMPLE IF YOU WANNA FIGHT
DIABETES AND OBESITY. YOU'VE
REALLY HAVE TO LOOK ATOUR
TRANSPORTATION PARTNERS WHO
DECIDE WHERE PUBLIC
TRANSPORTATION IS GOING TO GO
OVER SIDEWALKS ARE GONNA GO OVER
BY PATHWAYS ARE GONNA GO. SO
THIS IS GOING TO FORCE A NEW
KIND OF COLLABORATION BUT WHAT
BETTER WAY THAN TO HAVE TO
COMMUNICATE WITH A MULTITUDE OF
DIFFERENT PAYERS WITH VARYING
DEGREES OF MOTIVATION AROUND
DEALING WITH NON MEDICAL THINGS.
THEN TO HAVE A SINGLE PAYER
GOVERNMENT ENTITY THAT IS
CONCERNED ABOUT THE. HEALTH OF
THE POPULATION AND THAT CAN WORK
IN A COLLABORATIVE MODE WITH
THESE DIFFERENT JUST.
I AGREE WITH YOU KNOW TO THE
EXTENT OF THOSE SERVICES.
I HAD A BILL LAST YEAR THE GO
VETO THAT ACTUALLY HAD WOMEN
MISDEMEANORS GETTING
TRANSPORTATION GETTING. THE
SERVICES GETTING OFF FOR THE
SUBSTANCE ABUSES AND ALL OF
THOSE THINGS TO EXISTING FUNDING
AND I GOT VETOED SO YOU CAN SEE
THE WEIGHT WHERE HURT STATE IS
ON THAT.
OKAY.
QUICKLY.
I AM CONFUSED HOWEVER ABOUT THE
ESTIMATED REDUCTIONS IN
ADMINISTRATIVE COSTS IN
HOSPITALS AND PHYSICIAN OFFICES.
HOW THAT WOULD TRANSLATE INTO
LOWER HOLD SPENDING?
?
THE PROPOSAL WAS THAT PHYSICIANS
AND HOSPITALS BE PAID AT
MEDICARE RATES.
AN ESTIMATE THE SAVINGS FROM
THAT PROPOSAL IF PHYSICIANS AND
HOSPITALS ARE ABLE TO REDUCE
COSTS BY LAYING OFF BILLING
RELATED STAFF.
HOW WILL NOT RESULT IN REDUCED
COSTS FOR CONSUMERS?
IF THE PROVIDERS ARE STILL BEING
PAYING MEDICARE RATES
SO THAT OUTLAY IS STILL THERE
BUT. HOW DOES THAT TRANSLATE THE
ONLY WAY I CAN SEE THAT WORKING
IS IF?
ULTIMATELY THE PROPOSAL WOULD BE
PAYMENT RATES EVEN LOWER THE
SOMETHING.
OKAY SO IN OUR.
PROPOSAL AND.
.
YEAH I THIS I DIDN'T PUT UP THE
SLIDES BECAUSE I WANTED TO LOOK
AT ME.
BUT.
IF WE GO TO TABLE STAFF AND
WHICH I GUESS IS WHAT YOU'RE
REFERRING TO.
WE HAVE.
THREE SOURCES.
OF ADMINISTRATIVE SAVINGS.
AND SO THOSE WOULD BE.
ADMINISTRATION WITHIN HOSPITALS
ADMINISTRATION AND DOCTORS
OFFICES AND CLINICS.
AND THEN THE PRIVATE INSURANCE
AND AS YOU CAN SEE WE BREAK
THOSE OUT.
ARM ONE BY ONE SO THAT'S
ADMINISTRATIVE.
NOW THAT'S DISTINCT IN OUR
CATEGORIZATION FROM THE SAVINGS
THAT WOULD ACCRUE THROUGH MOVING.
TO UNIFORM MEDICARE RATES.
SAID THE UNIFORM MEDICARE RATES.
.
YEAH SO WE HAVE THE
ADMINISTRATIVE SAVINGS AND
HOSPITALS ONE POINT THREE
PERCENT.
.
I. AND THEN WE GET THAT BY
SAYING WE'RE GOING TO SAVE FORTY
PERCENT ON ADMINISTRATION WHICH
ACTUALLY IN AS AGAIN IT'S A LOW
NUMBER RELATIVE TO. WHAT WE'VE
HEARD AND SO FORTH?
NOW.
MOVING TO THE MEDICARE RATES.
.
THE.
.
S. AS WAS REFERRED TO A MOVING
TO UNIFORM MEDICARE RATES WOULD
MEET ME IN A RATE INCREASE
RELATIVE TO MEDI MEDI CAL.
AND WOULD MEAN A REDUCTION
RELATIVE A TO PRIVATE.
SO THERE THERE IS CERTAINLY AN
ISSUE.
THE DOCTOR TO ACTIONS KEY
RAISED ON THAT.
ON THE OTHER HAND WE HAVE TO
RECOGNIZE THAT WHEN. AS AS
DOCTORS DZERZHINSKY ALSO
MENTIONED.
WHEN THAT THE PHYSICIANS
OFFICES ARE GOING TO BE RELEASED.
FROM HAVING TO COVER THE THESE
ADMINISTRATIVE COSTS AND THE
TIME SPENT THAT WILL ENABLE THEM
TO ALSO.
BRING IN.
MORE PATIENTS AND SO THOUGH THE
RATES ARE RELATIVE TO PRIVATE
RATES ARE GOING TO COME DOWN.
THE AMOUNT OF TIME DEVOTED TO
BILLABLE HOURS WILL ACTUALLY
INCREASE AND.
WE WILL HAVE MORE PATIENTS
COMING IN BECAUSE EVERYONE IS
GOING TO HAVE DECENT CARE SO WE
THINK THAT. ON BALANCE.
PHYSICIANS HAVE.
INCOME WILL NOT BE HURT BY THIS
MEASURE.
AND DATA I THINK WE'LL BE ABLE
TO SHOW THAT.
ONCE YOU OPEN UP ACCESS LIKE
THIS YOU KNOW A LOT OF
PHYSICIANS WE WILLING TO SEE
PATIENTS.
NOW THAT THEY'RE NOT SEEING NOW
YOU WORLD.
GET CONTROL OF YOUR. ASTHMA
HEART DISEASE.
HYPERTENSION.
BOB DIABETES OTHER CHRONIC
ILLNESSES.
RIGHT NOW THERE'S A HUGE COST
BECAUSE THESE PATIENTS ARE BEING
SEEN WITH CHRONIC DISEASE AND
REGULAR. PRIMARY CARE WHETHER
THESE QUANTITIES CAN BE MANAGED
A SHOP IN EMERGENCY ROOMS
THERE'S A MUCH HIGHER
HOSPITALIZATION RIGHT FOR THESE
PATIENTS BECAUSE ARE NOT UNDER
REGULAR. PRIMARY CARE WHERE THE
GETTING CONTINUITY OF CARE.
OPENING UP LIKE THIS TO DOCK.
BUMPING UP THAT TYPE OF ACCESS
TO PHYSICIANS WOULD BE EXCEPT
ACCEPTING MORE PATIENTS LIKE
THIS WILL OVER TIME REDUCE
EMERGENCY ROOM VISITS REDUCE
HOSPITALIZATIONS AND ADMISSIONS
SO THEY WILL CUT COSTS THAT WAY.
IMMEDIATELY BUT OF AN UP FRONT
INVESTMENT BUT OVER TIME TO WILL
BE SAVINGS BECAUSE THE QUALITY
OF CARE WILL IMPROVE. AND YOU'RE
NOT GOING TO HAVE. A LOT OF
EMERGENCY ROOM VISITS AND
HOSPITALIZATION RATES THEY ALL
WILL GO DOWN.
HOW MANY?
I WAS GOING TO ADD THAT WE CAN
ASSUME THAT DOCTORS ARE GOING TO
WORK THE SAME NUMBER OF HOURS
THEY'RE WORKING NOW UNDER. THE
NEW SYSTEM BUT THEY WILL NOT BE
SPENDING THE HOURS ON
ADMINISTRATION SO THEY'RE
ACTUALLY BE MORE CLINICAL HOURS
AVAILABLE TO THEM IS. AS STEVE
SAYS AND SO WE TALK ABOUT THE
POSITION SHORTAGE WELL THE BEST
WAY TO CREATE MORE TIME FOR
PHYSICIANS TO DO CLINICAL
TREATMENT. IS TO ELIMINATE THEIR
ADMINISTRATIVE TIME AND SING AND
CRY SIX TWO DOZEN.
I'M IS AN ESTIMATE OF HOW MANY
PEOPLE ACTUALLY BE LAID OFF OR.
REMOVED FROM THE SYSTEM.
YEAH SO SO AS I MENTIONED IN IN
THE HEALTH.
OUR INSURANCE INDUSTRY.
.
RIGHT NOW THE STATE EMPLOYEES
ABOUT A HUNDRED AND FORTY SEVEN
THOUSAND PEOPLE.
AND IF WE IF YOU TAKE THESE
NUMBERS THAT WE HAVE THIS
ESTIMATE OF ADMINISTRATIVE
SAVINGS. THAT WOULD MEAN ROUGHLY
HALF OF THEM.
BUT GET A LAID OFF FROM THEIR
EXISTING POSITION.
THE OTHER HALF COULD BE MOVED
INTO THIS
ADMINISTERING THE STATE PROGRAM
AT YOU KNOW. TWICE THE LEVEL OF
EFFICIENCY
AND SO WHAT WE THEN.
WORK THROUGH OUR WAYS THROUGH
WHICH
TO EITHER AT THE PEOPLE WHO ARE
CLOSE TO RETIREMENT MOVE THEM
INTO RETIREMENT.
WITH A WITH A WAGE KAREN TEETH
UNTIL THEIR PENSION KICKS AND.
AND SECONDARILY.
TO.
TO MOVE PEOPLE IF THEY SO
CHOOSE INTO COMPARABLE TYPE
POSITIONS IN THE STATE
ADMINISTRATION AND SO WE
ACTUALLY WORK THROUGH SOME
DETAILS ON THAT AND WE LOOKED AT
HOW OUTSIDE OF THE HEALTH CARE.
WHAT ARE THE KINDS OF SKILL SETS
ON IN OTHER AREAS OF?
?
OF STATE ADMINISTRATION THAT IN
WHICH THESE PEOPLE COULD EASILY
MOVE. AND SO WHAT WE FOUND WAS.
.
THAT OF THOSE POSITIONS.
.
THE THE DEMOGRAPHIC OF PEOPLE
WHO ARE IN THAT AGE RANGE OF
SIXTY AND OVER.
ALL PEOPLE LIKE ME.
.
THAT'S ABOUT
SEVENTY SEVEN THOUSAND PEOPLE
AND SO THAT OVER A THREE YEAR
PERIOD WE THINK WE COULD MOVE.
IF PEOPLE WANT THOSE JOBS L.
INTO THOSE
OUR OTHER JOBS
AND IN ADDITION WE ALSO.
PROVIDE FOR THEM.
RETRAINING FOR TWO YEARS OF
WAGE INSURANCE UP PENSION
GUARANTEES
AND THROUGH THAT AS I SAID THERE
WERE THERE ARE COSTS AND THE
COST WOULD BE I THINK IN THE
RANGE OF ABOUT ONE PERCENT OF
SYSTEM COSTS FOR THREE YEARS. TO
MOVE PEOPLE INTO.
AT IT COULD TEACH ALTERNATIVE
SITUATION.
AND THEY'LL NEVER LOSE THEIR
HEALTH INSURANCE.
YEAH.
IN A.
I THINK TO DRILL DOWN ON THAT
QUESTION
TO THE DELIVERY SINCE
BECAUSE I HEARD YOU SAY WELL
WHAT ABOUT.
DOWN ON
CARE RATES BECAUSE THE HOSPITAL
DOESN'T HAVE TO HAVE AS MANY
BILLER'S STORY YOU KNOW DEALING
WITH ALL THE.
THE PAPERWORK.
THERE ARE SO MANY DEMANDS AT
THAT POINT OF DELIVERY OF THE
POINT OF SERVICE RIGHT NOW. DAY
CREATIVE THINKING IS THERE
AROUND HOW TO MAKE ADJUSTMENTS
AND I JUST WANT TO GIVE YOU ONE
EXAMPLE. ELECTRONIC MEDICAL
RECORD TECHNICALLY THAT ENDS UP
YET I MEAN THERE'S A WHOLE LOT
ISSUES RELATED TO THAT BUT FROM.
A FROM A WORK STANDPOINT.
IT TAKES AWAY JOBS BECAUSE ALL
OF A SUDDEN YOU DON'T NEED STAFF
TO DEAL WITH FILES AND AND
RETRIEVING FILES AND THINGS LIKE
THAT IT'S ALL ELECTRONIC.
BUT WHAT WE'VE DONE IT ASIAN
HEALTH SERVICES WE'VE TAKEN AND
LOOKED AT THE POOL OF FOLKS THAT
ARE WORKING IN MEDICAL RECORDS
AND ABLE TO SHIFT
RESPONSIBILITIES AROUND
INTERPRETATION AROUND CULTURAL
LINGUISTIC APPROACHES. AND
AROUND A COMMUNITY OUTREACH AND
HEALTH EDUCATION PROGRAMS SO
THAT THERE'S RE DIRECTION AND A
LITTLE BIT OF REAP WITH A LITTLE
BIT OF RETRAINING. AND HOSPITALS
ARE IN THE SAME SITUATION WHERE
AS AS WE BEGIN TO RECOGNIZE HOW
WE NEED TO MOVE BEYOND JUST THE
STRAIGHT MEDICAL MODEL AND NOW
WE NEED TO ADDRESS NON CLINICAL
ISSUES. THAT ACTUALLY YOU KNOW
WILL INFLUENCE WHETHER OR NOT
PEOPLE NEED TO COME INTO THE
HEALTHCARE SYSTEM.
THEN THERE IS GOING TO BE A NEW
WORKFORCE THAT ENDS UP EVOLVING
FROM THAT AND WE ARE LOOK AT A
LIMITED CAPACITY CURRENTLY.
WITHIN MOST OF OUR COMMUNITIES
BECAUSE MOST OF THESE HAPPEN TO
BE SOCIAL SERVICES THAT DON'T
GET THE TYPE OF UP PUBLIC
INTEREST TO AND.
POLICY SETTING AND THAT WE NEED
TO ACTUALLY MOVE TO CREATING AND
STRENGTHENING THOSE KINDS OF
RESOURCES WHEN OUR WITHIN OUR
COMMUNITIES AGAIN THAT'S WHAT
THE SINGLE PAYER WOULD DO. AND
THAT IT WOULD BE ABLE TO
CONSOLIDATE A LOT OF THE SAVINGS
ARE BEING ABLE TO SUPPORT THIS
EVOLUTION OF THE WAY WE PRACTICE
MEDICINE AND NOT IGNORING AND
SAYING THIS IS OF. THIS THIS IS
A DOCTOR'S OFFICE OR THIS IS A
MEDICAL OFFICE WE DON'T DEAL
WITH THAT PROBLEM BUT ACTUALLY
INTEGRATING OUR APPROACH AT THE
POINT A SERVICE LEVEL SO THAT WE
CAN. PROVIDE BETTER CARE.
I'M SORRY I'M JUST AS ONE MORE
QUESTION I'LL SAVE ALL MY OTHER
THROUGH LATER BECAUSE.
AND I WANT TO TAKE A FULL TIME.
UP I LOOKED AT CANADA.
.
IN GREAT BRITAIN AND WE HAVE
LOTS OF STUDIES BASED ON YOU
KNOW HOW THEY'VE BEEN THE
ADVOCATING AND. SOME OF THE UPS
AND SOME OF THE DOWNS.
ADMINISTRATIVE STAFF IN CANADA.
AND HERE AS WELL A PRIMARY LIVE
WOMEN I MEAN WE HAVE A LOT OF
WOMEN WHO WORK IN THAT CAPACITY
IN HEALTH CARE NOW. DOING THE
FILING OF THE CLAIMS AND
HANDLING DENIALS AND THINGS LIKE
THAT FOR THEIR DOCTORS.
.
THERE WERE LAID OFF AND
PHYSICIAN'S SALARIES.
IT ON AVERAGE WORK COSTS.
YOU KNOW IN CALIFORNIA WE'RE SO
LOW ON THE MOUND OF PHYSICIANS
WHO ACTUALLY TAKE MEDI CAL WE
NEED SO MANY MORE. SO IF WE
ESTIMATE ABOUT A THIRD OR
MEDICAL PROVIDERS THAT LEAVES
TWO THIRD OF FOR OF PROVIDERS OF
NOT MEDI CAL PROVIDER SO TWO
THIRDS WILL SEE A CUT PAY.
.
SO THEY'RE THOSE PHYSICIANS
SALARIES IN CANADA WERE CUT TO
HALF OF WHAT A PRIMARY CARE
DOCTOR MAKES IN THE UNITED
STATES.
SAVING MONEY UP FRONT.
THIS BEING THE CASE.
WHAT WILL HAPPEN TO NURSES
SALARIES BECAUSE WHEN I LOOK TO
GREAT BRITAIN THERE STARTING
SALARIES TWENTY TWO THOUSAND?
I MEAN ARE WE HOPE. WE DON'T
WANT TO GET TO THAT POINT SO
WHAT.
HOW HOW WILL OTHER HOWELL
CLINICIANS AND OTHER SALARIES BE
AFFECTED AS WELL SINCE WE'RE
LAYING OFF PEOPLE COMING OTHER
SALARIES AND WHO WERE NOT
CARRYING ANY SALARIES AND HIS
DOCTOR POLAN SAID?
THERE IS PLENTY OF MONEY WHERE
THE PHYSICIANS WILL ACTUALLY NOT
SUFFER A LOSS OF INCOME AND
CERTAINLY THE REGISTERED NURSES
WILL NOT EITHER BECAUSE THE
PROBLEM IS. WHAT WE'RE DOING NOW
IN THE IN THE CURRENT
ENVIRONMENT IS WERE RESTRICTING
CARE IN OR DECEIVE MONEY WERE?
A YOU AMERICANS GO TO THE
DOCTOR LESS THAN THE AVERAGE FOR
SIMILAR COUNTRIES IN THE WORLD
WE HAVE SHORTER LENGTH OF STAYS
WE USE LESS HEALTH CARE NOW. AND
A LOT OF THAT HAS TO DO WITH THE
BARRIERS TO CARE IF YOU LOOK AT
THESE INTERNATIONAL COMPARISONS
AT THE COMMONWEALTH FUND AND
OTHERS HAVE DONE THEY WILL TELL
YOU AMERICANS USE. A LITTLE BIT
LESS HEALTH CARE THAN AVERAGE
BUT WE PAY A LOT MORE OUR
PROBLEM ARE THE PRICES NOT THE
SALARIES.
AND THE DOCTORS INCOME WILL NOT
GO DOWN BECAUSE THEY WON'T BE
PAYING EIGHTY THOUSAND DOLLARS A
YEAR FOR BILLING CLERKS SO
SO THAT IS A HUGE SAVINGS FOR
THEM.
THEREFORE WHAT WE'RE ABLE TO DO
IS ACTUALLY MAINTAINING PROVIDER
SALARIES BECAUSE WE. PUT
EVERYONE IN RESPOND RISK POOL WE
SAVE ON PRESCRIPTION DRUG.
COST WE SAVE ON ADMINISTRATION
WE SAVE ON DELIVERY ALTHOUGH
SAVINGS DOCTOR POLAN TALKED
ABOUT IN ABLE US. TO THEN
PROVIDE COMPREHENSIVE BENEFITS
AT A CURRENT SALARIES WITH THOSE
SAVINGS THAT'S THE DIFFERENCE
THEN WE WHAT WE HAVE IN THIS
COUNTRY IS WE SPEND SO MUCH ON
HEALTH CARE THERE IS PLENTY OF
MONEY. IF WE SPEND IT WISELY IF
WE GET OUR MONEY'S WORTH WE
CAN'T COVER.
EVERYBODY.
SO WE'VE BEEN THROUGH FORTY FIVE
MINUTES OF QUESTIONS THUS FAR
AND JUST WANT TO ASK THE PANEL
IF YOU WOULD BE WILLING SINCE WE
HAVE. A FEW MORE ASSEMBLY
MEMBERS TEST QUESTIONS.
AND WOULD ASK THOSE WHO ARE IN
THE AUDIENCE TODAY IF AT ALL
POSSIBLE NOT TO APPLAUSE ONLY IN
THAT IT.
DELAYING LUNCH FOR UP. FOR YOU
PRIMARILY AND.
BUT WITH THAT AS LONG AS YOU'RE
OKAY WITH A FEW MORE QUESTIONS I
FOUND THIS QUITE SUBSTANTIVE AND
HELPFUL
SO. BOB NEXT WE WILL HAVE DOCTOR
WHAT.
THANK YOU AND AND THANK YOU ALL
EVERYONE ON THE PANEL I
APPRECIATE THAT I WANT TO COME
AND GO BACK TO JUST TO FOLLOW UP
A MISTER LIGHTLY TO WHAT.
ASSEMBLY MEMBER WALDRON WAS
JUST ASKING I'M SORRY I CUT YOU
MID BITE.
THAT'S OKAY.
IF I HAD WHEN I WOULD EAT WHEN
TO.
AM YOU SAID YOU KNOW WILL SAY
EIGHTY THOUSAND DOLLARS A YEAR
PER OFFICE AND BUILDING.
THOSE ARE PEOPLE'S JOB SO WHERE
THOSE PEOPLE GO. IN THE W.
BECAUSE YOU TALKED WITH DOCTOR
POLAN ABOUT THE HUNDRED FIFTY
THOUSAND STATE EMPLOYEES.
IT YOU SAY A HUNDRED FIFTY
THOUSAND PEOPLE PEOPLE AND THE
STATE OF CALIFORNIA EMPLOYED IN
IS IN. OUR ADMINISTRATION OF
HEALTH INSURANCE YEAH.
I THINK THAT NUMBER IT MUST BE
LOW DOCTOR TEARS ESCAPE. I KNOW
IN MY OWN UP DENTAL PRACTICE I
HAD TO PEOPLE.
THERE ARE TWENTY FIVE THOUSAND
DENTISTS IN CALIFORNIA THERE ARE
THIRTY THOUSAND DENNIS IN
CALIFORNIA I HAD A MODERATE SIZE
PRACTICE.
I HAVE TO BELIEVE THAT HUNDRED
FIFTY THOUSAND NUMBER IS MUCH
YEAH THAT'S FOR PRIVATE HEALTH.
THE PRIVATE HEALTH INSURANCE AND
RELATED ACTIVITIES FROM THE U.
S. QUARTERLY CENSUS OF
EMPLOYMENT THE MOST RECENT DATA
INDUSTRY WIDE FIGURES A HUNDRED
AND FORTY SEVEN THOUSAND SEVEN
HUNDRED AND FIFTY SEVEN.
DO YOU HAVE. WOULD SHUT ARTS.
I DON'T HAVE THOSE NUMBERS IN
FRONT OF ME.
BUT I CERTAINLY YES JOBS WILL
BE LOST BECAUSE OF THAT OKAY BUT
KNEW JOBS WILL BE CREATED. AND
THE QUESTION IS HOW DO WE MAKE A
TRANSITION IN A HUMANE MANNER
RETRAINING.
EARLY RETIREMENT.
YOU KNOW SURE BUT THAT'S A FACT
I MEAN YES IT'S GOING TO HAPPEN
BECAUSE THE SYSTEM WILL BE MORE
EFFICIENT. AND PEOPLE ARE
EMPLOYED RIGHT NOW IN THE SYSTEM
THAT IS HELPING MAKE IT ENOUGH.
ARE ONLY THERE BECAUSE IT IS
INEFFICIENT
SO YEAH WE'RE GONNA BUT DO ALSO
WILL BE NEW JOBS CREATED.
AND AND I GUESS THAT'S MY POINT
BECAUSE IT'S NOT GOING TO BE AN
EIGHTY THOUSAND DOLLAR SAVINGS
PER OFFICE BECAUSE THOSE PEOPLE
WILL STILL BE A PART OF THE
HEALTHCARE SYSTEM.
IN ANOTHER POSITION AND MY IS
THAT A FAIR CHARACTERIZATION.
THOSE.
IT'S ONE THING TO SAY YOU KNOW
THAT THE PHYSICIAN'S OFFICE WILL
NOT BEAR THOSE COSTS ANYMORE.
BUT THE SYSTEM STILL MIGHT IF
SYSTEM WILL BEAR.
SMALLER WORSHIP PORTION YEAH
AND THEN THERE WILL BE.
JOBS LOST AND THAT'S WHY WE I'VE
GONE THROUGH SOME OF THESE
PROPOSALS FOR A JUST TRANSITION.
OF PEOPLE I WHICH I DO BELIEVE
IN ANY FINAL BILL SHOULD BE AN.
PORTENT COMPONENT OF THE OVERALL
BILL.
I THINK THANK YOU JUST A.
I THINK THE OTHER AND ANOTHER
GO KIND OF ANOTHER FOLLOW UP TO
WEAPONS WATER WAS SAYING ABOUT.
SERVICES AND AND YOU TALKED
ABOUT TALKED ABOUT.
WHAT WE LEARNED IN OUR VERY
FIRST HEARING WAS THAT?
COUNTRIES THAT HAVE SINGLE
PAYER.
SPEND A LOT MORE ON SOCIAL
SERVICES WHICH RELATES TO THE
HEALTH OUTCOMES.
THE GREATER HEALTH OUTCOMES
THINGS LIKE EDUCATION LIKE
TRANSPORTATION ISSUES THERE BUT
THAT REALLY ISN'T ADDRESSED BY A
CARE COORDINATOR.
IT IT'S IF IT'S. IN MY PIGEON
SO. IF WE'RE GONNA GET THOSE
BETTER BIGGER NO BETTER HEALTH
OUTCOMES HOW DO WHERE IS THE IT
DISH NO MONEY COME FROM TO DO
THAT IF BECAUSE THAT. IS NOT
EXACTLY THE WAY IT WAS PRESENTED
TO US BY THE COMMONWEALTH.
WELL I THINK WE HAVE TO
UNDERSTAND FIRST OF ALL OF THAT
THE PRESENT SYSTEM HAS NO
ABILITY TO DO THAT.
SO YOU HAVE TO YOU HAVE TO
COMPARE THE PRESENT SYSTEM TO
THE ALTERNATIVES.
AND.
SO FOR. THE YOU'RE ACTUALLY
RIGHT WHAT HAPPENS IN IN
EUROPEAN COUNTRIES IS THEY HAVE
A HIGH TAX AND FIRE MEANT
USUALLY TO VALUE ADDED TAXES
WHICH ARE KIND OF SALES TAX. AND
NAY COMPREHENSIVELY FUND SOCIAL
SERVICES
WE ON THE OTHER HAND IN THE U.
S. FUND THOSE SERVICES TO
PRIVATE SPENDING.
WE YOU KNOW EITHER OUR EMPLOYER
PROVIDES BENEFITS OR WEALTHY
INDIVIDUALS BY THEM ON THEIR OWN
OR WE GET TAX SUBSIDIES TO
PURCHASE SOME SET OF THOSE
BENEFITS WHICH IN GENERAL ARE
NOT EQUIVALENT. TO THE EUROPEANS
JUSTICE DOCTOR CHEN SAYS THE
SOCIAL DETERMINANTS OF HEALTH
ARE THE PRIMARY DRIVER OF HEALTH
DISPARITIES ANNIE AND IN A
QUALITY WE KNOW THE SIXTY
PERCENT OF AMERICANS HAVE TWO OR
MORE CHRONIC CONDITIONS BY THE
TIME THEY'RE SIXTY FIVE. THAT
MEANS THEY'RE NOT GETTING THEIR
PREVENTIVE TREATMENT AND THE ON
GOING CARE THAT THEY NEED. AND
THAT HAS A LOT TO DO WITH
POVERTY.
INADEQUATE HOUSING NUTRITION SO
WE CAN'T JUST TALK ABOUT HOW DO
YOU. ADDRESS THE SOCIAL
DETERMINANTS OF HEALTH THE
QUESTIONS HOW DO YOUR RADICALLY
POVERTY SO WE HAVE TO GO KIND OF
TWO LEVELS BACK ULTIMATELY. AND
THAT IS OBVIOUSLY BEYOND THE
SCOPE OF S. B. FIVE SIX TO WHAT
WE CAN DO IS WE CAN ELIMINATE
MEANS TESTING THAT CURRENTLY
PREVENTS THAT. PEOPLE WHO DON'T
ACTUALLY CAN'T AFFORD IT FROM
GETTING THE BENEFIT AND I DO
THINK WE SHOULD WE SHOULD BE A
LITTLE MORE AMBITIOUS AND I
WOULD ENCOURAGE THE LEGISLATURE
TO BE MORE AMBITIOUS. WE CAN
CREATE A HEALTH CARE SYSTEM
BASED ON OUR VALUES.
WHEAT FAVOR INTEGRATED MEDICINE
WE FAVOR ALTERNATIVE THERAPIES
WE FAVOR SUPPORT SERVICES AND
BROADER SOCIAL SPENDING WE FAVOR
A TRANSITION SO THE PEOPLE LEAD
HEALTHY LIVES NOT JUST GET
MEDICAL CARE FOR DISEASE.
THAT'S WHAT'S POSSIBLE HERE IF
YOU REORGANIZE THE SYSTEM IN
THAT KIND OF WAY THE FIVE SIX
TWO ENVISIONS YOU CAN TAKE WE
CAN TAKE DEMOCRATIC CONTROL OVER
ON HEALTHCARE SYSTEMS AND
ADDRESS THESE PROBLEMS I WOULD
ARGUE.
CHAIRMAN WOULD MORE EFFECTIVELY
WE'RE GONNA HAVE TO ADDRESS
THESE PROBLEMS THE QUESTIONS
WHAT SYSTEM CAN BEST ADDRESS
THAT IS FIVE SIX TWO
COMPREHENSIVELY PERFECT ON THESE
QUESTIONS NOW NO IT IS NOT. IS
IT THE BEST FOUNDATION TO DO
THAT WE BELIEVE IT IS.
AND JUST TO BE CLEAR ON THE CARE
COORDINATOR.
IN FACT YES THEY WROTE THE ROLE
OF CARE COORDINATORS YOU KNOW AT
ALSO LABEL PATIENT NAVIGATORS
ALSO LABELED THE COMMUNITY
HEALTH WORKERS TO ALSO WERE
LABELED CASE MANAGERS. THAT
SOCIAL SERVICE PERSON THERE'S A
WHOLE FIELD RIGHT NOW THAT'S
EXPANDING AND THAT IS THIS AS
DOCTORS INFUSE MENTIONING THAT
IS AN AREA OF CREATIVE JOB
GROWTH. THAT'S OCCURRING WITHIN
THE HEALTH INDUSTRY WITHIN THEIR
HEALTH INDUSTRY AND THAT IT'S
HAD SEEN AS A DEFINITE COMPONENT
THAT NEEDS TO BE ADDRESSED. AND
SO THAT'S THAT'S GOING TO BE
HAPPENING AND THAT'LL BE AN AREA
FOR FOCUSING RETRAINING AND SO
ON. BUT IT IT ALSO BEGS THE
POINT THAT I THINK.
MISTER LADIES BRINGING UP.
IT'S BETTER FOR US TO BE.
COGNIZANT OF THAT AND RECOGNIZE
THAT THERE'S A WHOLE OTHER
SERIES OF INTERACTIONS AND
VALUES THAT NEED TO BE BROUGHT
INTO OUR PUBLIC POLICY. AROUND
THOSE SOCIAL DETERMINANTS THAT
INCLUDE EDUCATION NAM AS YOU'RE
POINTING OUT AND INCLUDE YOU
KNOW THE JOB TRAINING IN. AREAS
THAT WILL KEEP PEOPLE UP BRING
PEOPLE OUT OF POVERTY AND OUT OF
THE DISPARATE PROBLEMS THAT
THEY'RE FACING AS SUB
POPULATIONS WITHIN A COMMUNITY
AS A WHOLE. AND BETTER TO BE
INTERACTING COLLABORATIVELY ON
THAT BETWEEN SYSTEMS THAT ARE
LAID OUT THAT ARE RESOURCE AND
VERY COMMITTED TO IT OVERALL
IMPROVING THE HEALTH OF THE
COMMUNITY.
THANK YOU.
.
AND I'M KIND ALL OVER THE BOARD
HERE SO I APOLOGIZE THERE'S NO
THAT'S THE WAY MY MIND WORKS OF.
.
SO AS WE IN ON MONDAY WE HEARD.
FROM.
FOLKS RELATED TO.
HOW WE WOULD POTENTIALLY GET
RAVE WAIVERS FROM MEDICARE
HOW WE WOULD POTENTIALLY GET
WAIVERS FOR MEDICAID?
WE HEARD ABOUT LIKE MR FOUNTAIN
TALKED ABOUT THE CHALLENGES ARE
THE THAT WE LOOK AT.
RELATED TO THE CONSTITUTION AND
AND AND AGAIN LIMIT AND PROP
NINETY EIGHT.
WE SAW THERE'S A LOT OF A LOT
OF THINGS THAT KIND ALL HAVE TO
STACK UP. TO MAKE THIS WORK AND
SO WHEN I WHEN I GET THE
IMPRESSION IN ON AND IT'S NOT
EVERYBODY SO PLEASE DON'T
CHARACTERIZE IT THIS WAY.
THERE ARE PEOPLE WHO BELIEVE
THAT THE PASSAGE OF THIS BILL
WILL LEAD TO. AN OVERNIGHT.
EVERYBODY HAS CARE.
AND.
I THINK WE ALL KNOW THAT'S
REALLY NOT TRUE.
I DON'T SEE HOW THAT COULD
HAPPEN.
DOCTORS IS KEY TALKED ABOUT YOU
KNOW.
AND AND MENTIONED WHICH WAS ALSO
MENTION ON MONDAY THE TIME IT
WILL TAKE TO ACTUALLY GET
WAIVERS IS SIGNIFICANT.
SO AS WE LOOK AT AND AND ONE OF
THE THINGS THAT REALLY ISN'T
ADDRESSED IN FIVE SIXTY TWO. IS
IS IS YOU KNOW YOU'LL LEGAL
TALKED ABOUT TRANSITION. BEEN
YOU KNOW PARTS OF IT BUT THERE'S
REALLY NOT A TRANSITION PLAN IN
THERE SO WHAT DO YOU WHAT DO YOU
REASONABLY EXPECT. AS A TIME
FRAME.
FROM THE PASSAGE OF A SINGLE
PAYER BILL IN CALIFORNIA TO THE
POINT WHERE PEOPLE ACTUALLY HAVE
COVERAGE IN THE WAY YOU ENVISION
IT.
WE M. WE AGREE THERE IS A
TRANSITION PERIOD AND THAT'S WHY
WE'VE ASKED DOCTOR PULL INTO THE.
JILL DOWN AND EXAMINE THOSE
ISSUES MORE SPECIFICALLY.
TO FIGURE OUT. THAT THE COSTS
AS HE'S DESCRIBE TODAY FROM THE
JOB MAYBE THE OTHER COSTS AS
WELL AND ALSO TIMELINE.
AS I MENTIONED EARLIER THE BILL
DOES ENVISIONED NOT FULL
IMPLEMENTATION UNTIL THAT AND
FUNDS ARE CERTIFIED SUFFICIENT
TO OPERATE THE PROGRAM.
SO THAT'S THE TRIGGER WHERE WE.
GO LIVE WITH HEALTHY
CALIFORNIA'S THE FUNDS ARE
SUFFICIENT THAT'S A
DETERMINATION. ULTIMATELY MADE
BY BY THE BOARD WITH WITH ADVICE.
SO THAT'S THAT'S WHERE WE STAND
WITH THE BILL LANGUAGE TODAY.
WHAT WE?
IT IS TRUE THAT. WE'RE NOT
GONNA FLIP A SWITCH AND HAVE
GUARANTEED HEALTHCARE BUT I
THINK WHAT'S IMPORTANT IS THAT.
THE NOTION THAT WE SHOULD JUST
WAIT FOR FEDERAL STATUTORY
CHANGESIS HIGHLY PROBLEMATIC
ONE BECAUSE WE DON'T NEED
STATUTORY CHANGES. THERE IS
EXISTING STATUTORY LANGUAGE
ABOUT STATE'S ABILITY TO
ADMINISTER MEDICARE I KNOW YOU
HAD EXPERTS TO. YOU KNOW THOUGHT
THAT WAS VERY LIMITED AUTHORITY
EXPERIMENTAL OR IN SOME RESPECTS
BUT IT DOES EXIST IN STATUTE.
DOCTOR POLAN TALKED ABOUT THE
THIRTEEN THIRTY TWO WAIVER
PROVISIONS VERY BROAD VERY CLEAR
THAT THAT THOSE FEDERAL MONIES
CAN RE RE DIRECTED FROM
SUBSIDIES TO TO FUNDING.
AND YOU GOT ELEVEN FIFTEEN UNDER
MEDICAID.
WHICH IS EXTENT WE HAVE AN
EXISTING CALIFORNIA WAIVER THE
LAWYERS WE'VE TALKED TO WHO USED
TO WORK FOR CMS BELIEVE WE CAN
EXPAND THAT.
SO WE'RE MORE OP WERE MORE.
HOPEFUL ABOUT THAT WE ALSO
BELIEVE THAT THERE ARE AS
SENATOR KEWELL HAS SAID WAYS FOR
THE LEGISLATURE TO DEAL WITH
AGAIN AND PROP NINETY EIGHT
ISSUES AND WE WOULD LIKE TO DO A
DEEP DIVE ON THAT WITH. YOUR
STAFF OTHER OTHER POLICY LEGAL
STAFF IN THE ASSEMBLY.
SO OUR VIEW IS IS THAT.
WE CAN EITHER SIT BY AND LET THE
TRUMP ADMINISTRATION DETERMINE
WHAT HEALTH CARE CALIFORNIANS
GET BY NOT EVEN TRYING NOT EVEN
TRYING TO GET WAIVERS NOT EVEN
CALLING THEM ON. THEIR
OPPOSITION TO.
WAIVER IN THIS CASE THAT WOULD
BE FULLY COMPLIANT WITH ALL THE
STATUTORY ADMINISTRATIVE
REQUIREMENTS. AND IF THEY DENY
IT WE BELIEVE THERE'S A BASIS
FOR LITIGATION.
WE THINK IT'S WORTH
A FIGHT AND.
YEAH THAT'S A POLITICAL CHOICE.
REALISTICALLY IF WERE ABLE IF
THE DEMOCRATS ARE ABLE TO TAKE
CONTROL THE HOUSE OF
REPRESENTATIVES OR THE SENATE
THEN THE POLITICAL ENVIRONMENT
CHANGES.
DRAMATICALLY WHAT WE HAVE DONE
WITH S. B. FIVE SIX TWO WE'VE
BEEN CRITICIZED FOR THIS WE HAVE
NOT WRITTEN A HUNDRED FORTY PAGE
BILL LIKE SP A. TEN. BECAUSE WE
BELIEVE THAT THE FEDERAL DYNAMIC
REQUIRES US CERTAIN LEVEL OF
FLEXIBILITY LAY THE FOUNDATION
SET THE BENEFITS SET THE
FINANCING. SET THE POLICY
FRAMEWORK AND FOUNDATION BASIC
PRINCIPLES FOR THE PROGRAM BUT
GIVE THE BOARD THE POWER TO
RESPOND TO THE CHANGING FEDERAL
CIRCUMSTANCE.
A LONG WAY OF SAYING WE DON'T
KNOW HOW LONG THE TRANSITIONS
GOING TO TAKE BUT WE KNOW IT'LL
BE SHORTER THE SOONER WE START.
SO I JUST KEPT JUST CLARIFY IN
AND I'M AND I DON'T YOU KNOW I.
WE HEARD THAT THIS WOULD REQUIRE
A CHANGE IN FEDERAL LAW FOR
MEDICAL MEDICARE TRUST FUND DO
YOU. UNDERSTAND DO YOU DISAGREE
WITH ACCESO LIKE YOU DO YEAH WE
DO BUT THERE'S TWO THINGS TWO
THINGS TO POINT OUT IN THE BILL
ITSELF.
WE WE'VE.
THE PROVISION IS WE'RE GONNA
PLAY FOR THESE WAIVERS WERE
GOING TO INTEGRATE THE BENEFITS
AND WE'RE GOING TO INTEGRATE THE
MONIES.
WE ALSO HAVE A PROVISION THAT
SAYS WE'RE GOING TO MAKE SURE
THAT EVERYONE WHO'S ELIGIBLE FOR
A FEDERAL PROGRAM WHOSE IN
CALIFORNIA APPLIES AND IN RULES
IN THAT PROGRAM A. GETS THE
BENEFITS FOR THAT PROGRAM.
WE ALSO SPECIFY THAT WE WILL PAY
THAT MADE AT THE PREMIUMS FOR
PART B. COVERAGE AND WE WILL PAY.
THE PART D. COVERAGE FOR
MEDICARE.
AM AND THE STUDY SHOWS WILL HAVE
THE RESOURCES TO DO THAT SO WE
ARE EIGHT APPLY FOR THE WAIVER
SIMPLY WE HAS A STATUTORY BASIS
AND WILLIAM SHALL IS ACTUALLY
THE ONE WHO POINTED THE WAY. TO
THIS THESE PROCESSES RIGHT. AND
THEN IF WE CAN'T GET THE WAIVERS
WE HAVE A WE HAVE THE ABILITY TO
CREATE A PARALLEL STRUCTURE SO
THAT WE CAN INTEGRATE THOSE.
.
PAYMENTS AS MUCH AS FEASIBLE
WITHOUT.
WITHOUT NECESSARILY THE WAIVERS
WE HAVE A CONTINGENCY PLAN. AND
WE HAVE A PROCESS TO SEEK THE
WAIVERS.
LOOKING AT FINANCING.
AND THANK YOU THANK YOU FOR THE
ANSWER.
AND WE AS AROUND THE QUESTION
OF RESERVES AND AND DO YOU
DOCTOR POLLAND HAVE AN ESTIMATE
OF WHAT YOU WOULD CONSIDER A
PRUDENT PERCENTAGE. OF RESERVES
AND HOW MUCH ROUGHLY HOW MUCH
MONEY IN RESERVE. WOULD WIN BE
ABLE TO NEED TO HAVE.
TO ACCOUNT FOR THESE
FLUCTUATIONS THAT ARE GONNA
HAPPEN IN.
IN THE NATURAL UNNATURAL DOINGS
OF OUR OUR ECONOMY CALIFORNIA
YEAH. SO.
.
LET'S SAY IN TODAY'S DOLLARS THE
SYSTEM COST.
ON AVERAGE AN AVERAGE YEAR THREE
HUNDRED AND THIRTY BILLION. AND
SO YOU KNOW IF IF WE JUST TAKE
THAT METHODOLOGY THAT I BRIEFLY
DESCRIBED BEFORE. WHICH SAYS YOU
LOOK AT THE RANGE.
AROUND THE AVERAGE.
AND.
THE THE REVENUE COMING IN.
SO IF WE SAY THAT YOU KNOW. IN
A VERY VERY GOOD YEAR.
I SAID FOR FOREIGN HAVE PERCENT
BUT LET'S SAY IT'S FIVE PERCENT.
SO.
THAT THAT WOULD MEAN.
ANOTHER WE WOULD NEED ANOTHER
FIFTEEN BILLION IN RESERVE TO
COVER. THAT THAT WOULD BE THE
GOOD YEAR UP FIVE PERCENT TO
COVER THAT DID DOWN YEAR OF FIVE
PERCENT SO WE WOULD NEED
SOMETHING. IN THE RANGE OF
FIFTEEN BILLION.
WOULDN'T RELATIVE TO AT THREE
HUNDRED THIRTY BILLION SYSTEM.
AND WHERE WHERE WHERE WHERE
WOULD YOU SEE THAT COMING FROM
SO.
OVERTIME NOW LET'S NOT TALK
ABOUT YOUR ONE I MENTIONED HERE
ONCE OTHER WOULDN'T
SO YOU WOULDN'T YOU WOULDN'T
PROPOSE HAVING. SORT CASH ON
HAND YEAH I WOULD A AND HOW SO
HOW MUCH YEAH HOW MY SO WE SO
BASICALLY YOU KNOW LET'S TAKE A
TEN YEAR PERIOD.
THEN I'LL COME BACK TO YOU
OKAY SO.
IN YOU IT OVER THE TEN YEAR
PERIOD IF WE BELIEVE.
THAT LONG TERM TRENDS OUR ARE
ARE SHOWING US SOMETHING SO SOME
YEARS WE GO UP FIVE PERCENT SOME
YEARS WE GO DOWN FIVE PERCENT
AND WE NEED THREE HUNDRED AND
THIRTY BILLION PER YEAR ON
AVERAGE. SO IN THE YEARS WHEN WE
GET INSTEAD OF THREE THIRTY WE
GET THREE FORTY FIVE BILLION OR
LET'S SAY THREE FIFTY BILLION WE
GRABBED THE TWENTY BILLION.
THAT WE DON'T NEED TO FUND THE
SYSTEM AND WE PUT IT IN RESERVE.
AND THAT WOULD BE A NUFF TO
COVER THE YEARS WHEN WE GO DOWN
FROM THREE THIRTY TO THREE TEN
AND REVENUE SO THAT'S THE LONG
TERM FUNDING.
THAT WOULD BE ADEQUATE NOW THAT
DOES NOT ANSWER THE QUESTION
THAT LET'S SAY WE START OUT IN
YEAR ONE INSTEAD OF RAISING
THREE THIRTY RIGHT AND YOUR TO.
WEAR DOWN TO THREE TEN.
SO THAT MEANS THAT WE WOULD
NEED TO FOUR YEAR ONE WE WOULD
HAVE TO HAVE. THIS TWENTY
BILLION ADDITIONAL TWENTY
BILLION IN RESERVE SO WE WOULD
NEED TO EXPAND THE FIRST YEAR
REVENUE TO COVER THAT BUT OVER
TIME THE THIS SYSTEM FUNDS
ITSELF BASED ON THE AVERAGE
LEVEL. OF TAXES ARE FEE REVENUE.
IT'S JUST THAT WHEN WE HAVE THE
GOOD YEARS YOU CAN'T LIKE SAY
ALL GREAT NAY HERE WE HAVE EXTRA
MONEY LET'S START SPENDING IT.
YOU KNOW YOU HAVE YOU WOULD
HAVE TO PUT IT IN RESERVE.
THEN I GUESS WHAT I AS I READ I
READ YOUR STUDY MULTIPLE TIME
THANK YOU AND.
.
I'M SURE WAS GREAT REUNION.
EACH TIME YOU PICK UP A LITTLE
BIT MORE.
BUT BUT IT LEFT ME WITH
QUESTIONS AND AND ONE OF THE
QUESTIONS IS IT FEELS LIKE.
AND AND I DIDN'T HEAR MUCH
MENTION THAT YOU TALKED ABOUT
THE TWO POINT THREE PERCENT
GROSS RECEIPTS TAX NOW THERE IS
A TWO POINT THREE PERCENT SALES
TAX RIGHT.
WHICH IS WHICH IS OUT THERE AS
WELL SO YEAH BUT THAT WOULD MAKE
SURE THAT THAT THAT DIDN'T COME
OUT AS MUCH AS YOU TALK ABOUT
THE REGRET WE TALKED IN DETAIL
ABOUT GROSS RECEIPTS YEAH.
SO THIS FEELS TIMMY MORE LIKE A
SNAPSHOT IN TIME.
AND SO MY QUESTION IS.
WE NO BECAUSE OF THE REPUBLICANS
TAX PLAN IS SUPPOSED TO HELP US
ALL.
THAT
ONE OF THE THINGS IS ALREADY
BEING TALKED ABOUT IS A DECREASE
IN MEDICARE A DECREASE IN
MEDICAID.
WE KNOW THAT.
OVER TIME IN ADDITION TO YEAH I
AT THIS SNAPSHOT IN TIME.
COSTS IN EVERY SYSTEM IN THE
WORLD WHETHER SINGLE PAYER NOT
CONTINUE TO RISE.
PERIOD. THERE ISN'T IT'S NOT
STATIC AND MEAN.
I GO TO THE I GO THE GROCERY
STORE AND THINGS ARE MORE AND
MORE EXPENSIVE.
SO BY ONE YOU KNOW I'M WONDERING.
AND I HAVEN'T EVEN FACTORED IN
THE FACT THAT WE ARE IN SHOWING.
AN AMAZING EXPANSION IN OUR
ECONOMY HERE THAT ISN'T GOING TO
LAST FOREVER.
SO. IF WE HAVE A DIP IN THE
ECONOMY IF WE HAVE REDUCTION IN
FUNDING FROM THE FEDERAL
GOVERNMENT IF WE HAVE INCREASED
COSTS.
WHERE DO WE GET I DON'T KNOW I
DON'T KNOW THAT THAT STATIC UP
AND DOWN OF JUST WHAT YOU'RE
TALKING ABOUT THERE IS ENOUGH TO
COVER THIS WHERE WE GET THE
ADDITIONAL REVENUE?
HOW DO WE DO THAT BECAUSE THAT'S
WHAT SORT OF STRUGGLING WITH
ANYA AND IN YOUR ANALYSIS?
I'M SO YEAH THE THE EXACTLY IT'S
A AYE YOU'RE ABSOLUTELY RIGHT
WHAT OUR STUDY SHOWS BASICALLY
IS A SNAPSHOT.
AND A BUT WHAT WEEK IT'S EASY TO
INCORPORATE.
.
SO THE THE FACT THAT THE ECONOMY.
WILL GROW OVER TIME WIT WE WILL
BY THE WAY WE WE WILL HAVE A
RECESSION I DON'T KNOW WHEN IT'S
GOING TO BE A BUT WE ALWAYS HAVE
RECESSIONS.
WE HAVE NOT ABOLISHED RECESSIONS.
SO THERE WILL BE A RECESSION AND
REVENUE WILL GO DOWN.
AND IT WON'T BE THE FIRST TIME
AND IT'S HAPPENED MANY TIMES IT
HAPPENS IN EVERY SINGLE COUNTRY
THAT ALSO HAVE.
THESE PUBLICLY FUNDED
HEALTHCARE SYSTEMS SO YES YOU
NEED A RESERVE FUND TO COVER
THAT. OVERTIME ON AVERAGE THE U.
S. ECONOMY ADVANCED ECONOMIES
GROW.
AND.
THROUGH GROWTH WE WILL GENERATE
ADDITIONAL REVENUE THAT WILL BE
SUFFICIENT TO COVER THE GROWTH
IN THE POPULATION NOW YOU ALSO
SAID COSTS WILL RISE.
WHAT I'M SUGGESTING IS THAT
COSTS WILL NOT RISE OVER?
BECAUSE WILL A BE CONTROLLED.
COSTS ARE RISING IN BY THE HUESO
RIGHT NOW ON THE U. S. ECONOMY.
WE'RE PAYING ABOUT EIGHTEEN
PERCENT OF GDP FOR HEALTH CARE
AND IF YOU LOOK AT THE CMS
PROJECTIONS.
THEY SHOW IT GOING UP
ARE YOU KNOW.
WITH OBAMACARE IN WITH OF
WHATEVER CONTROLS THEY HAD IN IT
UP THIS IS COMPLETELY UNTENABLE
THEY'RE TALKING IF YOU LOOK OF
CMS PROJECTIONS.
I INTEND YEARS WE'RE GOING TO BE
SPENDING TWENTY PERCENT OF GDP.
ON HEALTHCARE.
ONE OUT OF EVERY FIVE DOLLARS.
AND OTHER COUNTRIES ARE AT
ROUGHLY HALF THAT
THAT WE'RE TALKING ABOUT TWO
TRILLION DOLLARS.
RELATIVE TO THE SIZE OF OUR
CONNIE AND EQUIVALENT FOR
CALIFORNIA SO WE MUST CONTROL
COSTS
AND AND I THINK THAT THE THIS
SYSTEM THAT WE HAVE IN PLACE.
AND SUGGESTED THROUGH A HEALTHY
CALIFORNIA WILL ENABLE VERY OF
THERE'D BE SOME VERY SIGNIFICANT
COST CONTROLS IN THE AREA OF
ADMINISTRATION AND THE AREA
FARMER AND IN THE AREA OF OF
REDUCING. WASTE THIS AREA THAT
YOU KNOW THE.
HA HA INSTITUTE OF MEDICINE HAS
SAID.
IS AT ABOUT TWENTY PERCENT OF
ALL SYSTEM COSTS RIGHT NOW.
SO YOU DON'T BELIEVE THERE WILL
BE AN ADDITIONAL NEED FOR
ADDITIONAL TAX REVENUE TAX THAT
DITCH Y..
NO NO NO NO NO NOT PERCENT NOT
IN ABSOLUTE DOLLARS YES BECAUSE
THE ECONOMY GOES UP POPULATION
BECAUSE OF. THAT AS A SHARE OF
THE ECONOMY NO NO I THINK ILL GO
DOWN. HOW IN FACT YOU KNOW WE
THAT ONE OF THE CRITICISMS OF OF
OUR STUDY IS TO HAPPEN YOU NOT?
A PUSHING DOWN COSTS MORE SO
THAT THEY LOOKED LIKE CANADA OR
FRANCE
UNDER OUR PROPOSAL RIGHT NOW
CALIFORNIA'S SPENDING ABOUT
FOURTEEN PERCENT OF STATE GDP ON
HEALTHCARE.
UNDER OUR PROPOSAL IS VERY IS
ACTUALLY PRETTY MODEST REDUCTION
WOULD BE AROUND.
TWELVE FOR TWELVE AND A HALF
PERCENT WHEREAS YOU KNOW THE
OTHER ADVANCED ECONOMIES ARE AT
NINE TO ELEVEN PERCENT SO.
ACTUALLYARE COST SAVINGS WHICH
I THINK ARE TOTALLY VIABLE ARE
FAIRLY MODEST.
I GUESS AND I AND IF I GO BACK
TO MY.
IN THE EARLIER PART OF THAT IS
THAT.
WHEN I PREFACE THIS QUESTION
WITH WITH.
WE ALREADY KNOW THE FEDERAL
GOVERNMENT WANTS TO REDUCE THE
FUNDING FOR MEDICARE AND
MEDICAID NO. THAT MEANS LESS
MONEY YEAH THAT'S A LOWER NUMBER
SO WHERE IS THE DIFFERENCE COME
FROM HIM OVERTIME BECAUSE IT'S
NOT GOING TO BE.
IT'S LIKE TO BE A ONE SHOT DEAL
I I PREDICT IT'LL BE IT IS IT IS
LIKELY TO GO DOWN IN INCREMENTS
OVER TIME. SO WHERE DOES THE
ADDITIONAL REVENUE COME FROM.
TO KEEP THE SYSTEM HOLE. RIGHT
IS THAT IT IS ADDING ITSELF MEAN
INCREASE SOMETIMES A SON NOW
LET'S. NOW THESE OF.
PUBLIC FUNDING CONSTITUTE
SEVENTY PERCENT OF ALL SPENDING.
SO ITS TWO HUNDRED AND TWENTY
FIVE BILLION.
CAN OKAY SO IF IF THEY'RE YOU
KNOW TAX CUTS.
THAT WILL LEAD TO A REDUCTION
AND FEDERAL REVENUES FOR
MEDICARE AND MEDICAID OR
MEDICARE HOW. OF YEAH THOSE
WOULD HAVE TO BE COMPENSATED
FOURTH THROUGH AN INCREASE IN
STATE BUT NOTE THAT THAT DOESN'T
MEAN THAT OVERALL TAX
OBLIGATIONS WOULD GO UP AND WE
JUST MEAN.
TAX CUTS.
THAT WERE.
PUT IN PLACE TO REDUCE FEDERAL
REVENUE FOR MEDI CAL MEDICARE.
WOULD THEN JUST BE COMPENSATED
BY A AN INCREMENTAL INCREASE
AND A STATE FUNDING.
WHICH WOULD BE ADDITIONAL TAXES
NO NOT NOT ON NET IT WOULD JUST
BE. WHEN YOUR FEDERAL TAX.
BILL GOES DOWN THEN THE STATE
WOULD HAVE TO GO UP TO MATCH THE
LOSSES OF FEDERAL REVENUE
SO ON BALANCE IT WOULD BE
NEUTRAL.
AND. I CAN I JUST ADD THAT YOU
KNOW YOUR QUESTION I THINK
UNDERSCORES THE COMPLEXITY OF.
YOU KNOW THIS WHOLE PROCESS AND.
YOU KNOW EVEN BEYOND AND SB
FIVE SIXTY TWO.
YOU'RE ASKING AT LEAST YOU KNOW
IN PART A TECHNICAL QUESTION BUT
THEN ALSO A POLITICAL QUESTION
BECAUSE THE PIE IT'S ONLY AS BIG
AS THE PEOPLE SUPPORT THAT PIE.
AND SO YES THERE'S AN UPSTREAM
PART OF THAT BATTLE AS TO WHY
WOULD WE BE CUTTING BACK ON
MEDICARE AND MEDICAID. IF IN
FACT WE HAVE NEEDS THAT ARE ON
ADDRESSED YOU KNOW AND AND
EVOLUTION OF OUR HEALTHCARE
SYSTEM.
THAT REALLY DEMANDS YOU KNOW
MORE FUNDING FOR THOSE
PARTICULAR PARTS OF OUR
POPULATION THE ELDERLY AND ALSO
THE.
THE POOR BUT IN ADDITION TO
THAT YOU KNOW FOR A LONG TIME
WE'VE KNOWN FROM A PUBLIC HEALTH
STANDPOINT. THAT WE DON'T INVEST
ENOUGH IN PREVENTION
NOW IN THIS COUNTRY.
ANYONE WHO'S IN HEALTH CARE
UNDERSTANDS THAT WE INSTEAD
INVEST.
WHOLEHEARTEDLY AND SICK CARE.
AND THE CONSEQUENCES OF OUR THE
OUR LACK OF GOOD POLICY IN AND
INVESTMENT IN PREVENTION SO THAT.
THAT DOESN'T GO AWAY WE STILL
NEED TO DEAL WITH THAT WHILE
WE'RE DEALING WITH. ADVANCES
SUCH AS SINGLE PAYER THAT'LL
GIVE US NOT US MORE INVESTMENT
AND AND BE ABLE TO A POLLING AND
MORE DOLLARS IN ADDRESSING THE
DOWNSTREAM BUT THEN ALSO PAYING
ATTENTION TO THE UPSTREAM ISSUES
AND WE JUST WE HAVE TO DO THAT.
IN COUNTRIES WHERE THEY'VE BEEN
ABLE TO LEVEL OUT THE COST CURVE
THEY HAVE THAT INVESTMENT IN
SOCIAL SERVICES AND MANY OTHER
AREAS THAT YOU MENTIONED EARLIER
AND SO.
WE GOTTA KEEP THAT IN MIND THE
CHAIRMAN WOULD IF I COULD
QUICKLY.
WE STILL HAVE TO ADDRESS THOSE
THINGS ARE GONNA HAPPEN IF THEY
HAPPEN.
WHAT KIND OF SYSTEM DO WE HAVE
TO RESPOND AS THE PRESENT SYSTEM
WHERE SO MUCH MONEY IS DIVERTED
TO WASTE INEFFICIENCY PROFITS
MARKETING? IS THAT SYSTEM BETTER
ABLE TO ABSORB THE CHANGES AT
THE FEDERAL LEVEL OR IS A SYSTEM
WHERE CALIFORNIA'S DESIGNED OUR
OWN. GUARANTEES HEALTHCARE IT'S
UNDER OUR CONTROL SO I THINK YOU
ALWAYS HAVE TO RELATE THOSE.
POLITICALLY I DRAW THE
CONCLUSION THAT MEDICAID IS
NEVER BEEN MORE POPULAR
MEDICARE'S NEVER BEEN MORE
POPULAR THERE WILL AYE AYE AYE
AIR ON THE OTHER SIDE I THINK
WE'RE ACTUALLY GOING TO
SUCCESSFULLY FOR.
FIGHT THOSE CUTS AND EXPAND
THOSE PROGRAMS THAT'S RIGHT
THINK IT'S GOING TO GO.
IN AND OUT HOW I JUST ONE MORE
QUESTION AND I'M FIRST ONE THANK
YOU FOR YOUR PATIENCE.
AYE I'D.
I DO TEND TO DIVE DEEP INTO
THINGS AND SO THESE ARE THE
THINGS TO KEEP ME AWAKE AT NIGHT
WONDERING AND.
ONE OF THE CHALLENGES THAT THAT
WHEN ONE OF THINGS WE HEARD
HEARD AND SEEN WITH COUNTRIES
THAT HAVE SINGLE PAYER. IS A
VERY DIFFERENT WORKFORCE.
SEVENTY PERCENT OF POSITIONS IN
A SINGLE PAYER COUNTRIES ARE
PRIMARY CARE PHYSICIANS. AND
THIRTY PERCENT OF SPECIALISTS
IT'S EXACTLY THE OPPOSITE IN THE
UNITED STATES.
SO. AND ALSO IN SINGLE PAYER
COUNTRIES A LOT OF THEM THEIR
EDUCATION IS SUBSIDIZED IN SOME
WAY BY THE GOVERNMENT WHICH
ALLOWS FOR IN IN SPITE OF WHAT.
THEY DO HAVE LOWER SALARIES I
MEAN THAT'S THAT'S EVERY
INFORMATION WE HAVE SHOWS THAT
HYSICIANS ANOTHER. IN SINGLE
PAYER COUNTRIES MAKE LESS MONEY.
THAT'S WHAT WE'RE HERE SO HOW
DO YOU ENVISION AND TAKING.
IF THE TRANSITION IT TO GET.
THE FLIP THAT SEVENTY PERCENT TO
THIRTY PERCENT. HOW DO WE GET
THERE?
BECAUSE WE DON'T HAVE WE WON'T
HAT WE DON'T HAVE THE PRIMARY
CARE FORCE RIGHT NOW.
ON THE BEST DAY
AND I GET CONCERNED IN A ROW I
REPRESENT A VERY RURAL DISTRICT
WE CAN'T GET DOCTORS THERE NOW.
WEEK WE STRUGGLE WITH THAT.
WE HAVE TO FLY THEY HAVE TO FLY
IN EMERGENCY ROOM DOCTORS FOR
ONE OF MY HOSPITALS IN. IN IN IN
IN ONE OF THE MOST REMOTE
COUNTIES IN IN THE STATE WHERE
THE POOREST COUNTIES IN THE
STATE.
SO WHERE DID THE DOCTORS COME
FROM
AND AND HOW YOU KNOW IT AND YOU
KNOW I SEE DOCTORS ASKING
NODDING THEIR BECAUSE WE'VE HAD
WE WE KIND OF HAD SOME OF THIS
DISCUSSION.
IT THIS IS SAY THIS IS A
MONUMENTAL MONUMENTAL SHIFT IN
THE WAY WE PRACTICE PRACTICE
MEDICINE SO.
THAT ISN'T AND I KNOW IT'S NOT
CAN CONSIDER CONSIDERED AN FIVE
SIX TWO SO MAYBE THIS IS JUST
MORE A COMMENTARY BUT. BUT I
HAVE CONCERNS ABOUT THAT BECAUSE
WE'RE NOT WE DON'T HAVE ADEQUATE
DOCTORS IN THE RIGHT PLACES NOW.
IS SO A A SYSTEM THAT IS FOCUSED
ON ANA UNSERVED A ONE SIZE FITS
ALL DOESN'T WORK FOR ME IN MY
RURAL COMMUNITIES.
WE FIGHT ALL THE TIME FOR THINGS
PURCHASED OUR FAIR SHARE OF
THINGS
AND SO WRITTEN ONE SIZE AND SO
ONE OF THE THINGS I LIKED ABOUT.
CENTER KILLS APPROACH WAS. A
REGIONAL APPROACH TO GOVERNANCE
TO TO BECAUSE THIS IS AN
EXTREMELY DIVERSE DAY.
EXTREMELY DIVERSE STATE SO THIS
ONE SIZE ONE WHEN WAY FITS ALL.
IT'S NOT GONNA WORK REAL WELL IN
MY IN MY DISTRICT.
WELL YEAH WE DON'T WE DON'T WE
DON'T.
.
WE DEFINIR NOT CREATING A ONE
SIZE FITS ALL BUT IMAGINE IF IN
THAT RURAL AREA THAT MEDI CAL
RATES WENT UP TWENTY PERCENT.
BECAUSE THAT'S WHAT WE'RE
PROPOSING THE MEDIC HOW RATES
GOING UP TWENTY PERCENT HOW MANY
MORE DOCTORS WOULD TAKE MEDI CAL
WOULDN'T DAD IMPROVE THE
SITUATION I AGREE THE CURRENT
SYSTEM WHERE YOU'VE GOT.
HUGE GRADUATE SCHOOL LOANS YOU
GOT A SYSTEM THE PRIVILEGES
SPECIALIST PAY. THAT HAS CREATED
FEWER PRIMARY CARE PHYSICIANS WE
WORK WITH TO PHYSICIANS FOR
NATIONAL HEALTH PROGRAM LIKE THE
CAPITATA. THEY SEE THIS TOO AND
THEY STILL SUPPORT THIS REFORM
AS THE BEST WAY TO ADDRESSING
THESE PROBLEMS EXIST CURRENT
SYSTEM NEW SYSTEM. THIS SYSTEM
IS BETTER ABLE TO ADDRESS THEM
IN OUR VIEW IT IS NOT A ONE SIZE
FITS ALL BY ANY MEANS.
AND IN FACT WE THINK THAT THAT
THAT THE STRUCTURE OF IT ENABLES
THE BOARD TO SET UP.
ADMINISTRATIVE FLEXIBILITY THE
COULD ACHIEVE SOME OF THOSE SAME.
OBJECTIVES THAT THE KILL BILL
DID DIE I WOULD ALSO COURSE ONE
HERE. DECISION.
WELL MY DAUGHTER'S A GENERAL
PAEDIATRICIAN DESPITE HER
FATHER'S EXAMPLE.
AND SHE GRADUATED WITH A
MEDICAL SCHOOL THAT OF TWO
HUNDRED FORTY THOUSAND DOLLARS.
SO.
THAT WE NEED TO YES IT'S ALL THIS IS
VERY GOOD BUT YOUR QUESTION AND
YOUR POINT IS IMPORTANT WE CAN'T
WAIT FOR THAT TO HAPPEN WHAT CAN
WE DO NOW. ONE OF THINGS THAT
THE STATE COULD LOOK AT IS
SIMILAR TO THE NATIONAL HEALTH
SERVICE CORPS. IS MAKING MEDICAL
SCHOOL EDUCATION FREE.
IF YOU GO TO PRIMARY CARE.
AND YOU FOR EVERY YEAR THAT YOU
THE STATE PAYS YOUR TUITION.
YOU SERVE IN A MEDICALLY
UNDERSERVED AREA RURAL URBAN
WHATEVER.
AND MUCH OF WHAT YOU'RE
DESCRIBING KNOCK WOOD.
IS.
IT'S KIND OF LIKE INTO THE DRUG
PROBLEM THE OP ó EIGHT
EPIDEMIC THAT WE'RE FACING RIGHT
NOW WE ACTUALLY HAVE ALL A LOT
OF THE ANSWERS.
BUT WE DON'T HAVE THE PUBLIC
POLICY THAT'S ALIGNED WITH
EFFECTIVELY IMPLEMENTING THOSE
ANSWERS AND SO IT IS WITH THE
HEALTH WHAT FIRST YOU HAVE. A
CALIFORNIA FUTURE HEALTH
WORKFORCE COMMISSION THAT IS
OPERATING RIGHT NOW AS WE SPEAK.
AND GENERATING A LOT OF
INFORMATION ABOUT HOW TO ADDRESS
THE CRISIS THAT YOU DESCRIBE IN
YOUR COUNTY. AND I CAN TELL YOU
QUITE FRANKLY NUMBER ONE IT'S A
PIPELINE ITS RECRUITMENT AND WE
KNOW THAT PEOPLE THAT COME FROM
AREAS THAT ARE IN RURAL AREAS IF
RECRUITED.
IF PUT IN A PIPELINE PROGRAM
EXPOSED TO THE HEALTH
PROFESSIONS AND THE DIGNITY ARE
AND THE AMAZING GRATIFICATION
FROM THE SERVICE.
THAT YOU CAN PROVIDE AS A
HEALTHCARE PROVIDER THAT PEOPLE
DO WANT TO GO INTO THE HEALTH
PROFESSIONS AND THEY DO WANT TO
GO SPECIFICALLY TO COME BACK TO
THEIR COMMUNITIES MUCH MORE. SO
THAN YOUR RECRUITING FROM OTHER
COMMUNITIES ON A SUSTAINABLE
SUSTAINABLE BASIS.
AND WE NEED TO EXTEND.
YEAH BEYOND PHYSICIANS THERE ARE
REALLY HIGHLY EXPERIENCED AND
QUALIFIED NURSES AND NURSE
PRACTITIONERS AND PHYSICIAN
ASSISTANTS COULD CONTRIBUTE TO
OUR. TEAM THAT DOES THE
COMPREHENSIVE TYPE OF PRIMARY
CARE THAT WE'RE PROVIDING NOW
AYE GRAFTING ON THE ALMOST
PROBABLY SPEAKING LIKE HERESY
BECAUSE I'M A MEMBER OF THIS
CALIFORNIA MEDICAL ASSOCIATION.
ABOUT BUT I'M BUT BUT SPEAKING
VERY PRACTICALLY. YOU KNOW
THAT'S WHAT WE NEED TO DO WE
NEED TO EXTEND OUR PRIMARY CARE
WORKFORCE OTHERWISE THAT RATIO
WILL CONTINUE TO PLAGUE US.
WITH OVER UTILIZATION ON THE
SPECIALTY SERVICES AND NOT
ENOUGH FOR THE CARE THAT PEOPLE
ACTUALLY NEED. NOT THE CAN BE
PROVIDED IN A VERY EFFICIENT AND
EFFECTIVE WAY AND AGAIN YOU KNOW
ROUTING IT BACK TO SINGLE PAYER
A SINGLE PAYER SYSTEM. WE'LL SEE
A LOT OF THOSE ISSUES AND A LOT
OF HOW THE HEALTH CARE WORK
WORKFORCE NEEDS TO BE DEPLOYED
AND HOW IT NEEDS TO BE
GEOGRAPHICALLY SPREAD AND HOW IT
CAN ALSO. WORK AS A PARTNER YOU
KNOW IN SYSTEMS.
AND SYSTEMS CHANGE THAT WILL
ADDRESS THE WORKFORCE NEEDS.
RIGHT NOW NOT HOW CLOSE IN A
DOCTOR WHAT DOCTOR ARAMBULA AND
I HAVE BEEN.
FIGHTING HARD FOR MORE HONEY FOR
FOR MEDICAL EDUCATION AND WE
WILL CONTINUE TO FIGHT THAT
BATTLE BUT IT IS IT IS REALLY
REALLY EXPENSIVE AND NOT JUST.
NOT JUST FROM POSITIONS BUT FOR
NURSES AND DENTISTS AND AND
EVERYBODY THERE IT IS BUT IT IS
A IT IS. WE HAVE TO RECOGNIZE IT
IS A KEY IS ONE OF THE
CHALLENGES WE FACE.
IF WE'RE GOING TO BE ABLE TO
DELIVER ON THE PROMISE OF A
ROBUST SUSTAINABLE SINGLE PAYER
SYSTEM SO THAT'S THAT'S REALLY
MY POINT THERE.
BUT BECAUSE AND IT'S NOT
SOMETHING I DON'T THINK WE CAN
TURN ON A DIME.
SO.
CAN BE RESPECTFUL AND
APPRECIATIVE OF YOUR TIME AS
WELL I'M GONNA TRY AND CAP US.
FOR FIFTEEN MINUTES MORE OF
QUESTIONS IF THAT'S POSSIBLE.
AND THEN WOULD LIKE TO ASK THE
SERGEANTS IF WE COULD GET MORE
WATER APPEAR FOR THE PANELISTS
AS WELL. I HAVE NEXT WILL HAVE
ASSEMBLY MEMBER CHIP.
THANK YOU DOCTOR KNOW WHEN I
THINK THE THE PANELISTS AND AND
EVERYONE HAS BEEN INVOLVED IN
THIS OUR CONVERSATION LET ME
JUST STATE AT THE OUTSET I'M
REALLY DISAPPOINTED I WAS IN
HERE EARLIER. I'VE ATTENDED
EVERY HEARING OF THE SELECT
COMMITTEE THIS MORNING I HAD A
LONG SCHEDULED.
INTERVIEW WITH MY TODDLER HAS
NOT YET TO WITH THE NURSERY
SCHOOL.
WHICH REFLECTS THE CHALLENGES
OF GETTING INTO A NURSERY SCHOOL
IN MY CITY.
.
YEAH EXACTLY CITY HALL TALK
ABOUT UNIVERSAL DAYCARE NEXT.
BUT I WANT FOLKS TO KNOW I DID
SPEND TWO HOURS IN THE CAR
LISTENING TO THE STREAMING
INTERNET OF THIS HEARING AND
I'VE GONE THROUGH ALL YOUR
PRESENTE
SO THANK YOU FOR THAT. LET ME
FIRST START BY BUILDING ON SOME
THE QUESTIONS FROM DOCTOR WOULD
AND I JUST WANT TO SAY I
COMPLETELY AGREE WITH DOCTOR
WOOD AND DUCT ARAMBULA AND
OTHERS THAT. WE HAVE TO INVEST
IN OUR PRIMARY CARE WORK FORCE
AND I AM A CO AUTHOR OF S. B.
FIVE SIXTY TWO I DO THINK.
THAT WE OUGHT TO EXPAND THIS TO
THINK ABOUT THAT ASPECT OF HOW
WE ENSURE REALLY THE FUTURE OF
OF WATER WORKFORCE NEEDS DEBATE.
BOMB THERE WERE TWO POINTS THAT
CAME UP IN YOUR DISCUSSION WITH
DOCTOR WHAT I JUST WANTED TO
CLARIFY A PRUDE SOME DISCUSSION
AROUND THE IDEA THAT.
THERE'S NOT AN EXPECTATION OF A
HUGE LOSS OF JOBS IN THE
HEALTHCARE SECTOR. ARM AND AND
AND AND I KNOW THERE'S SOME BACK
AND FORTH ABOUT WHAT JOBS WOULD
LOOK LIKE IN THE INSURANCE
INDUSTRY. BUT JUST ONE CLEAR MY
UNDERSTANDING IS YOUR CONTENTION
IS THAT JOBS ARE NOT GOING TO GO
DOWN THEY MAY GO DOWN IN THE
INSURANCE INDUSTRY. BUT OVERALL
THE HEALTHCARE SECTOR WITH THE
IDEA THAT YOU'RE GOING TO EXPAND
ACCESS TO HEALTH CARE THE NUMBER
OF JOBS IN THE ECONOMIC.
ECONOMIC ACTIVITY RELATED HEALTH
CARE YOU'RE NOT EXPECTING TO GO
DOWN DRAMATICALLY IS THAT IS AT
THE POINT THAT I THINK I'LL TRY
TO MAKE. WELL I KNOW I DON'T
YEAH I DON'T THINK THERE'D BE
ANY REDUCTION IN.
EMPLOYMENT FOR PEOPLE DIRECTLY
INVOLVED IN PROVIDING CARE.
THAT IS ALMOST CERTAINLY GOING
TO GO UP BECAUSE PEOPLE WILL
HAVE MORE ACCESS TO CARE.
AND AND.
OFFICES WILL BE ABLE TO SPEND
LESS TIME. ON ADMINISTRATION AND
MORE TIME ON CARE.
BUT THERE WILL BE JOB LOSSES IN
THE AREA OF ADMINISTRATION AND
THAT'S WHY WE FOCUS ON.
HOW DO?
PROVIDED JUST TRANSITION FOR
THE PEOPLE WHERE THEY WILL
EXPERIENCE JOB LOSSES
THROUGH THE CONTRACTION OF
ADMINISTRATIVE COSTS.
THANK YOU AND I WANT TO ACTUALLY
THANK YOU PROFESSOR POLLEN
BECAUSE WE'VE ALL READ YOUR
ANALYSIS I'VE BEEN SIGNING YOUR
STUDY AND.
IT'S GREAT TO HAVE YOU HERE IN
CALIFORNIA AND I ALSO WANT TO
JUST NOTE IF I HAVE NOT REALLY
HEARD MUCH BY WAY OF REFUTATION
OF YOUR STUDY AND IF THEIR FOLKS
TO. HAVE A VERY DIFFERENT
ECONOMIC ANALYSIS PERSPECTIVE I
IN TO BE GOOD TO HEAR BUT I
WANNA JUST THANK YOU FOR. FOR
YOUR ANALYSIS AND A DOCTOR WOULD
ALLUDED TO THAT TRUMP TAX LAW
THAT JUST WENT INTO EFFECT.
AND THIS IS A PLAN AS WE ALL
KNOW THAT PROVIDES MASSIVE TAX
BREAKS FOR CORPORATIONS IN THE
WEALTHIEST OF AMERICANS.
URINALYSIS OF THE TYPES OF TAX
POLICIES YOU PROPOSE TO
CALIFORNIA ARE OBVIOUSLY BASED
ON GROSS RECEIPTS AND PAYROLL
AND SALES TAX BUT YOU DIDN'T
LOOK AT WHAT WE MIGHT BE ABLE TO
DO IN CALIFORNIA. IF WE WERE TO
RAISE TAXES IN THOSE VERY AREAS
WHERE THINGS WERE CUT AT THE
FEDERAL LEVEL.
WHICH I THINK WOULD PROBABLY
BRING IN TENS OF BILLIONS OF
DOLLARS THAT MIGHT BE ABLE TO
OBVIATE THE NEED EVEN FOR SALES
TAX AS YOU PROPOSED IT IS EVEN
LOOKED EVEN LOOKED AT THE IMPACT
OF TRUMP TAX.
PROVISIONS ON WHAT OTHER OPTIONS
WE COULD CONSIDER HERE IN THE
SNOW CALIFORNIA I HAVEN'T BUT AS
WE KNOW THAT THE PRIMARY
BENEFICIARY OF THE OF THE.
TRUMP TAX CUTS ARE CORPORATIONS.
SO.
.
HAVING THE CORPORATIONS PAY LESS
AND FEDERAL TAXES WEALTH AND
THEREFORE MAKE IT EASIER FOR
THEM TO. INCREASE WHATEVER
OBLIGATIONS THEY WOULD HAVE
UNDER THIS PROVISION.
AND I HAVE TO ADMIT PROFESSOR
THAT'S THAT'S MY PERSPECTIVE AS
WELL THAT CORPORATIONS IN
CALIFORNIA THAT I'VE SEEN TENS
OF BILLIONS OF DOLLARS OF CUTS.
IF WE WERE ASSN TO GO BACK TO
WHERE THEY WERE ON DECEMBER
THIRTY FIRST. THAT WOULD BE MORE
THAN ENOUGH TO MAKE SURE WE
DON'T HAVE TO ACTUALLY CHARGING
YOU SALES TAX TO PAY FOR WHAT
WE'RE TALKING ABOUT.
RIGHT YEAH RIGHT I MEAN THE AND
ALSO THOUGH YES SO THAT THE AND
AGAIN IT YOU KNOW. MY JOB IS NOT
TO DECIDE HOW.
WERE RAISES REVENUES TO GIVE
YOU ALL OPTIONS.
AND SO THE WAY THAT WE DESIGNED
BOTH.
THE GROSS RECEIPTS TAX AND THE
PAYROLL TAX.
WAS TO LOAD IT
DISPROPORTIONATELY ON BIG
CORPORATION.
AND YOU KNOW UP AS WE DESIGNED
BOTH THE PAYROLL TAX AND THE
GROSS RECEIPTS TAX A SET EIGHTY
PERCENT OF BUSINESS OPERATIONS.
WE'LL PAY NO TAXES.
NOW A THE OTHER ONES YA THEY'LL
PAY TWO POINT THREE PERCENT
GROSS RECEIPTS TAX BUT AS YOU
SAID THAT IS BASICALLY MATCHING
UP AGAINST THE TAX CUT. THAT
TRUMP JUST GAVE THEM.
SO YEAH ON BALANCE THERE THEY'RE
COMING OUT EVEN.
AND IN THIS IS CERTAINLY
CONVERSATION INTERESTED AND THEN
WITHOUT PUTTING MY COLLEAGUE IS
THE CHAIR OF THE REVENUE TAX
COMMITTEE ON THE SPOT. I LOOK
FORWARD TO THE CONTINUATION THIS
CONVERSATION HERE IN THE
LEGISLATURE WANTED TO SHIFT THE
CONVERSATION TO A DRUG PURCHASES.
THERE WAS A SLIDE IN THE
PRESENTATION ON S. B. FIVE SIXTY
TWO. SUGGESTING WE NEED TO
CONSOLIDATE STARK ESTATE DRUG
PURCHASING AND AND I THINK A
NUMBER OF YOU KNOW I'VE BEEN
TRYING TO BE THOSE EFFORTS HERE
IN THE ASSEMBLY. WE HAVE HAD NOW
TO YOUR BILL US.
AB FIVE EIGHTY SEVEN THAT WOULD
REQUIRE THE OVER DOZEN SIT STATE
AGENCIES THAT PURCHASE DRUGS TO
ACTUALLY TALK TO EACH OTHER
BECAUSE AT THIS POINT THEY DON'T
SHARE INFORMATION. THEY DON'T
EVEN KNOW WHAT EACH OTHER'S
RESPECTIVE PRICING IS THEY DON'T
NEGOTIATE COLLECTIVELY.
AND AND THAT BILL.
HAS GOTTEN THROUGH THE PROCESS
BUT IT IS STALLED IN THE FINAL
SENATE COMMITTEE BUT THAT BEING
SAID SO I UNDERSTAND WHAT THE
PROPOSAL IS ON YOUR PART. YOU'RE
SUGGESTING THAT WE CONSOLIDATE
THE BUYING POWER NOT JUST OF
STATE AGENCIES BUT LOCAL
CONSUMER AND PATIENT STATUS AT.
IS THAT RIGHT YEAH THAT'S THAT'S
FAIR I MEAN I THINK WHAT I
SUGGEST IN THE STUDY WERE TWO
MODELS.
ONE A DOMESTIC MODEL THE
VETERANS ADMINISTRATION AND TO.
CANADA IN TERMS OF THEIR HAVING
FORMULARIES AND A AND USING
THEIR BARGAINING POWER TO LOWER
DRUG PRICES THEY'RE QUITE
SUCCESSFUL IN FACT THE NUMBER
THAT. WE HAVE IN OUR STUDY OF A
THIRTY PERCENT REDUCTION IN
PHARMACEUTICAL COSTS IS
EXTREMELY MODEST.
YOU KNOW AND YOU KNOW WE'RE
LOOKING AT OTHER COUNTRIES HERE
FORTY FIFTY PERCENT. THIS
SPENDING LESS.
THROUGH USING.
THEIR BARGAINING POWER SO IT
THAT IS A.
HUGE AREA FOR SAVINGS
AND IT'S AND IT'S PROVEN TO WORK
AND EVERY SINGLE SETTING THAT
ITS USE.
SO I I DON'T KNOW EXACTLY AND I
I'M GLAD T HEAR ABOUT THE WORK
YOU'RE DOING I DON'T KNOW THE
DETAILS OF WHAT YOU'RE DOING NOW
BUT.
IT CERTAINLY IS A VERY PROMISING
AREA ENDS WITHIN.
S. B. FIVE SIXTY TWO THAT WOULD
BE A FUNDAMENTAL BENEFIT THAT
WOULD BE GAINED ON BEHALF OF THE
PEOPLE OF CALIFORNIA I WOULD
LOVE IF YOU COULD PROVIDE MY
OFFICE WITH SOME MORE
INFORMATION ON THAT SUBJECT SO
WE CAN THINK FURTHER ABOUT IT.
UP I'D LIKE TO ASK THE THE
HEALTH COMMITTEE STAFF IF YOU
COULD REFERENCE A COUPLE OF
SLIDES IN THE PRESENTATION WHICH
REALLY JUMPED AT ME AND I HAVE.
A FEW QUESTIONS ABOUT THEM AND
THAT WAS ABOUT THE CONTENTION OF.
THE DENIAL OF OF CARE BY BY
HEALTH INSURANCE COMPANIES SO
I'D ACTUALLY NOT SEEN THIS
ANALYSIS BEFORE THAT SUGGESTED
THAT. ARE IN THE TIME FRAME OF
TWO THOUSAND NINE TO TWO
THOUSAND ELEVEN.
A QUARTER OF ALL CLAIMS.
HAD BEEN REJECTED BY THE
INSURANCE COMPANIES ARE THE IT
YOU KNOW FIFTEEN MILLION CLAIMS
THIRTEEN MILLION CLAIMS ARE
TALKING ONE OUT OF THREE.
CALIFORNIANS ARE ONE AYE IT'S
AN ENORMOUS NUMBER AND AND AND I
DIDN'T REALIZE THAT THIS
INFORMATION IS NO LONGER.
PUBLICLY AVAILABLE.
.
IT CAN YOU EXPLAIN IT WEISS
INFORMATION UP PUBLICLY
AVAILABLE.
WELL.
OUR VIEW.
ASSEMBLY MEMBER IS BECAUSE THE
STUDY CAME OUT AND THE INSURANCE
INDUSTRY DIDN'T WANT THE DATA
AVAILABLE ANYMORE SO TO SPEAK
THE STATE AGENCY NO LONGER
PROVIDES IT THAT'S WHAT OUR
RESEARCHERS.
CAME UP WITH WHEN THEY
INVESTIGATED IT AND SO THAT'S
WHY WE USE THE INDEPENDENT
MEDICAL REVIEW IS KIND OF A
PROXY.
BUT THAT THAT IS WHAT HAPPENED
THE THE INDUSTRY SHUT IT DOWN.
OKAY.
IT'S NOT STATE LAW.
THAT WE. GET THIS INFORMATION IS
NOT STATE LAW THAT THIS
INFORMATION BE PUBLICLY
AVAILABLE. IF WE COULD GO TO THE
NEXT SLIDE IF THAT'S POSSIBLE.
SO SO IF I READ THIS CORRECTLY
YOU'RE ESSENTIALLY SAYING THAT
MILLIONS OF CLAIMS WERE. WERE
DENIED AND OF THAT ONLY FORTY
PERCENT WERE APPEALED SO IN
OTHER WORDS EITHER. THAT YOU
KNOW OF ANY OTHER SIXTY PERCENT
AND A PERCENTAGE WAS REVERSED
THE DECISION BY THE PLANES
REVERSED OR. NOT THE PILLS WERE
RETURNED AND MY GETTING THAT
RIGHT YOU'RE CORRECT AND KEEP IN
MIND THAT EVERY BEFORE YOU GET
INTO HIM IN INDEPENDENT MEDICAL
REVIEW YOU HAVE TO GO THROUGH
THE COMPANIES AND.
GRIEVANCE PROCEDURE.
THAT IS A THIRTY DAY MINIMUM
PROCEDURE CONTROLLED BY THE
COMPANY.
MOST OF THE MONETARY AWARDS AT
THE END OF THIS PROCESS THAT ARE
GIVEN ARE BECAUSE OF HOW THE
GRIEVANCE PROCEDURE HAS FAILED
PATIENTS SO THIS IS THE SECOND
STEP.
FIRST WE GOT TO GET TO THE
GRIEVANCE PROCEDURE WHICH IS WHY
WE SAY IS THE TIP OF THE ICEBERG
AS GO THROUGH THAT GAUNTLET.
STILL GO TO INDEPENDENT MEDICAL
REVIEW AND STILL SIXTY PERCENT.
ARE OVERTURNED ESSENTIALLY.
IN THE NEXT SLIDE THIS IS
OBVIOUSLY PAYMENT TONIGHT FOR
MERCY URGENT CARE. AND THEN IF
YOU COULD JUST FLIP THROUGH THE
NEXT FEW SLIDES I KNOW THIS THIS
IS ABOUT INDUSTRY.
PROFITS AND.
AND WHAT'S NOT HAPPENING AND
THEN TO THE TIP OF THE ICEBERG
POINT WE DON'T KNOW AT THIS
MOMENT.
WHAT DENIALS OR WHAT WHAT WHAT
TO CLAIMS HAVE BEEN MADE THAT
WHEN THEY'RE DENIED UP A PATIENT
DECIDES NOT
APPEAL CARESSED DON'T KNOW THAT
THAT'S WHAT WE DON'T KNOW GIVING
ESTIMATE?
UP YOU KNOW WE DON'T WE DON'T
ACTUALLY.
HAVE AN ESTIMATE OKAY SO THE
POINT I'M ACTUALLY WANT TO MAKE
HERE IS I'D LIKE TO ASK THE
INSURANCE INDUSTRY IF YOU COULD
RESPOND TO THESE LAST FEW SLIDES
IT WOULD BE HELPFUL I THINK FOR
US TO KNOW.
ABOUT THIS DATA AND WHETHER
THIS I'M ASSUMING THIS
INFORMATION IS TRUE.
AND I'D I WOULD LOVE TO TO GET
SOME VERIFICATION ON THAT THAT
WE CAN PROVIDE.
THE RESEARCHERS WHO DID THIS
PROJECT WE CAN PROVIDE
ADDITIONAL A MATERIAL THIS IS A
SUMMARY OF THEIR WORK WERE HAPPY
TO CONTINUE TO WORK WITH YOU AND
OTHER MEMBERS OF THE COMMITTEE
ON THIS OKAY.
SOME AND THEN RELATED TO THIS I
KNOW I'VE HEARD AT LEAST EVERY
DEMOCRAT ON THE SELECT COMMITTEE
AND I DON'T WANT TO SPEAK FOR A
REPUBLICAN COLLEAGUE BECAUSE I
AB I JUST HADN'T HEARD THIS.
WHETHER THIS IS SOMETHING A
STATEMENT YOU WOULD BELIEVE IN
BUT I THINK EVERY DEMOCRAT ON
THIS COMMITTEE BELIEVES THAT
HEALTHCARE IS A RIGHT.
THAT EVERY CALIFORNIAN SHOULD
HAVE AN AXE ACCESS TO HEALTH
CARE I'M AND THAT HEALTHCARE
SHOULD JUST GO TO THOSE WHO CAN
PAY OR THOSE WHO CAN PAY A LOT
OF THOSE WHO.
DON'T GET A CERTAIN TYPE OF
ILLNESS.
FROM MY PERSPECTIVE IF THAT'S
THE CASE WHEN WE HAVE STATUS QUO
SYSTEM THAT ALLOWS FOR MILLIONS
OF DENIALS. IT SEEMS TO CUT UP
AGAINST THAT IDEA THAT
HEALTHCARE OUGHT TO BE A RIGHTS.
YES EXACTLY RIGHT EXACTLY RIGHT
ASSEMBLY MEMBER AND YOU CAN HAVE
HEALTH CARE'S HUMAN RIGHT IF YOU
CONDITION IT. WHERE CAN BE
DENIED WHERE FINANCIAL BEARS CAN
PREVENT CARE THAT'S NOT A HUMAN
RIGHT?
THAT'S A THAT'S A SOME WE BUY
AND SELL AND WE ONLY CAN DO SO
IF WE HAVE THE MONEY.
DIFFERENT CONVERSATION I KNOW WE
HAVEN'T TALKED THAT MUCH TODAY
ABOUT THE RATES OF UNDER INSURED
FOLKS BUT FROM MY PERSPECTIVE IF
THE ACA HAS BEEN GREAT IN
ENSURING MILLIONS OF MORE
CALIFORNIANS BUT AT THE SAME
TIME WE'VE SEEN.
NO IS A CALIFORNIANS WHO HAVE
HEALTH INSURANCE FROM THAT
HEALTH INSURANCE IS IS NOT IT
ENOUGH. AND A PROFESSOR PAUL AND
OR OTHERS AND WONDERED IF YOU
COULD COMMENT ON THE ISSUE OF
THE UNDER INSURED.
YES THANK YOU LIKE.
ALMOST ALL OF THE ISSUES BABY
ALL THE ISSUES IN OUR STUDY I
I'M NOT AN EXPERT I'M RELYING ON
A LOT OF THEIR OUTSTANDING
RESEARCH THAT'S OUT THERE. AND
SO I HAVE.
THIS STUDY.
HOW WELL THIS INSURANCE
COVERAGE PROTECT CONSUMERS FROM
HEALTHCARE COSTS FROM THE
COMMONWEALTH FUND? AND SO I I
QUOTED THOSE.
THERE.
DIFFERENT WAYS IN WHICH WE CAN
MEASURE UNDER INSURANCE.
SO.
THAT THE ONE THAT WE WERE.
USING AS OUR MEASURE OF UNDER
INSURANCE WAS THE ONE IN WHICH
WE SAY.
THESE ARE PEOPLE WHO HAVE
AT INSURANCE.
.
THAT THIRTY FOUR PERCENT.
DID NOT FILL A PRESCRIPTION
SKIP TO RECOMMEND A TEST
TREATMENT OR FOLLOW UP HAD A
MEDICAL PROBLEM DID NOT VISIT A
DOCTOR CLINIC OR DID NOT GET
SPECIALIST CARE.
THIRTY FOUR PERCENT OF THE
PEOPLE RESPONDING TO THE SURVEY.
DID.
WE'RE FACED WITH ONE OF THOSE
FOR ACCESS PROBLEMS WITH HAVING
INSURANCE THAT'S ONE MEASURE AND
JUST BRIEFLY THEY HAVE OTHER
MEASURES.
THAT UP PEOPLE FACING.
MEDICAL.
FINANCIAL PROBLEMS
OUR MEDICAL DEBT.
WITH HAVING INSURANCE.
OF PEOPLE RECEIVED A LOWER
CREDIT RATING THIRTY NINE
PERCENT.
USED UP ALL THEIR SAVINGS
THIRTY FOUR PERCENT
TOOK ON CREDIT CARD DEBT TWENTY
SEVEN PERCENT UNABLE TO PAY FOR
BASIC NECESSITIES DUE TO THE
HEALTHCARE COSTS.
FOOD HEAT OR RENT TWENTY THREE
PERCENT.
DELAYED EDUCATION OR CAREER
PLANS TWENTY PERCENT THESE ARE
PEOPLE THAT HAVE HEALTH
INSURANCE SO THIS IS THE PROBLEM
IT IS NOT JUST THE ISSUE OF.
UNINSURED IT'S THE IT THESE
ISSUES OF UNDER INSURED AND WHEN
I SAID AT THE OUTSET WHEN YOU
WERE LISTENING ON THE RADIO OR
AT YOUR MEETING WITH YOUR
CHILDREN.
.
OF.
THE THE LEGISLATIVE ANALYST'S
STUDY I SAID I AGREED WITH ABOUT
SEVENTY PERCENT.
THE THIRTY PERCENT THAT I DON'T
AGREE WITH UNFORTUNATELY IS
IMPORTANT
AND AND ONE OF THEM WAS THAT
THEY DON'T COVER THE ISSUE OF
POTENTIAL COST SAVINGS. AND THE
SECOND IS A DONE DEAL WITH THE
ISSUE OF UNDER IN.
HAVE YOU WRITTEN ON THAT IF YOU
COULD PROVIDE THAT ANALYSIS
BECAUSE I'VE READ THE WE'VE ALL
READ THE ONLY.
ANALYSIS IN THERE ARE SOME VERY
INTERESTING THINGS AND IT WOULD
BE GOOD TO GET YOUR ASPECT YEAH.
OKAY NAM I DO KNOW WE'RE COMING
UP AGAINST UNLESS SOMEONE HURT
YOU MAY I JUST ANSWER JUST ONE
OF YOUR QUESTIONS EARLIER WHERE
WE GOT THE DATA FROM AYE ON THE
INDEPENDENT MEDICAL REVIEW IS
FROM THE D. MHC FINANCIAL
FILINGS FROM THE INSURANCE
COMPANIES. THAT'S THE SOURCE OF
THAT AND SOLICIT AND WHAT
HAPPENED AFTER TWO THOUSAND NINE
FAMILIES FINANCED FILENE'S THAT
THEY'VE MADE WITH THE INMATES
SEE INCLUDE THE I AM OUR
INFORMATION.
NOT THE CLAIMS NINE SOME
INFORMATION GOT THAT WAS THE
BASIS FOR THE ANALYSIS WAS THOSE
DMA SEE VIOLENCE BY THE INSURERS
OKAY. OKAY AND I AM THE ONLY
OTHER THING I WANTED TO I JUST
TO MAKE IT JUST TO BRING IT HOME
AGAIN ON A ON A VERY HUMAN LEVEL.
SO IN MY PRACTICE YOU KNOW I
HAVE A TWO EXAMPLES OF ELDERLY
PATIENTS WHO ARE COVERAGE THEY
HAVE MEDICARE AND.
ONE OF THEM HAS MEDICAID AS
WELL.
WALKER YOU KNOW IT NEEDS A
WALKER AND HAD TO END UP PAYING
AN ADDITIONAL FIFTY DOLLARS. FOR
THE COMPLETE TO COMPLETE THE
COST OF THE WATER AND IS.
OPERATING MORE USING A CANE AND
NO WALKER BECAUSE SHE CAN'T
AFFORD IT.
PLAIN AND SIMPLE AS THAT THE
INSURANCE YOU KNOW. GOVERNMENT
INSURANCE YOU KNOW SHOULD STILL
BE A YOU KNOW A POSITIVE STEP
FORWARD.
BUT IS UNDER INSURED IN THAT
REGARD ANOTHER PATIENT WHO HAS
DIABETES AND HYPERTENSION AND
EVERY TIME I WRITE A
PRESCRIPTION FOR HIM. ASKED ME
HOW MUCH IS THIS GOING TO COST
BECAUSE HE HAS A HIGH DEDUCTIBLE.
AND I ALWAYS HAVE TO NEGOTIATE
WITH THEM AS TO WHETHER OR NOT
YOU CAN ACTUALLY AFFORD THAT
MEDICATION ANOTHER EXAMPLE OF
SOME UNDER INSURANCE AND SO IT'S
REAL. IT'S HUMAN YOU KNOW BEYOND
THE NUMBERS WHICH YOU NEED RIGHT
NOW TO BE ABLE TO MAKE SOME KIND
OF PROJECTIONS ON HOW IT IS THAT
WE CAN.
BOLSTER OUR INSURANCE COVERAGE.
IT'S A IT'S A VERY REAL ISSUE
ON A DAY TO DAY BASIS FOR PEOPLE
LIVING WITH UNDER INSURANCE.
THANK YOU AYE AYE I DO
UNDERSTAND I'M BUMPING UP
AGAINST ONE O'CLOCK OUR TIME
FRAME THAT.
OR CHAIR HAD WANTED US TO.
TO RESPECT LET ME LET ME JUST
CLOSE WITH THE FOLLOWING A.
I'VE BEEN A LONG TIME SUPPORTER
THE ACA AND I AND WE ALL KNOW
THAT DONALD TRUMP AND HIS ALLIES
ARE TRYING TO RIP APART THE ACA.
BUT I ALSO THINK THE ACA HAS NOT
BEEN.
WHAT WE WANTED IT TO BE AND AS
AS YOU'VE JUST BEEN DISCUSSING
THE LAST FEW MINUTES AROUND OUR
UNDER INSURANCE RATES AS WELL AS
THE FACT THAT WE STILL HAVE
MILLIONS WHO ARE UNINSURED? AND
AND SO THIS IS IN PART WHY I
HAVE BEEN A SUPPORTER OF THE
VISION OF SINGLE PAYER.
AND I. WANTED TO BE ON THIS
COMMITTEE BECAUSE I REALLY
WANTED TO SORT OF TEST THAT
HYPOTHESIS AND AND. I I REALLY
WANT TO THANK THE CHAIRS FOR
MANY HEARINGS OF IN DEPTH
DISCUSSION ABOUT A LOT OF THESE
ISSUES THAT IMPACT.
WHAT WE ARE TO DO WITH AND FOR
BUT I WILL SAY FUNDAMENTALLY MY
PROSPECTIVE STILL REMAINS THE
SAME WE NEED SIGNIFICANT REFORM?
I AND I THINK THE VISION A
SINGLE PAYER STILL MAKE SENSE
THAT BEING SAID CLEARLY WE HAVE
AN AWFUL LOT OF DETAILS THAT WE
STING STILL NEED TO DELVE INTO.
DETAILS.
EITHER WITHIN.
THIS BILL THAT.
IS BEING CONSIDERED OR OTHERS
OUGHT TO THINK ABOUT WHAT WE DO
GIVEN THE REALITY OF DONALD
TRUMP OVER THE NEXT FOUR YEARS.
HOW DO WE SET UP THE ROADMAP?
HOW DO WE THINK ABOUT COST
CONTROL HOW DO WE THINK ABOUT
TRANSITIONS HOW WE THINK ABOUT
REVENUES A LOT OF QUESTIONS?
BUT FOR ME THOSE THE FACT THAT
THOSE QUESTIONS ARE OUT THERE IS
NOT A REASON FOR US TO TO NOT
ENGAGE INTENSELY IN THIS
CONVERSATION THAT FIGURE OUT.
RIGHT NOW AND AND TWO BECAUSE
THE URGENCY OF NOW WITH THE FACT
THAT WE'VE GOT MILLIONS OF
CALIFORNIANS WHO ARE SUFFERING.
BECAUSE OF LACK OF ACCESS TO
HEALTH CARE IS AS REAL TODAY AS
IT HAS ALWAYS BEEN SO I WANT TO
THANK YOU FOR THE PRESENTATION I
LOOK FOR TO MANY OTHER
CONVERSATIONS ON THIS AND AS
I'VE BEEN SAYING TO EVERY
STAKEHOLDER. AND INVOLVED IN
THIS CONVERSATION FROM EVERY
PART OF THE HEALTHCARE SECTOR WE
NEED SOLUTIONS AND WE NEED TO
ACT NOW AND SO I'M ASKING FOLKS
AND I THINK WE'RE ALL ASKING
FOLKS. GIVE US YOUR BEST IDEAS
NOW.
WERE OBVIOUSLY HAVING THAT
CONVERSATION TODAY WITH.
S. B. FIVE SIX TWO AND OTHER
PROPOSALS BUT NOT WE DON'T HAVE
TIME TO WAIT. THANK YOU.
IN RESPECT OF THIS PANEL BOMB
I'D LIKE TO ASK ONE QUESTION
JUST TO.
REALLY.
TRY AND LEARN FROM YOUR
EXPERTISE.
DOCTOR PAUL IN IN YOUR PERRY
REPORT ON PAGE THREE YOU SAID
THAT WE WOULD NEED A HUNDRED AND
SIX BILLION DOLLARS IN.
STATE FUNDING TO BE ABLE TO
REACH.
THE GOALS OF SENATE BILL FIVE
SIXTY TWO.
BUT WITHIN THE SENATE
APPROPRIATIONS ANALYSIS THE
AUTHOR'S OWN COMMITTEE. THERE
WAS TWO HUNDRED BILLION THAT
THEY.
SAID WOULD NEED TO BE RAISED AND
I'M HOPING THAT YOU CAN HELP TO
RECTIFY THE DIFFERENCES AND
DISCREPANCIES BETWEEN THOSE TWO
FIGURES.
AND WATCH ASSUMPTIONS WERE MADE
WITHIN YOUR STUDY VERSUS WHAT
WAS DONE ON THE SENATE
APPROPRIATIONS ANALYSIS.
I'M.
SO A.
OF OF OF FOR ONE THING AT THE AS
I SAID I I DO LIKE.
MANY THINGS ABOUT THEIR STUDY
AND AND AND AND AGAIN WHAT ONE
OF MY FORMER STUDENTS IS ONE OF
THE AUTHORS.
BUT UP AT THE FACT IS THEY
DON'T FULLY DOCUMENT.
WHERE THEY GOT THEIR RESULTS
WHICH I THINK I THINK WOULD BE
FAIR TO SAY THAT OUR STUDY DOES?
CAREFULLY DOCUMENT SO IT'S IT'S
HARD FOR ME TO KNOW IN FULL.
IN GENERAL THE FACT IS THAT
THEY ARE NOT INCORPORATING
POTENTIAL COST SAVINGS.
WHEREAS WE ARE SO WE WE AGREE.
TO COVER EVERYBODY.
UNDER THE EXISTING SYSTEM.
WOULD COST FOUR HUNDRED BILLION
DOLLARS WE'RE IN TOTAL AGREEMENT
WITH THE LEGISLATIVE ANALYST'S
OFFICE ON THAT.
BUT WE'RE SAYING THAT WE CAN
GET COSTS DOWN FROM FOUR HUNDRED
BILLION TO THREE THIRTY BILLION
THROUGH THE VARIOUS SOURCES OF
SAVINGS THAT WE DISCUSSED.
THEY DON'T A ENGAGE
ON THAT QUESTION NOT VERY
BRIEFLY I MEAN THEY DO HAVE A
BRIEF DISCUSSION ABOUT. THE
IMPORTANCE OF HAVING FOR EXAMPLE
DRUG FORMULARIES BUT THEY SEEM
TO SUGGEST THAT THAT'S NOT
POSSIBLE.
UNDER H. P. FIVE SIX TWO WHEREAS
IN MY OPINION IT'S A EXTREMELY
VIABLE.
AND SO YOU KNOW THAT'S ONE
EXAMPLE THEY DO NOT ENGAGE ON
THE ISSUE OF ADMINISTRATIVE
SAVINGS.
I AM SO I I WOULD LIKE IT IF
THEY HAD DOCUMENTED MORE FULLY
WHY THEY DON'T THINK YOU CAN GO
DOWN FROM FOUR HUNDRED TO SAY
THREE THIRTY OR THEREABOUTS.
THAT'S WHAT MY.
MY SENSE OF IT OUT A BUT AS I
SAID WE WE DO GO THROUGH IT AND
AND I APPRECIATE YOU ALL READING
AND I DIDN'T KNOW THAT ANYBODY
ACTUALLY WOULD READ OF ACTUAL
THINGS. BUT.
.
YEAH I'M HERE OF MY STUDENTS
NEVER READ WHAT I TELL HUNDRED
SO.
.
THE I YOU CAN SEE VERY CLEARLY
HOW WE GET FROM FOUR HUNDRED TO
THREE THIRTY IT'S RIGHT THERE
AND I WOULD WELCOME.
MY FORMER STUDENT ROBERT
ENGINEERED A FEAR HERE ARE
LISTENING. TELL ME WHERE I WENT
WRONG IF SOMEBODY HAS A GOOD
CRITICISM I'M OPEN TO IT.
I I THINK IT'S I THINK THEY'RE
FAIRLY CONSERVATIVE OF ITS IT
CAN FAIRLY CONSERVATIVE ESTIMATE.
SO I'M WILLING TO STAND BY.
DON'T FOLLOW UP THE CORE.
REALLY.
YOU DON'T MUCH LIKE WE WERE
DISCUSSING EARLIER
ARE THOSE SAVINGS ACHIEVABLE DAY
ONE.
ARE THOSE SAVINGS THAT WOULD YOU
KNOW CHANGE OVER TIME.
AND REALLY WHAT I'M TRYING TO
GET AT IS.
HOW WE WOULD LOOK AT TRANSITIONS
OR IMPLEMENTATION YET NOT AND
THAT NOTHING HAPPENS AND DAY ONE
WE S. AS EVERYONE IS THAT WE DO
NOT FLIP SWITCH?
AND ALL THE SUDDEN WE GOT THIS
WONDERFUL SYSTEM THAT WORKS
PERFECTLY NO THERE HAVE TO BE. A
A TRANSITION PERIOD
I ON THE OTHER HAND SO. IN THIS
EXAMPLE THAT I GAVE ON THIS
ISSUE AROUND THE THE COST
SAVINGS FROM.
IMPROVE.
SERVICE PROVISION.
AS AS WE'VE TALKED ABOUT I'M
ASSUMING FIVE PERCENT SAVINGS IN
THAT AREA WHERE AS THE INSTITUTE
OF MEDICINE SAID IT'S SHOULD BE
NINETEEN PERCENT. SO WHAT I
ACTUALLY THINK IS THAT.
WE START IN THE RANGE OF THREE
FOUR FIVE PERCENT IN YEAR ONE
AND I THINK THAT'S POSSIBLE FROM
WHAT MY READING OF THE
LITERATURE. BUT I THINK WE CAN
IT IF THERE ISN'T REALLY TWENTY
PERCENT OR MORE WASTE OUT THERE.
OVER THE COURSE OF A DECADE OR
ROUGHLY A DECADE WE CAN GET
CLOSER TO TWENTY PERCENT AND
THAT'S ONE OF THE REASONS WHY I
THINK THAT THE. A CM ES
PROJECTIONS.
FOR RISING HEALTHCARE COSTS YOU
KNOW THE CURVE CONTINUALLY TO GO
UP. I THINK THAT IS THE MAJOR
WAY THROUGH WHICH WE CAN
ACTUALLY GET THE CURVE TO GO
DOWN RECOGNIZING. THAT THERE IS
THE TREMENDOUS WASTE IN THE
SYSTEM WE WILL NOT GET AT IT ALL
IN YEAR ONE MAYBE WE CAN GET TO
FIVE PERCENT IN YEAR ONE OR TWO.
BUT OVER THE COURSE OF A DECADE
THROUGH A MUCH MORE EFFICIENT
SYSTEM AND.
MUCH MORE CAREFUL MONITORING WE
WE SHOULD BE ABLE TO GET MORE
SAVINGS SO THAT'S WHY I THINK.
MY ESTIMATE OF THE EIGHTEEN
PERCENT.
SAVINGS IS PROBABLY PRETTY
CONSERVATIVE.
WHAT THAT IF I CAN I JUST WANT
TO THANK THE PANEL FOR YOUR
ENDURANCE?
ABILITY TO ANSWER THESE.
WE ARE GOING TO TAKE A BREAK
WITH THIS COMMITTEE NOW UNTIL
TWO PM I WOULD ASK THOSE WHO ARE.
IN THE AUDIENCE NOW. TO TAKE
EVERYTHING THAT WE HAVE AND TO
COME BACK WHEN WE BEGIN TO GET A
TO. LOOK FORWARD TO HAVING YOU
THERE
OKAY WE'D LIKE TO GO AHEAD AND
GET STARTED WITH THE NEXT. PART
OF OUR HEARING.
SO WE'RE GOING INVITE UP OUR
SECOND PANEL.
ANTHONY RIGHT PETER FAN.
AND JOHN ARSON MEYER.
OUR INSPIRE EXCUSE ME.
SORRY.
AND YOU NEED SLIDES ON.
RIGHT THERE
.
OKAY
SO WHAT WOULD GO AHEAD IT WILL
HELP GO AHEAD GET STARTED HERE
I'M.
OUR FIRST FIRST TO SPEAKERS
THIS AFTERNOON ANTHONY WRIGHT
EXECUTIVE DIRECTOR OF PUT.
OF.
HEALTHAXIS CALIFORNIA.
BETSY ESTUDIO.
THINKS SENIOR POLICY MANAGER.
HEALTH BENEFITS CALIFORNIA
IMMIGRANT POLICY CENTER.
PETER FAN OF THE TREASURE
PRINCIPLE OFFICER TEAMSTERS
LOCAL EIGHT FIFTY SIX
SARAH FLOCKS.
NO STRANGER TO US HERE IN THE
COMMITTEE.
POLICY COORDINATOR FOR THE.
TEMPERING LABOR FEDERATION AND
JOHN JOHN EARNS MEYER FOUNDER
AND CEO OF THE SMALL BUSINESS
MAJORITY SO MISTER RIGHT YOU
HAVE THE FLOOR.
I OFTEN.
LET ME TRY TO GET.
OKAY.
AGAIN THANK YOU CHAIRMAN WOULD
CHAIRMAN ARAMBULA.
I'M REALLY PLEASED TO BE HERE MY
NAME IS ANTHONY RIGHT AND THE
EXECUTIVE DIRECTOR OF HEALTH
ACCESS CALIFORNIA. HEALTH ACCESS
IS THE STATEWIDE HEALTHCARE
CONSUMER ADVOCACY COALITION
WORKING FOR THE GOAL OF QUALITY
AFFORDABLE HEALTHCARE FOR ALL
CALIFORNIANS.
FOR THIRTY YEARS WE BURKE BOTH
ON THE VISION OF A OF A
UNIVERSAL HEALTH HEALTHCARE
SYSTEM IN CALIFORNIA. AND ALSO
IN THE LEGISLATIVE AND BUDGET
BATTLES OF THE MOMENT ON THE
CAPITOL AS YOU YOU KNOW MANY OF
MY COLLEAGUES WORKING.
TO REPRESENT THE PATIENCE IN THE
PUBLIC SOMETIMES AS A
COUNTERPOINT TO INSURERS ARE
DOCTORS ARE DRUG COMPANIES OR.
HOSPITALS TO TRY TO MAKE SURE
THAT WE HAVE A BETTER HEALTHCARE
SYSTEM.
A AND WE'VE ALWAYS TRIED TO
BALANCE THAT WITH PUTTING
FORWARD THE VISION OF HOW DO WE
GET TO SET UP A SYSTEM THAT IS
TRULY UNIVERSAL BOTH IN CARE AND
COVERAGE IN PROTECTING PEOPLE SO
THAT WE. DON'T HAVE PEOPLE WHO
ARE UNINSURED WHO LIVE SICKER
WHO DIE YOUNGER AND WHO ARE ONE
EMERGENCY AWAY FROM FINANCIAL
RUIN WEEK YOU KNOW WE CARE ABOUT
THAT PEOPLE HAVE ACCESS TO CARE.
BUT ALSO THAT THERE FINANCIALLY
PROTECTED FROM.
IT MEDICAL BANKRUPTCY OR
SIGNIFICANT MEDICAL BILLS
WE'VE APPROPRIATE IN WORKING
WITH THIS LEGISLATURE IN THE
LAST FEW YEARS ON A RANGE OF
ISSUES WHAT WHETHER IT'S BEEN ON.
THE LEADERSHIP TO YOU THAT.
THAT THE FOLKS IN THIS
COMMITTEE HAVE WORKED ON TO.
BANNED THE PRACTICE OF SURPRISE
MEDICAL BILLS WHETHER TO ADDRESS
HIGH PRESCRIPTION DRUG COSTS
WHETHER TO WORK ON TIMELY ACCESS
TO CARE TO UNFAIR OUT OF POCKET
COSTS.
AND IT AND WE HOPE THAT WE CAN
CONTINUE TO MAKE PROGRESS AND
WE'RE EXCITED ABOUT THIS NEW
CONVERSATION ABOUT TAKING
ADDITIONAL ARE STEPS FORWARD.
I TO TALK ABOUT WHERE WE ARE WE
JUST OF PAID A LITTLE BIT OF
BASELINE OF WHERE WE ARE
OBVIOUSLY. OF THERE'S BEEN A LOT
OF PRO OF PROGRESS THAT WE'VE
MADE UNDER THE AFFORDABLE CARE
ACT AND ESPECIALLY BECAUSE OF
THE WORK THAT THIS COMMITTEE IS
DONE NOT JUST TO IMPLEMENT THE
TO IMPROVE UPON THE AFFORDABLE
CARE ACT. AS A RESULT OF THAT
THAT WORK TO IMPLEMENT IMPROVE.
MILLIONS OF CALIFORNIANS HAVE
NEW CONSUMER PROTECTIONS NEW
FINANCIAL ASSISTANCE OF WITH
REGARD TO GETTING THE CARE THAT
THEY NEED FOR MILLION
CALIFORNIANS HAVE NEW COVERAGE
AS A RESULT OF THAT AND WE'VE
SEEN THE BIGGEST DROP OF THE
UNINSURED WRITTEN RATE OF ALL
FIFTY STATES.
AND THAT'S SOMETHING TO BE I WAS
WE WERE AT AS MUCH AS TWENTY
PERCENT UNINSURED ARE JUST A FEW
YEARS AGO NOW THE CDC HAS THIS
IS BACK BELOW SEVEN PERCENT.
.
I'D IT WE'VE DONE THAT BECAUSE
WE'VE TAKEN PROACTIVE ACTIONS
AND I'M NOT JUST TO BE SATISFIED
WITH THE FEDERAL LAW BUT TO GO
FORWARD TO HAVE A. OF FOR
EXAMPLE ANY AN EXCHANGE THAT
NEGOTIATE FOR THE BEST POSSIBLE
PRICE.
A STANDARDIZED OF A BENEFITS TO
PROVIDE WAYS TO GET PEOPLE
QUICKLY AND EASILY INTO COVERAGE
TO EXPAND COVERAGE TO NEW OF
POPULATIONS AS WELL.
AND SO THE QUESTION I THINK THAT
THIS COMMITTEE IS GOOD GRAPPLING
WITH IS IF WE CAN PREVENT THE
ATTACKS ON OUR HEALTH CARE
SYSTEM THAT WE'RE SEEING.
THROUGH EIGHT AC REPEAL INSTEAD
MEDICAID CUTS
HOW CAN WE ACTUALLY GO FORWARD.
THOUGH I'D JUST ON A MOMENT
ABOUT THOSE ATTACKS THAT YOU
KNOW THE PROPOSALS THAT WE STATE
FACED LAST YEAR. IN A IN
CONGRESS WORST SIGNIFICANT IT
HARD TO OVERSTATE HOW MUCH.
DEVASTATION THEY WOULD HAVE
RACKED ON OUR HEALTH CARE SYSTEM
ON HOW MUCH THEY WOULD HAVE
HANDCUFFED OUR ABILITY TO
RECOVER. OR EVEN TAKE STEPS
FORWARD DAY WE DID THEY WHAT
THEY PROPOSE MASSIVE CUTS TO OUR
HEALTH CARE SYSTEM CUTTING IN
CAPPING THE MEDICAID PROGRAM
LEAVING MILLIONS AND MILLIONS
MORE UNINSURED FOR.
GIBT JUST FOUR MILLION MORE
FROM GET GETTING RID OF THE
MEDICAID EXPANSION MILLIONS MORE
IF YOU.
IF THE PROPOSAL ALSO.
AND DID SOME OF THE FINANCIAL
ASSISTANCE AND COVERED
CALIFORNIA OR AYE AND DID OTHER
PROVISIONS OF THE PROPOSALS.
AND UNDO SOME OF THE KEY
PATIENT PROTECTIONS THAT.
THAT.
THAT WERE PROPOSED.
WE DEREK DEATH DEATH THREAT VERY
MUCH DOES CONTINUE WE WANT TO BE
CLEAR THE BUDGET RESOLUTION THAT
THIS CONGRESS PASSED LAST YEAR.
DE OUTLINED ACTUALLY MEDICAID
TYPE
IT'S THAT WERE TWICE AS SEVERE
AS THE ECA REPEAL BILL YOU CAN
SEE THAT AGAIN BECAUSE OF THE
CAP THAT. IS BEING PROPOSED A
PROPOSED AT THE AT THE FEDERAL
LEVEL BY SOME OF THESE PROPOSALS
THAT OVER THE COURSE OF TEN
YEARS A YOU WOULD HAVE A MEDI
CAL PROGRAM THAT WOULD ACTUALLY
PROVIDING HALF AS MUCH DOLLARS
TO SEE EYE TO STATES. THAT IS A
SUGGEST SIGNIFICANT AMOUNT MONEY
OF TENS OF BILLIONS OF DOLLARS.
THAT YOU KNOW THAT IS MONEY
THAT WE WE NEED TO.
TO COVER OUR THIS POPULATION
WHICH NOW CUT IS ALMOST FOURTEEN
MILLION CALIFORNIANS A THIRD OF
THE STATE HALF OF ALL CHILDREN
TWO THIRDS OF ALL NURSING HOME
RESIDENTS.
AND THIS IS.
AND SO TO IMPORTANT RECOGNIZE
THAT IF IF THIS HAPPENED THIS
WOULD NOT JUST BE LESS MONEY FOR
THE TO EVEN MAINTAIN OUR
EXISTING SYSTEM OR TO FIND ANY
OTHER SYSTEM WHETHER BE SINGLE
PAYER ANY OTHER SYSTEM. SO OUR
FIRST GOAL AND OUR FIRST FOCUS
OF LAST YEAR WAS TO TRY TO FIGHT
BACK AGAINST THIS PROPOSAL NAKED
AND WE NEED TO HAVE CONTINUED
VIGILANCE WITH REGARD TO. OF
WHAT IS BEING DISCUSSED IN DC.
IF WE CAN HAVE THE FRAMEWORK IN
THE FINANCING OF THE AFFORDABLE
CARE ACT INTACT HOWEVER THERE
ARE THINGS CALIFORNIA CAN DO TO
IT TO RESIST SOME OF THE
ADMINISTRATIVE ATTACKS THAT
WE'VE SEEN IN OUR HEHE ON OUR
HEALTHCARE SYSTEM BY THE FIFTH
BY THE FEDERAL GOVERNMENT.
WE'VE WHO WE'VE OUTLINED AT
LEAST SIX OR SEVEN DIFFERENT
WAYS WHERE THE TRUMP
ADMINISTRATION HAS SOUGHT TO
UNDERMINE OUR MARKETS
DESTABILIZE OUR HEALTHCARE
SYSTEM.
AND UNDO THE ODE TO A.
THAT THEY DE FUND THE COST
SHARING REDUCTION.
THEY CUT MARKETING BY NINETY
PERCENT WE INCREASED OUR
MARKETING SO THAT PEOPLE CAN GET
ENROLLED IN TODAY WE ACTUALLY
HAVE NEW NUMBERS FROM COVER
CALIFORNIA THAT SUGGEST THAT IN
ROME AND ACTUALLY WENT UP BY
THREE PERCENT DESPITE ALL THE
FEDERAL UNCERTAINTY. AND AND
ISSUES AND SO OVER FOUR HUNDRED
THOUSAND NEW IN A NEW PEOPLE
SIGNING UP FOR COVERAGE IN THE
LAST OPEN ENROLLMENT.
THEY SOUGHT TO CUT THE OPEN
ENROLLMENT PERIOD BY THREE
MONTHS WE ARE A BIT FROM THREE
MONTHS TO SIX WEEKS WE MAINTAIN
A THAT THREE MONTH OPEN
ENROLLMENT PERIOD AND I DO SO
INTO THE FUTURE. WITH A WITH A
BILL BY A CHAIRMAN WHAT.
WE OWE WORK TO MAKE SURE THAT
AS INSURERS WERE EXITING THAT
CONSUMERS.
TO CONTINUE THE CONTINUITY OF
CARE AND TO THE EXTENT THAT THEY
SAW TO IT AND UNDERMINE
CONTRACEPTIVE COVERAGE WE
ACTUALLY HAD PRE EXISTING.
LAWS IN PLACE TO I TRY TO AT
LEAST MAKE FOR CALIFORNIA
REGULATED PLAN HAD THAT
PROTECTION.
BUT THERE IS MORE TO DO TO
PREVENT.
DID.
THE RESULTS OF SOME OF THESE
ARE AYE AND I ATTACKS ON OUR
HEALTH CARE SYSTEM TO MAKE SURE
THAT PEOPLE ARE NOT EXPERIENCING
THE PREMIUM SPIKES AND THE
PROJECTIONS OF. OUR INCREASED IN
TERMS OF MORE UNINSURED MORE
UNDER INSURED.
MORE JUNK COVERAGE ACCEPTANCE
OF ONE OF THE THINGS THAT ARE
THE TRUMP ADMINISTRATION DID WAS
TO TRY TO PROMOTE.
GUY JUNKER SUBSTANDARD COVERAGE
COVERAGE THAT DOES NOT MEET THE
STANDARDS OF THE ACA ARE OFTEN
CALLED ASSOCIATION HEALTH PLANS.
ARE A OR SHORT OUR ALSO SHORT
TERM INSURANCE.
WHERE WE'RE LOOKING CLOSELY AT
THOSE ESOS ASSOCIATION HEALTH
PLAN REGULATIONS THAT ARE BEING
PROPOSED? AND ON SHORT TERM
INSURANCE WE'RE PROUD TO BE
WORKING ON A BILL I ON THE BILL
WITH TENDER HERNANDEZ ON.
BANNING THAT OUT RIGHT EYES SO
THAT WE DO NOT HAVE SUB STANDARD
COVERAGE THAT LEADS PEOPLE IN
THE LURCH WHEN THEY DO WITH IT
WHEN THEY DO SIGN UP FOR IT BUT
ALSO DESTABILIZES THE OVERALL.
SYSTEM.
WE'RE ALSO LOOKING AT TO THE
EXTENT THE TRUMP ADMINISTRATION
IS TRYING TO LOWER THE MEDICAL
LOSS RATIO THE AMOUNT OF MONEY
THAT. INSURERS HAVE TO HAVE TO
PROVIDE TO PATIENT CARE RATHER
THAN TO ADMINISTRATION PROFITS
THEY WANT TO LOWER THAT AND.
ANNOUNCED THROUGH REGULATION.
BUT IT WILL WE BELIEVE IN
CALIFORNIA SHOULD LOOK AT THAT
ARE CLOSELY IT ACTUALLY RAISING
THAT I'M NOT MAKING SURE THAT
WE'RE GETTING MORE. DOLLARS THAT
GO TO PATIENT CARE RATHER THAN.
DOES OTHER ADMINISTRATIVE
EXPENSES.
AND WITH REGARD TO BROADER
MARKET STABILIZATION WE DO
BELIEVE THAT IN THE ABSENCE OF
AN INDIVIDUAL MANDATE WE DO NEED
IT OTHER EFFORTS TO TRY TO
STABILIZE OUR MARKET.
ESPECIALLY WE THINK THAT
ACTUALLY LEADS TO SUBSIDIES
RATHER THAN THE PENALTY THAT ARE
THE MAIN DRIVER OF ENROLLMENT
AND SO WELL. AND AT PACKAGE ON
GREATER AFFORDABILITY WOULD
WOULD HELP IN THAT REGARD TO
MAKING SURE THAT PEOPLE CONTINUE
TO BE COVERED. ARM IF THAT WAS
PARTIALLY FUNDED BY A PART A
MORE PROGRESSIVE AYE INDIVIDUAL
CONTRIBUTION THAT WOULD BE
APPROPRIATE TO ENCOURAGE
ENROLLMENT SO THAT. AGAIN WE
DON'T HAVE THE ISSUE OF INCREASE
PREMIUMS BY IF SPIKES AND MORE
PEOPLE ON IT UNINSURED THE CBO
SUGGESTED THAT.
PREMIUMS I'LL WILL GO UP TEN
PERCENT AS A RESULT OF SOME OF
THE TRUMP SABOTAGE THAT WE'VE
BEEN SEEING AND A ONE POINT
SEVEN MILLION A CALIFORNIANS
WOULD LOSE COVERAGE THAT'S A UC
BERKELEY FIGURE BASED ON CBO
NUMBER. OF THAT WE WANT TO
PREVENT THAT FROM HAPPENING SO
WE DON'T HAVE ANY THE
BACKSLIDING. AND OF COURSE WE
NEED AT ONGOING IN OUR VIGILANCE
WITH REGARD TO THIS.
BUT THAT'S ABOUT JUST STAYING IN
THE SAME PLACE AND THAT'S NOT
WHAT CALIFORNIA WANTS TO DO PORTANTINO DITION OF TRYING TO
MOVE FORWARD WITH HEALTH REFORMS
TO TRY TO MAKE SURE THE P. IT
ALL CALIFORNIANS HAVE ACCESS TO
THE CARE THAT THEY NEED.
I YOU KNOW THIS IS A BIPARTISAN
TRADITION DATING BACK TO
GOVERNOR EARL WARREN.
INTO SOME OF THE I WE HAVE
TRADITIONALLY OVER MANY YEARS ON
THAT CERTAINLY AND THE THIRTY
YEARS OF MY ORGANIZATION THE
SEVENTEEN YEARS THAT I'VE BEEN
IN THIS POSITION DOING THIS WORK.
OF WE'VE CERTAINLY SEEN A RANGE
OF DIFFERENT PROPOSALS WORK
TOGETHER AND I DO BELIEVE THAT
ALL OF THESE EFFORTS CAN GET CAN
AND SHOULD BE COMPLEMENTARY TO
TO GET TO THIS GOAL WERE ALL OF.
THE QUESTION IS ON SOME OF THESE
ARE THE PROPOSALS HAVE ALWAYS
BEEN ON DIFFERENT TRACKS AND
DIFFERENT TIME TABLES AND I
THINK THAT. OF WE ARE LOOKING AT
ONE OF THOSE.
TIMES AGAIN AND SO I WANT TO
TALK A LITTLE BIT ABOUT THAT.
AND THEN OBVIOUSLY THE THROUGH
THE GOAL THAT MY ORGANIZATION
HAS SUPPORTED SINCE ITS FOUNDING
OF OF A UNIVERSAL SINGLE PAYER
MEDICARE FOR ALL SYSTEM IS
SOMETHING THAT WE WE STRONGLY.
ADVOCATE WITH FULL THROATED LEE
THAT IT IS A. OF WHAT WE BELIEVE
THAT A SINGLE PAYER SYSTEM WELL
DESIGNED YEAH THIS IS NOT AN
IDEOLOGICAL ISSUE THIS IS ABOUT
HOW DO WE GET TO THESE GOALS OF.
A WELL DESIGNED SYSTEM IS A WAY
TO GET TO THE GOT TO GO OF
UNIVERSALITY OF HAVING A
PROGRESS A PUBLIC PUBLICLY IN
PROGRESSIVELY FINANCED
HEALTHCARE SYSTEM A SYSTEM THAT
IS MORE COST EFFECTIVE.
I SYSTEM THE ODD THAT HAS
COMPREHENSIVE COVERAGE THAT IS
SIMPLER AND MORE EFFICIENT AND
ON THAT IS FOCUSED ON PREVENTION
IS RATHER THAN PROFITS.
IT IS YEAH.
DID. WE DO IT THIS IS A SYSTEM
THAT ARE THAT WE SHOULD CONTINUE
TO TRY TO WORK TO.
WE RECOGNIZE HOWEVER THAT THIS.
SYSTEM HE AYE DOES HAVE ITS
OBSTACLES AS AS DO MOST HEALTH
ROOM CARE REFORMS AYE. AYE THAT
THERE ARE A VARIETY OF OBSTACLES
TO ANY TYPE OF HEALTH REFORM I
HAVE SOME OF THE SCARS ON MY
BACK.
TO SHOW FOR IT AND IT IS THE.
AND YOU KNOW IT'S IT IT'S
HAVING TO FIGURE OUT A LOT OF
DIFFERENT.
A EACH GET TO A LOT OF DIFFERENT
OBSTACLES AT ONCE IT'S ALMOST
LIKE THREADING MULTIPLE NEEDLES
AT ONCE
I'M THERE IS THE THE POLITICAL
FORCES OF INDUSTRY AND
IDEOLOGICAL OPPOSITIONS THERE'S.
YOU KNOW TRYING TO GET PUBLIC
ACCEPTANCE ESPECIALLY IF
SOMETHING.
IF IF YOU HAVE TO REPLACE THE
COVERAGE THAT PEOPLE ARE USED TO
IT SOMETHING DIFFERENT EVEN IF
IT'S GOING TO BE BETTER. IF IT'S
R. DOES THE POLICY ISSUES AND
TRADE OFFS INCLUDING FINANCING
AND THE PROCESS ISSUES OF OF
JUST GETTING THROUGH THE VARIOUS
HURDLES. I WENT WHETHER BE ON
THE BALLOT IN THE LEGISLATURE OR
OTHERWISE I THINK THE.
THIS COMMITTEE HAS I THINK.
BEEN A VERY HAD HAD A VERY
USEFUL SEVERAL HEARINGS THAT
HAVE GONE INTO THE DETAILS OF
THESE POLICY ISSUES THERE AND I
THINK. ARM RAISED A LOT OF THE
THE THE RIGHT ISSUES AND THE
RIGHT QUESTIONS
I'D I THINK THAT DESIRE
RESOLVABLE ISSUES BUT THEY DID
BUT THEY DO TAKE TIME AND WORK
TO DO TO RESOLVE SO DID THESE
ARE NOT. TO SAY THAT THESE
OBSTACLES HEY YOU CAN'T DO IT
THAT CERTAIN DEATH CERTAINLY NOT
WHAT I THINK ANYBODY SHOULD TAKE
AWAY FROM ANY THOSE
PRESENTATIONS BUT THEY ARE WE
NEED TO BE CLEAR EYED ABOUT HOW
WE ARE GOING TO ADDRESS THOSE
ISSUES IN ORDER TO MOVE FORWARD.
THE WHAT THE ONE ISSUE THAT DOES
LOOM LARGE IN IN MY MIND IS THE
ONE FOR NEED FOR FEDERAL
APPROVAL THAT. IF YOU'RE GOING
TO RECALL A CLAIM.
IN IN THE CASE OF A A SINGLE
PAYER SYSTEM.
THE.
TWO HUNDRED BILLION DOLLARS OR
SO FROM THE FEDERAL GOVERNMENT
AYE THE WHAT HOW DO YOU DO THAT
OF THROUGH MEDICAID TO MEDICARE.
THROUGH THESE OTHERS SYSTEMS IS
A REAL.
IT IS A REAL CHALLENGE EVEN
WITH A FRIENDLY FAN FEDERAL
PARTNER AND OBVIOUSLY THAT'S NOT
HOW I CAN'T WOULD CHARACTERIZE
THE CURRENT MINISTRATION.
THE AS IT IS ARE IN ISSUE THAT I
AYE REYES JUST BECAUSE.
EVEN EVEN IF YOU WERE TO SUBMIT
A PROPOSAL.
AND.
I MEAN EVEN EXPERIENCE THAT WE
HAVE THE IN JUST IN THE LAST
YEAR A WE HAVE OF PUT. OF
THIRTEEN THIRTY TWO WAIVERS THAT
WERE SUBMITTED BY STATES LIKE
MINNESOTA AND AND NEW YORK WHERE
THE PROPOSAL WAS SUBMITTED AND
THE FEDERAL MINISTRATION SAYS IF
YOU WANT THAT WAIVER FOR THIS
RELATIVELY MODEST. A ISSUE OF
REINSURANCE OR SOMETHING LIKE
THAT WE'RE GOING TO TAKE THAT
MONEY BY DE FUNDING ANOTHER PART
OF YOUR HEALTHCARE SYSTEM AS A
RESULT. AYE AYE AYE WE NOW HAVE
IN THE MEDICAID A SITUATION I A
SITUATION WHERE.
INDIANA AND OTHER STATES HAVE
HAVE THAT WAS SUBMITTED WAIVERS
TO INK INTRODUCED WORK
REQUIREMENTS AND LOCKOUTS AND
OTHER PROVISIONS IN THEIR
MEDICAID PROGRAM WE CAN ONLY
IMAGINE THE. THE.
WHETHER IT'S ON IMMIGRATION OR
REPRDUCTIVE RIGHTS OR FIVE
OTHER ISSUES WHAT THE FEDERAL
ADMINISTRATION IN THIS CURRENT
ENVIRONMENT WOULD REQUIRE FOR
THE UNPRECEDENTED OF PERMISSIONS
THAT WE WOULD BE ASKING FOR
INDESCRIBABLE.
SO I AGAIN NOT TO IT AYE SO WE
WE THINK THAT WE WANT TO
CONTINUE TO ADVOCATE TO ORGANIZE
AND DEVELOP. A THE GOAL OF A
SINGLE PAYER ARE OUT MEDICARE
FOR ALL TYPE HEALTHCARE SYSTEM.
AND WE SHOULD NOW TAKE WE SHOULD
TAKE STEPS
ARE IN THE MEANTIME WHILE WE ARE
THAT THAT DO NOT REQUIRE FEDERAL
APPROVAL WHAT CAN WE DO WHAT CAN
WE DO FOR. DEBT IS WHAT CAN WE
DO IN THE NEXT YEAR YEAR UNDER
GOVERNOR BROWN IN THE NEXT TWO
YEARS UNDER AND YOU GOVERNOR
THAT CAN ACTED WHERE WE CAN
ACTUALLY MAKE PROGRESS ON THE
GOALS. OF OF ADDRESSING ISSUES
OF COST AND QUALITY IN ACCESS
AND EQUITY WHY ARE WELL ALSO NOT
RUNNING INTO THE BRICK WALL OF
FEDERAL APPROVAL WHY AND ALSO
WHILE. CONTINUING TO DO THE
BROAD DUB THE ORGANIZING THE
POLICY DEVELOPMENT THE OTHER
WORK ON OUR ADDITIONAL BROADER
REFORMS
AND SO THAT THAT'S WHAT I WANT
TO TALK ABOUT TODAY JUST TO BE
CLEAR. CALIFORNIA CAN'T WAIT
PEOPLE NEED ARM CONTINUE TO HELP
NOW AS MUCH PROGRESS AS WE'VE
MADE THERE'S AN EDITOR'S MORE
WORK TO DO BUT. WE ARE AND WE
DON'T WANT TO WAIT FOR FEDERAL
APPROVALS WE CAN TAKE CONCRETE
ACTIONABLE STEPS
THEY ARE IN THE NEXT IT THIS
YEAR AND THE NEXT COUPLE YEARS.
AWHILE ALSO THEN WORKING TOWARD
A BROADER VISION AND A BROADER
GO AND SO YOU KNOW THAT'S WHAT I
WANT TO TALK ABOUT TODAY IS THE
IS THESE COMPLIMENTARY EFFORTS.
THE COMPLIMENTARY EFFORTS TO YOU
ARE TO MOVE FORWARD AND WE THINK
THAT SOME OF THESE GOALS ARE TO
GET TO BETTER UNIVERSALITY AND
AFFORDABILITY WE CAN EXPAND
COVERAGE TO. TALK TO AYE AYE
EXPAND COVERAGE AND PUBLIC
PROGRAMS TO COVER ALL REGARDLESS
OF IMMIGRATION STATUS SAID
NOBODY'S EXCLUDED IMMIGRATION
STATUS WE CAN EXTEND
AFFORDABILITY IN COVER
CALIFORNIA SO THAT NO ONE HAS TO
SPEND MORE THAN A PERCENTAGE OF
THEIR INCOME. FOR FOR THE OF OF
ON PREMIUM AND REDUCE PREMIUMS
AND COST SHARING SAID IT'S
GREATER AFFORDABILITY WE CAN
MAKE REAL PROGRESS ON ISSUES OF
COST DEALING WITH HEALTH CARE
PRICES DEALING WITH.
UNJUSTIFIEDMEDICAL BILLS
MAKING SURE THAT WHAT PEOPLE ARE
NOT LEFT AT W. AT THE WHIMS OF
PRIVATE INSURERS AND.
IN A BEAR COUNTY WITHOUT ANY
COVERAGE OPTIONS
SO THAT'S WHAT WE WANT TO TALK
ABOUT HERE.
THE.
WE YOU'VE SEEN THIS SLIDE BEFORE
EARLIER.
BY ONE OF MY COLLEAGUES AT A OF.
OUR ACADEMIC COLLEAGUES OF THE
UC BERKELEY SUGGESTING WHO IS
LEFT REMAINING UNINSURED WE'VE
GOTTEN IT UNDER THREE MILLION
BUT THERE'S STIRS CLEARLY MORE
TO DO. CLEARLY YOU SEE A LITTLE
BIT MORE THAN HALF ARE FROM OUR
THAT ARE UNDOCUMENTED AND THEN
THERE'S PEOPLE WHO ARE ELIGIBLE
FOR SUBSIDIES.
AND OTHERS WHO ARE WHO ARE JUST
ABOVE THAT ARE THAT THAT.
THAT THRESHOLD AND WHAT WE ARE
SO FAR AND YOU CAN SEE FROM THE
UNDERSIDE THERE TO TAKE UP MEDI
CAL THE ENROLLMENT TODAY'S ABOUT
A THIRD AYE.
.
ABOUT FOURTEEN MILLION FOLKS
THERE'S ABOUT THREE HUNDRED
MILLION ARE A THREE HUNDRED
THOUSAND ELIGIBLE BANANA ROLES
THAT OVER A DECK OF A RELATIVELY
HIGH TAKEN.
COVERED CALIFORNIA WHERE THERE
IS A PREMIUMS AND COST SHARING
TO TAKE UP IS IS IS IS GOOD BUT
IT COULD BE A LOT BETTER AND THE
QUESTION IS CAN WE PROVIDE SOME
ADDITIONAL AFFORDABILITY HELP.
IN ADDITION TO THE UNDOCUMENTED
I WOULD I I WENT OUT WHICH MY
COLLEAGUE WILL TALK ABOUT IN A
SECOND I WANTED I'D I WENT A
COUPLE PEOPLE WHO MIGHT NEED
MORE HELP. ONE IS SUCKS PEOPLE
WHO ARE IN THE QUOTE UNQUOTE
FAMILY GLITCH WHICH IS PEOPLE
WHO HAVE EMPLOYER BASED COVERAGE
FOR THEMSELVES AND HER FAMILY.
AND SO THE WORKER CAN GET
COVERAGE BUT THE FOR THE
FAMILIES ON AFFORDABLE AND
UNFORTUNATELY BECAUSE OF A
GLITCH AND HOW THE SEA WAS
WRITTEN AND HOW WAS INTERPRETED.
THOSE FOLKS DO NOT HAVE ACCESS
TO SUBSIDIES IN THE EXCHANGE
SO THAT'S SOMETHING THAT WE CAN
ADDRESS ARE DIRECTLY ANOTHER IS
PEOPLE WHO ARE OVER OF JUST OVER
FOUR HUNDRED PERCENT OF POVERTY
LEVEL WHO WEAR SAID THAT HE DID
ARE NO SUBSIDIES AVAILABLE. WHO
ARE NOW PAYING MORE THAN TEN
PERCENT OF THEIR INCOME ON
COVERAGE WE CAN WE WE CAN AND
SHOULD PROVIDE SOME ADDITIONAL
ASSISTANCE TO THEM WE LIVE IN A
HIGH COST OF LIVING STATE? FOUR
HUNDRED PERCENT OF THE POVERTY
LEVEL IN CALIFORNIA IS FIVE
HUNDRED EIGHTEEN IN AMERICA IS
FIVE HUNDRED PERCENT OF
CALIFORNIA AND SIX HUNDRED
PERCENT IN SAN FRANCISCO.
SO.
THAT WOULD BE APPROPRIATE
AND TO PROVIDE ADDITIONAL HELP.
UNDER WITHIN THE OF OUR.
WITHIN UNDER FOUR HUNDRED
PERCENT FOR PEOPLE WHO NEED A
LITTLE BIT MORE HELP WHERE WE IN
SOME CASES WE'RE PROVIDING AN
EIGHT FOOT ROPE FOR PEOPLE WHO
ARE IN A TEN FOOT HOLE IN A
LITTLE BIT MORE HELP GO A LONG
WAY. OF GETTING THEM THE THE
THAT THE CARING COVERAGE THEY
NEED.
AND AS YOU CAN SEE AGAIN THE
THERE IS A MIX OF THE PEOPLE AT
IT IN TERMS OF THE INCOMES THAT
THEY REPRESENT.
AND I WOULD SO AGAIN HE'S TO. IT
WE CAN WE ARE HEARTBREAKINGLY
CLOSE TO UNIVERSALITY IN
CALIFORNIA WE'VE GONE FROM
TWENTY PERCENT TO SEVEN PERCENT
THE LARGEST DROP.
WE DID TWO BIG STEPS ARE ONE IS
INTRODUCING MORE AFFORDABILITY
COVERED CALIFORNIA TO SET A
SECOND IS COVERING THE
UNDOCUMENTED AND TO TALK ABOUT
THAT AS MY COLLEAGUE BETSY
ESTUDIO. WHO WE'VE BEEN PER UP
FROM THE CALIFORNIA IMMIGRANT
POLICY CENTER WHO'S BEEN OUR
COACH SHARE ON THE HEALTH FOR
ALL CAMPAIGN TO EXPAND COVERAGE
TO?
TO ALL CALIFORNIANS REGARDS
IMMIGRATION STATUS HOW TURNED
OVER TO HER.
YOU ANTHONY.
CAN YOU ALL HEAR ME.
OKAY GREAT SO GOOD AFTERNOON AYE
CHEERS AND MEMBERS OF THE
SUBCOMMITTEE MY NAME IS BUT HAVE
A LIST OF THE OIL CYCLE BY BETSY.
AND THE SENIOR POLICY MANAGER OF
THE CALIFORNIA IMMIGRANT POLICY
CENTER SO I'M ACTUALLY GONNA
TALK TO YOU ABOUT A HEALTH FOR
ALL PROPOSAL. AND I'M GONNA GIVE
YOU SOME CONTEXT AND CAN SHARE A
LITTLE BIT ABOUT SOME OF THE
GAINS WE'VE MADE ON IMMIGRANT
HEALTH. AND THEN TELL YOU HOW WE
ACTUALLY GET TO.
OF A REALITY WHERE HEALTH FOR A
WAS PASSED IN OUR STATE SO.
AND TO BEGIN AYE A LITTLE BIT
ABOUT THE CALIFORNIA IMMIGRANT
POLICY CENTER.
SO WE WERE FOUNDED IN NINETEEN
NINETY SIX IN RESPONSE TO VERY
HARSH FEDERAL LAWS THAT.
EXCLUDED AT CERTAIN IMMIGRANTS
FROM VITAL SOCIAL AND UP PUBLIC
BENEFIT PROGRAMS TODAY CA PC
CONTINUES TO ADVOCATE FOR
INCLUSIVE AND HEALTH.
INCLUSIVE HEALTH AND PUBLIC
POLICIES THAT SUPPORT THE WELL
BEING OF IMMIGRANT COMMUNITIES.
SO IN ORDER TO BETTER UNDERSTAND
WHY EXCLUSIONS. ARE BASED ON
IMMIGRATION STATUS HARM OUR
STATE I LIKE TO BEGIN WITH SOME
DEMOGRAPHICS AND KEY DATA ABOUT
THE POPULATION IN QUESTION
UNDOCUMENTED PEOPLE.
IN CALIFORNIA
SO ACCORDING TO THE TWENTY TEN
TWENTY FOURTEEN AMERICAN
COMMUNITY SURVEY THERE ARE
APPROXIMATELY TWO POINT NINE
MILLION UNDOCUMENTED
CALIFORNIANS IN OUR STATE.
ONE IN SIX OF ALL CALIFORNIA
CHILDREN HAVE AT LEAST ONE
UNDOCUMENTED PARENTS AND ONE IN
TEN WORKERS IS AN UNDOCUMENTED
WORKER ARE UNDOCUMENTED
CALIFORNIANS. UNDOCUMENTED
CALIFORNIANS COUNTRY READ A
HUNDRED AND EIGHTY BILLION PER
YEAR TO OUR STATE ECONOMY. AND
OVER HALF OF UNDOCUMENTED
CALIFORNIANS HAVE LIVED IN THE
U. S. RALLIES THAT DECADE.
SO IN ADDITION IMMIGRANTS ARE
ALSO VERY DIVERSE.
WHILE WE KNOW THAT A MAJORITY
OF AMERICANS ARE LEFT. ARE THE
FASTEST GROWING IMMIGRANT
POPULATION ARE ACTUALLY ASIAN
AND PACIFIC ISLANDERS IN FACT IN
CALIFORNIA SIXTEEN PERCENT OF
UNDOCUMENTED IMMIGRANTS ARE API.
AS YOU CAN SEE IMMIGRANTS ARE
HEADS OF HOUSEHOLD THEIR WORKERS
ACROSS A NUMBER OF INDUSTRIES
AND ARE LONGTIME RESIDENTS OF
OUR STATE. MAY PROVIDE ACT
INCREDIBLE ECONOMIC AND CULTURAL
CONTRIBUTIONS AND ARE DEEPLY
EMBEDDED IN OUR SOCIAL FABRIC.
TAKE FOR EXAMPLE THE STORY OF
ISABELLA AND HER MOTHER DAISY
WHO'S ON THE RIGHT SIDE OF THE
SLIDE. HE SAID WELL AS A TWELVE
YEAR OLD GIRL FROM COLUMBIA WHO
HAS SUFFERED FROM SEVERAL POLICY
SINCE SHE WAS BORN.
IN ORDER TO SEEK TREATMENT.
FORTY SEVEN US CONDITION
ASSEMBLY LINE HER MOTHER
IMMIGRATED TO CALIFORNIA AND
SEARCH OF HEALTH CARE.
WHICH THEY DID NOT RECEIVE THEM
THE HOME COUNTRY FOR MANY YEARS
HE SAID WELL I WASN'T ABLE TO
ACCESS COMPREHENSIVE CARE
BECAUSE OF OUR IMMIGRATION
STATUS.
BUT THINGS TO HOLD FOR ALL KIDS
SHE NOW WAS ABLE TO GET PRIMARY
CARE PHYSICAL AND SPEECH THERAPY
AND IS ABLE TO THRIVE.
ISABELLA RELIES ON HER MOTHER
DAISY TO TAKE CARE FOR.
BUT DAISY HERSELF IS EXCLUDED
FROM HEALTH CARE BECAUSE OF HER
IMMIGRATION STATUS.
SO WHAT HAPPENS TO DAISY WHEN
SHE GETS SICK.
WHAT IS I MEAN FOR A SUB ELLA?
SO A LITTLE BIT OF MORE
BACKGROUND I'M SO WHAT DOES IT
LOOK LIKE TO HAVE A FOR
UNDOCUMENTED ADULTS LIKE DAISY.
I NOT HAVING ACCESS TO HEALTH
CARE WELL. UP THE AFFORDABLE
CARE ACT ACTUALLY EXPLICITLY
UNJUSTLY EXCLUDES UNDOCUMENTED
IMMIGRANTS FROM RECEIVING HEALTH
COVERAGE THROUGH MEDICAID HOW.
AND SELECTING A PLAN OR
RECEIVING SUBSIDIES TO COVER
CALIFORNIA.
DESPITE THIS BETTER EXCLUSION
THERE THERE IS SOME CARE
PROVIDED TO UNDOCUMENTED PEOPLE
AND I'M GONNA I TALK A LITTLE
BIT ABOUT THOSE ON THE LIST. SO
FIRST THERE IS RESTRICTED SCHOOL
MEDIC CAO WHICH PROVIDES LOW
INCOME UNDOCUMENTED ADULTS WITH
EMERGENCY CARE.
THERE IS PREGNANCY RELATED CARE
THROUGH MEDI CAL WHICH GIVES
IMMIGRANT WOMEN PREGNANCY
RELATED MEDICAL CARE AS WELL AS
ALL OTHER PRIMARY AND SPECIALTY
A SPECIALTY CARE.
AS I MENTIONED WE DO HAVE HEALTH
FOR ALL KIDS WHICH GIVES
UNDOCUMENTED CHILDREN ACCESS TO
COMPREHENSIVE FULL SCOPE
MEDICARE HOW.
AND WE ALSO HAVE A SAFETY NET.
WHERE AT SOME COUNTIES PROVIDE
SOME CARE AND TO UNDOCUMENTED
ADULTS TO THEIR SAFETY NET
SYSTEMS BUT? THERE ARE STILL
MANY COUNTIES THAT DO NOT.
AND THEM FOR DOT GOV RECIPIENTS.
LOW INCOME DOCTOR RECIPIENTS
ARE CURRENTLY ELIGIBLE FOR FULL
SCOPE MEDICARE HOW AS
INDIVIDUALS WHO FALL UNDER A
BENEFIT ELIGIBILITY CATEGORY
KNOWN AS PRUE CALLS. AND THAT I
I KNOW THERE'S BEEN RECENT NEWS
AROUND THE DECISION TO.
TERMINATE DHAKA BUT THE
DEPARTMENT OF HEALTH CARE
SERVICES HAS CLARIFIED THAT DACA
RECIPIENTS WHO LOSE THEIR
DEFERRED ACTION STATUS WILL
STILL CONTINUE TO BE ELIGIBLE
FOR HEALTH CARE UNDER OUR FORCE
WONDERFUL SCHOOL MEDI CAL.
SO HOWEVER THIS PATCHWORK OF
CARE STILL LEAVES MANY
UNDOCUMENTED ADULTS WITH NO
ACCESS TO HEALTH CARE.
AS A RESULT FIFTY PERCENT OF
THOSE WHO REMAIN UNINSURED ARE
UNDOCUMENTED ADULTS
THIS IS WHY IT'S ESSENTIAL THAT
WE TALK ABOUT.
UNDOCUMENTED CALIFORNIANS AS
PART OF THE CONVERSATIONS TO GET
TO UNIVERSAL COVERAGE.
SO MONO WALKING THROUGH SOME
PASSED LEGISLATIVE ACTIONS THAT
THE HEALTH FOR ALL CAMPAIGN A
COALITION HAS AS MOVE FORWARD.
UM C. A. B. C. HEALTHAXIS
CALIFORNIA AND OUR HEALTH FOR
ALL COALITION LAUNCHED EFFORTS
TO MAKE HEALTH CARE MORE
INCLUSIVE FOR UNDOCUMENTED
IMMIGRANTS. AND IT WE HERE ARE
SOME KEY SUCCESSES IN THE HEALTH
FOR ALL CAMPAIGN.
SO I'M WE ARE FIRST SUCCESS WITH
HEALTH FOR ALL KIDS AND IN
TWENTY FIFTEEN IMMIGRANTS AND
HEALTH CARE ADVOCATES WORK
TOGETHER TO PASS SB SEVENTY FIVE.
AND S. BEFORE KNOWN AS HEALTH
FOR ALL KIDS.
HEALTH FOR ALL KIDS WAS ENACTED
IN MAY SIXTEENTH OF TWENTY
SIXTEEN AND PROVIDING FULL SCOPE
MEDICAID TO UNDOCUMENTED
CHILDREN UNDER THE AGE OF
NINETEEN. SINCE THEN OVER TWO
HUNDRED THOUSAND UNDOCUMENTED
CHILDREN HAVE HAD ACCESS TO
COMPREHENSIVE HEALTH CARE.
THE NEXT.
BILL WE WORKED ON WAS S. B. TEN.
WHICH WAS OUR THIRTEEN THIRTY
TWO WEAVERVILLE IN TWENTY
SIXTEEN S. B. TEN DIRECT THAT
THE STATE TO APPLY FOR FEDERAL
WAIVER.
FEDERAL THIRTEEN THIRTY TWO
WAIVER ALLOWING UNDOCUMENTED
IMMIGRANTS AND DOCTOR RECIPIENTS
TO PURCHASE ON SUBSIDIZED
COVERAGE. AYE INCORRECT HEALTH
WARNING.
HOWEVER THE WAIVER WAS RESCINDED
DUE TO CONCERNS OVER THE NEW
ADMINISTRATION TARGETING OF
IMMIGRANT FAMILIES.
AND THEN LAST YEAR.
THE HEALTH FOR ALL YOUNG ADULTS
BUDGET PROPOSAL IN TO REMOVE A
CRITICAL BARRIER TO HEALTH
ACCESS BY PROVIDING FULL SCOPE
MEDICARE. TO UNDOCUMENTED YOUNG
ADULTS THE ASSEMBLY AND SENATE
DID INCLUDED IN THE BUDGET
INVESTMENT.
BUT HOWEVER THE PROPOSAL WAS
NOT INCLUDED IN THE INACTIVE
TWENTY SEVENTEEN TO TWENTY
EIGHTEEN STATE BUDGET.
BUT WE HAVE AN OPPORTUNITY TO
BUILD ON THESE LEGISLATIVE
ACTIONS TO BRING US CLOSER TO
UNIVERSAL HEALTH COVERAGE. AND
WE CAN DO THAT THIS YEAR WITH
HEALTH FOR ALL.
TWO WEEK REITERATE HEALTH FOR
ALL IS A PROPOSAL THAT ENSURES
THAT CALIFORNIANS HAVE ACCESS TO
HEALTH CARE REGARDLESS OF IT
THEIR IMMIGRATION STATUS.
THERE ARE SOME LEGISLATIVE
PROPOSALS OUT THERE.
IN MID DECEMBER THE ASSEMBLY
RELEASED A BUDGET BLUEPRINT THAT
HIGHLIGHTS THE PRIORITIES FOR
THIS YEAR WHICH INCLUDES
EXPANDING MEDICARE ACCESS TO
COVER ALL UNINSURED. WE
APPRECIATE THE ASSEMBLIES
CONTINUE SUPPORT FROM LAST YEAR
WHICH I KNOW MANY OF YOU
SUPPORTED AND CHAMPION.
HELPFUL YOUNG ADULTS.
AND INCLUDE AN INCLUDING HEALTH
FOR ALL AND THEIR BUDGET
BLUEPRINT THIS YEAR WE LOOK
FORWARD TO WORKING WITH ALL OF
YOU VERY CLOSELY IN THE BUDGET
PROCESS.
AND THEN.
ON THE SENATE SIDE AYE CENTER
RECOLETA DID INTRODUCE OUT
RECENTLY INTRODUCED S. B. NINE
SEVEN FOR IT WHICH WOULD IN
PROVIDE FULL SCOPE MEDICAID TO
LOW INCOME UNDOCUMENTED ADULTS.
SELASSIE ARE JUST SAY THAT THE
IS VERY POOR AND TO NOTE THAT
THE NATION NEEDS CALIFORNIA'S
LEADERSHIP NOW MORE THAN EVER
AND WITH HEALTH FOR ALL WILL BE
ABLE TO HELP. OUR FAMILIES AND
COMMUNITIES THRIVE AND CREATE A
MODEL FOR THE NATION
THANK YOU.
IN MY.
THANK YOU BETSY AND IN IN MY AYE
AGAIN WE GREATLY APPRECIATE
PARTNERING WOULD SEE IF YOU SEE
AN WITH THE DOZENS AND OF GROUPS
THAT HAVE BEEN WORKING ON THE
HEALTH FOR ALL COALITION OVER
SEVERAL YEARS AND WE WE THINK
THAT WE CAN MAKE. ANOTHER LARGE
STRIDE THIS YEAR ON THAT FRONT
ARE AND AGAIN WE ARE SO CLOSE TO
UNIVERSALITY BUT I DO WANT TO.
ALSO TALK DEAD DEAD THERE'S ALSO
WORK TO DO WITH REGARD TO NOT
JUST MAKING SURE THAT PEOPLE CAN
GET ACCESS TO CARE BUT ALSO THAT
THEY. ARE DEAD THAT WE ADDRESS
ISSUES OF COST AND QUALITY IN
EQUITY ON SOME OF THIS IS
ALREADY AN AGENDA THAT IS
ALREADY IAN. ARE IN LINE IN. IN
PROPOSED AND I IN FRONT OF YOU
AYE AGAIN YOU YOU TOOK A
IMPORTANT STEP LAST YEAR WITH S.
B. SEVENTEEN ON PRESCRIPTION
DRUG PRICES THERE SEVERAL OTHER
BILLS. TO ADDRESS THE ISSUE
PRESCRIPTION DRUG PRICES WHETHER
IT'S ARE WITH REGARD TO FARMERS
PRACTICE OF PROVIDING GIVES TO
PROVIDERS.
IT DID TO POSSIBLY HAVE AN
IMPACT ON.
SO IT SUBSCRIBING OR THE ISSUE
OF PHARMACEUTICAL BENEFIT
MANUFACTURERS THAT CHAIRMAN
WOULD IS WORKING ON OR OF WORK
TO JUST MAKE MAINTAIN AND
ACCOUNT AND EXTEND. ON CAPS ON
CO PAYMENTS FOR THE OF SPECIALTY
MEDICAL DRUGS.
I I I THINK THERE'S ALSO A LOT
OF WORK ON THE ISSUE OF
CONSOLIDATION WHICH HAS SERVED.
TO DRIVE UP PRICES IN OUR
HEALTHCARE SYSTEM.
AN EVEN INCLUDING BILLS ON
WORKING ARE A TOOK PRIDE
OVERSIGHT OVER.
HEALTH PLAN MERGERS AGAIN
CHAIRMAN WOULD AND HAS THAT BILL
AND IN ANOTHER BILL IN THE
SENATE.
OR THAT HAS PASSED THE SENATE
IS NOW IN THE ASSEMBLY ON THE
ISSUE OF.
UNFAIR AND ANTI COMPETITIVE
HOSPITAL CONTRACT PROVISIONS
WHICH HAVE SERVED HIM TO MAKE
SURE TO HAVE LED TO NORTHERN
CALIFORNIA PREMIUMS BEING
SIGNIFICANTLY HIGHER THAN
SOUTHERN CALIFORNIA. OF RACE AS
AN EXAMPLE OF. IT ULTIMATELY.
WHATEVER SYSTEM WE WE PUT IN
PLACE WE NEED TO DO ADDRESSED
THE ISSUE OF PRICES IN OUR
HEALTHCARE SYSTEM
SINGLE PAYER IS USEFUL IN
BUILDING A PURCHASING POOL. THAT
IS BIG ENOUGH TO BE ABLE TO
BARGAIN FOR THE IT OF A FOR
PRICE BUT YOU STILL NEED A
MECHANISM TO.
CHANGE THAT WE AND WOOD
WHATEVER SYSTEM YOU HAVE AND IT
IS AT THE END OF THE DAY THE
FUNDAMENTAL ISSUE OF AMERICAN
HEALTHCARE SYSTEMS AMERICANS DO
NOT USE MORE HEALTHCARE THAN ANY
OTHER.
THE COUNTRY IT IS THE UNIT
PRICE THAT IS MUCH MORE
EXPENSIVE IN IN THIS COUNTRY
THAN ANY PLACE ELSE AND WE NEED
TO PLAY WE NEED A MECHANISM TO
REVIEW. TO TO REVIEW AND AND
BENCHMARK AND AND LOOK AT THOSE
PRICES I KNOW MY COLLEAGUES IN
BUSINESS AND LABOR WILL TALK
MORE ABOUT THAT. AND FINALLY WE
NEED TO HAVE MORE ACCOUNTABILITY
OVER OUR OF MANAGED CARE PLANS
INCLUDING THE ONES THAT ARE
PUBLICLY FINANCED TO THEM IT IS
IT OUT TO OUR MEDICAL SYSTEM AND
MAKE SURE THAT THER IS.
ACCOUNTABILITY FOR QUALITY IN
EQUITY IF THE IF WE ARE GOING TO
HAVE A PLANS WHETHER THEY BE
PUBLIC PART OF PRIVATE PROP OF
FOR PROFIT OR NONPROFIT WE WANT
TO MAKE SURE THEY ARE
ACCOUNTABLE FOR ACTION PROVIDING.
THE CARE THAT WE'RE CONTACTING
THEM FOR. ANOTHER OPTION THAT IS
BEING THAT.
WE WOULD.
THAT THE COMMITTEE SHOULD LOOK
INTO IS WITH REGARD TO MAKING
SURE THAT NO CALIFORNIANS
SPECIALLY THOSE ARE BETTER IN
RURAL AREAS ARE LEFT.
WITHOUT ANY COVERAGE OPTIONS
WHATSOEVER.
THE ISSUE OF BEAR COUNTIES YEAH
EASE ONE THAT SOME OTHER STATES
HAVE DEALT WITH AND.
WE WANT TO MAKE SURE THAT
WHETHER IT'S THAT NORTH OF
SACRAMENTO REGION OR CENTRAL
COAST OVER OUR CENTRAL VALLEY
DEAD A CALIFORNIANS ARE NOT ARE
NOT LEFT WITHOUT A COVERAGE
OPTION. AND IF IF IF THERE IS AN
ISSUE WITH.
.
I AND IF AT THAT IF THAT ISSUE
DOES COME UP ABOUT THAT WE HAVE
WE USE THE MEDIC HOW
INFRASTRUCTURE WE HAVE TO MAKE
WHETHER TO THE MEDICARE MANAGED
CARE PLANS ARE THE EXISTING
PROGRAM TO MAKE SURE THAT THERE
IS AN OPTION.
FINAL THING I'D JUST LIKE TO
WRAP UP IS THAT AGAIN WE THINK
THAT THERE IS AN ASPIRATIONAL
AGENDA HERE AS COMPLEMENTARY
WITH THE BROADER LONG IT'S A
VISION THAT IS ON. AT A
DIFFERENT TIME TABLE TO
DO THAT IN THE NEXT YEAR THE
NEXT COUPLE YEARS TO THAT IT ARE.
THAT WE CAN ACHIEVE WITHOUT
FEDERAL APPROVAL TO STABILIZE
THE MARKET AND RESISTANCE
ADVERTISE TO GET TO UNIVERSALITY
IN AFFORDABILITY AND TO START
DEALING WITH THE ISSUE OF COST
QUALITY IN EQUITY.
AND.
AND I THE.
THE ARGUMENT THAT HAS BEEN MADE
BY SOME ON.
YOUR SENATOR TED Z
OTHERS SAY THAT THE AFFORDABLE
CARE ACT WAS A SLIPPERY SLOPE TO
SINGLE PAYER.
AND I THINK THAT THERE ARE I
THINK DAD'S.
HE ARE HE WAS HE WAS WRONG HE
GOT THE METAPHOR REVERSE
IT'S A. IT'S A IT'S NOT.
IT IS THE FACT THAT WE ARE
CLOSER BUT IT'S ACTUALLY IT'S
NOT GOING IT'S NOT SO BE SLOWED
DOWN THE MATHIS SCALING UP THE
MOUNTAIN.
IT'S HOW CAN WE CAN DO AND THE
QUESTION IS HOW DO WE CONTINUE
TO GO UP ENOUGH AND TO THE GO TO
THE VISION OF EVERYBODY HAVING.
THE CARE THAT THEY NEED WHEN
THEY NEED IT WITHOUT FINANCIAL
BARRIERS AND WHAT WE THINK IS
THAT THE STEPS ACTUALLY GETS
THAT MUCH CLOSER ACTUALLY DID
ARE BUILDING THE INFRASTRUCTURE.
THE POLITICAL INFRASTRUCTURE THE
POLICY INFRASTRUCTURE TO GET TO
THAT GOAL AND THAT'S WHY WE
THINK THAT WE DON'T WE GET WE
DON'T SHOULDN'T WAIT FOR FEDERAL
APPROVALS OR THE OTHER OBSTACLES
ARE NO WAY WE CAN TAKE STEPS NOW.
TO GET THAT MUCH CLOSER TO THE
HEALTHCARE SYSTEM THAT WE ALL
DESERVE THANK YOU VERY MUCH.
THANK YOU.
NEXT WE'LL HAVE SARAH FLOCKS
WITH THE LABOR. FEDERATION AS
WELL AS PETER FENN FROM THE TEAM.
YOU GET AFTERNOON.
MANY MISS APPEAR FAN I'M THE
SECRETARY TREASURER AND
PRINCIPAL OFFICER OF TEAMSTERS
LOCAL EIGHT FIVE SIX AM THE
RECORDING SECRETARY. OF JOINT
COUNCIL SEVEN OF THE TEAMSTERS
COVERING A HUNDRED THOUSAND
MEMBERS THROUGHOUT NORTHERN
CALIFORNIA.
I WANTED UP UP FIRST THANK THE
COMMITTEE FOR THE OPPORTUNITY TO
BE HERE TODAY.
HEALTHCARE IS SOMETHING THAT
THAT I AM VERY PASSIONATE ABOUT.
ALONGWITH THE AFFORDABLE
HOUSING THE SKYROCKETING COST
THE HEALTH CARE IS AMONG THE
BIGGEST CHALLENGES.
FACING MIDDLE CLASS FAMILIES
HERE IN CALIFORNIA.
THIS IS CERTAINLY THE CASE FOR
THE WORKERS THAT WE REPRESENT
OUR LOCAL UNION TEAMSTERS LOCAL
EIGHT FIVE SIX REPRESENTS
THIRTEEN THOUSAND MEMBERS
WORKING AT NEARLY TWO HUNDRED
DIFFERENT EMPLOYERS. IN BOTH THE
PUBLIC AND THE PRIVATE SECTOR IN
EVERY INDUSTRY YOU CAN THINK OF
FROM FROM SCHOOL EMPLOYEES TO
LAW ENFORCEMENT.
FROM HOTEL WORKERS TO TO AIRLINE
MECHANICS.
AND WHILE THE WORKERS WE
REPRESENT ARE VERY DIFFERENT
THERE THERE'S ONE THING THAT'S
CONSISTENT ACROSS ALL INDUSTRIES
AND SECTORS WHERE MEMBERS WORK.
HEALTHCARE IS THE MOST
CHALLENGING ISSUE WE FACE EVERY
BARGAINING TABLE.
THE CHALLENGERS WORKERS SPACE
AROUND HEALTH CARE. ARE
SIGNIFICANT.
THE SKYROCKETING COSTS IN
HEALTHCARE IS MAKING THE
EMPLOYEE SHARE OF MONTHLY
MEDICAL PREMIUMS REACHED BUT
AFFORDABLE LEVELS.
AND AS MORE MORE MONEY IS BEING
DIVERTED FROM SALARY TO HEALTH
CARE THERE'S DOWNWARD PRESSURE.
ON WAGES WE'VE ALSO SEEN RISING
HEALTHCARE COSTS RESULT IN FEWER
PLANCHA VOICES.
BENEFIT LEVEL REDUCTIONS AND
WORST OF ALL.
AND WORST OF ALL MORE EMPLOYERS
OR ATTEMPTING TO LIMIT ACCESS TO
HEALTH CARE TO THE USE OF PART
TIME.
AND TEMPERATURES.
I SPEND.
I SPENT MOST OF MY TIME.
I SPEND MOST MY TIME BARGAINING
CONTRACTS ALONGSIDE THE MEMBERS
THAT WE REPRESENT.
IN NEGOTIATIONS WHY START THE
DISCUSSION ON HEALTH CARE WITH
AN EMPLOYER ALWAYS BEGIN BY
TALKING ABOUT IT'S. IT'S EIGHT
SHARE PROBLEM THAT WE NEED TO
SOLVE TOGETHER.
I MAKE IT CLEAR TO THE EMPLOYER
THAT THEY DID NOT CREATE THE
PROBLEM.
THAT OUR MEMBERS DIDN'T EITHER.
THAT THE SKYROCKETING COST OF
HEALTHCARE SOMETHING THAT HAS
BEEN DROPPED IN OUR LAP.
BOTH EMPLOYERS AND WORKERS LEFT
HOLDING THE BAG LEFT TRYING TO
FIGURE OUT. HOW TO PAY FOR?
THE PROBLEM.
IT IS THAT HEALTHCARE COSTS JUST
KEEP GOING UP AND IT FEELS LIKE
THERE'S NO END IN SIGHT.
IT IS BECOMING UNSUSTAINABLE.
OF FOR EXAMPLE MY WE REPRESENT
WORKERS IN MANY SCHOOL DISTRICTS
IN THE BAY AREA.
THESE DISTRICTS CONTRACT WITH
CALPERS FOR MEDICAL INSURANCE.
BUT GUESS WHAT EVEN CALPERS.
WITH ITS HUGE STATEWIDE BUYING
POWER CAN'T KEEP RATES DOWN.
THE MONTHLY THE MONTHLY PREMIUM
FOR A BASIC KAISER FAMILY
PLANNING.
TWO THOUSAND DOLLARS PER MONTH.
THAT'S TWENTY FOUR THOUSAND
DOLLARS PER YEAR AGAIN. THIS IS
NOT A CADILLAC PLAN THIS IS A
BASIC KAISER FAMILY POINT.
THAT THE TWO BIGGEST SCHOOL
DISTRICTS WHERE WE REPRESENT
WORKERS
THE EMPLOYER PAYS EIGHTY PERCENT
OF THE KAISER IT.
AT FIRST GLANCE.
THIS DOESN'T SEEM UNFAIR
EMPLOYERS PAYING NEARLY TWENTY
THOUSAND DOLLARS PER YEAR FOR
EVERY EMPLOYEE.
IN FAMILY MEDICAL.
BUT THE STORY GETS WORSE.
WHEN YOU LOOK AT THE PAYCHECK OF
A WORKER.
FOR EXAMPLE A CUSTODIAN.
MAKES JUST UNDER TWENTY BUCKS AN
HOUR FOR FORTY. THOUSAND DOLLARS
PER YEAR.
AFTER TAXES TAKEN PAYS JUST JUST
OVER TWENTY FIVE ON ABOUT A
MONTH.
THEY HAVE TO PAY YOUR TWENTY
PERCENT OF THE KAISER FAMILY
POINT.
THAT'S OVER FOUR HUNDRED DOLLARS
PER MONTH.
AFTER PAYING THAT FOUR DOLLARS
PER MONTH FOR HEALTHCARE THAT
LEAVES JUST OVER TWO THOUSAND
DOLLARS.
FOR. RENT.
CLOTHES FOR THE KIDS FOR
GROCERIES
AND OTHER EXPENSES OF DAILY LIFE.
IN THE SCHOOL DISTRICTS NOT THE
WORST OF IT ONE VERY COUNTY
WHERE WE JUST RECENTLY ORGANIZED
WORKERS. THE EMPLOYEE MONTHLY
SHARE FOR KAISER FOR THE
EMPLOYEES.
MONTHLY SHARE FOR THE KAISER
FAMILY PLAN WAS EIGHT HUNDRED
DOLLARS.
AND A THOUSAND DOLLARS FOR.
OTHER PLANTS PARTICULAR IN THE
CONTEXT OF THE AFFORDABLE
HOUSING CRISIS THAT.
WE FACE THROUGHOUT THE STATE.
THESE OUTRAGEOUS HEALTHCARE
COSTS ARE SIMPLY.
ON AFFORDABLE.
I IN THE PRIVATE SECTOR.
MAINTAINING QUALITY HEALTHCARE
IS COME AT THE EXPENSE OF WAGES.
OUR MEMBERS DIVERTING SALARY
INCREASES TO PAY FOR HEALTHCARE.
FOR EXAMPLE.
IN THE HOTEL INDUSTRY WILL WE
REPRESENT A THOUSAND WORKERS IN
SAN FRANCISCO.
HEALTHCARE NOW COSTS OVER TWELVE
DOLLARS.
PER OUR.
YES TWELVE DOLLARS PER HOUR
THAT'S TWENTY FIVE THOUSAND
DOLLARS A YEAR BEING DIVERTED
FROM WAGES TO HEALTH CARE. MONEY
THAT COULD OTHERWISE BE SPENT ON
IN THE LOCAL ECONOMY HELP
WORKERS MANAGE THE EVER
INCREASING COST OF LIVING.
IN OUR EXPERIENCE IT IS
UNDENIABLE THAT THE OUT OF
CONTROL HEALTHCARE COSTS ARE KEY
DRIVER IN WAGES STAGNATION.
SKYROCKETING HEALTHCARE COSTS.
THE ALSO LEAD TO ELIMINATION OF
PLANNED TO RACES AND REDUCTION
OF BENEFIT LEVELS NON KAISER HMO
AND PPO IS BEING ELIMINATED TO
CUT COSTS.
AND WHEN WE CAN KEEP THOSE
OPTIONS DEDUCTIBLES AND CO IN
COPAYS ARE ARE GOING UP.
THE MOST DISTURBING OF ALL.
EMPLOYERS IN BOTH THE PUBLIC AND
THE PRIVATE SECTOR DEALING WITH
THE SPIKES OF HEALTH CARE COSTS
BY DENYING ACCESS TO MEDICAL
COVERAGE TO THE USE OF PART TIME
AND TEMPORE KERR'S.
AT ONE IMPLORE WE JUST ORGANIZED
OF EIGHTEEN HUNDRED WORKERS IN
THE UNIT ONLY SIX HUNDRED
QUALIFY FOR MEDICAL BENEFITS.
THIS ABUSE A PART TIME AND
TEMPORARY WORKERS IS A DIRECT
RESULT.
OF THE IMPACT OF SKYROCKETING
HEALTHCARE COSTS.
IN ADDITION TO NEGOTIATE
CONTRACTS.
I'M ALSO A TRUSTEE ON A UNION
TAFT HARTLEY TRUST FUND THE
COVERS TEAMSTER MEMBERS THEIR
FAMILIES. RETIREES.
THE TRUST FUND CONTRACTS WITH
KAISER ANTHEM BLUE CROSS.
AND OFFERS A SELF FUNDED PPL
WERE THE TRUST FUND PAYS
THE CLAIMS DIRECTLY.
IN THE YEARS FOLLOWING THE TWO
THOUSAND FIFTEEN PASSAGE OF THE
HEALTH CARE TRANSPARENCY LOCKED
AS BE FIVE FOUR SIX THE PRESSURE
FROM SACRAMENTO.
SEEM TO HAVE AN IMPACT.
WE SAW FEW YEARS OF LOW RATE
INCREASES FROM KAISER AN ANTHEM
BLUE CROSS.
AS A TRUST FUND.
WE DID EVERYTHING WE COULD TO
TAKE ADVANTAGE OF THE TOOLS
AVAILABLE TO US TO KEEP RATES
DOWN.
WE HIRED A DATA WAREHOUSE
COMPANY TO ANALYZE UTILIZATION.
WITH THE DATA WE WERE NOW ABLE
TO ATTAIN FROM INSURANCE
COMPANIES.
AND WE GREW A TRUST FUND BY
ADDING PARTICIPANTS.
IN FACT WE NEARLY DOUBLED THE
SIZE.
OF OUR TRUST FUND.
UNFORTUNATELY.
IT APPEARS WE HAVE COMPLETELY
EXHAUSTED THE POSITIVE IMPACT
OF THE TRANSPARENCY LAW.
AND THE DAYS OF HUGE DOUBLE
DIGIT INCREASES ARE BACK WITH US.
AND BACK IN A BIG WAY LISTEN TO
THIS.
KAISER JUST ANNOUNCED THEY ARE
INCREASING OUR RATE BY FIFTEEN
PERCENT.
THENANKAI THEIR HMO IS WORSE.
ANTHEM BLUE CROSS IS PROPOSING A
TWENTY FIVE PERCENT INCREASE
THAT MEANS THE FAMILY RATE WILL
BE GOING UP. FIVE HUNDRED
DOLLARS PER MONTH.
AND WHETHER IT'S THE EMPLOYER
PAYING FOR.
FOR THE EMPLOYEES.
IT'S ABSOLUTELY.
UNSUSTAINABLE.
ON OUR SELF FUNDED DIRECT PAY
PPO SIDE.
I WAS TOLD BY OUR EXPERTS THE
ONLY WAY TO REDUCE COST.
WAS THE GREATEST SKINNY NETWORK
HOSPITALS.
IN OTHER WORDS CUT OUT THE
HOSPITALS THAT CHARGE THE MOST.
BUT HERE'S THE CATCH.
THAT WOULD LIMIT THIRTY PERCENT
OF THE HOSPITALS THAT OUR
MEMBERS DEPEND ON USING.
AND OF COURSE THAT'S A A NON
STARTER.
AS YOU CAN PROBABLY GUESS.
I'M FRUSTRATED.
DISHEARTENED.
THE STATUS QUO'S IT IS JUST NOT
SUSTAINABLE.
CAN'T HELP BUT FEEL LIKE WORD A
BREAKING POINT.
THAT WE'RE OUT WE'RE OUT OF
OPTIONS FOR WORKERS EMPLOYERS TO
SOLVE THE ISSUE OF SKYROCKETING
HEALTHCARE COSTS AT THE
NEGOTIATING TABLE.
WE NEED A STRONG LEGISLATIVE
SOLUTION THAT CONTROLS COSTS
THROUGHOUT THE SYSTEM.
I'M HOSPITALS
TO INSURANCE COMPANIES.
I WANT TO CLOSE BY MAKING IT
CLEAR.
WORKING PEOPLE ACROSS THE STATE
STAND READY.
TO WORK WITH YOU.
STILL ACCOMPLISH THIS GOAL AND
SOLVE THIS PROBLEM.
CAN'T AFFORD NOT TO.
THANK YOU.
MR SHARES MEMBERS THERE OF LOCKS
ME THE CALIFORNIA LABOR
FEDERATION AND THE LABOR
FEDERATION REPRESENTS TWELVE
HUNDRED AFFILIATED UNIONS UNIONS
JUST LIKE PETERS.
THAT BOTH BARGAINED FOR AND
PURCHASE HEALTH BENEFITS FOR OUR
TWO MILLION UNION MEMBERS AND
THEIR FAMILIES IN CALIFORNIA.
I DID WAS START BY THINKING THIS
COMMITTEE AND THE STAFF FOR THE
GREAT WORK YOU'VE DONE IN THESE
HEARINGS I'VE WATCHED AND RE
WATCHED.
EVERYONE IF YOU LIKE I HAVE A
PHD NOW IN HEALTH CARE SO THANK
YOU FOR THIS VERY IMPORTANT WORK.
.
AND I JUST WANNA START.
MY PRESENTATION BY SAYING THAT
THE LABOR FEDERATION SUPPORT
SINGLE PAYER.
WE HAVE OVER THE DECADES
SUPPORTED BILLS TO MOVE TOWARDS
A SINGLE PAYER SYSTEM.
WE ALSO SUPPORT S. B. FIVE SIXTY
TWO.
SUIT IN MY PRESENTATION TODAY
I'M GONNA TALK TO THAT THE
COMMITTEE ABOUT OPTIONS THAT
MOVE US CLOSER TO THE GOAL OF
SINGLE PAYER AND TO A UNIVERSAL
HEALTHCARE SYSTEM IN THE STATE.
SU AD DATED DECEMBER HEARING
THAT THIS COMMITTEE HAD GOVERNOR
SOMEONE FROM FOR MONTHS OFFERED
SOME RECOMMENDATIONS.
THAT I THOUGHT WERE WERE VERY
APT TO START MY PRESENTATION HE
SAID THAT THE RISING COST OF
HEALTHCARE ALSO APPLIES TO
UNIVERSAL HEALTHCARE.
WHETHER YOU PAY FOR IT THROUGH
PUBLIC FUNDS.
OR THROUGH THE CURRENT PRIVATE
SYSTEM THAT WE HAVE
NO SYSTEM WILL WORK UNLESS WE
FIND A WAY TO CUT THE RISING
COST OF HEALTHCARE.
AND HE RECOMMENDED TO CALIFORNIA
THAT WE GET COSTS COULD
CONTAINMENT RIGHT FIRST AND THEN
WE CAN CONSOLIDATE INTO A SINGLE
PAYER SYSTEM.
AND THE LABOR FEDERATION. KNOWS
HOW IMPORTANT COST CONTAINMENT
AS YOU CAN'T LISTEN TO PETER
TALK AND AND NOT FEEL THE
URGENCY OF HAVING TO DO TO BE
ABLE TO GET COSTS UNDER CONTROL.
AND WE'VE TRIED EVERY YEAR TO
FOCUS ON SMALL PARTS OF THE
INDUSTRY TO DO THAT WE'VE MOVED.
BILLS AROUND AND THE PRICE OF
CHRISTIAN PRESCRIPTION DRUGS WE
SUPPORTED MISTER WOODS BILL ON
PHARMACY BENEFIT MANAGERS WE'VE
DONE WORK ON INSURANCE COMPANIES
AND HEALTH PLANS.
AND WE'VE LOOKED AT THE ANTI
COMPETITIVE PRICING OF HOSPITALS.
BUT THROUGH ALL OF THAT.
WE STILL SEE THAT EVERY DOLLAR
THAT WE HAVE TO SPEND ON RISING
HEALTH CARE PRICES.
IS A DOLLAR THAT'S COMING RIGHT
OUT A WORKERS POCKETS.
AND SO WE KNOW THROUGH DESPITE
HOW DIFFICULT IT IS TO TACKLE
THE ISSUE OF COST CONTAINMENT
BECAUSE WE ARE GOING UP AGAINST
A BILLION DOLLAR INDUSTRY.
BUT IT IS CRITICAL IT IS
CRITICAL BOTH AS A FIRST STEP TO
SINGLE PAYER AND IT IS CRITICAL
TO WORKING PEOPLE AND TO
CALIFORNIANS.
.
SO YOU SEE IF I CAN USE THIS.
OKAY SO THIS IS JUST AN EXAMPLE
OF WHAT WE'RE SUFFERING FROM.
BILL TWO LINES GOING UP OUR
PREMIUMS AN EMPLOYEE
CONTRIBUTIONS TO PREMIUMS.
THE FLAT LINES OUR WAGES AND
INFLATION.
AND IN THAT GAP.
THAT IS THE WHOLE WHERE ARE
MIDDLE CLASS IS FALLING.
THAT IS WHAT IS EATING UP OUR
MIDDLE CLASS IN THE STATE OF
CALIFORNIA.
SO ON THIS SIDE YOU ALSO SEE IN
THIS IS BEEN EMPHASIZED OVER AND
OVER THAT THE U. S. SPENDS
ALMOST TWICE WHAT OTHER
COUNTRIES SPEND ON HEALTHCARE.
BUT AN INTERESTING PART OF THIS
SLIDE IS IF YOU LOOK AT THE DARK
BLUE LINE.
THAT'S PUBLIC EXPENDITURE.
THAT'S KIND OF ON PAR OR LESS
THAN WHAT A LOT OF OTHER
COUNTRIES SPEND OUR REAL PROBLEM
IS IN THE COMMERCIAL MARKET.
IN THE MARKET WHERE WE HAVE OUR
TRUST FUNDS THE INDIVIDUAL THE
SMALL THE LARGE GROUP THE SELF
INSURED THAT'S WHERE SPENDING IS
GETTING OUT OF CONTROL.
AND WHAT WE CAN SEE IS THAT ALL
OF THESE COUNTRIES HERE.
THE ONE THING THAT THEY ALL HAVE
IN COMMON.
AND ALL OF THESE COUNTRIES WITH
UNIVERSAL HEALTH CARE HAVE IN
COMMON WHETHER THERE A SINGLE
PAYER SYSTEM OR A MULTI PAYER
SYSTEM.
IS THAT THE GOVERNMENT
REGULATE HEALTH CARE PRICES AND
CONTROLS COSTS THROUGHOUT THE
SYSTEM
INCLUDING IN THE COMMERCIAL
MARKET IF THEY HAVE.
AND I WANT TO EMPHASIZE THIS
POINT AGAIN AND ALSO EMPHASIZE
WET AND ANTHONY SAID.
IS THAT IT REALLY IS THE PRICES.
BECAUSE HEALTH CARE SPENDING OUR
HEALTH CARE COST IS JUST.
PRICE.
TIMES UTILIZATION
AND IF YOU CAN SEE FROM THIS
GRAPH.
ONCE AGAIN ALL THE LINES GOING
UP.
DOES OUR PRICES.
THE LINE'S GOING DOWN.
IS UTILIZATION.
SO EVEN THE U. S..
WE ARE USING LAST HEALTH CARE.
GETTING WORSE HEALTH OUTCOMES
AND YET PAYING MORE FOR EVERY
SINGLE DOCTOR VISIT EVERY SINGLE
HOSPITAL SERVICE EVERY SINGLE
PRESCRIPTION DRUG.
DAN UP PEOPLE PAY IN OTHER
COUNTRIES.
AND SO PRICES ARE WHAT ARE
DRIVING OVERALL COSTS IN THIS IS.
AND AND PETER RATES S. B. FIVE
FORTY SIX WHICH IS A BILL THAT
WE DID ON HEALTH PLAN PREMIUMS.
TODAY IN SAN FRANCISCO D. MHC IS
HAVING A PUBLIC HEARING LOOKING
AT THE RATE FILINGS OF HEALTH
PLANS
AND IF YOU LOOK THROUGH THOSE
HEARING HERE THAT FILINGS. YOU
WILL SEE THE SAME THING IS THE
SLIDE UTILIZATION REMAINS FLAT.
PRICES ARE SKYROCKETING AND THAT
IS WHAT IS DRIVING PREMIUM
INCREASES.
THE OTHER PROBLEM THAT WE HAVE
IS THAT NOT ONLY ARE PRICES HIGH
BUT THEY VARY WILDLY.
SO THIS IS JUST AN EXAMPLE OF
THE RANGE OF M. ARISE IN THE
HUNDRED MILE AREA AROUND SAN
FRANCISCO WHICH REYES. RANGE
FROM FOUR HUNDRED SEVENTY FIVE
DOLLARS TO OVER SIX THOUSAND
DOLLARS.
SOMETIMES YOU HAVE HOSPITAL'S
RIGHT NEXT DOOR TO EACH OTHER
THAT ARE CHARGING THIS VARIATION
PRICES SOMETIMES YOU HAVE
PATIENTS IN THE SAME HOSPITAL
FOR THE SAME SERVICE. THAT ARE
PAYING WILDLY DIFFERENT PRICES
DEPENDING ON. WHO HAS THE
COVERAGE OF THEIR AYE MEDICARE
AND MEDICAID?
SO WE HAVE A SYSTEM THAT NOT
ONLY WERE THE PRICES ARE TOO
HIGH BUT THEY ARE OPAQUE. AND
THEY'RE ALL OVER THE PLACE SO
THERE'S MASSIVE PRICE
DISCRIMINATION.
.
AND SO.
WHAT DO WE DO ABOUT THIS?
PETER IS SAD THAT CALPERS IN
SOME OF THAT THE LARGEST
EMPLOYERS IN THE LARGEST UNIONS
IN THIS COUNTRY. HAVE TRIED TO
DO EVERYTHING THEY CAN TO GAIN
CONTROL OVER THE PROBLEM OF
COSTS.
THEY'VE TRIED TO USE THE TOOLS
OF TRANSPARENCY THEY'VE TRIED TO
DO BENEFIT DESIGN REFERENCE
PRICING.
YOU KNOW WE HAVE THE OFFERS OF
TRYING TO GO TO NARROW NETWORKS
TO EXCLUDING HOSPITALS. ALL OF
THIS WE'VE TRIED TO DO OUR
SELVES AS PURCHASERS TO REALLY
GET COSTS UNDER CONTROL.
BUT WE ARE STILL AT THE POINT
WHERE THE PRICES ARE GOING UP.
WE KEEP HAVING TO PAY THEM.
AND IT IS GETTING TO THE POINT
TO BE A REAL CRISIS IS
UNSUSTAINABLE. AND THAT IS WHY
WE REALLY DO NEED LEGISLATORS
AND DO NEED THE GOVERNMENT
POLICY MAKERS TO TAKE BOLD
ACTION TO REALLY EFFECTIVELY DO
COST CONTAINMENT ACROSS THE
HEALTH CARE INDUSTRY.
I'D I DON'T THAT'S THE EASY PART
USE THE ANALYSIS OF THE PROBLEM
OKAY WHAT WE DO.
.
SO I WOULD SAY THAT EVEN KNOW
AMAZON AND I'D JPMORGAN CHASE IN
BERKSHIRE HATHAWAY HAVE GOTTEN A
LOT OF PLAY IN THE LAST COUPLE
WEEKS.
WE DON'T REALLY NEED BIG
COMPANIES TRYING TO FIGURE OUT
WHAT TO DO ABOUT COST
CONTAINMENT THIS COUNTRY.
WE ALREADY KNOW WHAT TO DO WE
ALREADY HAVE SOME REALLY
INCREDIBLE EXAMPLES IN THIS
COUNTRY OF HOW WE CAN START TO
GET COSTS UNDER CONTROL.
I'M SO I WILL START WITH
MEDICARE.
MEDICARE IS.
A PROGRAM THAT YOU KNOW EVERYONE
WHAT GETTING GOVERNOR SOMEONE
SAID WAS THE ONLY GOOD REASON TO
TURN SIXTY FIVE.
WAS TO GET ON TO MEDICARE.
IT IS THIS IS A SYSTEM THAT IS
TRANSPARENT AND PUBLIC IN THE
WAY THAT IT SETS RATES.
IT SETS RATES THAT ARE PAID TO
HOSPITALS TO DOCTORS AND FOR OUT
PATIENT SERVICES.
IT'S A MODEL THAT NOT ONLY COULD
SERVE AS A MODEL FOR CALIFORNIA
BUT HAS ALSO BEEN ADOPTED BY
OTHER COUNTRIES INCLUDING FRANCE
GERMANY AND AUSTRALIA.
AND THEY'VE A PRIDE APPLIED IT
WAY MORE BROADLY THAN JUST FOR
PEOPLE OVER SIXTY FIVE THEY'VE
APPLIED AT A TO THE COMMERCIAL
MARKET AS WELL. AND YOU CAN SEE
THAT IN THAT THE PLIGHT THAT I
PRESENTED AT THE COST SAVINGS
THAT THEY HAVE.
IT ALSO IS FLEXIBLE IN THAT IT'S
NOT A ONE SIZE FITS ALL RATES
RATES ARE ADJUSTED THEIR
ADJUSTED FOR REGIONAL
DIFFERENCES FOR WAGES FOR OUT
LIARS.
FOR HOSPITALS THAT ARE ARE
SERVICES THAT ARE
DISPROPORTIONATE SHARE OF THAT
SERVE MORE LOW INCOME OR
MEDICAID PATIENTS.
AND AND SO THERE IS SOME
FLEXIBILITY BUILT INTO THE
SYSTEM.
ANOTHER GREAT THING ABOUT
MEDICARE AS A MODEL IS THAT
THERE IS MEDICARE ADVANTAGE AND
SO THIS IS AN OPTION. FOR.
PRIVATE HEALTH PLANS TO PROVIDE
COVERAGE TO.
MEDICARE ENROLLEES AND SO IN
CALIFORNIA FORTY PERCENT OF
MEDICARE ENROLLEES ARE IN
ADVANTAGE PLANS.
IN THIS IS WHERE THERE'S A
CAPITATED RATE THAT IS PAID SO
IT'S NOT JUST A MODEL FOR FEE
FOR SERVICE BUT FOR OTHER
PAYMENT MODELS AND YET IT STILL
RETAINS. MEDICARE'S MODEL OF
SETTING RATES AND CONTROLLING
PRICES.
TROLLING THE PRICE THAT IS PAID
TO PROVIDERS ACROSS THIS IS.
AND THEN THERE'S MARYLAND YOU
HAD A GREAT PRESENTATION FROM
MARYLAND ON THAT THE MOB THE
SYSTEM THAT THEY USE. AND THEY
USE SOMETHING CALLED ALL PAYER
RATE SETTING THIS IS A MODEL
THAT IS ALSO USED BY MANY OTHER
COUNTRIES TO.
CONTROL COSTS AND PRICES AND
IT'S FRANCE GERMANY JAPAN THE
NETHERLANDS AND SWITZERLAND.
AND MARILYN SINCE THE SEVENTIES
HAS SAT AT THE GOVERNMENT HAS
SET THE RATES THAT ARE PAID TO
HOSPITALS.
AND AND SO THEY USE A MEDICARE
LIKE MODEL AND THEY SAY. OKAY.
WE DON'T CARE WHAT YOU CHARGE
BUT THIS IS WHAT WE ARE GOING TO
PAY YOU WE ARE GOING TO CONTROL
THE PRICE
AND THOSE ARE THE PRICES THAT
ARE PAID. BY EVERYBODY BY
MEDICARE BY MEDICAID.
BY THE SELF INSURED AND BY
ANYBODY COVERED IN THE
COMMERCIAL MARKET.
MEDICARE DID RUN INTO SOME
ISSUES IN THAT
OR IT'S AYE MARYLAND INTO SOME
ISSUES IN THAT.
WHEN YOU SQUEEZE THE BALLOON AT
ONE END.
SOMETIMES EXPANDS AT THE OTHER
END AND SO YOU HAVE TO BE
CAREFUL IN TO ONE OF THE ISSUES
WAS THAT IF YOU JUST LOOK AT
PRICE.
YOU MAY HAVE A GROWTH IN THE
VOLUME OF SERVICES IN THE
INTENSITY OF SERVICES IT MIGHT
NOT ACCOUNT FOR IF YOU'RE JUST
LOOKING AT HOSPITAL'S SHIFTS TO
OUT PATIENT SETTINGS.
THAT ARE NOT SUBJECT TO RATE
SETTING.
AND EVEN IN THAT SITUATION WHERE
YOU'RE CONTROLLING PRICE
YOU MIGHT STILL HAVE AN INCREASE
IN OVERALL SPENDING BECAUSE YOUR
NOT LOOKING AT THAT.
FULL BALLOON TIME TO CONTINUE
THE EXAMPLE.
SO MARILYN RESPONDED TO THAT
ISSUE BY. IN TWENTY FOURTEEN
ADDING A BUDGET CAP
SO BASICALLY SAYING WE'RE GONNA
LOOK AT OVERALL HOW MUCH.
HEALTHCARE SPENDING THERE IS
ACROSS THE SYSTEM WHILE KEEPING
IN PLACE THE RATE SETTING THAT
THEY'VE HAD SINCE THE SEVENTIES
AND HOPEFULLY WE'RE GONNA SEE
SOME GOOD RESULTS FROM THAT
SO THERE ARE MODELS OUT THERE
FOR HOW WE CAN MOVE FORWARD ON
EFFECTIVE COST CONTAINMENT THAT
WILL.
REALLY DO SOMETHING FOR PETER'S
LOCAL AND FOR PEOPLE IN THE
COMMERCIAL MARKET.
AND SO I'M NOT GONNA LEAVE YOU
WITH A FULL PROPOSAL THAT.
WE DO HAVE SOME KIND OF CORE
PRINCIPLES AS WE MOVE FORWARD
LOOKING AT AT COST CONTAINMENT.
ONE IS THAT IT BUILDS TOWARDS A
UNIVERSAL SINGLE SINGLE PAYER
SYSTEM.
AND THIS IS ONE ELEMENT OF IT A
KEY ELEMENTS AND AN ELEMENT THAT
WILL. IMPACT PEOPLE RIGHT NOW.
WE NEED TO REALLY GET CONTROL
ABOUT HOW MUCH OUR PEOPLE ARE
SPENDING ON HEALTHCARE.
THAT THIS THE COST CONTAINMENT
HAS THE OVERALL GOAL OF COMPLETE
OF CONTAINING COSTS.
WHICH YOU NEED TO LOOK AT AS
BOTH THE PRICE.
AND UTILIZATION.
THAT IT INCREASES QUALITY.
THAT IT IMPROVES HEALTH OUTCOMES
ONE BECAUSE WE CARE VERY MUCH
ABOUT OUR MEMBERS HEALTH AND TWO
BECAUSE IT JUST MAKES GOOD LONG
TERM SENSE TO KEEP PEOPLE
HEALTHY.
AND REDUCES DISPARITIES IN THE
SYSTEM THROUGH A FORM OF
REGULATION.
FOURTH THAT IT ALLOWS FOR
FLEXIBILITY.
TO ASSURE THE FINANCIAL
STABILITY OF THE REGULATED
ENTITIES BECAUSE WE WANT TO MAKE
SURE WE HAVE FULLY FUNCTIONING
HOSPITALS AND CLINICS IN ALL
AREAS OF THE STATE. WE HAVE
MEMBERS IN VERY RURAL DISTRICTS
FROM NORTHERN CALIFORNIA TO. FAR
SOUTHERN CALIFORNIA WE WANT TO
MAKE SURE THAT THEY HAVE ACCESS
TO THE HOSPITAL'S THAT THEY NEED
TO GO TO AN ACCESS TO THE CARE
THAT THEY NEED.
AS WELL AS TO COUNT ACCOUNT FOR
REASONABLE COSTS INCLUDING LABOR
COSTS.
HOSPITALS AND IN THE HEALTH
CARE INDUSTRY IS A BIG EMPLOYER
IN THE STATE TO BIG CONTRIBUTOR
TO THE ECONOMY WE WANT TO MAKE
SURE THAT IT STAYS THAT WAY. AND
THAT OUR BROTHERS AND SISTERS
WHO ARE HEALTH CARE WORKERS AND
WHO BUILD HOSPITALS AND WHO
PROVIDE. HEALTH FOOD SERVICES IN
JANITORIAL ARE ABLE TO MAINTAIN
A HIGH STANDARD OF LIVING.
AND AND ALSO THAT THAT'S SYSTEM.
OPERATES WITH MAXIMUM SIMPLICITY
AND TRANSPARENCY.
SO THAT WE ALL MOVED FROM THIS
REALLY OPAQUE HEALTHCARE SYSTEM
THAT WE HAVE RIGHT NOW TO ONE
THAT WE CAN ALLUNDERSTAND AND
CAN ACCESS.
.
AND I WILL ADD ONE OF THE BULLET
POINTS THAT IS NOT ON HERE IS
JUST URGENCY.
AND THAT TACKLING COSTS IN DOING
COST CONTAINMENT EVEN IF WE SAY
THAT IT'S AT A STOP ON THE ROAD
TO SINGLE PAYER IT'S A BIG JOB
AND IT IS. AN URGENT JOB AND IT
IS ONE THAT IS GOING TO AFFECT
EVERY SINGLE CALIFORNIAN AND
EVERY SINGLE CALIFORNIA BUSINESS
AND SO IT IS A TASK THAT IT IS
WORTH TAKING ON. I KNOW THIS IS
THIS COMMITTEE HAS SPENT.
HOURS AND HOURS PREPARING FOR
THIS TAX AT TAX SKIN IS VERY
WELL PREPARED AND WE LOOK
FORWARD TO WORKING WITH YOU AND
TO ACHIEVING THIS GOAL THANK YOU.
I BIGGER PREP WHICH YOU KNEW
YOUR NAME A COUPLE TIMES SO I
APOLOGIZE MISTER ARE INSPIRED
CRACK THERE OKAY GOT ME THEY GOT
RIGHT FOR.
FROM THE.
FOUNDER AND CEO OF SMALL
BUSINESS BUSINESS MAJORITY
PLEASE THANK YOU ALL THANK YOU
CO CHAIRS AROUND YOU I'M WOOD
AND THE ENTIRE COMMITTEE.
I'M JOHN ARMS MEYER FOUNDER AND
CEO SMALL BUSINESS MAJORITY.
THE REPRESENTATIVE OF MORE THAN
THREE POINT EIGHT. MILLION SMALL
BUSINESSES IN CALIFORNIA WE'RE
PLEASED TO OFFER TESTIMONY DAY
SUPPORT OF COMMON SENSE
SOLUTIONS TO ENSURE CALIFORNIA'S
BUSINESSES. AND SELF EMPLOYED
ENTREPRENEURS HAVE ACCESS TO
QUALITY AFFORDABLE HEALTH CARE.
WE'RE A NATIONAL SMALL BUSINESS
ADVERSITY ORGANIZATION FOUNDED
TWELVE YEARS AGO IN CALIFORNIA.
WITH THREE OFFICES IN THE STATE
AND SEVEN THOUSAND SMALL
BUSINESS OWNERS ARE NETWORK OUT
OF FIFTY FIVE THOUSAND
NATIONWIDE.
WE WERE FOUND IN RUN BY SMALL
BUSINESS OWNERS TO ENSURE
AMERICA'S. ORDERS ARE A KEY PART.
OF A THRIVING ECONOMY.
WE ACTIVELY ENGAGE SMALL
BUSINESS OWNERS AND POLICYMAKERS
IN SUPPORT OF POLICY SOLUTIONS
AND WE DELIVER INFORMATION
RESOURCES START SHIPPING ORDERS.
THAT PROVIDE SMALL BUSINESS
GROWTH AND DRIVE A DIVERSE AND
INCLUSIVE JOB CREATING ECONOMY.
A KEY PART OF OUR WORK OVER THE
PAST TWELVE YEARS. HAS BEEN
ADVOCATE FOR POLICIES THAT HELP
SMALL BUSINESSES THEIR EMPLOYEES
AND SELF EMPLOYED ENTREPRENEURS.
ACCESS AFFORDABLE AND
COMPREHENSIVE HEALTH COVERAGE
AND CARE.
TODAY I'LL DISCUSS SEVERAL
PROPOSALS WE BELIEVE A CRUCIAL
TO ENSURING AN EXPANDING THIS
ACCESS.
OVER THE PAST FIVE YEARS THE ACA
HAS PROVIDED HEALTH CARE TO
TWENTY FOUR MILLION INDIVIDUALS
NATIONWIDE WHO OTHERWISE
COULDN'T ACCESS COVERAGE. MANY
OF WHOM WORK FOR SMALL EMPLOYERS
OR ARE THEMSELVES BUSINESS
OWNERS OR SELF EMPLOYED.
IN CALIFORNIA ALONE MORE THAN
FIVE MILLION PEOPLE HAVE
INSURANCE THANKS TO THE NEW
HEALTH CARE LAW.
IT'S IMPORTANT THAT THIS
COMMITTEE AND EVERYBODY REALIZE
HOW IMPORTANT THE ACA ACTUALLY
IS TOO SMALL BUSINESS AND
ENTREPRENEURSHIP IN THIS COUNTRY
AND THIS STATE.
UNFORTUNATELY PRIOR TO THE LOS
ENACTMENT
SMALL BUSINESSES AND THEIR
EMPLOYEES CAN PRICE A
DISPROPORTIONATE SHARE OF THE
WORKING UNINSURED. INDEED IN
TWENTY ELEVEN NEARLY TWO THIRDS
OF THE NATION'S UNINSURED
WORKERS WERE SELF EMPLOYED OR
WORKING AT A COMPANY WITH FEWER
THAN A HUNDRED EMPLOYEES.
AND WHEN THEY COULD ACCESS
HEALTH COVERAGE SMALL BUSINESSES
PAID AN AVERAGE EIGHTEEN PERCENT
MORE THAN THEIR LARGER
COUNTERPARTS.
USUALLY FOR LESS COMPREHENSIVE
COVERAGE.
DUBBED I SHOULD POINT OUT THAT
THE SINCE THE ENACTMENT AND
IMPLEMENTATION OF THE ACA THE
RATE OF INCREASE IN THE SMALL
GROUP MARKET HAS DROPPED THE
ANNUAL RATE OF INCREASES DROPPED
FROM TWENTY TEN POINT FOUR
PERCENT. TO FIVE POINT TWO
PERCENT THOSE ARE NATIONAL
NUMBERS BUT THE NUMBERS IN
CALIFORNIA ARE NOT FAR OFF.
IT SHOULD COME AS NO SURPRISE
THAT IS SCIENTIFIC OPINION
POLLING WE'VE CONDUCTED LAST
YEAR. FOUND THAT SIX INTEND
SMALL BUSINESS OWNERS SUPPORT
THE ACA DESPITE ALL OF THE
MISREPRESENTATION PARTISAN NOISE.
SURROUNDING ITS ENACTMENT AND
IMLEMENTATION.
THE ACA SO FIRST MEANINGFUL
HEALTHCARE REFORM TO HELP
ADDRESS THESE NEEDS AND
DISPARITIES AND SPEND
PARTICULARLY IMPORTANT FOR
CALIFORNIA SMALL BUSINESSES A
SELF EMPLOYED ENTREPRENEURS.
IN PARTICULAR THE INDIVIDUAL
MARKET PLACES BEEN CRUCIAL TO
EXPANDING ACCESS TO QUALITY
AFFORDABLE HEALTH CARE FOR THE
SMALL BUSINESS COMMUNITY. WITH
EIGHT POINT SAID EIGHT POINT ONE
PERCENT OR THREE MILLION SELF
EMPLOYED CALIFORNIANS.
.
PAPER EIGHT PUT A FOUR PERCENT
OUT OF THE THREE MILLION SELF
WHAT CALIFORNIANS OF THREE
HUNDRED SEVENTY THOUSAND TOTAL
ENROLLED IN PLAN THROUGH COVER
CALIFORNIA AND TWENTY FIFTEEN.
COMPARED JUST TWO POINT NINE
PERCENT OF ALL WORKERS.
EMPLOYEES OF SMALL BUSINESSES.
TOTALING FIFTY FIVE POINT ONE
MILLION IN CALIFORNIA ALSO MORE
LIKELY HAVE BENEFITTED FROM ME A
CA WITH RUST ROUGHLY TWENTY ONE
PERCENT.
SMALL BUSINESS EMPLOYEES GAINING
COVERAGE IN CALIFORNIA THROUGH
BOTH THE INDIVIDUAL MARKET PLACE
AND THE EXPANSION OF MEDICARE
HEALTH THAT'S THIRTEEN PERCENT
MEDI CAL EIGHT PERCENT IN COVER
CALIFORNIA.
THE STATISTICS ILLUSTRATE HOW
CALIFORNIA'S BEEN THE LEADER IN
ENSURING ACCESS TO QUALITY
AFFORDABLE HEALTH CARE THANKS TO
ITS CREATION OF ROBUST
INDIVIDUAL MARKETPLACE. EASY
ENROLLMENT IN THE SMALL GROUP
MARKET PLACE RECOVER CALIFORNIA
FOR SMALL BUSINESS AND VIGOROUS
MARKETING AND EDUCATION
CAMPAIGNS.
HOWEVER AS WE'VE HEARD NATIONAL
EFFORTS TO CHIP AWAY AT THE
HEALTH CARE LAW REPEAL ENTIRELY
THREATEN THIS PROGRESS.
RECENT PROPOSALS TO UNDO KEY
PROVISIONS OF THE ACA THROUGH
LEGISLATION AND EXECUTIVE ACTION
THREATEN TO DISRUPT THE MARKET
PLACES AND IN TURN HARM SMALL
BUSINESS OWNERS THEIR EMPLOYEES.
AND SELF EMPLOYED INDIVIDUALS.
WHAT WE BELIEVE CERTAIN
PROVISIONS OF THE ACA CAN AND
SHOULD BE IMPROVED UNDERMINING
THE A CA ERADICATES HARD WON
BENEFITS FOR AMERICA'S
ENTREPRENEURS POTENTIALLY
CAUSING A RAPID RISE IN
HEALTHCARE COSTS? AND CREATING
TREMENDOUS ECONOMIC INSTABILITY.
CALIFORNIA SMALL BUSINESSES LOOK
FORWARD TO THE DAY WHEN ONCE
EMPLOYMENT AND INCOME STATUS
DON'T GOVERN ACCESS TO QUALITY
AFFORDABLE HEALTH CARE.
BUT IN THE SHORT TERM CALIFORNIA
CAN AND MUST TAKE IMMEDIATE
STEPS
TO PROTECT ITS CITIZENS AND ITS
SMALL BUSINESS COMMUNITY BY NOW
ACTING PRACTICAL ACHIEVABLE
REFORMS. THAT WILL STRENGTHEN
CALIFORNIA'S MARKETPLACES AND
PREVENT HUGE INCREASES IN HEALTH
CARE COSTS WHILE POTENTIALLY
LAYING THE GROUNDWORK.
TO ACHIEVE THE LONG TERM GOAL OF
UNIVERSAL COVERAGE.
TODAY I'LL FOCUS ON THREE KEY
AREAS.
MARKET STABILITY EXPANDED ACCESS
TO COVERAGE AND COST AND
AFFORDABILITY.
FIRST AND FOREMOST STEPS MUST BE
TAKEN TO IMPROVE THE STABILITY
OF AN INDIVIDUAL MARKETPLACE
ESPECIALLY IN LIGHT OF THE
FEDERAL REPEAL OF THE INDIVIDUAL
MANDATE PENALTY.
STRONG INDIVIDUAL MARKET PLACES
VITALLY IMPORTANT FOR OWNERS AND
EMPLOYEES.
OF.
SMALL BUSINESSES THAT ARE ABLE
TO OFFER GROOVE COVERAGE THAT'S
HALF OVER HALF OF ALL SMALL
BUSINESSES.
ESPECIALLY FOR THE ROUGHLY THREE
MILLION SOLO ENTREPRENEURS IN
CALIFORNIA WHO'VE HAD HAD NO
THEIR ACCESS TO OF COVERAGE
BEFORE THE ACA.
THE ABILITY OF SELF EMPLOYED
INDIVIDUALS AND ENTREPRENEURS TO
PURCHASE AFFORDABLE HEALTH
INSURANCE FROM ALSO RIPPED
ROBUST SMALL BUSINESS ECONOMY BY
REDUCING JOB BLOCK. ALLOWING
WORKERS WHO PREVIOUSLY FELT TIED
TO THEIR JOB BY THEIR LARGE
EMPLOYER BENEFITS PACKAGE TO
STRIKE OUT ON THEIR OWN LAUNCH
BRUTAL PATH OR JOIN THRIVING
SMALL BUSINESSES.
THIS IS WHY CALIFORNIA MUST
PURSUE INNOVATIVE STATE
SOLUTIONS TO ENCOURAGE YOUNGER
HEALTHIER INDIVIDUALS TO STAY IN
THE SYSTEM WHICH IS NECESSARY TO
ENSURE A ROBUST COMPETITIVE AND
AFFORDABLE MARKETPLACE.
CALIFORNIA HAS ALREADY WORKS TO
STABILIZE RATES DESPITE
UNCERTAINTY REGARDING FEDERAL
ENCOURAGE THE STATE TO CONTINUE
TO FIND CREATIVE SOLUTIONS TO
STABILIZE INDIVIDUAL MARKETPLACE.
AS SUCH WE HAVE A LIST OF
RECOMMENDATIONS THAT WOULD HELP
ENSURE A HEALTHY A THRIVING
MARKET PLACE FOR CALIFORNIA'S
ENTREPRENEURS AND SMALL BUSINESS
EMPLOYEES.
FIRST WE ENCOURAGE LAWMAKERS TO
PURSUE LEGISLATION THAT WOULD
REQUIRE ALL CALIFORNIANS TO
PARTICIPATE IN THE HEALTH
INSURANCE RISK POOL. IS ABSOLUTE
CRITICAL THE CALIFORNIA
REINSTATED INDIVIDUAL MANDATE.
OF ORDER EQUIVALENT PROVISION TO
ENSURE A STABLE HEALTHY
MARKETPLACE FOR CALIFORNIA'S
ENTREPRENEURS BY ENCOURAGING
YOUNG HEALTHY PEOPLE TO JOIN AND
REMAIN IN THE SYSTEM WE CAN ALSO
PROMOTE AFFORDABILITY FOR
EVERYONE.
WE ALSO CAUTIONED AGAINST
ALLOWING SO CALLED JUNK
INSURANCE PLANS THAT DON'T
CONFORM TO THE ACA. THESE PLANS
WOULD WEAKEN THE LARGER
INDIVIDUAL MARKET WHILE FAILING
TO PROVIDE ADEQUATE COVERAGE
SPECIFICALLY WE ENCOURAGE ALL OF
YOU AND YOUR COLLEAGUES TO
SUPPORT LEGISLATION LIKE. SP
NINE TEN WHICH WOULD PROHIBIT
INSURERS FROM OFFERING SHORT
TERM LIMITED DURATION INSURANCE
PLANS AND IN SO DOING HELP TO
PROTECT CONSUMERS FROM PLANTS
THAT FELT PROVIDE ADEQUATE
COVERAGE.
TO PROTECT PROTECTOR OF BUSES OF
THE SMALL GROUP MARKET
CALIFORNIA SHOULD CONTINUE TO
PREVENT BUSINESSES FROM FORMING
ASSOCIATION HEALTH PLANS
INCLUDING RETAINING THE CURRENT
BAN ON NEW MULTIPLE EMPLOYER
WELFARE ARRANGEMENTS FOR ME WAS.
WELL AGE PEAS AND WE WAS MIGHT
NO DOUBT OFFER PLANS WITH LOWER
COST FOR SOME SMALL BUSINESSES.
THEY LARGELY BENEFIT ENTITIES
WITH LARGER HEALTHIER EMPLOYEES
THIS CREATES SEPARATE RISK POOLS.
.
CREATING.
.
THE PROBLEM WITH WHEN WE CAN'T HAVE BIFURCATED
BALKANIZED MARKETS WE HAVE TO
HAVE AS A ROBUST.
LARGE ENOUGH MARKET THAT
EVERYBODY'S PARTICIPATING AND.
HP'S OFF ALSO OFTEN DON'T COVER
ESSENTIAL HEALTH BENEFITS AND
ARE GOVERNED BY RULES PREVENTING
INSURERS FROM CHARGING MORE BASS
ENTREE SUCH AS GENDER OR HAVING
A PRE EXISTING CONDITION.
CALIFORNIA'S ALREADY A LEADER IN
PREVENTING ABUSES FROM THESE
TYPES OF PLANS AND WE HOPE THE
STATE WILL CONTINUE TO PUSH BACK
AGAINST NATIONAL EFFORTS THAT
WOULD UNDERMINE OUR STATE
PROTECTIONS.
SECOND ISSUE IS ACCESS TO
COVERAGE.
IN ORDER JUST.
TO HAVE STABLE HEALTH CARE
MARKETPLACE IS IT'S CRITICAL
THAT SMALL BUSINESS OWNERS
EMPLOYEES AND SELF EMPLOYED
ENTREPRENEURS HAVE ACCESS
THE QUALITY AFFORDABLE HEALTH
CARE.
CALIFORNIA STONE IMPRESSIVE JOB%
OF PROMOTING ITS HEALTH CARE
OPTIONS BUT PROVIDING ONLINE
ENROLLMENT AND COMMUNICATING THE
MARKETPLACES BENEFITS THROUGH
EDUCATION AND OUTREACH.
HEARING CALIFORNIA ARE TEAM OF
SMALL BUSINESSMEN JORDY HAS
CONDUCTED MORE THAN FIVE HUNDRED
WORKSHOPS FOR SMALL BUSINESSES
ACROSS THE STATE. REACHING
NEARLY TWENTY THOUSAND
CALIFORNIANS DIRECTLY THROUGH
OUR HEALTH CARE EVENTS AND MORE
THAN TWO HUNDRED THOUSAND
OVERALL THROUGH OUR FREE
HEALTHCARE RESOURCES FOR
CALIFORNIA SMALL BUSINESSES.
BASED UPON OUR EXTENSIVE WORK ON
THE GROUND EDUCATING UR STATE
SMALL BUSINESSES AND LISTENING
TO THEIR NEEDS WE RECOMMEND THE
FOLLOWING ACTIONS TO FURTHER
EXPAND ACCESS TO AFFORDABLE
COVERAGE.
THE FIRST AND MOST IMPORTANT IS
MEDI CAL EXPANDING MEDICAID
UNDER THE ACA'S PLAYED A CRUCIAL
ROLE IN REDUCING CALIFORNIA'S
UNINSURED RATE ESPECIALLY FOR
SMALL BUSINESS EMPLOYEES IN THE
SELF EMPLOYED. FOR EXAMPLE A
RECENT STUDY FOUND AT THIRTEEN
POINT THREE PERCENT OF SELF
EMPLOYED CALIFORNIANS AND FIFTY
TWO PERCENT OF SMALL BUSINESS
EMPLOYEES CAME COVERAGE. THANKS
TO MEDI CAL EXPANSION.
ROUGHLY ONE QUARTER.
OF CALIFORNIA SELF EMPLOYED
POPULATION WAS INSURED THROUGH
MEDI CAL IN TWENTY FIFTEEN AND
REPEAT ONE QUARTER OF CALIFORNIA
SELF INSURE POPULATION ENSURE
THROUGH MEDI CAL. WHILE MORE
THAN ONE THIRD OF CALIFORNIANS
WORKING AT COMPANIES WITH TEN OR
FEWER EMPLOYEES. THAT'S ALMOST A
HUNDRED THOUSAND EMPLOYERS WERE
ENROLLED IN THE SAME EMPLOYEES
GIVE ME ROLE IN THE SAME YEAR.
YET TWENTY TWO POINT NINE
MILLION CALIFORNIA STILL DON'T
HAVE INSURANCE OF THOSE WHO ARE
UNINSURED ONE POINT EIGHT ARE
EMPLOYED WITH FORTY FOUR PERCENT
OF THEM WORKING AT A COMPANY
WITH FEWER THAN FIFTY EMPLOYEES.
WHILE ONE IN SIX ARE SELF
EMPLOYED.
ONE IN THREE OF THOSE WITHOUT
INSURANCE IN CALIFORNIA HAVE
ANNUAL INCOMES BELOW TWENTY FIVE
THOUSAND DOLLARS MEANING THEY'RE
LIKELY FILLED ELIGIBLE FOR MEDI
CAL.
FURTHER EXPANDING MEDICARE ON
CONTINUING TO EDUCATE
CALIFORNIANS ABOUT ITS BENEFITS
WOULD HELP LOW INCOME SMALL
BUSINESS EMPLOYEES AND SELF
EMPLOYED INDIVIDUALS OBTAIN
COVERAGE.
ADDITIONALLY WE ENCOURAGE THE
LEGISLATURE TO EXPAND MEDICARE
ALSO INCLUDE UNDOCUMENTED
CALIFORNIANS.
EXTENDING THIS COVERAGE WOULD
DRASTICALLY DECREASE THE NUMBER
OF REMAINING ON IN SHORT IN THE
STATE HAS ROUGHLY ONE POINT
EIGHT MILLION UNDOCUMENTED
CALIFORNIANS ARE WITHOUT. HEALTH
CARE COVERAGE MORE THAN HALF OF
THE TOTAL UNINSURED. THESE
PEOPLE MANY OF WHOM RUN OR WORK
IN SMALL BUSINESSES ARE
ACCESSING OUR HEALTHCARE SYSTEM
IN AN EFFICIENT MANNER WITHOUT
ANY WAY TO PAY FOR THEIR CARE.
THEREBY ADDING TO THE
INSTABILITY OF THE SYSTEM AND
INCREASING HEALTHCARE COSTS FOR
EVERYONE ELSE.
AND LASTLY THERE'S THE ALL
IMPORTANT ISSUE OF COST AND
AFFORDABILITY.
CALIFORNIA'S LEGISLATORS MUST
MUST PURSUE ADDITIONAL POLICIES
AND IMPROVE COSTS IN
AFFORDABILITY FOR CALIFORNIANS.
OUR SCIENTIFIC POLLING HAS SHOWN
THAT SMALL BUSINESS OWNERS ARE
DEEPLY CONCERNED WITH THE COST
OF PRESCRIPTION DRUG COVERAGE.
AND OF THESE RISING COSTS ARE
HURTING THE BOTTOM LINE AS A
RESULT THEY'RE STRONGLY
SUPPORTIVE OF A NUMBER OF
POLICIES THAT AIM TO BRING DRUG
COSTS DOWN.
IN ADDITION WE ARE POLLING SHOWS
EIGHTY FIVE PERCENT OF SMALL
BUSINESSES SUPPORT THE ABILITY
OF GOVERNMENT TO NEGOTIATE DRUG
PRICES.
WE ENCOURAGE LAWMAKERS TO
CONSIDER PROPOSALS LIKE A. B.
FIVE EIGHTY SEVEN TO ALLOW POOL
PURCHASING POWER FOR
PRESCRIPTION DRUGS.
CALIFORNIA'S LAWMAKERS CAN
FREELY FROM FURTHER PROMOTE
AFFORDABILITY BY NOW ACTING
POLICIES THAT REQUIRE HEALTH
PLANS TO SPEND MORE ON HEALTH
CARE LESS ON ADMINISTRATIVE
COSTS AND PROFITS.
ONE OPTION IS TO CODIFY MEDICAL
LOSS RATIO WENT INTO CALIFORNIA
ON A REINFORCES STATE'S
COMMITMENT TO AFFORDABILITY.
WALKING INTO IT INTO EIGHTY
TWENTY RATIO IN CASE FEDERAL LAW
LOOSENS ES REQUIREMENT WOULD BE
A GOOD FIRST STEP. WE ENCOURAGE
FURTHER RESEARCH TO DETERMINE IF
A HIGHER RATIOS ECONOMICALLY
FEASIBLE OBVIOUSLY. WE HAVE TO
HAVE A SYSTEM UNDER THE CURRENT
SYSTEM WHERE INSURANCE CAN BE
OFFERED BY PRIVATE INSURERS SO.
WE DON'T WANNA RATIO IS GOING
TO MAKE THAT ON A SUSTAINABLE
BUT I THINK WE CAN LOOK AT MAYBE
DOING BETTER THAN THE EIGHTY
TWENTY RULE.
ANOTHER EXAMPLE WOULD BE TO
CONSIDER A PUBLIC OPTION TO
ALLOW MEDI CAL TO COMPETE WITH
PRIVATE HEALTH INSURERS IN THE
OPEN MARKET.
CONSUMERS WOULD HAVE THE CHOICE
TO BUY INTO THESE PROGRAMS OF
THEIR OWN COSTS WHICH WOULD
INCREASE COMPETITION PROVIDE
MORE COVERAGE OPTIONS AND HELP
LOWER COSTS.
ADDITIONALLY THIS TYPE OF PUBLIC
PLAN WILL ENSURE THAT ALL AREAS
OF THE STATE HAVE ACCESS TO
COMPETITIVE COVERAGE.
ADDITIONAL OPTIONS INCLUDE
MAKING PLANS MORE AFFORDABLE
PRIVATE BY PROVIDING ADDITIONAL
FINANCIAL ASSISTANCE TO
CALIFORNIANS WHO ARE PURCHASING
SUBSIDIZE PLANS THROUGH COVER
CALIFORNIA. SPECIFICALLY BY
INCREASING COPAYMENTS OR COST
DURING MEASURES TO THOSE WHO
QUALIFY FOR FEDERAL A CA
SUBSIDIES.
CALIFORNIA CAN ALSO PROMOTE
AFFORDABILITY BY WORKING TO KEEP
PREMIUMS DOWN FOR ALL
INDIVIDUALS.
S. F. ANY MENTION FIXING THE SO
CALLED FAMILY GLITCHES ALSO WAY
TO ENSURE MORE CALIFORNIANS HAVE
ACCESS TO AFFORDABLE COVERAGE.
THIS IS PARTICULARLY IMPORTANT
FOR EMPLOYEES OF SMALL
BUSINESSES MANY OF WHOM CAN'T
AFFORD TO PROVIDE COVERAGE TO
DEPENDENCE.
WE ENCOURAGE THE STATE
LEGISLATURE CONSIDER PROVIDING A
STATE SUBSIDY FOR SPOUSES AND
DEPENDENTS WHO ARE CURRENTLY
UNABLE TO RECEIVE A SUBSIDY
THROUGH CLOUD COVER CALIFORNIA
DUE TO THE FACT.
THE PRIMARY ENSURE FAMILY MEMBER
ME SEE EMPLOYEE AFFORDABILITY
CENTER ON THE LAW.
FINALLY WE ENCOURAGE LAWMAKERS
WHO SUPPORT LEGISLATION LIKE S.
B. FIVE THIRTY EIGHT THE
HEALTHCARE MARKET FAIRNESS ACT.
A BILL INTRODUCED IN THE
PREVIOUS LEGISLATIVE SESSION TO
PROMOTE HOSPITAL CONTRACTING
REFORM TO DRIVE DOWN COSTS.
VERTICAL EVIDENCE SHOWS THAT THE
PROVIDER CONSOLIDATION UNFAIR
CONTRACTING A KEY DRIVER OF
INCREASES IN HEALTHCARE COSTS.
AND THE BILL ADDRESSES SOME OF
THE MOST COERCIVE PRACTICES BY
PROVIDERS. THAT HAVE NO RELATION
TO VALUE AND SERVE ONLY TO FUEL
A JUSTIFIABLE INCREASES IN PRICE.
IN SOME.
THE AFFORDABLE CARE ACT HAS LED
TO SIGNIFICANT GAINS FOR ALL
CALIFORNIANS AND PARTICULARLY TO
SMALL BUSINESS EMPLOYEES.
IT EMPLOYERS EMPLOYEES AND SELF
EMPLOYED THANKS IN NO SMALL PART
TO A PROACTIVE ATTITUDE
CALIFORNIA'S TAKEN TO
ESTABLISHING A ROBUST
MARKETPLACE IT HAS MADE IT EASY
FOR INDIVIDUALS. AND SMALL
EMPLOYERS ACCESS AFFORDABLE
COVERAGE.
TO CONTINUE THIS PROGRESS
CALIFORNIA LAWMAKERS SHOULD
CONSIDER ADDITIONAL COMMON SENSE
SOLUTIONS TO IMPROVE MARKET
STABILITY EXPAND COVERAGE AND
MAKE HEALTH CORPS. OR EVEN MORE
AFFORDABLE THIS CAN ALL BE DONE
IN PARALLEL WITH CONSIDERING.
THE MANY OF SUGGESTIONS FOR LONG
TERM UNIVERSAL CARE INCLUDING
SINGLE PAYER WINTERS LEGISLATOR
TO WORK THE LEGISLATURE WORK ON
BOTH TRACKS AT THE SAME TIME.
THANK YOU FOR THE OPPORTUNITY
COMMENT ON THIS IMPORTANT ISSUE
BEFORE DANCING YOUR QUESTIONS.
THANK YOU VERY MUCH.
.
QUESTIONS.
THANK YOU HAVE A LOT OF
QUESTIONS I'LL TRY TO KEEP IT
CONCISE BUT I'D LOVE TO JUST
DRILL DOWN TO THE NEXT LEVEL OF.
OF DETAIL FROM WHERE
PRESENTATIONS WERE SO STARTING
FIRST WITH HELP ACCESS I KNOW
THERE'S BEEN A LOT OF DISCUSSION
ABOUT HOW TO EXPAND
AFFORDABILITY HELP IN. THE IDEA
THAT NO ONE SHOULD SPEND MORE
THAN A PERCENTAGE OF INCOME ON
PREMIUMS THAT'LL MAKE SENSE TO
ME QUESTION YOU DO HAVE
SPECIFICS ON THIS.
WHAT NUMBERS YOU'RE TALKING
ABOUT HOW MUCH WOULD IT COST?
I AM VERY VESTED IN THAT IDEA I
THINK. WE COULD WE ARE CURRENTLY
WORKING WITH BOTH OURCOLLEAGUES
AND IN THE ADVOCACY COMMUNITY
AND IN THE ACADEMIC COMMUNITY TO
COME UP WITH SPECIFIC NUMBERS
BUT I THINK.
.
IF IT AFFORDABLE CARE ACT GETS
US.
PRETTY CLOSE TO THE WAY THERE
THERE IS A BIG THAT GUARANTEE OF
YOU DON'T HAVE TO SPEND MORE THE
CERTAIN PERCENTAGE YOU IF YOU IF
YOU'RE IF YOU DON'T HAVE THE
BENEFIT OF EMPLOYER BASED
COVERAGE. IF YOU'RE AN
INDIVIDUAL MARKET YOUR HAVE TO
SPEND MORE THE CERTAIN
PERCENTAGE OF YOUR INCOME.
ON PREMIUM.
FOR.
FOR SILVER LEVEL PLAN IS A IS
SOMETHING THAT IS EXTENDED TO
FOLKS UNDER FOUR HUNDRED PERCENT
OF POVERTY LEVEL WHICH IS ABOUT
FORTY THOUSAND DOLLARS FOR AN
INDIVIDUAL AND NINE.
I NINETY EIGHT THOUSAND DOLLARS
BEFORE OF FAMILY OF FOUR. IT IS.
.
THAT IS THE ISSUE OF THE FAMILY
GLITCH FOR THOSE WORKERS IN SOME
INTENDED IT IS IS ONE OF THE HOW
ARE THE HOLES THAT NEEDS TO BE
PLUGGED.
.
THE.
THE QUESTION IS.
FOR THOSE FOLKS ARE JUST OVER
FOUR HUNDRED PERCENT WE DO HAVE
DATA THAT SIXTY PERCENT THAT
SUGGEST THAT IT. THAT.
WHERE THE POPULATIONS THEY TEND
IF THE PEOPLE WHO ARE JUST OVER
FOUR HUNDRED PERCENT TEND TO BE
IN HIGH COST OF LIVING AREAS?
AND.
.
AND EIGHT AND OLDER BECAUSE
THERE IS AS THE AFFORDABLE CARE
ACT DOES LIMIT BUT DOES ALLOW
FOR THREE TO ONE AGE BAND
BETWEEN. THE.
BOULDER AND THE PREMIUMS OR AN
OLDER PERSON AND THE AND THE
YOUNGEST PERSON.
THE.
SO I THAT WE THINK THAT.
IT IS DOABLE TO DO THAT WE ALSO
THINK IT'S IMPORTANT TO ALSO
PROVIDE SOME ADDITIONAL WAS AS
ASSISTANT THAT BIT OF THE VAST
MAJORITY PEOPLE COME IN
CALIFORNIA BY. SILVER OR BETTER
PLANS AND IN FACT AND YOU
ENROLLMENT DATA SUGGEST THAT WE
EVEN HAD MORE PEOPLE PICKING UP
GOLD PANS. ESPECIALLY WITH THE
COST SHARING REDUCTION WORK
AROUND THAT WAS.
DEVELOP I COVER CALIFORNIA
INVERT IN LIGHT OF THE TRUMP
ADMINISTRATION ATTACK
BUT THE.
BUT YOU KNOW FRANKLY WHAT WE
WIND WE WANNA MAKE SURE IT'S
ALWAYS AFFORDABLE SO THAT EVEN
SAID PEOPLE DON'T FEEL LIKE WE
NEED TO GET TO THAT BRONZE PLAN
WHICH IS THAT SIX THOUSAND
DOLLAR DEDUCTIBLE PLAN WHICH IT
YOU YOU KNOW WE WE WANT TO. MAKE
SURE THEY'RE AT LEAST THAT
THAT'S OVER PLAN WHERE EVEN FOR
THOSE WHO HAVE A DEDUCTIBLE.
MOST OF THEIR CARE OUTSIDE OF
HOSPITAL CARE IS IS IS COVERED
OUTSIDE OF DEDUCTIBLE AS A
PEOPLE HAVE ACCESS TO THE KEY
DID TOO. TO CARE THAT THEY NEED.
IN TERMS OF.
IN TERMS OF COSTS I WOULD SAY
THAT.
WE ARE STILL WORKING ON A
NUMBER THE LA ALL GAVE YOU SOME
ESTIMATES.
ON ON MONDAY AND I YOU KNOW I
THINK WE ARE KIND OF REFINED AND
SEE WHAT KIND OF EFFICIENCIES WE
CAN PROVIDE WHAT KIND OF SAVINGS.
AN OFFSETTING SAVINGS THERE ARE
BUT I WOULD SAY THAT IN TERMS OF
SCALE. THAT YOU'RE QUITE DE YAH
I KNOW YOU HAD YOUR DIALOGUE
WITH THE LA O. ON MONDAY AND.
I WOULD SAY THAT.
HOW TO DO THE WHOLE THING ABOUT
WITH THE ADDITIONAL? COVERED
CALIFORNIA AND THE IN THE HEALTH
FOR ALL WE ARE EXPANDING MEDICAL
UNDOCUMENTED WOULD BE LESS THAN
SAY WHAT WE WHAT WE RAISED UNDER
PROP THIRTY.
LIKE IT IS A IT IS A. IT IS NOT
THE SORT OF THE TENS OF BILLIONS
OF DOLLARS FOR EXAMPLE THAT WE
WOULD HAVE LOST UNDER THE
VARIOUS FEDERAL PROPOSALS THAT
WE WERE CONSIDERING LAST YEAR
LET IT TO IT. IT'S AND IT'S IT'S
A SCALE THAT IS DOABLE WE UP THE
HOPE THAT WE CAN EVEN MAKE
PROGRESS WITHIN THE BUDGET. BUT.
BUT BUT TO DO THE WHOLE THING
WOULD BE IT WOULD REQUIRE SOME
RAISING REVENUES BUT BUT ON A
SCALE THAT WOULD BEASTS
CERTAINLY MANAGEABLE.
AND THEN A FOLLOW UP FOR THAT.
YOU TALK ABOUT HEALTHCARE
PRICES NO UNJUSTIFIED MEDICAL
BILLS BEYOND BENCHMARKS DE OF
SPECIFICITY AND WHAT THAT LOOKS
LIKE IT'S THIS SOUNDS LIKE. THE
OP HERE CAP
IT FROM MARYLAND AND I'M NOT
SURE IF YOU MEANT THAT TO BE THE
CASE BUT CURE SO I MEAN I THINK
THERE ARE DIFFERENT MODELS ABOUT
HOW YOU COULD DO A A HOW YOU
COULD DO THIS I THINK YOU COULD
LOOK AT.
.
BY YOU AGAIN ESPECIALLY SINCE SO
MANY PROVIDERS DO TAKE MEDICARE
LOOKING AT THAT AS A AS A AS A
STARTING POINT BUT AND THEN
SEEING WHERE THERE NEEDS TO BE
ADJUSTMENTS ACCORDINGLY SIMILAR
TO HOW TO SURPRISE MEDICAL BILL
LAW THAT.
THIS LEGISLATURE ADOPTED NOT
TOO LONG AGO DID DID WHERE YOU
START WITH A CERTAIN OF
BENCHMARK WOULDN'T ALLOW IT
DISPUTE RESOLUTION PROCESS TO GO
OVER IT I THINK THERE ARE OTHER
MODELS AS WELL SO I DID I. I
THINK YOU KNOW YOU YOU COULD SEE
MARILYN'S ONE MODEL WE CAN
GREATER ON CALIFORNIA MODEL BUT
THIS IS THE MECHANISM THAT.
WE WE WILL HAVE TO HAVE WHETHER
BY.
EIGHT EIGHT IN ORDER TO DEAL
WITH THE ISSUE OF WHY ARE PRICES
SO HIGH AND WHY DO THEY GO UP
HIGHER I MEAN AS WE SAID WITH
PRESCRIPTION DRUG PRICES. YEAH
IT'S WHEN WINDOWS PRICES GO UP
BY THREE HUNDRED FOUR HUNDRED
FIVE HUNDRED PERCENT IT'S NOT
LIKE THE.
MADE IT MEDICATION BECAME THREE
HUNDRED FOUR HUNDRED FIVE
PERCENT MORE EFFECTIVE.
SO SO SO THEN.
TO WHAT IS WHAT IS THE ISSUE
AND YOU KNOW AGAIN WE DO THIS IN
THE PUBLIC UTILITY WORLD AS WELL
WELL AND YOU KNOW THAT'S AND
MAYBE NOT THE PERFECT MODEL BUT.
OUT WE RECOGNIZE THAT WHEN THERE
IS A AYE A CONCENTRATED MONOPOLY
FOR IN THE CENTER OR OLIGOPOLY
FOR AN ESSENTIAL SERVICE THAT
WE'VE IT WE TRY TO SAY OF A DAD.
THE OF THE COMPANIES PROVIDING
IT CAN.
.
I GET THE THE REVENUE THEY NEED
TO PROVIDE THE SERVICE AND NOW
BUT THEY NEED TO JUSTIFY WHAT
WHAT WHAT HOW DOES EXPENSES ARE
THEN THERE ARE DEBATES UNIT OUT
ABOUT. DO OF WITH REGARD TO THE
INVESTMENTS THEY MAKE WITH
REGARD TO A BUILDING THERE AND
WHAT THEY'RE TO
TELECOMMUNICATIONS NETWORK OR
CABLE NETWORK OR WHATEVER.
I'M JUST ONE COMMENTED ON THE
ISSUE OF HEALTH CARE ALL OF YOU
KNOW I THINK A NUMBER OF YOU
KNOW THIS BUT.
I'M PREPARED AND I THINK THEIR
NUMBER OF US WHO ARE PREPARED TO
AUTHOR THAT BILL CHO AUTHOR THAT
BILL VOTE ON THAT BILL TODAY.
SO I JUST WANT TO SAY THAT THIS
IS SOMETHING THAT SHOULD HAPPEN
YEARS AGO AND.
I THINK WE NEED TO A FEW TO GET
THAT DONE.
NUMBER COUPLE QUESTIONS TO.
TO THE CALIFORNIA LABOR
FEMINISTS THINK THINK YOU FOR
THAT SURE IF YOU CAN.
SO JEWISH ARE YOU PROPOSING
THAT WE CONSIDER THE MARYLAND
ALL PAYER.
RIGHT MODEL HERE IN CALIFORNIA.
I KNOW YOU LAID IT OUT BUT I
WASN'T SURE IF IT WAS A PROPOSAL
COMING FROM THE CALIFORNIA LABOR
FAN NO WE WERE.
BASICALLY WHAT. WE DID FOR OUR
PROPOSAL WAS PUT OUT A NUMBER OF
DIFFERENT MODELS.
AND OUR CORE SET OF PRINCIPLES
AND SAY THAT WE DEFINITELY YOU
KNOW MARYLAND IS A VERY VERY
DIFFERENT STATE THING CALIFORNIA
WE NEED TO LOOK AT.
OUR STATE THAT LEVEL OF MANAGED
CARE WE HAVE SOCIETIES THE
NUMBER OF HOSPITALS EVERYTHING
AND FIND.
PERFECT A MODEL THAT FITS OUR
STATE AND SO THAT WORK NEEDS TO
BE DONE.
IF I HAD MORE TIME I COULD HAVE
GONE INTO A WHOLE LOT MORE
EXAMPLES.
INCLUDING MASSACHUSETTS AND
VERMONT AND WEST VIRGINIA.
JAPAN AND OTHER COUNTRIES.
AND ALSO YOU KNOW ANTHONY
RAISED UTILITY STYLE.
REGULATION THERE'S EXAMPLES IN
THE NON HEALTH CARE SPEARS WELL.
THAT COULD BE USEFUL AND SO. I
THINK WE NEED TO TAKE ALL OF
THESE PIECES THAT WE HAVE IN ALL
OF THE EXPERTS THAT YOU'VE HEARD
FROM AND FIGURE OUT WHAT'S THE
BEST.
WHAT'S THE BEST FIT FOR OUR
STATE.
OKAY IN I JUST WANTED OBSERVE
RIGHT I'VE ABSOLUTE PRECIADO
YOUR CORE PRINCIPLES BUILDING
TOWARD A UNIVERSAL SYSTEM
CONTAINING COSTS INCREASING
QUALITY IMPROVING HEALTH
OUTCOMES.
SIMPLICITY TRANSPARENCY BUT
OBVIOUSLY THERE ARE PRINCIPLES
AND I'D LOVE I THINK WE'D ALL
LOVE CHO KIND CONCRETE PROPOSALS
COMING FROM. STAKEHOLDER SO THAT
WE CAN START SIFTING AND AND
COMPARING.
.
ANOTHER QUESTION.
ANOTHER QUESTION IS AROUND WHICH
OF THESE UP OPTIONS WOULD
REQUIRE FEDERAL WAIVER SOME
ASSUMING PUBLIC OPTION IF WE
WERE TO MOVE FORWARD IN THE
PUBLIC OPTION WORLD THAT WOULD
REQUIRE A WAIVER. MARILYN APPEAR
RATE WOULD REQUIRE I HAVE BEEN
READINGDIFFERENT THINGS ABOUT
THAT NOW WE COULD WE COULD JUST
EXPAND THAT HERE.
I MEAN IT'S DUBBED THE POINT MY
SLIDES IS THAT I.
OR YOU WAS TO TRY TO SIFT
THROUGH AND PROVIDE PROVIDE THE
COMMITTEE OPTIONS OF WHAT WE
BELIEVE. WHAT IS DOABLE WITHOUT
OF FEDERAL APPROVALS BECAUSE?
WE ARE CONSISTENT YOU KNOW
CONCERNED EVEN PROPOSING SOME
APRIL OF A TO THE FEDERAL
GOVERNMENT AT THIS TIME WOULD
OPEN THE DOOR THAT WOULD HAVE
UNINTENDED CONSEQUENCES I MEAN
AND I. AND I. AND I SAY THIS
SOMEBODY WHO WORKING WITH MY
FRIENDS AT THE IMMIGRANT POLICY
CENTER YOU KNOW HAD A THIRTEEN
THIRTY TO WAVER YOU KNOW ON. THE
FOR THE FEDERAL GOVERNMENT'S.
YOU GO ABOUT TRYING TO OPEN UP
COVER CALIFORNIA TO.
.
TO ALL CALIFORNIA'S REGARDLESS
IMMIGRATION STATUS BUT THAT YOU
KNOW I THINK IT WAS WISE TO HAVE
WITHDRAWN. THROUGH THAT BECAUSE
YOU DIDN'T EVEN WANT TO SET THE
PRECEDENCE OF WHAT WHAT THE
FEDERAL GOVERNMENT. COULD HAVE
DONE WITH THAT
SO. NOW. I'M I'M
IT'S CERTAINLY THE CASE THAT
THERE MAYBE VERSIONS OF A PUBLIC
OPTION OR VERSIONS OF IT ALL
PAYER CLAIMS DATABASE THAT WOULD
REQUIRE SOME FEDERALLY MERRILEES
HAVE TO GET THEM AND I MISS. IT
DO IT BUT I THINK THAT THERE ARE
VERSIONS OF IT THAT DO NOT
REQUIRE IT AND THAT'S AND AND
THAT'S WHAT I'M SAYING SO. IT'S
CERTAINLY THE CASE THAT ARE
PROBABLY VERSIONS OF IT THAT ARE
MORE.
MORE ROBUST BUT WE DO WE DO
THAT WE SEE A PATH WHERE DOES
NOT REQUIRED TO SORT OF.
THE ROAD BLOCK OF THOSE OF
FEDERAL OF PERMISSIONS EITHER
ADMINISTRATIVE OR AN ACT OF
CONGRESS CONTINENT JUST A FINAL.
QUESTION ON TURN AROUND MY BRAIN
AROUND SO I THINK WE ALL HEARD A
FORMER VERMONT GOVERNOR SHUMLIN.
TELL US AND WAS REALLY
INTERESTING TO HEAR FROM HIM
FROM HIS PERSPECTIVE WE NEED TO
TACKLE COST CONTAINMENT FIRST.
AND I I I THINK THAT MAKES SENSE
EXCEPT FOR THE FACT THAT.
IN EVERY STATE IN THE COUNTRY
FOR DECADES.
WE'VE ALL BEEN TRIED TO COST.
AND AND IT'S BEEN VERY VERY
DIFFICULT AND AND WE HAVE BEEN
ABLE TO FIGURE IT OUT. AND I
KNOW SOMEONE SAID WE SHOULD
FIGURE OUT HOW TO SUCK ACOSTA
FOR CONSIDERING SINGLE PAYER I'M
NOT SURE IF THAT'S YOUR
PERSPECTIVE BUT. IT SEEMS TO ME
THAT SINGLE PAYER HAS AN OBVIOUS
SOLUTION AND HOW YOU TO
LOS.
AND SO.
HOW SHOULD WE THINK ABOUT
VARIOUS COST CONTAINMENT EFFORTS
AND HOW WE?
PARALLEL TRACK.
HOW WE THINK ABOUT SINGLE PAYER
VERSUS THINKING ABOUT TACKLING
COST CONTAINMENT IF IF IF WE'VE
BEEN ALL? I MEAN AT THIS POINT
WE CAN ALL AGREE ON PRINCIPLES
BUT WE HAVE NOT BEEN ABLE TO
TACKLE COSTS.
FOR DECADES SO HOW HO SHOULD WE
THINK ABOUT THAT.
WHILE OTHER BACK TO WHAT. I
GOVERNOR SOMEONE SAID IN THE
HEARING. AND IN WHAT I REMEMBER
HIM SAYING IS IS THAT.
HE WAS SAYING THAT EVEN IN A
UNIVERSAL HEALTHCARE SYSTEM EVEN
IN A SINGLE PAYER SYSTEM. YOU
ARE STILL GONNA HAVE THE RISING
PRICES.
THE RISING PRICES OF HEALTH CARE
SERVICES YOU DEFINITELY GET.
UP HUGE ONE TIME AND ONGOING
SAVINGS FROM ELIMINATING
INSURANCE COMPANIES.
GET RID OF THEM AND THE
BUREAUCRACY AND THE
ADMINISTRATION.
BUT.
YOU STILL HAVE TO REIMBURSE AND
PAY HOSPITALS DOCTORS.
CAPTION DRUG COMPANIES.
AND SO THERE NEEDS TO BE A
EXPLICIT AFFECTED OF ROBUST.
COST CONTAINMENT ELEMENT THAT IS
PART OF ANY SINGLE PAYER
UNIVERSAL HEALTHCARE SYSTEM AND
THAT.
THAT HAS TO BE EXPLICIT.
AND SO I THINK THAT SINCE THAT
IS A REALLY DIFFICULT PIECE LIKE
YOU SAD WE'VE BEEN GRAPPLING
WITH THIS FOR DECADES UPON
DECADES.
WE NEED TO FIGURE OUT HOW TO
GET THIS RIGHT.
AND TAKE BOLD ACTION SO THAT
WE ARE ABLE TO REDUCE THE COST
OF HEALTHCARE AS WE MOVE TO A
SINGLE PAYER SYSTEM WHICH
RESULTS IN. HAVING TO PAY LAUGHS
ON THE PUBLIC SIDE.
BECAUSE IT WE MOVED TO A
PUBLICLY FINANCED SYSTEM.
WORK THERE'S MONEY COMING FROM
SOMEWHERE SOMEONE PACE AND SO WE
WANT TO MAKE SURE THAT THAT IS
AT A REASONABLE AND SUSTAINABLE
RATE.
BUT ISN'T ANY PART OF THE VISION
A SINGLE PAYER AND I'M AND I'M
TRULY OBVIOUS EPONA SUPPORTER
SINGLE PAYER BUT I'M THE ONE TO
HAVE A DIALOGUE.
PART OF THE COST SAVINGS IS FROM
WHAT HAPPENS WITH THE INSURANCE
INDUSTRY BUT PART OF THE COST
SAVINGS COMES FROM. THE CLERK TO
PURCHASING POWER OF A SINGLE
PAYER
AND HOW THEY NEGOTIATE WITH
DOCTORS AND HOSPITALS.
AND FORMA AND OTHER ACTORS IN
THE SYSTEM SO HOW DO YOU IT HURT
YOU MODEL THAT IF YOU.
BUT YOU CAN'T REALLY MODEL THAT
IN AYE IN A IN A SEPARATE COST
CONTAINMENT EFFORT THAT IS NOT
TIED TO SEE.
I'M.
I MEAN I THINK THAT'S ABSOLUTELY
RIGHT THAT THAT YOU KNOW. IT.
S. AS SUPPORTERS A SINGLE PAYER
THE THAT PART OF IT IS THE
GETTING RID US OF.
DONE THE MIDDLE. DOES TO
ADMINISTRATIVE BUREAUCRACY
SIMPLIFYING THOSE TYPES OF
ISSUES BUT BUT STILL EVEN IF YOU
DO THAT YOU'RE STILL LIKE AGAIN
EIGHTY PERCENT OF OUR COSTS ARE
DOCTORS HOSPITALS DRUG COMPANIES
EXIT IF THE PLUS OF EACH
ARM. POLY NINETY EIGHTY WERE
ANYWHERE FROM EIGHTY TO NINETY
PERCENT OF SO THE QUESTION IS
THIS UNIT PRICE ISSUE.
AND AGAIN I THINK.
THOUGH THE WAY THAT IT THAT THIS
COUNTRY HAS HAS TRIED IS IS
THROUGH COMPETITION BUT THERE IS
OF IT ALLY AND.
THE THREE WAYS THAT YOU TRY TO
DO IT THIS IS COMPETITION
NEGOTIATION OR OF REGULATION. BY
THE THAT COMPETITION IS NOT WORK
PARTICULARLY WELL BECAUSE
AT THE END OF THE DAY.
CONSUMERS PURCHASERS WHETHER
THEY BE BUSINESS OR LABOR DON'T
HAVE THE ABILITY TO SAY NO.
RIGHT IF YOU HEALTH CARE YOU
YOU'RE JUST NOT AND IF IT DID I
YOU'RE NOT IN THE SPACE TO DO
THAT AND CUTS AND CLASSIC MORE
HOUSE.
RIGHT EXACTLY AND IF IT IS NOT A.
AND IT'S ALSO SUCH A
CONSOLIDATED FEEL THAT THAT ARE
THERE ARE MORTGAGE. IT AT AT
BEST MARKET FAILURES
SO THEN THE QUESTION IS.
WHAT OTHER MECHANISM DO YOU USE
TO HAVE SOME OVERSIGHT AND
REVIEW VIEW OF OVER PRICES AND?
THE.
THE AND WHETHER IT'S IN A SINGLE
NOW IN THE IN OTHER COUNTRIES
WHETHER IT'S A SINGLE PAYER
SYSTEM OR A MULTI OF THE PAYERS
SYSTEM. THEY USE EITHER THOUGH
THE PURCHASING POWER OF THE
GOVERNMENT OR THE REGULAR TO.
TORY PARA THE GOVERNMENT TO DO
TO PUT TO PROVIDE THAT OVERSIGHT
AND TO THEN AND THE COURT THE
QUESTION IS CAN WE BILL THAT.
MECHANISM EVEN ABSENT SOME OF
THE OTHER COMPONENTS AS A AS A
STEP ESTEPONA AS LIKE THE
INFRASTRUCTURE THAT YOU WOULD
NEED FOR THE FOR. AYE BUT
OVERALL SINGLE PAYER SYSTEM THAT
THAT'S WHERE.
JUST LEGISLATURE OTHER OR
FUTURE LEGISLATORS DECIDE TO GO
THE.
I MEAN AND IT'S SOMETHING THAT
FRANKLY NEEDS TO BE FLESHED OUT
IN THE FIVE SIX TWO PROPOSALS
TERRACE AS YOU KNOW WE SUPPORT
FIVE SIX TWO WE PUT ON OUR
SCORECARD. ON BUT IS ONE OF THE
QUESTIONS THAT WE HAD WAS ARMED
THAT IT BUILDS THIS GREAT
PURCHASING POOL OF FORTY MILLION
CALIFORNIANS. BUT THERE'S NOT
NECESSARILY THE ID SPELLED OUT
THE EXACT MECHANISM OF HOW.
IT WOULD NEGOTIATE WITH THE
DRUG COMPANIES IF YOU DON'T
NECESSARILY HAVE A FORMULARY AND
I AND I KNOW THERE WAS SOME
DISCUSSION THE EARLIER PANEL
ABOUT.
IS ENVISIONED ARE NOT HER OI
EATS IT'S NOT SPELLED OUT AGAIN.
DISPENSERS ARE CLEAR THAT THEY
DID
DILLON DID NOT GO INTO A CERTAIN
LEVEL OF DETAIL WITH AND THAT'S
WHERE THE DETAILS ARE ABOUT HOW
DO YOU NEGOTIATE TO THE DRUG
COMPANIES GET TO THIS GET TO
DECIDE. IF YOU IF YOU'RE SETTING
UP A SINGLE PAYER SYSTEM AND
SAYING YOU'RE COVERING EVERY
DRUG. IN THE DRUG COMPANIES WILL
THEN SAY TIME WILL CHARGE
WHATEVER WE WANT UNLESS YOU HAVE
SOME SORT MECHANISM AND IT
DOESN'T HAVE TO BE FORMULARIES
BUT THEN THE QUESTION IS WHAT IS
IT. TO THEN BE ABLE TO AND TOOK
TO MAKE THAT NEGOTIATING POWER
HAPPEN AND SO YOU NEED TO CREATE
A MECHANISM ONE WAY OR ANOTHER.
WE'RE SUGGESTING.
I DID YEAH THAT WE SHOULD MOVE
FORWARD WITH THAT PROJECT.
POST HASTE
BECAUSE WE'RE GONNA NEED IT
REGARDLESS OF WHAT WE DO.
OKAY.
NUMBER ONE.
FINAL QUESTION WHAT DO YOU ALL
THINK ABOUT CHINA BRING BACK AN
INDIVIDUAL MAN
TO CALIFORNIA I NOTICED THAT WAS
NOT.
MENTION IN ANY THE PROPOSAL'S
SO FARMS. SO I I'M ACTUALLY I
THINK I'D GO I THINK YOU DID
YEAH AND ITALY TO I MEAN
ABSOLUTELY I THINK THAT WE'VE
SEEN AT THAT.
MARKETS ARE MOST STABLE AND COST
SPREAD OUT ARE. MINIMIZED
THEY'LL COST INCREASE OR
MINIMIZE THE MOST WE HAVE MORE
PEOPLE IN THE SYSTEM.
SO I'VE WHATEVER LEGAL.
WAIT THEY CAN BE DONE TO ENSURE
THAT YOU'RE GETTING EVERYONE IN
THE SYSTEM WE ALL KNOW A MANDATE
A PENALTY DOESN'T SURE
EVERYBODY'S IN THE SYSTEM.
EVEN THOSE WHO ARE ELIGIBLE BUT.
YOU KNOW THERE'S NO.
IT IS AN ADDITIONAL TOOL IN THE
ARSENAL. AND.
OBVIOUSLY WE NEED TO WAIT TO
SEE WHAT'S GOING TO HAPPEN
NATIONWIDE WITH A MANDATE BEING
PULLED BACK.
BUT ABSOLUTELY IT TO THE EXTENT
THAT THAT.
THAT REQUIREMENT CAN BE IN
PLACE AND CAN HAVE SOME IMPACT
ON PEOPLE JOINING THE
SYSTEMATICALLY YOUNGER HEALTHIER
PEOPLE BUT WE THINK THAT HELPS
BRING DOWN COSTS STABILIZE
MARKETS.
AND IN HEALTHAXIS AND
I WOULD I WOULD I AS A SUDDEN IN
MY PRESENTATION THAT HAPPY TO
REPEAT THE. I THINK WE THINK
THAT THE AND NUMBER ONE DRIVER
OF.
ENROLLMENT
HAS BEEN THE SUBSIDIES NOT A
PENALTY THAT THAT HAS BEEN WHAT
WHAT HAS BEEN ENCOURAGING PEOPLE
TO GET CITED CITY IT'S THE IT'S
THE PARENTS NOT TO STICKS.
AND SO WE DO THINK THAT.
ARE TO STABILIZE THE MARKETS
THAT WE DON'T HAVE THE IMPACTS
OF THE REPEAL OF THE MANDATE
WHICH THE CBO SCORED AT A TECH
YOU KNOW IT EIGHT TO TEN PERCENT
INCREASE IN PREMIUMS. WHICH ARE
UC BERKELEY ESTIMATED WOULD
LEAVE ABOUT ONE POINT SEVEN.
MILLION CALIFORNIANS.
WROTE OVER ARE LOSING COVERAGE.
AND THE IMPACTS OF THAT
INCLUDING FOLKS WHO MAIN WHO MAY
DECIDE NOT TO SIGN UP FOR MEDI
CAL OR OTHER PRO PROGRAMS AS A
RESULT.
THAT HAVING AN AFFORDABILITY
PACKAGE THAT ENCOURAGES PEOPLE
TO ENROLLED IF IT IS. ARE IN
PART FUNDED BY A CONTRIBUTION BY
INDIVIDUALS TO ADD TO YOUR WHO
WHO ARE NOT PAYING INTO THE
SYSTEM. THAT WOULD BE
APPROPRIATE IF WE THINK THAT
THAT CALIFORNIA COULD COULDN'T
SHOULD DESIGNED ONE THAT'S MAYBE
MORE PROGRESSIVE THAN WHAT THE
WHAT WITH THE FEDERAL GOVERNMENT
PROPOSED. WE ALSO THINK THAT THE.
THE MECHANISM OF HAVING.
JUST THE PROMPT.
AT.
AT TAX TIME IS JUST A HELPFUL
ENCOURAGEMENT TO REMIND PEOPLE
TO TO GET COVERED SO THEY DON'T
THEY ARE NOT IN A SITUATION
WHERE THEY FIND THEMSELVES.
AS THE COVER CAL COUPLING A
COMMERCIAL HAD YOU KNOW ON THE
ROOF PUTTING UP THE CHRISTMAS
LIGHTS IN.
IN A HAVING A AT IT AND HAVING
OF A MOMENT AT THE E. ARE.
THAT.
THAT I DIED THERE ARE IT IT IS
THERE'S INTO USEFUL KNOWLEDGE TO
GET FOLKS THERE BUT I THINK THE
THE PRIMARY FOCUS SHOULD BE ON
AFFORDABILITY AND THAT'S WHAT WE
WERE KIND OF.
I'M JUST ONE FINAL COMMENT WHICH
IS I FEAR MUCH APPRECIATE.
YOUR PRESENTATIONS AND AND I'VE
HAD MEETINGS I THINK WITH ALMOST
ALL OF YOU IN YOUR ORGANIZATIONS
TO TALK THROUGH. UP OPTIONS.
I THINK FOR US WE'RE ALL STILL
LOOKING FOR THAT NEXT LEVEL OF
SPECIFICITY AROUND PROPOSALS.
ARM AND AND I KNOW THERE BEEN A
LOT OF.
THERE BEEN A LOT OF SHOTS TAKEN
AT AT THAT FOR SIXTY TWO FOR
SOME LEVELS OF ON SPECIFICITY
BUT I WOULD SAY IN THE OTHER
HAND. WE'RE ALSO JUST WAITING
FOR OTHER IDEAS AND IF WE AND IN
THE ABSENCE OF IDEAS WE HAVE
SOMETHING HERE THAT THAT WE'RE
CONSIDERING.
AND I WOULD ALSO NOTE THAT I
KNOW THAT ALL OF YOU HAD WANTED
TO PARTICIPATE. IN TODAY'S PANEL
BUT IT'SVERY NOTICEABLE THAT
THERE ARE MANY PLAYERS THAT HAVE
NOT OFFERED PROPOSALS.
AND I SAY THIS WITH GREATEST
RESPECT AS A SON OF A DOCTOR TO
THE DOCTORS TO HOSPITALS TO
INSURERS TO PHARMA. THERE SO
MANY OTHER PLAYERS IN THIS
WE NEED EVERYONE.
TO EITHER GIVE US YOUR BEST
IDEAS OR OR OR OR OR OR HELP US
FIGURE THIS OUT BECAUSE.
WE HAVE TO WE HAVE TO DO
SOMETHING SO I JUST WANT TO SAY
THAT AND AGAIN THANK YOU FOR
YOUR PRESENTATION.
MISS WALDRON.
THANK YOU MISTER CHAIRMAN A.
LOTS OF GOOD DISCUSSION.
SOURCE ABOUT THE FORMULAS
CONCERT WAS ONE OF THE QUESTIONS
I HAD.
.
WE. YOU KNOW WILL ISSUE OF
EXCESS ACCESS AND TREATMENT
WHICH IS ALWAYS THAT.
COMES UP AGAINST THE FORMULARY.
REMAIN A PROBLEM ONGOING IF WE
MOVE TO ANOTHER SYSTEM.
REASONING BECAUSE.
IN I BELIEVE THE DOCTORS SHOULD
ACTUALLY HAVE THE SAME WHAT
TREATMENT THE PATIENTS GET BUT
ALL THAT'S KIND OF UNHEARD OF IN
THE CURRENT SYSTEM.
AND WILL BE UNHEARD OF IN A NEW
SYSTEM I MEAN HOW DO ENVISIONED
IT BECAUSE COST CONTROL IS AN
ISSUE.
BUT YOU KNOW I'VE ALWAYS
ADVOCATED THAT IF YOU GET THE
BEST TREATMENTS OF FRONT YOU
ACTUALLY CAN SAVE MONEY IN THE
LONG RUN INCLUDING
HOSPITALIZATION RATES.
.
JUST YOU KNOW COMMUNITY VIRAL
LOAD IF IT'S AN ISSUE OF.
INFECTIOUS DISEASE.
QUALITY OF LIFE FOR THE
PATIENTS A CORRECTION MAYBE GO
BACK TO WORK NOT HAVE TO HAVE A
TRANSPLANT OR SOMETHING LIKE
THAT. I MEAN WHERE WILL THIS NEW
SYSTEM FALL AND MAYBE IN THOSE
BUSINESSES CHOOSE SAY WE WOULD
NEED SPECIFICITY BECAUSE WHEN IT
COMES DOWN TO BRASS TACKS THAT'S
HOW WE'RE GOING TO MAKE YOUR
DECISIONS.
IF WE JUST HAVE THE SAME KIND
OF SYSTEM WE HAVE NOW THAT WE
SOLVE THE PROBLEM OF ACCESS.
.
I WOULD SAY THAT I THINK IN
TERMS OF.
I THINK THERE'S ALWAYS A BALANCE
BETWEEN HOW DO YOU MAKE SURE YOU
HAVE THE BROADEST MAD ABOUT
ACCESS
A CARE THAT IS.
AND YOU KNOW WE HAVE MY
ORGANIZATION IS AND YOU KNOW THE
NAME OF ORGANIZATIONS HEALTH
ACCESS WE FOUGHT FOR. EVERYTHING
OPERATE YOU KNOW FOR EACH MO
PATIENTS BILL OF RIGHTS OVER A
DECADE AGO TO MAKE SURE THAT
PEOPLE ARE NOT TONIGHT MEDICALLY
NECESSARY CHAIR THAT DATA ABOUT
THE INDEPENDENT MEDICAL REVIEW
TO.
EARLIER WAS.
WAS THE RESULT OF SOME OF THE
WORK THAT YOU KNOW WE HAVE DONE
AND CONTINUE TO DO TO MAKE SURE
THE PEOPLE ARE NOT DENIED FROM
FROM MEDICALLY NECESSARY CARE.
THAT THERE THAT THERE WAS AN
INDEPENDENT MEDICAL REVIEW
PROCESS SO THAT PEOPLE IT.
DOT DOES ENSURE CHINA'S
COMPANIES ARE OVERTURNED WHEN
THEY ARE DONE. DENYING THAT CARE.
NOT TO SAY THAT THE PROBLEM IS
ENTIRELY SOLVE BUT THAT THAT
THAT WAS AN IMPORTANT FIRST STEP
FOR PEOPLE TO GET THE JUSTICE
THEY NEED.
AND THE CARE THAT THEY NEED I
THINK IN TERMS OF AYE AND
WHETHER IT IS WITH MARTIN
NETWORKS WHETHER YOU WHETHER
IT'S REGARD TO FORMULARIES I
THINK THAT'S ALWAYS THE BALANCE
I DO. THINK ARE THERE IS ALWAYS
A BALANCE BETWEEN THAT AND IN
THE IN THE REALM OF COST CONTROL
BECAUSE WE ALSO AS A CONSUMER
ADVOCATE I ALSO.
.
THINK IT IS APPROPRIATE TO HAVE.
A MECHANISM TO BE ABLE TO COULD
TO BARGAIN FOR THE BEST PRICE
AND FOR THE BEST QUALITY. THAT
IF THERE IS A PROVIDER OR A
HOSPITAL OR WHATEVER THAT IS
PROVIDING PARTICULARLY POOR
QUALITY THAT THERE IS A MECCA IT
OF OUR OR.
OR LOW QUALITY HIGH COST
CARE THAT THERE IS A MECHANISM
TO STE
STEER OF. PATIENTS AWAY FROM
THAT BECAUSE THAT'S NOT IN
ANYBODY'S INTEREST.
INCLUDING THE PATIENTS UPDATE
IF THERE IS THAT CASE AND SO.
THAT I THINK THAT THERE IS A ROW
OF ONLY A ROLE FOR THOSE
MECHANISMS AND THAT'S SOMETHING
THAT. NEEDS THAT ARE HE'S
REPLACED OUT IT SHOULDN'T BE
DRIVEN BY PROFIT IT SHOULDN'T BE
DID I DROVE DRIVEN BY THE. OF BY
THE NEEDS OF ENSURE YOUNG
ADVENTURERS BEHIND CLOSED DOORS
IT SHOULD BE IN A YOU KNOW POKE
PUBLIC IN OPEN PROCESS SEIZE AND
THAT'S WHAT ONE OF THE REASONS
WHY. WE WE WOULD LIKE A WELL
DESIGNED SINGLE PAYER SYSTEM
THAT ADDRESSES THAT ISSUE BUT.
AND AND I THINK THAT THAT'S
SOMETHING THAT WE NEED TO BE
MINDFUL AS WE ARE.
TAKE A STEPS FOR COST CONTROL
BUT WE DON'T. AT THE END OF THE
DAY WE DON'T THINK THAT THE
ISSUE OF COST.
SHOULD HAVE AN IMPACT ON QUALITY
ARE ACCESS AGAIN IT IT'S THIS
UNIT IT'S NOT BECAUSE WE USED
HIM.
IT'S NOT BECAUSE WE USE TOO MUCH
HEALTH CARE AND.
IT'S IT'S BECAUSE OF THE PRICE
AND SO THE MORE WE HAD ADDRESS
JUST WHY THAT UNIT PRICES SO
HIGH A WHITE GOES UP AT IN THIS
IS UNSUSTAINABLE RATE.
I I DID THAT'S THE THAT'S THE
ISSUE THAT WE HAVE TO GET TO AND
THAT WE SHOULD GET TO AND
IMMEDIATELY.
AND WE CAN MOVE FORWARD WITH
THAT.
EVEN DESPITE SOME THE OTHER
OBSTACLES THAT EXIST.
I'M WE WERE TALKING ABOUT
MARYLAND'S A LITTLE BIT AND I
HAD PULLED MY NOTES FROM THE
PREVIOUS HEARINGS ALL WE HAD
MARILYN AND THE COST CONTROL WAS
THE TOPIC.
AND YOU KNOW I FULLY AGREE IF
ANYTHING THAT WE MOVE FORWARD
WITH WE HAVE TO GET A HANDLE ON
THE COST BEFORE WE JUST CARRY
THE BAGGAGE.
YOU KNOW WITH US TO OF ANY OTHER
SYSTEM.ONE OF THE THINGS
MARILYN DID AND YOU KNOW TRYING
TO. REFILL MY OWN NOTES HERE.
WAS.
THEY COMBINE YOU KNOW WHEN THEY
LOOK AT PRICE THEY LOOK AT
UTILIZATION ALSO SO THAT KIND OF
CONTROLLING ON BOTH ENDS.
.
AND I'M A LITTLE CONCERNED ON
PART OF IT BECAUSE THEY SAID
INSTEAD OF INCREASEDLIKE HOW IT
IS CURRENTLY THE MORE PEOPLE
THAT COME IN THE MORE MONEY
THAT'S MADE BECAUSE YOU HAVE
MORE PEOPLE GO THROUGH THE
SYSTEM MORE PEOPLE PAYING.
BUT SO INSTEAD OF INCREASING
UTILIZATION RATES TO MAKE MORE
MONEY THE PROGRAM WILL SIMPLY
INCREASE THEIR BUDGET BY GREAT
OF GROWTH EVERY YEAR. ON THE IS
AN EXAMPLE OF SIZE TWO PERCENT
YOU HAVE THERE BEEN SO MANY MORE
PEOPLE IT'S INCREASE OF BODIES
THIS AMOUNT.
SO IT DOESN'T MATTER HOW MANY
PEOPLE HAVE SEEN SO IT'S NOT
BASED ON THE UTILIZATION IS JUST
MONEY CAPPED.
AND IT'S AN EFFORT TO REDUCE
HOSPITALIZATION MISTAKES THEY'RE
SAYING READMISSIONS INFECTIONS
SPREAD AT CENTER BECAUSE THE
BUDGET CAP BUT. MY CONCERN IS.
THAT PEOPLE AREN'T GETTING CARE.
THIS
YOU CAN ONLY SQUEEZE SO MANY
PEOPLE IN THE ON THE BUDGET.
I'M ONE OF THE THINGS I TALKED
ABOUT WAS IF.
A SYSTEM IS ACTUALLY EXCEEDING
AND THEY HAVE BETTER OUTCOMES
AND METALLICA WAY TO LOWER AND
YOU KNOW. PEOPLE GETTING KILLED
THEY DON'T HAVE THE INFECTION
RATES THERE'S A BONUS AIDED.
AS AN ENSIGN OF.
YOU KNOW AND THEN THE OTHER
SIDE OF THE COIN IS IF MORTALITY
RATES ARE HIGH OR THEY'RE NOT
TAKING CARE PEOPLE OR THEY HAVE
MORE HOSPITAL READMISSIONS.
WOULD THERE BE CUTS OF FINES.
TO INCENTIVIZE STAYING WITHIN
THE CAP I. I'M JUST GOING THAT
OUT THERE BECAUSE THAT IS.
YOU WERE TALKING ABOUT MARILYN
THE COSTS AND THINGS LIKE THAT
OF.
FOR THEM I AM NOT AN EXPERT ON
MARYLAND I ALMOST FEEL LIKE THE
NEXT HEARING SHOULD MAYBE BE IN
MARYLAND.
BUT.
AND MY UNDERSTANDING OF.
WHY MARYLAND HAD A KIND OF TWO
POINT KNOW? THAT SYSTEM WHY THEY
WANTED TO ADD THE. BUDGET CAP
WAS THAT WOULD IS KINDA GOING
BACK TO THE BALLOON ANALOGY THAT
I USE THEY WERE JUST LOOKING
THEIR SYSTEM WAS ALL PAYER RATE
SETTING. BUT IT WAS ONLY LOOKING
AT HOSPITALS.
AND ONLY LOOKING AT PRICES AND
SO THEY WERE SQUEEZING ON PRICES.
IN HOSPITALS AND THEN OVER TIME
SINCE THE SEVENTIES THERE'D BEEN
A COUPLE JUST SHIFTS IN THE
MARKET THERE WAS MORE. CARE
MOVING TO OUTPATIENT SETTINGS
THAT DIDN'T HAVE ANY PRICE
CONTROLS ON IT.
AND MARYLAND. HAD AN OVERALL
INCREASE I'VE BY AS I UNDERSTAND
IT IN HEALTH CARE SPENDING
BECAUSE THERE WAS SO MUCH
UTILIZATION THE IT REALLY HIGHER
RATES OF RE ADMISSIONS AND
HOSPITAL. ACQUIRED INFECTION.
SO. THERE WASN'T MAYBE THE
QUALITY AND THAT SHOULD HAVE
BEEN OUT THERE AND YOU KNOW EVEN
IF YOU HAVE VERY HIGH
UTILIZATION BUT. POOR QUALITY
YOU'RE NOT GONNA HAVE GREAT
HEALTH OUTCOMES
AND SO I THINK WHAT THEY WERE
TRYING TO DO WAS A LITTLE BIT OF
WHAT SOMETIMES ADVOCATES CALL
THE TRIPLER THE QUADRUPLE AIM.
IS THAT NOT ONLY ARE YOU
CONTAINING COSTS IN TERMS OF
PRICES AND UTILIZATION BUT YOU
ALSO HAVE TO MAKE SURE THAT YOU
ARE IMPROVING QUALITY. AND
OUTCOMES FOR PATIENTS.
AND SOMETIMES IMPROVING
OUTCOMES FOR PATIENTS MEANS.
DECREASING UTILIZATION BECAUSE
YOU DON'T WANT OVER DIAGNOSIS OR.
INAPPROPRIATE CARE.
AND SOMETIMES IT MEANS
INCREASING UTILIZATION BECAUSE
YOU WANT TO MAKE SURE YOU HAVE
THOSE PATIENTS WITH CHRONIC
DISEASES THAT ARE GETTING THE
PREVENTIVE CARE THAT THEY NEED
THAT THEY'RE GETTING THEIR
DIABETES MEDICATION THAT.
THEY'RE YOU KNOW THEY'RE NOT
SHOWING UP AT THE ER FOR THESE
VERY EXPENSIVE TREATMENT SO IT'S.
YOU KNOW AS AS THE THE CHAIRS
AND ALL THE MEMBERS OF THIS
COMMITTEE KNOW IT'S A VERY KIND
OF. COMPLEX DELICATE BALANCE
THAT I THINK THAT MARYLAND'S TWO
POINT NO WAS TRYING TO GET AT
THAT.
AND I AM TOTALLY NOT EXPERT AND
I DON'T THINK WE'VE TOTALLY SEEN
THE RESULTS I'D LOVE TO SEE MORE.
HAVE KIND OF WHAT CAME OUT OF
THERE THEIR EXPERIMENT.
THANK YOU SEE YOU KNOW THE
BOMBERS PUT MY HOPE.
OKAY JUST A COUPLE MORE THINGS
BECAUSE THEY FEEL A NEED TO SAY
SOME THINGS ON THE RECORD.
.
SO WE WERE TOUTING YOU KNOW HOW
MANY MORE PEOPLE WE'VE BEEN
ROLLED WITH COVER CALIFORNIA AND
YOU KNOW IT'S. FAR EXCEEDING THE
NATURE THE NATIONAL AVERAGE OF
GETTING PEOPLE INTO COVERAGE.
YOU KNOW WHEN YOU COMBINE.
WE. NEED MEDI CAL MEDICARE COVER
CALIFORNIA THE INDIVIDUAL THOSE
ON COMMERCIAL WERE AT ABOUT
NINETY TWO POINT FOUR PERCENT OF
THE FOLKS THAT COVERED AS WE
KNOW. AND THEN WE HAVE ABOUT
THREE MILLION YOU KNOW
UNDERINSURED OR NOT INSURED AT
ALL.
.
AND WE'VE KIND OF IDENTIFIED I
THINK ALL OF OUR COMMITTEES OF
IDENTIFIED SOME OF THE PROBLEMS
THAT KEEP RISING UP TO THE
SURFACE WHICH IS. THE
UNNECESSARY SERVICES THE NON
INSUREDS AND DENIALS.
UNDER INSURED BARACK OR SEE
MALPRACTICE THE STREAMLINING I
MEAN.
NO COST CONTAINMENT.
IMPROVEMENTS NEEDED ACCESS
ALWAYS ACCESS.
WHY THE BUT? IT'S JUST AN OPEN
QUESTION AS.
WHY? WOULD WE DISCARD WHAT WE'VE
DONE WHICH IS NINETY TWO POINT
FOUR PERCENT COVERAGE.
RATHER THAN FOCUS ON.
SOLVING SOME OF THE KEY PROBLEMS
THAT WE KNOW MAYBE WE CAN GET A
HANDLE ON A FOR YOU.
DID THAT RATHER AND START A
WHOLE NEW SYSTEM TRYING TO GO
AND GET THESE WAIVERS WITH AN
ADMINISTRATION THAT IS CLEARLY
NOT GONNA BE.
FAVORABLE THE CALIFORNIA THAT
COULD TAKE YEARS THAT. MAYBE
LEAVE FOLKS KIND OF.
YOU KNOW NEEDING CARE ENOUGH
GETTING INTO. THIS IS A OPEN
QUESTION.
CAN.
IS THAT NOT DOABLE.
SO WHENEVER I WOULD AGREE THAT.
THE PERSON WE NEED TO DO IS FIX
WE CAN FIX AND SHORT THE CV WITH
MADE TREMENDOUS GAINS OF THE ACA
I ALSO AGREE WITH ANTHONY THAT.
.
A ROBUST AND FUNCTIONING SYSTEM
BASED UPON THE ACA IS CAN BE
THAT MUCH CLOSER TO A MORE
COMPREHENSIVE UNIVERSAL SYSTEM I
DON'T THINK. BY WORKING ON THAT
WERE MOVING AWAY FROM A LONG
TERM SOLUTION I MEAN AS SOARING
REPRESENTS SMALL BUSINESS OWNERS
WHO THINK IT IS A CRAZY QUILT
SYSTEM I'M WELL YOU KNOW FIRST
OF ALL. OF HIS ARMS UP TO TAKE
THE TIME TO FIGURE OUT YOU KNOW
TO LEARN ABOUT IT WILL MAKE IT
OFF FROM WHAT I CAN OFFER NOW
THEY DON'T OFFER THEIR EMPLOYEES.
YOU KNOW HAVE THE CHOICE OF
GOING TO THE INDIVIDUAL EXCHANGE
OF OR MAYBE THEY'RE ELIGIBLE FOR
MEDI CAL I MEAN THAT DOESN'T
MEAN WE SHOULDN'T.
PROMOTE ALL THAT GOES ARE ALL
OPTIONS IT DIDN'T EXIST BEFORE.
BUT I DO THINK THAT.
.
BY DOING THAT.
WE'VE SOLVED NAM
WE DO OUR BEST TO SOLVE THOSE
PROBLEMS AND THEN WE ALSO PUT
OURSELVES IN A POSITION. TO
SIMULTANEOUSLY YOU KNOW WORK ON
POTENTIAL LONG TERM SOLUTIONS
WHICH TO HAVE FINANCIAL AND
LEGAL CONSEQUENCES THAT ARE
GOING TO BE FIXED IMMEDIATELY SO
DON'T THINK IT'S ONE VERSUS THE
OTHER.
AND I IT AND AND I WOULD AGREE I
DON'T I.
I DON'T THINK IT'S THE. THE
DIALECTIC OF A CA VERSES OF A
COMPLETELY DIFFERENT SYSTEM I
BELIEVE THAT THESE ARE ALL
WITHIN A IT OUT ALL WITHIN THE
SPECTRUM AND THAT THE ACA DID.
IT GET US CLOSER TO. A CLOSER TO
AND A LOT OF DIFFERENT WAYS AND
EXPANDING YOU KNOW JUST GETTING
MORE PEOPLE INTO THE INTO THE
HEALTH SYSTEM IN EXPANDING
PUBLICLY FINANCED COVERAGE IN IN
PROVIDING THOSE. OF OLD
PROVIDING ADDITIONAL JUST
RESOURCES THAT IS THAT COULD BE
IF IF IT ALL WORKS TOGETHER.
WERE ARE PUT PUT FOR AS A DOWN
PAYMENT TO THE FINANCING OF A
BROADER HEALTH CARE SYSTEM FOR
DEFINING WHAT THE TERM COVERAGE
IS AND WHAT IT YOU KNOW WHAT
WHICH ARE ESSENTIAL BENEFITS.
AND AND AND SETTING A STANDARD
FOR THAT PUTTING LIMITS AND AND
MAXIMUMS FOR CO PAYMENTS AND
DEDUCTIBLES EVEN IF WE THINK
THAT THEY'RE TOO HIGH THAT AT
LEAST PUT PUT SOME DEFINITIONS
AND STRUCTURES IN PLACE. THAT
THEN OF WE CAN ADJUST GOING
FORWARD.
IE IS AND I THINK IF WE CAN
TAKE ADDITIONAL STEPS WITH
REGARD TO COST WITH REGARD TO
YOU KNOW ADDRESSING SOME OF THE
ISSUES. THAT ARE ON OUR
OUTSTANDING IN OF IT WHETHER
IT'S THE ISSUE OF SHOULD ARE ALL
CALIFORNIANS INCLUDED REGARDLESS
OF IMMIGRATION STATUS AS BETSY
WAS TALKING ABOUT OR WHETHER
IT'S THE ISSUE.
IF IF WE CAN ADDRESS THAT ISSUE
THAT'S ONE LESS ISSUE THAN AND
WE.
AT HAVE TO DEAL WITH WITH THE
WITH THE NEXT STEP THAT. IN IN
REFORMING OUR HEALTHCARE SYSTEM
IF WE CAN DEAL WITH THE ISSUE OF
OF YOU KNOW DISH YOU KNOW. A
GETTING MORE PEOPLE IN COVERAGE.
THAT'S JUST
YOU ARE DEAD THAT MEANS THAT
JUST NARROWS AND NARROWS THE
FURTHER GAPS I DON'T. WE'D.
WE CERTAINLY DON'T BELIEVE THAT
THE DECISION EITHER OR THIS IS A
CONTINUUM AND WE.
WHERE LONGEST CONTINUE AND WE
UNDER AND WE APPRECIATE THAT
THERE? SOME PEOPLE ON THE DICE
THAT MAY HAVE DIFFERENT DESIRES
OF WHERE YOU WANT TO END UP ON
THAT CONTINUUM. AND AND AND SO I
WE HOPE THAT LIKE A THAT AGENDA
ON COST CONTAINMENT IS SOMETHING.
YOU KNOW LIKE.
LIKE THE WORK THAT WE DID LAST
YEAR ON PRESCRIPTION DRUGS IS
SOMETHING THAT FAX INTEREST FROM
BOTH SIDES OF THE AISLE. IT EVEN
IF YOU DON'T I'LL BUY INTO THE
FACT THAT THAT AND THAT IS.
.
I TAKES US ALL THE WAY TO A
SINGLE PAYER SYSTEM I DON'T
THINK YOU I THINK THAT WE CAN
HAVE SOME AGREEMENT ON THAT THE
NEXT COUPLE OF STEPS.
EVEN IF WE'RE NOT ALL THE EVEN
IF YOU DON'T BUY INTO WHERE'D
WHERE'D ALL IS BECAUSE THAT CAN
AGAIN I DON'T BELIEVE IT'S A
SLIPPERY SLOPE BUY BIT ARE. AND
HOW YOU MAY DO YOU MAY DECIDE
THAT THE THE VIEW IS IS IS OKAY
AT. NEXT LEVEL THE MOUNTAIN
WHERE OTHERS WANT TO KEEP
CLIMBING TO THE TOP.
WELL THANK YOU THAT'S AN
EXCELLENT POINT BECAUSE I THINK
AT THE END OF THE DAY WE ALL
WANT TO HAVE A.
PAGE
PATIENTS SOMEONE THAT SOMETIMES
SLIPS THROUGH THE CRACKS
SO I I'M GONNA WHO BY LIKE FOUR
QUESTIONS INTO ONE THE FIFTH.
SAKE OF TIME THIS IS ONE NO
ONE'S GONNA LIKE BUT I JUST NEED
TO SAY IS.
WILL LOOK TO VERMONT.
THREE YEARS AGO THEY HAD TO
WITHDRAW FROM THEIR SINGLE PAYER.
A NEW NO PLAN THAT WAS SIGNED
INTO LAW THE HEAD A BILL IS
SIGNED INTO LAW ON TWENTY ELEVEN.
BECAUSE THE INCOME AND PAYROLL
TAXES HAD TO GO UP SO MUCH NOW
VERMONT IS A LOT SMALLER THAN
CALIFORNIA SO THAT COULD HAVE
BEEN.
PART OF THE ISSUE THERE.
.
COLORADO VOTERS VOTERS REJECTED
A SINGLE PAYER PLAN IN TWENTY
SIXTEEN EIGHTEEN TO TWENTY.
A RATIO.
THE HEAD OF THE DEMOCRATIC
GOVERNOR HAD TO URGE HIS OF
VOTERS NOT TO SUPPORT THE BILL
BECAUSE OF A DOUBLE THE STATE
BUDGET.
THEN WE LOOKED WE DID HAVE A
LOT HEARINGS WITHOUT THAT OTHER
STATES WITH THEIR DOING WOULD
LOOK THAT OTHER COUNTRIES WHICH
WAS ACTUALLY FASCINATING AND
VERY.
.
INFORMATIVE.
LIST THEM WE SAW THE SCALE OF
HOW MUCH WE'RE PAYING AND HOW
MUCH LESS WE YET VERSUS OTHER
COUNTRIES WHEN YOU LOOK THAT AND
THAT'S WHY I BROUGHT UP ABOUT
THE NETWORK OF SOCIAL SERVICES
NORMALLY OTHER THINGS THAT ARE
BEING DONE.
HOW?
THE ONES THAT SEEM TO WORK THE
BEST ACTUALLY HAD.
MORE PAYER OPTIONS
THEY ACTUALLY HAD PRIVATE.
PLANS MIXED IN WITH THE
GOVERNMENT PLANS.
.
THOUGH SEEM TO BE THE ONES THAT
WERE REALLY THE STRONGEST.
AND YOU KNOW I PARKS I'VE.
I DON'T A LOT OF STUDY ON IT.
CAME UP WITH THERE WAS A STUDY
THAT'S BEEN DONE OF THIS AND ANY
OVER TWO DECADES TO ALL
SPECIALTIES TWELVE PROVINCES. IN
CANADA. AND IT LOOKS AT WAIT
TIMES IT'S A BIG SERVICES
SOMEONE FROM TWENTY SEVENTEEN.
AND IT'S SHOWING THAT.
.
TO SIT FROM APART FROM GETTING
TO A PRIMARY CARE DOCTOR BEING
REFERRED FOR TREATMENT TO A
SPECIALIST THEY AVERAGES TWENTY
ONE. POINT TWO WEEKS OF WEIGHTS.
THAT'S OVER FIVE MONTHS IN
CANADA.
DISK TO GO FROM A GENERAL
PRACTITIONER TO TREATMENTS AT A
SPECIAL IT FOR I AM
OPHTHALMOLOGY.
ALMOST EIGHT MONTHS.
AND IT IS THE.
.
DONE BY THE FRAZIER INSTITUTE.
TWENTY SEVENTEEN UNLESS IT'S ALL
HERE. A. I'M JUST I'M POINTING
THIS OUT SO MAYBE IF THERE'S
DATA THAT PROVE IT'S NOT RIGHT
WHEN ONE HERE.
OUR ORTHOPEDIC SURGERY OVER A
TEN MONTH WAIT. AND AS I SAID
BEFORE MY RELATIVES COME FROM
CANADA THEY HAVE THEY BOUGHT
SUPPLEMENTAL PLANS BECAUSE.
THEY WERE YOU KNOW HAD MORE
MONEY.
THEY'RE ABLE TO DO IT MUCH ONCE
AGAIN WE HAVE VOTE THE
UNDERSERVED COMMUNITY WILL NOT
BE ABLE TO BUY SUPPLEMENTAL PLAN.
SO HOWELL WE ENSURE THAT THIS
DOESN'T HAPPEN.
AND YOU KNOW IS WE KNOW FOR
THAT'S WHY I WANT TO BRING IT UP
WHEN I WANT TO GO DOWN THE.
HOW CAN WE ENSURE THAT IT WON'T
HAPPEN IN CALIFORNIA?
WHAT CAN BE DONE BECAUSE OF
WE'RE?
WE DON'T HAVE ENOUGH PROVIDERS
AS IT IS NOW.
PEOPLE ARE PAYING FOR THE PLAN
THROUGH THEIR TAXES THAT BY YOU
KNOW SOMETHING THE SALES TAX
WILL PAY FOR IT. SO THE NOT
ACTUALLY PAYING WHEN THEY GET
THERE.
IT'S CONSIDERED FREE IF THEY
THINK IT'S FREE SO THAT I USE IT
MORE THEY'LL BE GOING TO THE
EMERGENCY ROOM MORE THAT'S WHAT
THEY'VE SEEN IN ALL THESE PLACES.
HOW OLD?
TO.
AND THAT'S WHAT CAUSES THE WAIT
TIME ISSUE HOW DO WE PREVENT
THAT THAT'S THAT'S OF.
HONEST QUESTION AND THAT'S MY
LAST QUESTION.
SO I'M HAPPY TO PROVIDE I YOU
WERE. HAPPY TO PROVIDE OUR.
EVIDENCE I'D IT WE I DON'T THINK
WE'VE EVER SEEN. ANECDOTALLY OR
EVIDENCE OF IN A CANADIANS
COMING TO AMERICA FAR HEALTHCARE
SYSTEM.
THAT IS.
IF ANYTHING IT'S IF IF ANYTHING
IT'S THE. IT'S THE REVERSE BUT
I'M HAPPY TO PROVIDE YOU KNOW
DID TO YOU. I DO THINK I DON'T
THINK THAT THERE'S A LOT OF
PEOPLE WHO GO TO THE EMERGENCY
ROOM.
YOU KNOW THERE'S NO BEEN
SHOPPING GOING ON IN THE
EMERGENCY ROOM PEOPLE.
IT YOU KNOW THE PEOPLE GO AYE
THEY.
IT THEY NEED TO GO CARE IF
NOBODY'S IDEA OF A GOOD TIME TO
GO THE ER.
AND SO EIGHT SO I.
ARE THERE ARE MECHANISMS TO TRY
TO ENCOURAGE PEOPLE TO GO TO
PRIMARY CARE RATHER THAN
EMERGING. EMERGENCY ROOMS
ABSOLUTELY AND AND WE THINK THE
KEY THING IS TO PROVIDE THOSE
URGENT CARE AND PRIMARY CARE AND
OTHER OPTIONS SO THAT PEOPLE CAN.
YOU KNOW GET THE CARE THEY NEED
IN THE APPROPRIATE PLACE RATHER
THAN USE THE E. ARE
APPROPRIATELY BUT I'D. I AGAIN I
DON'T THINK ANYBODY OR.
.
I DID DESIRES TO DO THAT THERE'S
AND THERE ARE EXISTING SYSTEMS
IN PLACE FOR THE QUOTE UNQUOTE
FREQUENT FLYERS. OF PEOPLE WHO
DO SHOW UP OCCASIONALLY FOR
SPECIFIC ARE ISSUES BUT THOSE
TEND TO BE IN ISSUES MORE ABOUT
OUR SOCIAL SAFETY NET AND ABOUT
YOU KNOW DO WE HAVE APPROPRIATE.
HOUSING AND HOMELESSNESS AND
OTHER TYPES OF OF.
SERVICES IN PLACE AND I THINK
THE DATA ACTUALLY SHOWS THAT IN
FACT A LOT OF. THERE'S A LOT OF
THOSE ARE A LOT OF OUR.
ONE OF THE REASONS WHY WE HAVE A
VERY HIGH HEALTHCARE COSTS
AMERICA'S BECAUSE WE HAVE OF WE
ACTUALLY HAVE RELATIVELY LOW
INVESTMENT IN THE SOCIAL SAFETY
NET.
AND AND SO THAT AND SO IT IT IT
IT IT'S REFLECTED.
IN OUR HEALTHCARE SYSTEM AS A
RESULT AND I AND I THINK AND
THAT MAYBE GOES TO THIS OUR. OUR
OTHER QUESTION OF.
.
WITH REGARD TO THE.
IT YOU KNOW IN TERMS OF CANDOR
THAT I MEAN AT THE END OF THE
DAY CALIFORNIA WILL CREATE ITS
OWN HEALTHCARE SYSTEM THAT WILL
BE DIFFERENT IN CANADA THAT WILL
BE DIFFERENT THAT YOU KNOW IT
WILL BE A CALIFORNIA HEALTHCARE
SYSTEM AND WE CAN. PUT IN PLACE
THE CONSUMER PROTECTIONS ABOUT
WAIT TIMES EXCEPT WHAT WE'RE
TRYING TO DO SOME OF THAT IT
WITH OUR EXISTING SYSTEM WITH
STANDARDS WITH REGARD TO TIMELY
ACCESS TO CARE.
AND OTHER OF PIECES AND WE
THINK THAT THAT SHOULD BE
INCORPORATED IN WHATEVER SYSTEM
WE MOVE FORWARD WITH THAT WAS
ONE OF OUR OUR QUESTIONS ABOUT
FIVE SIX TWO WAS WHAT WAS JUST
MAKING SURE THAT. THE STANDARDS
THAT WE ARE TRYING TO HOLD THE
INSURERS ACCOUNTABLE TO. IN OUR
IN OUR CURRENT LAW WHICH
SOMETIMES THEY DON'T ABIDE BY
AND THEY GET FINED FOR.
ARE IN PLACE FOR WHATEVER IT
WHAT WHATEVER OUR SYSTEM IS AND
AND AND SO I THINK THAT YOU KNOW
THEY ARE BUT.
YOU KNOW THAT WILL BE A DECISION
BASED ON AT LEAST.
A THAT PROCESS THAT IS
DETERMINED BY ELECTED
DEMOCRATICALLY ELECTED
REPRESENTATIVES RATHER THAN BY
INSURERS.
IN A PRIVATE BOARD ROOM.
YOU KNOW I WANT TO START MY
COMMENTS TODAY IF I CAN BY.
.
REMEMBERING WHERE WE CUT OUR
TEETH AND HOW WE LEARNED TO
BECOME ADVOCATES.
I WAS MOVED BY THE CALIFORNIA
IMMIGRANT POLICY CENTER WHICH
STARTED IN NINETEEN NINETY SIX
AFTER. I BELIEVE THE NINETEEN
NINETY FOUR PROP ONE EIGHTY
SEVEN.
AND.
I ALSO HAVE BEEN FIGHTING FOR
HEALTH FOR ALL. AND REALLY
BELIEVES THAT THAT GOAL IS A
NOBLE ONE.
AND BOTH WANT TOBE FOCUS OF I
CAN ON THREE MAIN AREAS.
FIRST.
I'D LIKE BETTER INFORMATION IF I
CAN FROM THE SMALL BUSINESS
OWNERS AS WELL AS HEALTH ACCESS
REGARDING THE FAMILY GLITCH.
HOW COULD WE BETTER MEET THE
NEEDS OF OUR FAMILIES AND WHAT
COULD WE DO TO IMPROVE UPON THAT?
SECOND I WANTED TO ASK ABOUT THE
MEDICAL LOSS RATIOS THAT WAS
BROUGHT UP.
BOTH IN TERMS OF STABILIZING AND
OPPORTUNITIES FOR US TO LOOK AT
INCREASES.
AND BUT IF YOU COULD FURTHER
EXTRAPOLATE WHAT RAISING THIS
AMOUNT WOULD DO FOR US AS
CALIFORNIANS AND HOW THAT WOULD
HELP US.
AND FINALLY I'D LIKE TO ASK
ABOUT THE UNDER INSURED.
THAT'S AN AREA THAT REALLY
TOUCHES HOME TO ME.
WHEN YOU BROUGHT UP THE FACT
THAT.
TWELVE DOLLARS AN HOUR IS GOING
TOWARD HEALTH CARE I'M REMINDED
THAT THERE ARE MANY PEOPLE IN MY
DISTRICT WHO DON'T MAKE TWELVE
DOLLARS AN HOUR.
AND WANTS TO FIGURE OUT WHAT WE
COULD DO AS A STATE.
TO HELP IN PAYING FOR THOSE
PREMIUMS AND COST SHARING SO
WHAT OPPORTUNITIES WE HAD TO
HELP THE MIDDLE CLASS WITHIN OUR
STATE. TO REALIZE THE SUCCESSES.
OUT OF TAKE A COUPLE OF THESE.
BUT NOT NOT ALL OF THEM SO I'M
FOR THE FAMILY WHICH I MEAN THAT
AND AS I SAID THAT PARTICULARLY.
HERTZ
SMALL BUSINESSES THAT TEND TO
HAVE PLANS THAT ARE A PLEA ONLY
WHEN THEY DO HAVE PLANS THAT ARE
MORE MORE OFTEN EMPLOYEE ONLY
THEN LARGER. ORGANIZATIONS
BUSINESS I HAVE CLIENTS THAT
OFTEN INCLUDE DEPENDENCE.
.
I'M NOT SURE I WOULD DEFER TO
EXPERTS HERE I'M NOT SURE THAT.
IT WE AND OTHER WORDS I THINK
THAT FEDERAL.
YOU BET WE CAN INCREASE THE
FEDERAL SUBSIDIES ON AROUND YOU
KNOW TO TO COVER.
DEPENDENCE OF.
THE WHO WERE LATER POLICE THAT
HAVE PLANTS WHERE THEY MEET THE
AFFORDABILITY STANDARD.
SO I THINK IT WOULD REQUIRE
FUNDING I MEAN AT THIS BE CLEAR
AND SO AND THAT'S A DECISION ALL
YOU NEED TO MAKE WITH THE
SURPLUS THAT EXISTS OF YOU KNOW
THERE'S A MILLION PLACES RIGHT
MONEY CAN GO. ON IT IS A HUGE
PROBLEM FOR.
EMPLOYEES OF SMALL BUSINESSES
THAT ARE HAVE DEPENDENTS WHERE
THE BUSINESSES HAVE STRUGGLED
OFFER THE PLANS TO STORM OFF
REPEAT CAN'T AFFORD OFFER.
DEPENDENT COVERAGE SO ON THE
POINT THAT OUT FROZEN ROLLERS
CONCERN I MEAN JUST WANNA MAKE
SURE THAT THERE'S SOME SANITY IN
PLACE AND.
YOU KNOW WHAT THE ROAD TO THE
RICH MORE PROPOSALS TODAY IN
WASHINGTON FOR THE DISARRAY MISS
OUT OF THE OTHER SO OF ICE WHEN
I MET YOU KNOW I THINK IT IT'S
JUST WANT TO POINT OUT THAT IT'S
IMPORTANT. THAT.
IF THERE'S A NEED TO HAVE A
ILLEGAL BACKSTOP THE CASE
WASHINGTON DOES IT'S MORE CRAZY
STUFF THAT WE SHOULD HAVE THAT
I'M GOING TO MAKE ONE POINT
IMMIGRANTS.
AS MANY OF YOU KNOW EMUS ARE
TWICE AS LIKELY AS THE GENERAL
POPULATION TOO SMART AND TO
START AND RUN SMALL BUSINESSES.
SO WHEN YOU TALK ABOUT.
IMMIGRANTS AN OBVIOUS IS BOTH
DOCUMENT AND UNDOCUMENTED YOU
TALK WHEN IMMIGRANTS YOU THERE'S
A HUGE CROSS OVER WITH SMALL
BUSINESSMEN AND MANY. PARTS OF
THE STATE.
YOU KNOW WHEN YOU LOOK THIS
WALLACE'S COMMUNITY IT'S
PREDOMINANTLY DEMOCRATS.
AND SO.
TO TO TO PROMOTE AND CONTINUE
TO PROMOTE ENTREPRENEURSHIP IN
THE STATE.
WE HAVE TO DEAL WITH THE
MEDICAL NEEDS OF IMMIGRANTS BOTH
DOCUMENTED AND UNDOCUMENTED.
I WOULD AGAIN AND AND I.
FUND AGREEING WITH JOHN OF THE
FAMILY WHICH I THINK IT IS
CERTAINLY HAD A DOABLE PROPOSAL
WE HAVE AND MODELING HOW MUCH
SHOULD WE ARE HOW MUCH MONEY
WOULD BE REYES AND I DO THINK
DEPENDING ON. YOU KNOW WHAT ELSE
TO FEDERAL GOVERNMENT DOES IT
ACT ACTION MIGHT HAVE SOME
IMPACT ON HOW MUCH.
FIXING THE FAMILY WHICH IS THIS
IS SOMETHING THAT WE BELIEVE
THAT A DE A DIFFERENT PRESIDENT
WITH A DIFFERENT AYE ARRESTS
WOULD HAVE INTERPRETED IN
DIFFERENT WAY AND WOULD HAVE
SOLVED IS AT THE FEDERAL LEVEL.
BUT AGAINST GIVEN THAT WE DON'T
HAVE THAT FOR THE NEXT THREE
YEARS IT WOULD IT WOULD BE
APPROPRIATE TO TAKE A LOOK. FOR
FOLKS AGAIN YOU KNOW INDIVIDUALS
WHO GET WORKER COVERAGE FOR
THEMSELVES BUT NOT AFFORDABLE
COVERAGE FOR THEIR FAMILY
MEMBERS AND IT'S THOSE FAMILY
MEMBERS THAT ARE.
YOU KNOW DON'T HAVE THE ABILITY
TO GET SUBSIDIES IN THE
EXCHANGES AT ADDED ARE AS A
RESULT SOME OF THOSE FOLKS.
BY COVERAGE ANYWAY THEY JUST
PROVIDED A MUCH HIGHER
PERCENTAGE OF THE.
OF OF THEIR INCOME AND.
IT'S SOMETHING THAT WOULD IT
WOULD PROVIDE A GO A LONG WAY
TOWARD AFFORDABILITY IT'S NOT A
IT'S NOT A HUGE POPULAR
ELATION IT'S.
BUT IT'S IT'S A POPULATION
DESERVES SOME ATTENTION A DISH
IN ADDITION TO SOME OF THE OR
FOR OTHER AFFORDABILITY
PROPOSALS THAT WE OUTLINED ON
THE MEDICAL LOSS RATIO I DO IS
TO DO ONE OF JUST HIGHLIGHT.
WHAT THIS IS BECAUSE?
IT'S A VERY TECHNICAL TERM BUT
IT LITERALLY IS THAT HOW THE
INSURERS DESCRIBED.
HOW MUCH MONEY IS QUOTE UNQUOTE
LOST TO ACTUAL MEDICAL CARE?
THAT.
THE.
THAT IS THAT OF ITS TO
DESCRIPTION OF HOW MUCH MONEY.
IS GOING TO MEDICAL CARE THAT
ARE.
AND
YOU KNOW WE WE THINK THAT THAT
SHOULD BE HIGHER AND AND JUST AS
PUBLIC PROGRAMS DO IT WHETHER IT
BE MEDICARE OR MEDIC HOW BOTH I.
HAVE.
MUCH HIGHER MEDICAL LOSS RATIOS
THAN IN THE COMMERCIAL MARKET
NOW SOME OF THAT IS JUST THE.
OUR. IMPACT OF HAVING A SYSTEM
WHERE YOU HAVE TO DO MARKETING
AND HIGHER UP PEOPLE TO HELP SO
THE PRODUCT AND YOU KNOW THE
TRANSACTIONAL COSTS O. WITH
RELATION TO THAT BUT SOME OF
THAT IS ABOUT PROFIT AND SOME OF
THAT IS ABOUT ADMINISTRATIVE.
BURDEN AND SO TAKING A LOOK AT
HOW WE CAN DO IT DO THAT
ESPECIALLY SINCE YOU KNOW WE ARE.
MORE ON THE.
CALIFORNIA SIDE OF CHINESE YOU
KNOW HOW THAT CENTRALIZING GET
PEOPLE YOU KNOW INTO THESE PLANS
AND THAT DID DOES THAT MEAN THAT
HATE NOW WE CAN. ASK THE
INSURERS TO. OF. OUR.
BE MORE EFFICIENT I'M SINCE
COVERED CALIFORNIA'S DOING SOME
OF THAT WORK.
A FOR THEM AND I THINK THAT
THAT WOULD BE APPROPRIATE.
BEFORE WE GET TO THE OTHER ONES
I JUST
SURE I UP.
FULLY BY INCREASING THE MEDICAL
LOSS RATIO.
PREMIUMS THAT
CALIFORNIANS ARE PAYING MORE OF.
SCENT OF THAT PREMIUMS WILL GO
TOWARDS
DIRECT HEALTHCARE RELATED COSTS
THAT TRACK SO WE WILL SEE A
BETTER BENEFIT.
BY INCREASING THE MEDICAL LOSS
RATIO IN TERMS OF DIRECT RESULT
IS CALIFORNIA VETERANS DAY YEAH
AND I MEAN CURRENTLY THE WAY THE
ACA WORKS IS THAT IF IT IF THEY
SPEND TOO MUCH. OF. IT IF THEY
VIOLATE THE MLR STANDARD THAN
ACTUALLY.
INDIVIDUALS GET REBATES AND YOU
KNOW CALIFORNIA AT THE X.
ARCHITECTURE THE HUNDREDS OF
THOUSANDS CALIFORNIANS HAVE
GOTTEN DEBATE THEY TEND TO BE
RELATIVELY SMALL. A CHECKS
BECAUSE BUT IT IS A A A.
IT'S IT'S A IT'S A USEFUL PRIDE
TO ENCOURAGE THE INSURERS TO.
THAT IF THEY IF THEY ARE GOING
TO TRY TO PROVIDE VALUE FOR THE
CONSUMER THAT THEY THAT THEY ARE.
THE THAT
DAISY YOU KNOW TO PUT.
THE PROOF FOR THE PUTTING PLAYER
TO SAY IF THEY ARE THAT THEY'RE
GOING TO SPEND EIGHTY EIGHTY
FIVE WHATEVER THE RIGHT
PERCENTAGES FOR.
FOR PATIENT CARE.
BUT WE ALSO THINK THAT THEN
THAT DOES STILL CIRCLE BACK TO.
IF EIGHTY OR EIGHTY FIVE PERCENT
OF THE OF THE PREMIUM IS DOCTORS
HOSPITALS AND DRUGS THAT WE
STILL NEED A MECHANISM TO
ADDRESS ADDRESSING THOSE BASE
COSTS AND THAT'S THE KIND OF
THINGS THAT I THINK SEVERAL OF
US HAVE BEEN TALKING TO.
AND JUST TO FINISH
SO I CAN PASS IT ON YOU KNOW I.
I WAS MOVED PETER WHEN YOU SAID
THAT THIS WAS A SHARED PROBLEM
THAT WE NEED TO SOLVE TOGETHER.
AND YOU HAD MENTIONED EMPLOYERS
AND EMPLOYEES BUT I'D LIKE TO
MAKE SURE THAT WE'RE PUTTING THE
STATE OF CALIFORNIA IN THERE AS.
WE ARE CALIFORNIA AND WE DON'T
FOLLOW WITH THE REST OF THE
STATES WE ARE LEADING ON THIS
ISSUE. AND WANTS TO MAKE SURE
THAT WE ARE DOING OUR FAIR SHARE.
TO HELP OUR BROTHERS AND SISTERS
WHO ARE WORKING WHO ARE.
STRUGGLING TO MAKE ENDS MEET WHO
ARE THE PEOPLE IN MY COMMUNITY.
AND IT'S JUST.
REALLY APPRECIATE ALL OF THE
WORK THAT THIS PANEL HAS DONE.
ON THE TO BRING THESE
PRESENTATIONS HERE TODAY.
PERFECT THANK YOU I THINK. I'M
GONNA MORE COMMENTS I THINK THE
QUITE SOME THE QUESTIONS THE KEY
QUESTIONS HAVE BEEN ANSWERED I'M
I'M DIGEST.
BUT MORE COMMENTS AND AND I
THINK IT'S IMPORTANT PERSONAL
THANK YOU VERY MUCH FOR YOUR
WORK THANK YOU FOR.
GIVING US YOUR STORIES AND AND
THE IMPORTANCE THEIR.
THE TAKE AWAY I GUESS FOR ME IS
THAT.
THAT AS WE.
MOVE WERE MOVED WE NEED TO MOVE
ON TWO TRACKS.
WE NEED TO MOVE ON THE TRACK TO
A SYSTEM THAT IS THAT IS
DIFFERENT THAN WHAT WE HAVE
TODAY AND WHAT THAT LOOKS LIKE
EXACTLY CALIFORNIA I DON'T KNOW.
BUT WE ALSO HAVE TO WORK ON
THOSE THINGS THAT WE CAN WORK ON
NOW.
AND AND BECAUSE IF WE DON'T
CONTAIN COSTS
IF WE DON'T SLOW DOWN AND BEND
THE CURVE.
IT'S GONNA MAKE IT THAT MUCH
MORE DIFFICULT.
WITH A FRIENDLY ADMINISTRATION.
TO GET TO THE TOP OF THE
MOUNTAIN. AND SO THESE ARE
FOUNDATIONAL THINGS THAT
ABSOLUTELY HAVE TO BE DONE AND
SO.
I'M ANXIOUS TO SEE WHAT IT IS
THAT AS YOU AS WE FLESH THIS OUT
THAT WE CAN ACTUALLY BE WORKING
ON THIS YEAR.
TO TO GET THERE BECAUSE THE
OTHER THE OTHER PROJECTS WE KNOW.
BASED ON OUR HEARING THAT WE HAD
MONDAY.
SOME OF THE SOME OF THE
LOGISTICS AND THE CHALLENGES WE
HAVE GOING FORWARD ARE MULTI
YEAR CHALLENGES.
AND.
.
RIGHT WE CANNOT IGNORE THAT.
WAIVERS WITH THE FEDERAL
GOVERNMENT WITH IF WITH A
FRIENDLY ADMINISTRATION.
STILL TAKE TWO TO THREE YEARS.
WE DON'T HAVE A FRIENDLY
ADMINISTRATION NOW BUT THAT
DOESN'T MEAN WE CAN'T DO. THE
FOUNDATIONAL WORK TO GET TO
WHERE WE NEED TO GO.
SO I THANK YOU FOR THAT LOOK
FORWARD TO WORKING WITH YOU ON
THAT IT IS ABSOLUTELY IMPERATIVE
THAT WE SLOW THIS DOWN.
WHEN THE BEAUTIES OF MARYLAND
WHAT THEY HAVE DONE.
SLOW THE COST DOWN.
SORRY.
WELL.
YEAH.
SLOW THE COST COULD SLOW THE
COST CURVE DOWN IN A MINUTE AND
IT AND THE REASON I'M SAYING
THAT IS THAT.
MARYLAND HAS HAS DONE WHAT
MARROW HAS DONE IS IS IS IS
REALLY ADMIRABLE. IT HAS BENT
THAT CURVE.
IS SLOW THE COSTS DOWN IT HASN'T
DROPPED THEM BUT IT'S SLOWING
THE COST DOWN AND WE'VE GOT TO
DO THAT BECAUSE WE CANNOT.
SUSTAIN THE INCREASES YEAR AFTER
YEAR AFTER YEAR AND SO I THANK
YOU FOR.
THANK YOU FOR YOU DOING LOOK
FORWARD TO WORKING WITH YOU AS
WE LOOK FORWARD TO WORKING ON A
PARALLEL TRACK BUT RECOGNIZING
THAT.
WE CANNOT IGNORE THE WORK THAT
WE NEED TO DO NOW.
BECAUSE IT WILL MAKE IT THAT
MUCH HARDER FOR US TO GET LIKE I
SAID TO THE TOP OF A MOUNTAIN.
OTHER COMMENTS BEFORE WE GO TO.
.
A PUBLIC PUBLIC COMMENT.
I. YEAH I THINK ALL MY COMMENTS
NOW.
BEFORE THE PUBLIC COMES UP.
IF THAT'S OKAY.
SO I'M THIS IS I THINK THE LAST
OF OUR HEARINGS LETS GET ONE THE
LAST SCHEDULED HEARING WE MADE
TWO MORE IT SOUNDS LIKE.
WHICH IS FINE.
AND I KNOW ARE THERE PEOPLE OUT
THERE THAT YOU KNOW THINK THAT
THIS HEARINGS WERE.
YOU KNOW NOT NECESSARY BUT I CAN
TELL YOU FROM SOMEONE WHO NO
MATTER WHAT IS GONNA HAVE TO
VOTE ON SOMETHING.
YEAH I AM I FOUND THEM VERY
IMPORTANT AND VERY.
EDUCATIONAL AND I HOPE THAT.
EVERYBODY DID OUR HELP THE
PUBLIC WATCHED AND LEARNED
SOMETHING I KNOW THAT I LEARNED
A LOT I THINK ALL OF US FROM
GOING THROUGH THIS PROCESS DID
IN.
.
YOU KNOW I I THINK ABOUT.
I THINK A LOT OF THIS DISCUSSION
HAS TO DO WITH REALLY CHANGING
IMPRESSIONS OF.
WHAT WE THINK HEALTH CARE IS AND?
THE SLOGANS AT A LOT OF THE
ACTIVISTS USE ABOUT HEALTHCARE
BEING A HUMAN RIGHT. MIHT KIND
OF SOUND OBVIOUS BUT IT'S REALLY
NOT OBVIOUS AND IT'S CERTAINLY
NOT IN THE WAY THAT HEALTH
CARE'S BEEN REGARDED IN THIS
COUNTRY.
YOU KNOW THERE WAS ONCE A TIME
I'M SURE WHERE YOU KNOW. THE WAY
THAT PEOPLE GOT HEALTHCARE WAS
THEIR IN THEIR SMALL TOWN AND
THERE WERE IT WAS A DOCTOR TO
AND IF YOU GOT SICK YOU WENT TO
THAT DOCTOR BUT WE'VE EVOLVED.
YOU KNOW THERE WAS ONCE A TIME
IN THIS COUNTRY WHEN IF YOUR
HOUSE WAS ON FIRE THERE WERE
DIFFERENT PRIVATE FIRE COMPANIES
THAT YOU COULD CALL THAT WOULD
KIND OF COME AND YOU COULD PAY
THEM OR NOT PAY THEM TO AND IF
YOU DIDN'T PAY HIM THEY WOULDN'T
PUT. YOUR FIRE OUT.
AT A CERTAIN POINT AS A SOCIETY
WE DECIDED THAT.
WE HAD A PUBLIC BENEFIT TOWARDS
THEIR BEING PUBLIC SAFETY THAT
WE ALL PAID FOR. AND THE SAME
THING WITH PUBLIC EDUCATION
NOBODY QUESTIONS THAT ALL OF US
PAY COLLECTIVELY INTO EDUCATING
SOCIETIES CHILDREN WHETHER THE
YOUR CHILD OR SOMEBODY ELSE'S
CHILD.
AND I THINK THAT THIS IS. THE
RESULT WHEN I SAY THIS I MEAN
THIS HEARING AND PEOPLE BEING
HERE IS NOT JUST A RESULT OF
COSTS GOING UP AND MEDICARE
MEDICAID. MEDICAL CARE BEING
LESS AND LESS EXPENSIVE BUT OF
EVOLVING PERCEPTION ABOUT
HEALTHCARE BEING SOMETHING THAT
WE SHOULD ALL HAVE.
AND IT'S SOMETHING THAT WE ALL
HAVE EQUALLY AND THAT EVERYONE
SHOULD EXPECT.
WE REALLY DO NEED TO CHANGE THE
WAY WE THINK ABOUT PAYING FOR
THEIR HEALTHCARE. WE DON'T
EXPECT EVERYBODY TO PAY
INDIVIDUALLY FOR THEIR CHILDREN
GOING TO SCHOOL. YOU KNOW WE ALL
PAY WE ALL QUE AND NOBODY
QUESTIONS UP BECAUSE WE KNOW
THERE'S A PUBLIC GOOD FOR ALL OF
US OF HAVING EDUCATED CHILDREN.
AND WE HAVE GOT TO THINK ABOUT
HEALTHCARE IN THE SAME WAY FOR
EVER GOING TO HAVE THE KIND OF
HEALTH CARE THAT WE WANT AND THE
KIND OF ACCESS WE WANT. BECAUSE
WE'VE HEARD OVER AND OVER FROM
EVERY SINGLE PERSON HAS BEEN UP
HERE FROM ACROSS THE IDEOLOGICAL.
SCALE FROM PEOPLE WHO HAVE
STUDIED THIS ISSUE THAT THE
SYSTEM THAT WE'VE HAD THAT'S
JUST BEEN THE SYSTEM THAT'S NOT
TRULY A BALL FOR TWO HUNDRED
YEARS. IS ONE OF JUST ALMOST
UNBRIDLED FREE MARKET
COMPETITION.
WITH IT WITH.
PRIVATE COMPANIES PAYING THE
BULK OF HEALTHCARE COSTS FOR
THEIR EMPLOYEES AT GREAT COST TO
THEM.
AND WITH A MARKET THAT'S.
ALMOST UNREGULATED IS COMPARED
TO OTHER DEVELOPED NATIONS.
AND SO.
.
BUT THE SINGLE PAYER
CONVERSATION IS
YOU NO IT'S IMPORTANT BUT THE
SINGLE BUT WHETHER WERE SINGLE
PAYER OR NOT. THAT'S ONLY PART
OF THE EQUATION TOWARDS REALLY
HAVING THE KIND OF HEALTHCARE
SYSTEM THAT WE NEED BECAUSE WE
HAVE GOT TO.
DO THAT THE COUPLE OF THINGS
THAT OTHER COUNTRIES HAVE DONE
THAT WE'VE BEEN RELUCTANT TO DO.
NUMBER ONE TO TRULY REGULATE THE
HEALTH CARE INDUSTRY.
FROM BEGINNING TO END
SO THAT.
COSTS ARE KEPT UNDER CONTROL BY
GOVERNMENT INTERVENTION.
EVERY OTHER DEVELOPED COUNTRY
DOES IT.
AND WE DO IT IN A LOT OF AREAS
YOU KNOW IN IN PUBLIC SAFETY AND
IN EDUCATION AND IN UTILITIES
WATER AND POWER. WE DON'T HAVE
THE UNBRIDLED FREE MARKET WORK.
OUR GOVERNMENTS DECIDE WHAT'S
GOING TO BE PUTS FAIR TO PAY FOR
DIFFERENT PARTS OF THOSE
SERVICES WE ALL GET TO SEE WHAT
THAT IS.
EVERYBODY CAN LOOK AT THEIR
WEBSITE FOR THEIR LOCAL
GOVERNMENT TO SEE WHAT THEY PAY
FOR POLICE AND FIRE TO SEE HOW
THEY NEGOTIATE THOSE TO SEE WHAT
TEACHERS ARE PAID AND HOW WOULD
ADMINISTRATORS ARE PAID. WE
DON'T ALLOW THE FREE MARKET TO
DECIDE WHAT ADMINISTRATORS IN
THE PUBLIC SCHOOL SYSTEMS OR IN
OUR LOCAL GOVERNMENTS ARE PAID.
BECAUSE WE CONSIDER THAT TO BE
TOO IMPORTANT TO LEAVE UP TO THE
FREE MARKET.
AND.
WE NEED TO BE WILLING TO DO
THAT ON ALL ASPECTS OF HEALTH
CARE WHICH IS EXTREMELY
DIFFERENT FROM WHO WE DO NOW IN
VERY DISRUPTIVE AND VERY
DIFFICULT TO GET TO. LET'S BE
HONEST LAST YEAR WE HAD A BILL
JUST FOR TRANSPARENCY IN DRUG
PRICING
AND THAT BARELY GOT THROUGH THIS
LEGISLATURE SO THIS IS A HUGE
TASK TO DO THIS ALL ACROSS.
THE SPECTRUM OF HEALTH CARE BUT
IT'S THE ONLY WAY TO REALLY.
REGULATE COSTS AND I FOUND IT
REALLY INTERESTING THAT WE HAD
SOME FOLKS FROM THE I A A VERY
PROGRESSIVE DOCTORS GROUP COME
UP AND THANK YOU FOR BEING HERE
TO TESTIFY AND WHETHER THINGS
THEY SAID WAS. WE NEED TO DO ALL
THIS REGULATION BUT LET'S NOT
LOOK AT DOCTOR SALARIES YOU KNOW
WHERE WE HAVE GOT TO KEEP THOSE
SALARIES KIND WHERE THEY ARE
BECAUSE WE HAVE A DOCTOR
SHORTAGE AND YOU KNOW WE DON'T
WANNA. INTERRUPT THAT WELL WE
HAVE TO LOOK AT EVERYTHING.
YOU KNOW THAT ALL HAS TO BE ON
THE TABLE BECAUSE THAT'S THE WAY
IT'S DONE EVERYWHERE ELSE AND IF
YOU HAVE ONE GROUP THAT CAN KIND
OF CHARGE WHAT THEY WANT THEM
THE NEXT GROUP'S GONNA WANT TO
CHARGE WHAT THEY WANT IN THE
NEXT GROUP. SO THIS IS I'M I'M
SAYING THIS ONLY TO REMIND YOU
WHAT YOU ALREADY KNOW WHICH IS
THAT THIS IS A FUNDAMENTALLY
DIFFERENT WAY OF LOOKING AT
HEALTH CARE THEN WE'VE DONE IT
BUT I THINK. WE REALLY HAVE TO
DO IT BECAUSE WITH THE OTHER
THING THAT WE KNOW IS THAT THE
CURRENT SYSTEM JUST DOESN'T WORK
IT JUST DOESN'T WORK IT DOESN'T
CONTAIN COSTS. IT DOESN'T
DELIVER.
CARE WELL AND I DO THINK THAT
SINGLE PAYER IS THE GOAL BECAUSE
IT SEEMS TO BE THE BEST WAY TO.
UTILIZE THAT.
ABILITY FOR THE GOVERNMENT TO.
CONTROL COSTS AND NEGOTIATE ITS
ELEGANT IT'S MORE SIMPLE.
.
IT'S NOT THE ONLY WAY IT'S
ANOTHER PLACES BUT IT SEEMS TO
BE THE ONE THAT.
IS THE MOST EFFECTIVE.
WHEN WE TALK ABOUT COST
CONTAINMENT TO WE TALK YOU KNOW
WHEN PEOPLE MENTION WASTE AND
ALL OF THAT WHAT WE'RE REALLY
TALKING ABOUT IS SOMEBODY'S
PROFITS.
SOMEONE'S JOB AND THOSE PEOPLE
ARE GOING TO FIGHT BACK KNOWS A
LOT OF THEM WITH IT GOT A LOT OF
MONEY SO ALL OF US WHO WANT TO
DO THIS HAVE TO REALIZE THAT
THIS IS NOT GOING TO BE
SOMETHING EASIER SIMPLE. THAT'S
GONNA HAPPEN OVERNIGHT IT'S
GOING TO BE A HUGE FIGHT AND
EVERY STEP OF THE WAY.
AS YOU ALL KNOW.
.
SORRY I DIDN'T REALLY I DID
WRITE A SPEECH USER DOES NOTES
ARM.
AND THERE'S A LOT OF THEM HERE.
.
WE DO I THINK NEED A ROADMAP
THAT BUILDS ON THE GOALS OF FIVE
SIX TWO.
YOU KNOW IT'S A GREAT STATEMENT
OF PRINCIPLES IT'S A GREAT
STATEMENT OF VALUES BUT FLUSHING
THIS OUT INTO A COMPREHENSIVE
SYSTEM IS GOING TO TAKE TIME.
AND.
YOU KNOW THAT'S SOMETHING THAT
I THINK THAT WE NEED TO REALLY
START DOING.
REALIZING THAT WE DO NEED THAT
ROADMAP WE NEEDED TO BE IN PLACE
AT THE TIME WHEN WE HAVE A.
FEDERAL GOVERNMENT THAT'S
POSITION TO GIVE US THE WAIVERS
THAT WE'RE GONNA NEED AND I
ABSOLUTELY AGREE THAT YOU THAT.
THIS IS A ROADMAP THAT'S
ACHIEVABLE IN STEPS IN THERE'S A
LOT OF THINGS THAT WE CAN DO IS
WE GET THERE.
IN COVERING ALL OF OUR RESIDENTS
WHETHER THEY'RE DOCUMENTED OR
NOT IN MAKING SURE WE HAVE COST
CONTAINMENT TO GIVE RELIEF.
TO FILL IN THE GAPS WHERE
THERE'S ON AFFORDABILITY RIGHT
NOW FOR PEOPLE IN COVERED
CALIFORNIA AND ALL OF THOSE
AREAS SO I HOPE THAT EVERYONE
WHO'S BEEN HERE IS COMMITTED TO
WORKING WITH US. I KNOW THE
ADVOCATES ARE GOING TO BE HERE.
YOU KNOW BLESSED SOME BECAUSE
YOU KNOW THAT'S THE ENERGY THAT
YOU KNOW WE NEED TO TO HOLD
EVERYBODY ACCOUNTABLE YOU KNOW.
US AND THE ONES THAT ARE THEM
MAKING MONEY ON THIS AND WITHOUT
I'M COMMITTED TO HAVING AS MANY
HEARINGS AS IT TAKES TO WORK ON
THIS.
I AM COMMITTED TO WORKING AS
LONG AS IT TAKES WITH MY
COLLEAGUES TO. TRY TO COME UP
WITH SOMETHING THAT REALLY IS A
MODEL I'M FOR THE REST OF THE
COUNTRY I'M AYE I THINK
EVERYBODY WHO DIDN'T SEE IT.
IT'S EVERYBODY
I DIDN'T WATCH THE OTHER
HEARINGS PARTICULARLY THE LAST
HEARING ABOUT THE CHALLENGES WE
HAVE NEED TO WATCH THAT BECAUSE
WE ALL HAVE TO BE MINDFUL THERE
MAY VERY WELL BE BALLOT MEASURES
THAT ARE NECESSARY I YOU KNOW WE
HEARD THE LEGAL EXPERTS SAY
THAT'S PROBABLY GOING TO. HAVE
TO HAPPEN AND WE CANNOT IGNORE
THAT WE DON'T TO BE TIED UP IN
LITIGATION FOR YEARS TRYING TO
IMPLEMENT THIS EITHER. SO.
YOU KNOW I I THIS IS THE MOST
ONE OF THE MOST EXCITING THINGS
I THINK THAT ANY OF US CAN DO
WHILE WE'RE UP HERE. I MEAN IF
WE WALK OUT OF HERE WHENEVER
HAVING FUNDAMENTALLY CHANGED
HEALTH CARE DELIVERY IN
CALIFORNIA TO MAKE SURE THAT
IT'S AFFORDABLE AND ACCESSIBLE
AND EXCELLENT FOR EVERYBODY IN
THE STATE. EVEN IF WE DON'T DO
ANYTHING ELSE WE CAN ALL RETIRE
HAPPY LEGISLATORS
SO. SAY THANKS AND WE'LL KEEP
GOING.
WHAT COULD ONE HAVE TO SAY AFTER
THAT?
NO I AT AGAIN AS ALWAYS IT'S YOU
KNOW THIS IS BEEN OF GREAT
EDUCATION PROCESS AND THEY DO
PROBABLY THINK WE WILL WILL
CONTINUE IT I I THINK. THE
ASSEMBLY MEMBER SENATE PERFECTLY
IF WE DO NOTHING ELSE IF WE ARE.
ABLE TO ACCOMPLISH AND WE ARE
ABLE TO PROVIDE ALL CALIFORNIANS
HEALTH CARE AND IN TURN CREATE A
MODEL FOR THE REST OF THE
COUNTRY I THINK. WE HAVE ALL
WELL DONE MORE MORE THAN WE EVER
HAD HOPED FOR WHEN WE RAN FOR
OFFICE SO. I AYE SO DITTO FOR
EVERYTHING SHE SAID.
WITH THAT WE ARE GOING TO START
PUBLIC COMMENT AND JUST AS WE
STARTED THEM. HERE TODAY JUST
WANT TO THANK AGAIN THE PANEL
FOR BEING HERE REALLY APPRECIATE
ALL OF THE.
AT.
N'T. INTO START PUBLIC COMMENT
AND JUST AS I SAID AT THE START.
WE'RE GOING TO DO TWO MINUTES
AT A TIME JUST TO ATTEMPT TO GET
THROUGH. AYE IT WE'RE GONNA
START HERE ON OUR LEFT AND THEN
WILL. ALTERNATE HERE TO OUR
RIGHT.
GREAT.
THANK YOU VERY MUCH THIS IS A
TERRIFIC HEARING.
I'M ALISON VIEWS WITH THE
CHILDREN'S DEFENSE FUND OF
CALIFORNIA AND I'D LIKE TO SPEAK
TODAY ON BEHALF OF CTF
CALIFORNIA AND THE CHILDREN'S
PARTNERSHIP.
CALIFORNIA STRONGER WHEN
EVERYONE HAS ACCESS TO HEALTH
COVERAGE IN CARE AND CALIFORNIA
TOOK A HUGE STEP FORWARD. A FEW
YEARS AGO BY PASSING HEALTH FOR
ALL KIDS THAT EXTENDED MEDI CAL
TO UNDOCUMENTED CHILDREN.
HOWEVER RESEARCH CLEARLY SHOWS
THAT WHEN PARENTS AND CAREGIVERS
ARE COVERED CHILDREN ARE MORE
LIKELY TO HAVE COVERAGE AND GET
TIMELY CARE AND ALSO PARENTS WHO
ARE HEALTHY CAN CARE BET BETTER
CARE FOR THEIR CHILDREN. SO
EXTENDING COVERAGE TO ALL
CALIFORNIANS WILL HELP
CALIFORNIA'S CHILDREN ONE IN SIX
OF WHOM HAVE AT LEAST ONE PARENT
WHO IS UNDOCUMENTED.
CDF CALIFORNIA AND THE
CHILDREN'S PARTNERSHIP STRONG
SUPPORT THE HEALTH FOR ALL
PROPOSAL PRESENT PRESENTED BY
THE CFTC PANELIST AND AN
ASSEMBLY BUDGET. BLUEPRINT.
SPEAKING NOW ONLY FOR THE
CHILDREN'S DEFENSE FUND I'D LIKE
TO MAKE THE POINT THAT INCOME
ELIGIBILITY LEVELS.
AFFORDABILITY PROTECTIONS AND
COMPREHENSIVENESS OF BENEFITS
FOR CHILDREN ARE VERY DIFFERENT
THAN THOSE OF ADULTS.
IN MEDICAID AND CHIP IN
PARTICULAR MEDICAID'S A
COMPREHENSIVE PEDIATRIC AND
DEVELOPMENTALLY APPROPRIATE EPS
DUTY BENEFIT IS THE GOLD
STANDARD. UNPARALLELED IN ANY
INSURANCE PRODUCT AND THIS IS
WHAT ALL CHILDREN NEED TO
DEVELOP THEIR FULL INTO THEIR
FULL POTENTIAL. AND.
TO BECOME A TAX PAYING CITIZENS
WE FEEL VERY STRONGLY THAT ANY
PROPOSAL MOVING FORWARD MUST
THINK UP FRONT NOT AS AN AFTER
THOUGHT ABOUT HOW THE PROPOSAL
WILL IMPACT CHILDREN.
PARTICULARLY THE MOST VULNERABLE.
ANY ATTEMPT TO MAKE INCREMENTAL
OR SYSTEMIC CHANGES TO THE
CURRENT SYSTEM MUST NOT RESULT
IN CHILDREN LOSING GROUND FROM
WHERE THEY ARE TODAY.
OUT REFORM PROPOSALS MUST ENSURE
THAT COVERAGE FOR CHILDREN IS
AFFORDABLE EASY TO GET AND KEEP
AND NOT SUBJECT TO THE LOTTERY
OF GEOGRAPHY AND THAT CARE IS
COMPREHENSIVE AND PEDIATRIC
APPROPRIATE. FINALLY AS YOU WORK
TOWARD UNIVERSAL COVERAGE WE
ASKED YOU RECOGNIZE THE SPECIAL
PROTECTIONS THAT CHILDREN NOW
HAVE AND TO BUILD ON THAT PROP
UP PROGRESS AND A MINIMUM TO DO
NO HARM THANK YOU.
THANK YOU.
TOM I'M MELINDA MARKETS
REGISTERED NURSE AND PRESIDENT
OF THE CALIFORNIA NURSES
ASSOCIATION.
RECENTLY THE REPUGNANT AND
PRESIDENT TRUCK RAMMED THROUGH A
BILL THAT GIVES A HUGE CAT CASH
TAX CUTS TO THE RICH.
ELIMINATION OF THE MANDATE TO
BUY INSURANCE WAS ONE OF THE
MOST DESTRUCTIVE COMPONENTS IN
pSUGGEST WOULD PROP INSURANCE TO
LEVY NEW DOUBLE DIGIT PREMIUM
HIGH.
IF WE DON'T IMPLEMENT SINGLE
PAIR THE RESULT WILL BE MILLIONS
WILL LOSE OR NOT BE ABLE TO
AFFORD THEIR HEALTH INSURANCE.
AND EVEN MORE PREMIUMS RISING
FORTUNATELY THERE IS AN
ALTERNATIVE IN CALIFORNIA A
STATE BILL THAT WOULD GUARANTEED
HEALTHCARE COVERAGE FOR ALL.
FIVE SIX SENATE BILL FIVE SIX
TWO IS NOT A SYMBOLIC BILL.
S. B. FIVE SIX TWO IS A
COMPREHENSIVE REFORM AS YOU
HEARD TODAY FROM MICHAEL ID AND
HAS HEALTH CARE FUNDING FINANCES.
AS DOCTOR POLLAND SAID.
AS A REGISTERED NURSE I HAVE
WATCHED OUR PATIENTS AFTER. WE
HAVE HEARD STORIES FROM OUR
PATIENTS DELAYING CARE. CUTTING
PILLS IN HALF OR TAKING
MEDICATION EVERY OTHER DAY DUE
TO THE COSTS.
HAVING TO MAKE A CHOICE TO GET
MEDICAL CARE OR LOU ARE HAVE TO
BUY FOOD HAVING TO DECLARE
BANKRUPTCY. OR A BECAUSE OF
MOUNTING A MEDICAL BILLS.
WE ARE STILL ALL TOO FREQUENTLY
THE DOES DIABETIC PATIENT IN
FOUR LIMB AMPUTATION.
A PREVENTABLE OUTCOME IF THEY
HAVE ACCESS TO HEALTH CARE.
BUT BECAUSE THEY HAVE TO CHOOSE
BETWEEN RENT AND FOOD OR INSULIN.
THE FOOT LOSES.
I SINGLE PAYER IS A PLAN THAT
THAT THE CALIFORNIA NURSES
ASSOCIATION HAS BEEN FIGHTING
HARD FOR.
AT TO END STORIES LIKE THIS AND
I WILL SAY WE DON'T BELIEVE THAT
ANY TRANSPARENCY BILL.
ANY PRINCIPLES WILL REALLY STOP
THOSE STORIES.
CALIFORNIA'S WORKING WILL IS
REALLY LOOKING FORWARD TO
WORKING WITH ASSEMBLY TO ADDRESS
THESE ISSUES AND CONCERNS. THAT
MAY BE RAISED DURING THE
LEGISLATIVE PROCESS BUT THE
PEOPLE OF CALIFORNICA HOLDS
PUBLIC HEARINGS AS PART OF THE
DEMOCRATIC. LEGISLATIVE PROCESS
AND CONSIDER ANY AMENDMENTS AND
VOTES ON THE BILL THAT IS
CRITICAL TO THE PEOPLE OF THE
STATE. SO MY INDIAN WORDS ARE.
WE THE NURSES DEMANDED THAT
SPEAKER RENDON RELEASE THE BILL
OUT OF OF THE COMMITTEE AND DO
HIS JOB AND E HOPE THAT THIS
COMMITTEE AND ALL ASSEMBLY
MEMBERS WILL HELP US WITH THAT.
BECAUSE ENOUGH PEOPLE HAVE DIED
AND WILL BE LOSING THEIR LIVES
THANK YOU.
GOOD AFTERNOON THANK YOU MY NAME
IS KATHY DONOGHUE I'D BEEN A
REGISTERED NURSE FOR ALMOST
TWENTY FIVE YEARS IN MATERNAL
CHILD UNIT WHICH I SHOULD NOT
SEE DEATH. BUT I DO OFBOTH
MATERNAL AND INFANTS A SADLY TO
SAY.
AS A REGISTERED NURSE MY LICENSE
REQUIRES THAT I BE A PATIENT
ADVOCATE SOMETHING I TAKE
SERIOUSLY. EVERYONE HERE HAS
EITHER BEEN A PATIENT FOR WILL
BE A PATIENT SO MY ADVOCACY
INCLUDES ALL OF YOU.
AS ELECTED OFFICIALS IT IS YOUR
OBLIGATION TO DO WHAT IS IN THE
BEST INTEREST OF THOSE WHO
ELECTED YOU.
IF EVERYONE IN EACH OF YOUR
DISTRICTS HAD THE CARE THEY
NEEDED WHEN THEY NEEDED IT.
WE WOULDN'T BE HERE TODAY.
SADLY THIS IS NOT THE CASE AND
WE WILL CONTINUE TO SEE
UNNECESSARY DEATHS UNTIL S. B.
FIVE SIX TWO IS LEGISLATIVE.
I LIKE TO ADDRESS THE ELEPHANT
IN THE ROOM WHITE HOUSE AND THE
CALIFORNIA NURSES ASSOCIATION
THE NURSES OF THE STATE. AND THE
PROUD SPONSOR VESTRY FIVE SIX
TWO. NOT TO MENTION RECOGNIZE
CATALYST OF THESE HEARINGS AND
RESPONSIBLE FOR RAISING PUBLIC
AWARENESS ON THIS IMPORTANT
PUBLIC HEALTH ISSUE. BEEN GIVEN
SO LITTLE TIME TO DISCUSS
GUARANTEED HEALTHCARE FOR ALL S.
B. FIVE SIX TWO. THERE BEEN SIX
HEARINGS BY THE SLICK
SUBCOMMITTEE INCLUDING TODAY'S
FOR APPROXIMATELY THIRTY TWO
HOURS NINETEEN TWENTY MINUTES
FOR SOME OF.
AS FOR SOME REASON YOU DECIDED
TO GIVE THE NURSES ONLY THIRTY
MINUTES OF THAT TOTAL TIME TO
TALK ABOUT THE ONLY SOLUTION
THAT WOULD GUARANTEE HEALTH CARE
FOR ALL. IN OTHER WORDS HIS
COMMITTEE HAS A LOT OF ONE POINT
FIVE PERCENT OF ITS TIME SHE
HEARING FROM THE NURSES ABOUT
THE ONLY MEANINGFUL SOLUTION TO
OUR HEALTHCARE CRISIS.
AND THAT IS THE ONLY SOLUTION
THAT WOULD GUARANTEE HEALTHCARE
FOR ALL.
THAT MEANS THIS.
CAN YOU EXPLAIN THIS UPON WHAT
BASIS TO THIS COMMITTEE
DETERMINED TO A LOT ONLY ONE
POINT FIVE PERCENT OF THE TIME
TO THE NURSES AND THEIR
REPRESENTATION OF WHAT THEY
THINK THE SOLUTION IS.
S. B. FIVE SIX TWO THIS MUST
STOP. GET INSURANCE OUT OF OUR
HEALTH CARE SP FIVE SIX TWO IS
NEEDED NOW NO MORE DELAYS NO
MORE DOG AND PONY SHOWS. ENOUGH
IS ENOUGH.
THANK YOU MA'AM.
GOOD AFTERNOON LINDA WAY WITH
WESTERN CENTER ON LAW AND
POVERTY FIRSTLY WOULD LIKE TO
THANK THE ASSEMBLY FOR HOLDING
THIS VERY IMPORTANT HEARING. AND
ALIGN OUR COMMENTS WITH SOME OF
THE PREVIOUS SPEAKERS
PARTICULARLY HEALTH ACCESS.
HIKES CALIFORNIA IMMIGRANT
POLICY CENTER AS WELL AS LABOR
PARTICULARLY WE ARE IN STRONG
SUPPORT OF HOPE FOR ALL. AYE WE
BELIEVE THAT WE'VE GOT WITH
THROUGH HELL FOR ALL KIDS WE'VE
WE'VE GONE THROUGH. A LOT OF
WE'VE MADE. VAST IMPROVEMENTS
BUT I IN TERMS OF GETTING TO
UNIVERSAL COVERAGE RECOGNIZING
THAT OVER HALF OF THE UNINSURED
ARE UNDOCUMENTED PEOPLE WE
STRONGLY SUPPORT HEALTH FOR ALL.
AS WELL AS WE TALK ABOUT
UNIVERSAL COVERAGE THE I LOVE
TALKING ABOUT AN ANOTHER
POPULATION THAT WAS LEFT OUT OF
THE AFFORDABLE CARE ACT.
SENIORS INDIVIDUALS SIXTY FIVE
AND OLDER WHO JUST BECAUSE OF
THEIR AGE ARE SUBJECT TO A LOWER
INCOME ELIGIBILITY THRESHOLD IN
MEDI CAL SO. I URGE OUR
CONSIDERATION OF RAISING THAT
THRESHOLD SO THAT THERE IS A
BRIGHT LINE FOR ALL ADULTS
I. OF SENIORS WHETHER YEAR ARE
BORN IN THIS COUNTRY ARE NOT AYE
IN ADDITION.
LOOKING AT SOME OF THE GAINS
THAT WERE MADE THROUGH WITH THE
P. A CA AND HOW MANY PEOPLE ARE
COVERED THROUGH MEDICAID HOW I.
REALLY HOLDING PLANS ACCOUNTABLE
BY LOOKING AT QUALITY AND I AND
AND YEAR OVER YEAR IMPROVEMENTS
IN SOUTH I'VE. THESE ARE JUST A
FEW OF THAT THE THINGS THAT WE
BELIEVE CAN BE HAPPEN IN THE
SHORT TERM AND. AND SO ARE IN
FULL SUPPORT OF THOSE PROPOSALS
THANK YOU.
THANK YOU MA'AM.
TOO QUICK NOTICED AGAIN I'M
AFTER TWO MINUTES WE'RE GONNA
TURN THE MIKE DOWN ONLY TO MAKE
SURE WE HAVE TIME.
THE SECOND ONE IS THAT HAVE BEEN
NOTIFIED BY THE SERGEANTS THAT
WE'RE AT CAPACITY CURRENTLY
WITHIN THE ROOM AND SO THOSE WHO
TESTIFY. IF YOU GO TO THE
OVERFLOW ROOMS IT MAY ALLOW THE
OTHERS TO ENTER THE ROOM TO
TESTIFY AS WELL TO MAKE SURE WE
GIVE AS MANY VOICES AS POSSIBLE.
WITH THAT PLEASE.
THANK THE COMMITTEE FOR GIVING
ME THIS OPPORTUNITY TO SPEAK AS
A MEMBER OF THE PUBLIC.
MY NAME IS DOCTOR JONATHAN
PIERCE I'M A SIXTY EIGHT YEAR
OLD INTERNIST AND COMPLETED MY
RESIDENCY AT UC DAVIS.
AND RETIRED AT SIXTY SIX FROM
PRIMARY CARE AND SEMI RURAL
GRASS VALLEY NEVADA CITY. AREA I
PLAN TO WORK UNTIL AT LEAST
SIXTY NINE IT NOT SEVENTY.
HAS MANY OF MY COLLEAGUES HAVE
DISCUSSED BUT COULD NOT MAINTAIN
PRACTICED MAINLY DUE TO IT
ONEROUS ADMINISTRATIVE WORK
PRESSURES HAVING TO DO WITH
PRIVATE INSURANCE AS.
I HAD ONE POINT FIVE FULL TIME
EMPLOYEES.
A PROVIDERS MYSELF IN A PART
TIME NURSE PRACTITIONER.
MY PATIENTS HAD ALMOST
EXCLUSIVELY MEDICARE INSURANCE
SOME WITH MEDI CAL SECONDARY
INSURANCE NOT TALKING WITH YOU
ABOUT THIS YOU CAN GET AN
ANECDOTE FROM A PRACTITIONER.
THAT'S WHY.
WITH A SINGLE PAYER SYSTEMS.
AVOIDING A CALLING APPROVAL
PROCESS I WOULD HAVE SAVED ABOUT
ONE POINT SIX FULL TIME
EMPLOYEES FOR ADMINISTRATIVE
COSTS. AND ABOUT FIFTY THOUSAND
DOLLARS PER YEAR MY PRACTICE
CONSERVATIVELY SAID.
SO THANKS
SO I'M IF HEALTHY CALIFORNIA ARE
IMPLEMENTED I ESTIMATE I WOULD
HAVE BEEN ABLE TO SEE THREE TO
FOUR MORE PATIENTS A DAY. AND
PROBABLY KEEP ABOUT THREE
HUNDRED FIFTY MORE PATIENTS MY
TOTAL PATIENT PANEL.
SO I TALK WITH THE PRIMARY CARE
PRACTITIONERS MY AREA AND IS AN
ESTIMATE ABOUT FIVE THOUSAND
EIGHT TOUSAND FORMER MEDI CAL
PATIENTS WOULD BE ABLE TO GET A
PRIMARY CARE DOCTOR WHO CANNOT
NOW IF THIS.
HEALTHY HEALTHCARE FOR ALL
SYSTEM IMPLEMENTED AS MY TIME IS
RUNNING OUT OF A FEW OTHER
POINTS BUT I'M GONNA STOP AND I
JUST ASK THIS COMMITTEE.
WITH ALL THE HARD WORK YOU'VE
DONE PLEASE ASK SPEAKER RENDON
TO RELEASE S. B. FIVE SIXTY TWO
FROM THE RULES COMMITTEE. FOR
FLOOR DEBATE THANK YOU VERY MUCH.
THANK YOU SIR.
HELLO MY NAME IS DOCTOR NATASHA
LEAD. I'M PRESIDENT OF THE
TWENTY SEVEN THOUSAND MEMBERS
STRONG CALIFORNIA DENTAL
ASSOCIATION.
I LIVE IN PRACTICE DENTISTRY IN
SAN FRANCISCO AND ALSO SERVED AS
A DENTAL SCHOOL ASSISTANT
PROFESSOR.
I WANT TO THANK THE COMMITTEE
MEMBERS AND WITNESSES FOR THEIR
THOUGHTFUL TESTIMONY INSIGHTFUL
QUESTIONS AND DIFFICULT WORK
OVER THE LAST SEVERAL MONTHS.
IT IS ESSENTIAL THAT ORAL HEALTH
AND DENTAL COVERAGE CONTINUE TO
BE PART OF THE HEALTH CARE
REFORM DISCUSSION.
DENTISTS IN THEIR TEAMS ARE
ACUTELY AWARE OF HOW POOR ORAL
HEALTH CONTRIBUTES TO POOR
OVERALL HEALTH. AND IS
ASSOCIATED WITH SYSTEMIC DISEASE.
THEM DISEASE HAS BEEN ASSOCIATED
WITH ADVERSE PREGNANCY OUTCOMES
RESPIRATORY DISEASE
CARDIOVASCULAR DISEASE AND
DIABETES.
POOR ORAL HEALTH CONTRIBUTES TO
CHRONIC PAIN. LAW SCHOOL DAYS
UNEMPLOYMENT. LOW SELF ESTEEM
AND HIGHER HEALTHCARE COSTS
INCLUDING OVER USE OF OUR
HOSPITAL EMERGENCY ROOMS.
THIS IS WHY CDA HAS JOINED WITH
OTHER PROVIDER GROUPS TO OPPOSE
S. B. FIVE SIXTY TWO.
OUR GOAL IS TO PROTECT THE GAINS
WE'VE MADE AN EXPANDING HEALTH
CARE COVERAGE OVER THE LAST
SEVERAL YEARS.
WE ARE COMMITTED TO CONTINUING
OUR WORK TO EXPAND ACCESS FOR
CALIFORNIANS WHO DO NOT HAVE
REGULAR ACCESS TO HEALTH OR
DENTAL CARE.
WE KNOW THE EXISTING SYSTEM IS
NOT PERFECT WHICH IS WHY WE HAVE
COME BEFORE YOU IN RECENT YEARS
TO URGE INVESTMENTS IMPROVEMENTS.
ADDRESSING THE GAPS THAT EXIST
ON THE CURRENT SYSTEM IS MORE
PRUDENT THING TO DO RATHER THAN
RECKLESSLY THROWING OUT OUR
ENTIRE SYSTEM. AND LOSING FOCUS
ON THE PROGRESS WE'RE MAKING TO
INSTEAD PURSUE AN UNDEFINED AND
UNFUNDED SINGLE PAYER SYSTEM.
AS YOU WEIGH THE PROPOSALS
PRESENTED TODAY I URGE YOU TO
PROTECT THE PROGRESS CALIFORNIA
HAS MADE UNDER THE ACA.
ESPECIALLY A POSITIVE STEPS THE
STATE HAS TAKEN TO INCREASE
ACCESS TO DENTAL COVERAGE
THROUGH MEDI CAL AND COVERED
CALIFORNIA. AND LOOK FOR
PRAGMATIC OPPORTUNITIES AND
ALTERNATIVES TO ADDRESS THE
REMAINING GAPS.
CDI IS COMMITTED TO WORKING WITH
YOU AS YOU SEARCH FOR REAL
SOLUTIONS TO FORTIFY
CALIFORNIA'S HEALTH CARE SYSTEM
AND TO ENSURE THAT ORAL HEALTH
HAS A SEAT AT THE TABLE. THANK
YOU AGAIN FOR YOUR TIME.
MY NAME IS GIULIANA MILLER NASA
I AM REPRESENTING JOBS WITH
JUSTICE A BROAD COALITION OF
FORTY COMMUNITY AND LABOR
ORGANIZATIONS THE BAY AREA SAN
FRANCISCO AND SO KNOW ABOUT. OUR
COALITION INCLUDES DIVERSE
ORGANIZATIONS THAT SUPPORT AND
EMPOWER. WORKERS IN LOW WAGE
SERVICE JOBS IMMIGRANT.
COMMUNITY AND PETE AND
COMMUNITIES OF COLOR ALL
SEVERELY IMPACTED BY THE
HEALTHCARE CRISIS.
WE FULLY SUPPORT SP FIVE SIXTY
TWO AS THE BEST SOLUTION TO
PROVIDE UNIVERSAL HEALTH CARE.
TWO HIGH QUOTE IT UNIVERSAL
ACCESS TO HIGH QUALITY
HEALTHCARE FOR ALL. ON A
PERSONAL NOTE. I LOST MY FATHER
WAS FIFTY THREE I LOST MY
HUSBAND. BOTH WHO WERE DENIED
CRITICAL TREATMENTS AT KAISER
WHICH COULD HAVE SAVED THEM. A
DOCTOR FOLLOWING MY HUSBAND'S
DEATH CRYING SAID TO ME.
HOW HE WAS STARTED IN THE HOW
HOW MANY TIMES THIS HAPPENS?
THE COST WAS A HUGE FACTOR IN MY
LOS
WE URGE THE SELECT COMMITTEE IN
SPEAKER ROAD DONE TO MOVE S. B.
FIVE.
SIXTY FIVE SIXTY TWO FORWARD AS
THE ONLY SOLUTION TO GUARANTEE
QUALITY HEALTHCARE FOR ALL.
GOOD AFTERNOON MY NAME IS ANGELA
PERRY WITH CONSUMERS UNION THE
POLICY ARM OF CONSUMER REPORTS.
AS AN ORGANIZATION STEEPED IN
ADVOCACY FOR ACCESS TO
AFFORDABLE SAFE HIGH QUALITY
HEALTHCARE FOR ALL CONSUMERS.
WE'RE DEEPLY APPRECIATIVE OF
THESE COMMITTEE HEARINGS.
OVER THE PAST SEVEN YEARS
CALIFORNIA HAS DONE A REMARKABLE
JOB TO EXPAND HEALTH CARE TO
MILLIONS OF CALIFORNIANS.
BUT WE ARE NOT DONE.
AS YOU HEARD FROM SEVERAL
SPEAKERS TODAY COVERAGE GAPS
STILL REMAIN AND COVERAGE
UNFORTUNATELY DOES NOT GUARANTEE
ACCESS OR AFFORDABILITY FOR
EVERYONE WHO LIVES IN CALIFORNIA.
WE HOPED THAT THE EFFORTS TO
COMBAT THE STEEP RISE IN COSTING
CARE.
BUT. I AND TO IMPROVE THE
OUTCOMES OF CARE ARE INTERWOVEN
WITH EFFORTS TO SOLVE THE
PROBLEMS IN GAPS OF COVERAGE.
WE THINK THE COMMITTEE FOR THESE
HEARINGS AND LOOK FORWARD TO
THOUGHTFUL AND PRODUCTIVE
CONVERSATIONS IN THE COMING YEAR.
IF YOU.
GOOD AFTERNOON.
UP MY NAME IS GUSTAVO IT AND I'M
THE WESTERN REGIONAL DIRECTOR OF
YOUNG INVINCIBLES.
YOUNG INVINCIBLES IS A NATIONAL
RESEARCH POLICY AND ADVOCACY
ORGANIZATION DEDICATED THEIR
AMPLIFYING THE VOICES OF YOUNG
ADULTS ACROSS THE ISSUES OF
HEALTH CARE. A WORKFORCE HIGHER
EDUCATION AND CIVIC ENGAGEMENT.
OUR MISSION IS REALLY TO
CONTINUE TO BUILD. THE ECONOMIC
SECURITY AND POLITICAL
PARTICIPATION OF YOUNG PEOPLE
ACROSS THE COUNTRY.
YOU KNOW THROUGHOUT OUR WORK
ACROSS CALIFORNIA WE HAVE
CONNECTED WITH MANY YOUNG ADULTS.
LIVING.
.
LIVING AND MIXED IMMIGRATION
STATUS FAMILIES
WE HEAR STORIES FROM THOSE YOUNG
ADULTS OF LOW INCOME
UNDOCUMENTED CALIFORNIAN PARENTS.
THAT ARE LOCKED OUT OF ACCESS TO
HEALTH CARE AND ARE SUFFERING
AND DYING FROM TREATABLE
CONDITIONS
AND IT DOESN'T STOP THERE WHEN
YOUNG AMERICANS HAVE TO CARE FOR
ILL PARENTS.
WHO ARE UNABLE TO ACCESS A
PORTABLE HEALTH CARE IT CREATES
A DOMINO EFFECT?
YOUNG ADULTS IN THIS POSITION
ARE FORCED TO MAKE TOUGH CHOICES
ABOUT CONTINUING EDUCATION
CAREER CHOICES AND EVEN STARTING
FAMILIES.
WE KNOW THAT THE SOCIAL AND
FISCAL COST OF EXCLUDING THE SET
A SEGMENT OF THE STATE'S
POPULATION SETS BACK CALIFORNIA.
AS A WHOLE AND WE BELIEVE.
THAT WE ALL HAVE A STAKE IN
PROMOTING THE WELL BEING OF ALL
CALIFORNIANS WE ARE PROUD TO BE
HERE. WITH YOU AS A MEMBER OF
THE HEALTH FOR ALL COALITION
ALSO AS A CAP BUT ADVISORY BOARD
MEMBER IN SUPPORT OF. ADDRESSING
THE OVERALL COST AND QUALITY OF
CARE. IN MOVING US TOWARDS A
HEALTHCARE SYSTEM THAT EXPANDS
COVERAGE FOR ALL CALIFORNIANS
THANK YOU.
BUT YOU START TOM SOME HALF THE
CALIFORNIA MEDICAL ASSOCIATION I
JUST WANT TO FIRST THANK THE
COMMITTEE FOR ALL THE WORK THAT
YOU'VE PUT IN.
THERE'S BEEN A LOT OF HEARINGS
AND IT'S BEEN EXTREMELY
INFORMATIVE SO FIRST OF ALL
THANK YOU. AYE I THINK FOR A LOT
OF THE ADVOCATES A FUNDAMENTAL
QUESTION.
SO ALIVE PEOPLE STILL
STRUGGLING WITH THIS HOW MUCH
ADDITIONAL FUNDING IS GOING TO
BE AVAILABLE UPPER PROPOSALS
THIS YEAR I THINK ANY OF THE
REPORT TO SHOOT HERE. BOARD BOTH
SHORT TERM AND LONG TERM IT WILL
REQUIRE AN INCREASE IN FUNDING
IN THIS YEAR AND SO IF WE GET A
BETTER IDEA OF WHAT THAT MIGHT
BE I THINK THAT WILL. HELP
INFORM THE DECISIONS THIS
COMMITTEE MAKES A GOVERNMENTAL
ASSOCIATIONS GOING TO FOCUS ON
PROPOSALS THAT DO NOT REQUIRE
FEDERAL APPROVAL GOING FORWARD
IS GIVEN THE CLIMATE IN DC.
WE THINK THAT IS THE BEST WAY
TO PROGRESS EMERGING GUIDED BY
FOR A KIND OF FUNDAMENTAL
UNDERLYING PRINCIPLES WHEN WE
LOOK AT LEGISLATION THE FIRST
UNIVERSAL ACCESS MAKING SURE
EVERY CALIFORNIAN. A REGARDLESS
OF IMMIGRATION STATUS HAS ACCESS
TO CARE AND COVERAGE THE SECOND
IS AFFORDABILITY ESPECIALLY WITH
BUT LOW INCOME AND MIDDLE INCOME
PEOPLE WHO DON'T QUALIFY FOR
MEDICARE HOW.
YOU YOU CAN DO THIS IN THE FORM
OF MORE GENERAL SUBSIDIES BUT
BUT THAT UP POPULATION REALLY IS
THOUGH AT THE ONE KIND OF.
GET IN CROSSED A LITTLE BIT A IN
THAT MARKET.
THIRD POSITION WORKFORCE
DEVELOPMENT I KNOW WE'VE WORKED
DOCTOR ARAMBULA ON SOME GME
FUNDING THAT WE LOOK TO CONTINUE
THAT ADVOCACY THIS YEAR FINALLY
A MARKET STABILIZATION THIS CAN
COME IN THE FORM OF. A
REINSURANCE PROGRAMS IN THERE
SOME OTHER POLICY PROPOSALS BUT
MAKING SURE THAT THE UP PREMIUMS
DO NOT.
GO UP DOUBLE DIGIT EVERY YEAR
BY GIVING SOME CERTAINTY TO THAT
MARKET TO US ENSURE A LOW PRICES
SO WITH THAT THANK YOU AGAIN FOR
FOR ALL THESE HEARINGS.
HELLO MY NAME IS DIANE MCCLURE
I'M A REGISTERED NURSE AND HAVE
BEEN FOR TWENTY NINE YEARS AND I
WORK HERE IN A RECOVERY ROOM IN
SACRAMENTO AREA.
.
THE LACK OF POLITICAL WILL IS
REAL PROBLEM HERE.
ALL THE COUNTER ATTACKING
ENGAGED IN BY THE CO CHAIRS OF
THIS COMMITTEE AS WELL AS THE
SPEAKER HAVE BEEN ABOUT FIVE S.
B. FIVE SIX TWO SUPPOSEDLY
LACKING IN DETAILS.
BUT WITHOUT ADEQUATE DISCUSSION
WITH THE NURSES MAIN SPONSORS OF
S. B. FIVE SIX TWO.
STOP ATTACKING THE NURSES.
STOP TRYING TO NEGOTIATE THE
BILL IN THE PRESS AND STOP THE
FACADE.
WE NEED TO MOVE PAST THESE
HEARINGS AND START SERIOUSLY
TALKING ABOUT THE NURSES
SOLUTION SINGLE PAYER GUARANTEED
HEALTHCARE FOR ALL. AND STOP
BENDING OVER BACKWARDS TO GO TO
THE OPPOSITE DIRECTION BY
CALLING FOR MORE INSURANCE FOR
PEOPLE AND THEREBY TAKE THE SIDE
OF THE INSURANCE COMPANIES
PLEASE.
OUR PATIENTS DEMANDED THE NURSES
DEMANDED. THE ASSEMBLY NEEDS TO
DEVELOP THE COURAGE TO RECOGNIZE
THAT S. B.FIVE SIX TWO IS NOT
WOEFULLY INCOMPLETE. AS YOU
HEARD TODAY.
THIS IS A DEBATE IS A DIVISION
OF. THIS IS A.
DIVERSIONARY TACTIC DESIGNED TO
KEEP THE FOCUS OFF THE FACT THAT
THERE'S A SEVERE LACK OF
POLITICAL WILL IN THE ASSEMBLY.
TO HELP PATIENTS BUT AN
ABUNDANCE OF POLITICAL WILL TO
HELP THE INSURANCE COMPANIES
WE NEED GUARANTEED HEALTHCARE
COULD CARE FOR ALL WE NEED S. B.
FIVE SIX TWO.
THANK YOU MA'AM.
YEAH GOOD AFTERNOON MY NAME IS
FLOYD BRIAN I'M FROM LA ON
INTERNATIONAL LONGSHORE AND
WAREHOUSE UNION. SOUTHERN
CALIFORNIA DISTRICT COUNCIL.
AND WE ARE VERY MUCH IN FAVOR OF
FIVE SIX TWO WE WANT.
AND WE ALSO ARE WE'VE ALWAYS
WORKED FOR SOCIAL JUSTICE IN OUR.
LONG SHORT.
UNION AND.
HEALTHCARE IS A RIGHT WE DON'T
UNDERSTAND PEOPLE IN THIS ROOM
VERY FEW OF YOU HAVE BETTER
HEALTHCARE THAN I DO.
BUT MY BIGGEST QUESTION TO YOU
UP THERE IS WHY NOT.
EVERYBODY IN THIS ROOM SHOULD
HAVE HEALTHCARE ON A PARITY WITH
WHAT I HAVE.
WE HAVE OTHER LOCALS THAT DON'T
HAVE HEALTH CARE YOU KNOW THEY
HAVE TO PAY.
ONE IS THEY MAKE THIRTEEN
DOLLARS AN HOUR.
AND THEN THEY PAY THREE HUNDRED
DOLLARS IN A COLD PAID THREE
HUNDRED A MONTH SO THEY'RE DOWN
ELEVEN DOLLARS AN HOUR TO LIVE
ON.
THEM IN THEIR FAMILY WHY CAN'T
WE DO BETTER.
WHY CAN'T WE TAKE THE MONEY THAT?
MY LOCAL IS SPENDING ON HEALTH
CARE BECAUSE IT IS PART OF THE
NEGOTIATIONS.
THEN PUT IT BACK INTO WAGES AND
PENSION AND BACK INTO THE
ECONOMY.
AND YOU SIT UP THERE AND SAY
WELL YOU KNOW WE'RE NOT SURE HOW
WOULD DO THE MONEY THIS IS THE
SIXTH OR EIGHTH I'M NOT SURE
WHICH ONE LARGEST ECONOMY IN THE
WORLD.
AND YOU GUYS CAN'T FIGURE THAT
OUT.
I MEAN SERIOUSLY I BEEN WORKING
ON THIS FOR THE LAST TWENTY
YEARS.
AND MY LAST QUESTION IS HOW MUCH
LONGER WE GONNA KICK THIS CAN'T
ON THE ROLE.
SERIOUSLY.
THANK YOU SO.
GOOD AFTERNOON DOCTORS WOULD AND
ARAMBULA AND THE STING MEMBERS
OF THE ASSEMBLY MY NAME IS SANDY
READING. I'M ON THE BOARD OF
DIRECTORS FOR THE CALIFORNIA
NURSES ASSOCIATION AND AN
OPERATING ROOM NURSE OF THIRTY
YEARS.
I'VE HEARD A LOT OF TALK ABOUT
INCREMENTALISM. AND.
AND ALSO.
UNIVERSAL COVERAGE BY WAY OF
HEALTH INSURANCE AND THAT'S NOT
THE ANSWER.
INSURANCE IS NOT HEALTH CARE.
WE KNOW THAT AND I'LL TELL YOU A
LITTLE STORY AND I KNOW YOU'VE
HEARD A LOT TODAY.
I WORK SIDE BY SIDE WITH THE
NURSE.
THAT NURSE WORK VERY HARD.
GOT A CANCER DIAGNOSIS.
AND EXCEEDED THE TREATMENT. TIME
SO THE HOSPITAL FIRED HER.
THERE IS A BREAK IN TREATMENT
AND THAT NURSE PASSED AWAY.
THAT'S NOT ACCEPTABLE TO ME
THAT'S PERSONAL TO ME.
AND I WILL FIGHT FOR S. B. FIVE
SIX TWO.
AND HEALTHCARE FOR ALL UNTIL I
TAKE MY LAST BREATH.
I'LL TELL YOU ANOTHER STORY.
I WAS WILLING A CHILD INTO THE
OPERATING ROOM WHEN THE BILLING
PERSON CAME WITH A PIECE OF
PAPER SAID WAIT WAIT. GREW AND I
SAID WAIT ABOUT WHAT.
FIRST OF ALL DON'T GET BETWEEN A
NURSE AND A PATIENT JUST TELL
YOU THAT. THAT CHILD DID HAVE
SURGERY.
AND I HAD TO GO UP THE CHAIN OF
COMMAND WE DON'T DO SURGERY ON
PEOPLE THAT DON'T. REQUIRE
MEDICALLY OKAY SO INCREMENTALISM
IS NOT THE ANSWER INSURANCE IS
NOT ACCESS TO HEALTH CARE WE
NEED S. B. FIVE SIX TWO AND OUR
PATIENTS CANNOT WAIT.
MY NAME IS JENNIFER HOME I'VE
BEEN A REGISTERED NURSE FOR
TWELVE YEARS AND I WORK IN A
NEONATAL INTENSIVE CARE UNIT
CYBERCOOK TINY BABIES.
SPEAKER RENDON HAS CLAIMED
PUBLICLY THAT IS SPOKEN AT
LENGTH TO THE SPONSORS ABOUT
MAKING THE NECESSARY AMENDMENTS
TO S. B. FIVE SIX TWO.
THE TRUTH IS AFTER FREEZE IN THE
BILL ON THE RULES COMMITTEE ON
JUNE TWENTY THIRD TWO THOUSAND
SEVENTEEN. THE SPEAKER HAS NEVER
SPOKEN TO SEE ANY LEGISLATIVE
ADVOCATES OR POLICY STAFF OR ANY
NURSE LEADERS OF CNN AT ANYTIME
ABOUT THE BILL. DESPITE MULTIPLE
REQUESTS FROM US THE LEAD
SPONSORS OF S. B. FIVE SIX TWO.
CNN SAID OVER AND OVER AGAIN
THAT WE LOOK FORWARD TO WORKING
WITH THE ASSEMBLY TO ADDRESS ANY
ISSUES AND CONCERNS RAISED
DURING THE ASSEMBLY LEGISLATIVE
PROCESS.
THE PEOPLE OF CALIFORNIA DESERVE
AN ASSEMBLY THAT IS RELEASED TO
DO ITS JOB.
FREE TO CONSIDER AMENDMENTS AND
VOTE ON A BILL THAT IS CRITICAL
TO THE PEOPLE OF THE STATE.
INSTEAD THE SPEAKER HAS CHOSEN
TO IGNORE THIS RESPONSIBILITY
AND ATTACK THE VERY PEOPLE
TRYING TO IMPROVE THE HEALTH
CARE OF THE STATE.
WHEN HE SAYS. THAT WE HAVEN'T
HAD AN OPPORTUNITY TO HAVE AN
HONEST DISCUSSION ABOUT SINGLE
PAYER.
COULD THAT NOT HAVE HAPPENED
DURING THE PROCESSING OF S. B.
FIVE SIX TWO THROUGH THE NORMAL
LEGISLATIVE PROCESS WHICH ALSO
INCLUDES HEARING SUCH.
WHY HASN'T THE SPEAKER LET THE
BILL PROCEED THROUGH THE NORMAL
LEGISLATIVE PROCESS IN WHICH
POLITICIANS WOULD BE HELD
ACCOUNTABLE FOR THEIR ACTIONS ON
THIS VERY IMPORTANT MATTER?
PLEASE RELEASE THE BILL GET THE
INSURANCE COMPANIES OUT OF OUR
HEALTH CARE WE NEED GUARANTEED
HEALTHCARE FOR ALL NOT
GUARANTEED INSURANCE.
WE NEED S. B. FIVE SIX TWO NOW.
GOOD AFTERNOON MY NAME IS JANE
SANDOVAL AND I'M A REGISTERED
NURSE I'VE BEEN A REGISTERED
NURSE FOR THIRTY THREE YEARS I
RECKON EMERGENCY DEPARTMENT IN
SAN FRANCISCO. SO I SEE ON A
DAILY BASIS PATIENTS COMING TO
THE EMERGENCY DEPARTMENT FOR
CARE DUE TO LACK OF OR POOR OR
COMPLICATED ACCESS TO CARE.
FOR BUSINESSES BUYING POLICIES
APART FROM THE AFFORDABLE CARE
ACT WHICH IS WHERE MOST
AMERICANS GET THEIR COVERAGE THE
NEXT YEAR'S PREMIUM INCREASES
ARE EXPECTED TO RISE BY
UNPRECEDENTED PERCENTAGES. AT
LARGE.
COMPANIES.
PREMIUMS FOR EMPLOYER PLANS ROSE
THREE PERCENT THIS YEAR TO AN
AVERAGE OF EIGHTEEN THOUSAND SIX
HUNDRED SEVEN HUNDRED SIXTY FOUR.
DOLLARS THAT COSTS IS USUALLY
DIVIDED BETWEEN EMPLOYERS AND
WORKERS THE COSTS KEEP GOING UP.
PEOPLE CAN AFFORD TO USE THEIR
INSURANCE MANY EFFECTIVELY HAVE
NO HEALTH CARE THIS MUST CHANGE.
GET THE INSURANCE COMPANIES OUT
OF OUR HEALTH CARE HEALTH CARE
IS A FUNDAMENTAL HUMAN RIGHT. WE
NEED GUARANTEED HEALTHCARE FOR
ALL NOT GUARANTEED INSURANCE WE
NEED S. B. FIVE SIX TWO LET US
ELIMINATE HEALTH CARE IN THE
QUALITY AND LEVEL THE PLAYING
FIELD. NOW.
HI. MY NAME IS WORTH A COOL I'M
A REGISTERED NURSE AND I'M AN
OFFICER WITH CALIFORNIA NURSES
ASSOCIATION. I WANT TO TELL YOU
ABOUT TWO CHILDREN WITH CANCER.
THAT I SEE ON MY JOB THEIR IDEAL
CHILDREN.
AND THEY HAVE THE SAME DIAGNOSIS
CHILD DAY COMES FROM A WEALTHY
FAMILY HAS GOOD INSURANCE HAS
GOOD PRIMARY CARE. CHILD V.
COMES FROM A POOR FAMILY HAS NO
PRIMARY CARE.
WE'RE NO INSURANCE OR IS UNDER
INSURED CHILD EIGHT GETS AN
EARLY DIAGNOSIS.
AND PROMPT TREATMENT CHILD BE
HAS DELAYED DIAGNOSIS AND DELAY
TREATMENTS AND MISSED
APPOINTMENTS.
CHILD A AND CHILD BE BOTH
BECAUSE OF THEIR DIAGNOSIS NEEDS
SPECIALTY CARE TO SURVIVE.
SHALL THEY GET SICK.
CHILD BE DOES NOT
CHILD DAY SURVIVES.
CHILD BE DOES NOT THIS IS THE
GRIM REALITY OF OUR HEALTH CARE
SYSTEM.
THE KITTY MAKE COMMITTEE MEMBERS
HERE ENJOY THE BENEFITS OF A TAX
PAYER PAID GUARANTEED HEALTHCARE.
YET SOMEONE STILL DO NOT WANT TO
GUARANTEE TAXPAYER PAID HEALTH
CARE IS A SOCIAL AND ECONOMIC
RIGHT TO THE REST OF US.
IT APPEARS TO ME THAT THIS IS
DUE TO A LACK OF POLITICAL WILL.
IN THIS IS NOT TRUE.
FROM WHAT YOU SAY IN THIS IS NOT
TRUE PLEASE STAND WITH NURSES TO
PROTECT AN ADVOCATE FOR OUR
PATIENTS.
WE CALL ON YOU TO GET RENDON TO
RELEASE THE BILL IT IS THE ONLY
CONCRETE PROPOSAL BEFORE YOU
RELEASE S. B. FIVE SIX TO MOVE
IT THROUGH THE REGULAR
LEGISLATIVE PROCESS.
WE ALL KNOW THAT HEALTH CARE
JUSTICE CANNOT WAIT.
HELLO MY NAME IS CAROL COOLEY
HAD BEEN A NURSE FOR TWENTY FOUR
YEARS ON.
CARDIAC UNIT.
HEALTH CARE IS A BASIC HUMAN
RIGHT ALL OF YOU SEEM TO AGREE.
BUT ARE SOMETHING IMPACT AS A
HUMAN RIGHT IT CANNOT BE DENIED
JUST BECAUSE SOMEONE CAN'T
AFFORD IT.
BUT THAT'S THE SYSTEM YOU THE
ASSEMBLY ARE PROMOTING IN
BACKING ONE IN WHICH HEALTHCARE
IS IN FACT DENIED WHEN SOMEONE
CAN'T AFFORD IT.
SO YOU SO YOU CAN'T HAVE IT BOTH
WAYS YOU CAN'T CLAIM IT HEALTH
CARE IS A HUMAN RIGHT WHILE
SIMULTANEOUSLY ENDORSING A
SYSTEM THAT DENIES HEALTH CARE.
WHEN SOMEONE CAN'T AFFORD TO PAY.
THE TWO ARE MUTUALLY EXCLUSIVE.
STOP MISLEADING THE PUBLIC AND
CHOOSE ONE SIDE OR THE OTHER.
LIKE THE BIBLE SAYS NO ONE CAN
SERVE TWO MASTERS
EITHER YOU HATE ONE. AND LOVE
THE OTHER OR YOU BE DEVOTED TO
ONE AND DESPISE THE OTHER.
YOU CAN NOT SERVE BOTH GOD AND
MONEY. THE SAME IS TRUE IN THIS
INCIDENT YOU CANNOT SERVE THE
PEOPLE WHILE SERVING THE
INSURANCE COMPANIES YOU CAN YOU
HATE. THE ONE AND LOVE THE OTHER.
IN OUR CURRENT SYSTEM AND THE
WHITE CLEARLY BEING PROMOTED
THROUGHOUT THE SELECT COMMITTEE
HEARINGS INSURANCE COMPANIES AND
THEIR PROFITS ARE LOVED BY OUR
POLITICIANS FIRST.
WELL THE PEOPLE THE PATIENTS GET
LIP SERVICE ABOUT HEALTH.
HEALTH CARE BEING A HUMAN RIGHT.
THERE'S ONLY ONE WAY TO ENSURE
THAT THE HEALTH CARE IS TRULY
HUMAN RIGHT AND THAT THIS IS
BEING SUPPORTED IS THE ONLY BILL
THAT CALLS FOR THE TRUE SINGLE
PAYER. GUARANTEED HEALTHCARE FOR
ALL WE NEED HEALTH CARE FOR ALL.
WE NEED S. B. FIVE SIXTY TWO NOW.
HUMAN MARK VAN LANDLORDS ARE
REVOLUTION CONTRA COSTA.
DISTINGUISHED LADIES AND
GENTLEMEN THIS IS A HEAVY LIFT.
IT'S A HEAVY LIFT AND WILL
REQUIRE OUR MORAL STRENGTH.
WHEN I WAS DRIVING OVER ON ONE
OF THE OVERPASSES WAS TO SIGN
WHAT WOULD MLK DO.
WE JUST RECENTLY CELEBRATED THE
MEMORY OF DOCTOR MARTIN LUTHER
KING AS APPROPRIATE THAT WE'RE
TALKING ABOUT THIS NOW. BECAUSE
THE FIGHT FOR HEALTHCARE
EQUALITY IS THE FIGHT FOR SOCIAL
EQUALITY IT IS THE FIGHT FOR
ECONOMIC EQUALITY IT IS THE
FIGHT. FOR RACIAL EQUALITY
AND YEARS FROM NOW IT WILL BE
ASKED OF US
WHAT WERE WE DOING WHEN MILLIONS
OF CALIFORNIA FAMILIES WERE
SUFFERING WITHOUT HEALTHCARE.
AND I THINK IT'S IMPORTANT THIS
DEBATE
TO PRIORITIZE THE VOICES OF THE
NURSES
THERE ON THE FRONT LINES OF THIS
BROKEN SYSTEM.
THEY KNOW THE FACES BEHIND THE
NUMBERS THEY KNOW THE STORIES
BEHIND THE STATISTICS.
AND
TO UNDERLINE THE URGENCY OF THIS
MOMENT IT CAN'T BE DONE ENOUGH.
EVERYDAY WE LET THIS CRISIS
CONTINUE.
IT'S ANOTHER NEIGHBOR GONE.
IT'S ANOTHER FAMILY MEMBER GONE.
IT'S ANOTHER CHILD
GONE.
SO THERE IS NO BETTER WAY TO
HONOR THE LEGACY OF DR MARTIN
LUTHER KING.
THEN TWO FORWARD TO ADVOCATE TO
FIGHT.
PASS S. B. FIVE SIX TWO.
PLEASE BE LEADERS IN THAT FIGHT
THANK YOU.
SIR.
GOOD AFTERNOON.
MY NAME IS THE LORD STERN HELIO.
I BEEN A REGISTERED NURSE FOR
EIGHTEEN YEARS AND I WORK IN A
NEONATAL INTENSIVE CARE UNIT.
ONE HERE'S TO CRITICISM. THAT S.
B. BY SIXTY TWO CANNOT PROCEED.
BECAUSE ALL OF THE DETAILS HAVE
NOT BEEN SPELLED OUT AHEAD OF
TIME.
THIS IS WRONG.
BUT FOR THE ABSENCE OF POLITICAL
WELL AND LEADERSHIP IN THE
ASSEMBLY. THE DETAILS IN ANY
ALLEGED DEFICIENCIES.
WOULD HAVE BEEN WORKED OUT BY
NOW.
SINGLE PAYER GUARANTEED
HEALTHCARE FOR ALL. IS AN IDEA
WHOSE TIME HAS COME.
IT REQUIRES OUR BASS THINKING.
NOW IS NOT THE TIME. TO STOP
BEFORE WE START.
IDEAS MATTER AND THIS IDEA IS
SUPPORTED. BY THE VAST MAJORITY
OF DEMOCRATS
AND AN OVERWHELMING MAJORITY OF
CALIFORNIA RESIDENTS.
IDEAS MATTER.
AND THE EMBRACE OF IMPORTANT
IDEAS BY THOSE IN POSITIONS OF
LEADERSHIP.
IS HOW GREAT THINGS HOW GREAT
THINGS ARE ACCOMPLISHED.
GONE ARE THE DAYS OF POLITICIANS
WHO CLAIM TO SUPPORT GUARANTEED
HEALTHCARE FOR ALL. OR THAT
HEALTHCARE IS A HUMAN RIGHT.
BUT WHO SIMULTANEOUSLY ATTACK
THE ONLY BILL BEFORE THE
LEGISLATURE.
THAT WOULD GUARANTEE HEALTH CARE
FOR ALL. AND IN FACT
MAKE IT A HUMAN RIGHT.
GET THE INSURANCE COMPANIES OUT
OF OUR HEALTHCARE.
WE NEED GUARANTEED HEALTHCARE
FOR ALL. NOT GUARANTEED
INSURANCE
RELEASE THE BILL.
WE NEED S. B. FIVE SIXTY TWO NOW.
THANK YOU MA'AM MY NAME IS CASEY
CARPENTER I'M A PARENT ANA
ELECTED THAT DELEGATE THE
CALIFORNIA DEMOCRATIC PARTY I'M
A LEADER IN OUR EVOLUTION. AS A
LEAD THE CALIFORNIA.
DEMOCRATIC CLUB BOMB BEJAR
PROGRESSIVE DEMOCRATS.
OF HEALTH CARE IS VERY PERSONAL
TO MY FAMILY MY MY DOLLARS A
CANCER SURVIVOR SHE SURVIVED
WITHOUT A SECOND YEAR MED SCHOOL.
BUT MY SON HAS ASTHMA. WITHOUT.
INSURANCE.
I WOULD NOT HELP PROVIDE HIM THE
MEDICAL. DRUGS AND PRESCRIPTIONS
HE NEEDS AND NINETY THREE YEAR
OLD GRANDMA MERRY.
LET ME JUST SAY.
BOB SHE IS CAUGHT IN THE CRACKS
OF OUR BROKEN HEALTHCARE SYSTEM
IN CALIFORNIA.
BUT TEN YEARS AGO MY PARENTS
ACTUALLY RETIRED WITH MEXICO MY
GREATEST FEAR.
WAS WHAT ABOUT HEALTHCARE.
NOW FAMILY MEMBERS ARE FLYING
DOWN TO MEXICO TO GET DENTAL
WORK IN MEXICO.
IT'S ACTUALLY GREAT WORK AT HALF
THE PRICE YOU CAN GET FROM THE
OTHER DENNIS THIS BOOK EARLIER.
AND DID YOU KNOW YOU CAN BOOK A
FIRST CLASS TICKET. INCLUDING A
WEEKEND IN ALCOHOL CHO AND GET
HEALTHCARE IN MEXICO WE'RE NOT
TALK ABOUT CANADA.
SO CALIFORNIA MAY BE LEADING IN
MANY AREAS HURT SUMMIT SUPER
LEADING. THIS GROUP WAS NOT
LEADING AND HEALTH CARE.
NOT IN ANY WAY WHATSOEVER.
I RECOMMEND SO MUCH A FIELD TRIP
TO TO.
.
OUR TO MARYLAND HOW ABOUT A
FIELD TRIP TO VISIT SOME OF THE
NURSES.
AND EXPERIENCE HEALTHCARE IN IN
THE GAPS ARE HAPPENING ASSIST
WITH THE DATES BROKE.
YOUR JOB IS ELECTED OFFICIALS IS
TO LEAD BRING TOGETHER THOSE
CONSTITUENTS AND LET'S REALLY
GET THE STATE OF CALIFORNIA.
NO MORE WHAT WE'RE AFRAID WHAT
THE TRUMP FEDERAL GOVERNMENT'S
GONNA DO FOR CALIFORNIA.
LET'S GET THIS DONE RELEASE THIS
BILL NOW DO YOUR JOB.
THE CAN RELIGION ON BEHALF THE
CALIFORNIA PAN ETHNIC HEALTH
NETWORK THANK YOU FOR THE
CONVERSATIONS HERE TODAY AND ONE
FIRST. PLEASE TO HEAR THE
GROWING SUPPORT FOR.
ENSURING ACCESS TO HEALTH CARE
TO ALL CALIFORNIANS REGARDLESS
OF IMMIGRATION STATUS WHO STRONG
SUPPORT HEALTH FOR ALL OWNERS
LEGISLATURE TO ACT ON THAT THIS
YEAR. SECOND THERE ARE STEPS
THAT WE CAN TAKE NOW TO ADDRESS
THE DISPARATE LEVEL OF CARE AND
IT EQUABLE OUTCOMES IN HEALTH.
THAT WE'RE EXPERIENCING.
IN WITH ISN'T THE SYSTEM
PARTICULARLY IN MEDI CAL WE
BELIEVE WE CAN HOLD MEDI CAL
MANAGED CARE ACCOUNTABLE FOR FOR
THESE VERY OUTCOMES AND.
QUALITY OF CARE THAT THEY'RE
PROVIDING TO INDIVIDUALS.
AND PROVIDE THE DEPARTMENT
HEALTHCARE SERVICES THE TOOLS
THEY NEED TO TO DO THAT AND WE
BELIEVE WE CAN BE DOING THIS TO
TARGET THE DISPARITIES THAT WE
SEE ACROSS REGION. OF ACROSS
RACE ETHNICITY.
GENDER SEXUAL ORIENTATION ALL
THESE FACTORS THAT WE KNOW THAT
IMPACT PEOPLE'S HEALTH OUTCOMES
ON AND WE ARE WORKING WITH OUR
PARTNERS AT THE WESTERN CENTER
ON LAW AND POVERTY.
AND WE HOPE THAT WE CAN WORK
WITH MEMBERS OF THE LEGISLATURE
THIS YEAR TO.
MOVE THIS.
STEP THIS YEAR AND.
LOOK FOR THAT CONVERSATION
THINK.
COULD YOU.
MY NAME IS NORMA WILCOX.
I AM A REGISTERED NURSE OF OVER
FIFTY YEARS.
THE BUTTE COUNTY HEALTH CARE
COALITION WHICH IS A LOCAL
ORGANIZATION. WHOSE MISSION IS
TO SUPPORT.
I A SINGLE PAYER HEALTHCARE
SYSTEM I'M ALSO.
A MEMBER AND A DIRECTOR OF THE
ORGANIZATION HEALTH CARE FOR ALL
WHICH IS A STATEWIDE.
ORGANIZATION AND I'M ALSO A AND
ELECTED DELEGATE TO THE DEBATE
DEMOCRATIC PARTY.
AND ONE OF THE THINGS THAT I WAS
JUST THINKING ABOUT IS WHEN WE
ARE TALKING ABOUT ALL THE
EUROPEAN COUNTRIES THAT HAVE
UNIVERSAL HEALTHCARE.
AND THE OF VARYING SYSTEMS ONE
THING THEY HAVE IN COMMON IS
IT'S ALL NON PROFIT.
IT'S NONPROFIT.
AND ONE OF THOSE WAYS THAT THEY
GET THAT IS THROUGH THEIR
LEGISLATORS.
IT'S THE LEGISLATORS
RESPONSIBILITY.
TO CREATE A SYSTEM.
SO THAT EVERY PERSON HAS ACCESS
TO THE SAME HIGH QUALITY
AFFORDABLE. HEALTHCARE.
AND I'M GOING TO JUST SHARE A
PERSONAL STORY OF HOW. YOU AS
LEGISLATORS ARE RESPONSIBLE.
FOR THE BUT POVERTY LEVEL.
AND IN THIS IN THIS WAY.
IS.
I WAS IN A CAR ACCIDENT.
AND SOON AFTER MY HUSBAND WAS
DIAGNOSED WITH CANCER SO WE WERE
BOTH UNABLE TO WORK AT THE SAME
TIME.
IT TOOK US TEN YEARS TO PAY OUR
MEDICAL BILLS.
WE ENDED UP ALMOST IN BANKRUPTCY
AND HOMELESSNESS.
THAT NEVER NEVER SHOP. IN THEN
HE OTHER COUNTRY.
NINE NINE ANY OF EUROPEAN
COUNTRIES
AND IT IS BECAUSE OF THE
LEGISLATORS THEY HAVE.
A RESPONSIBILITY AND THEY HAVE
TAKEN A RESPONSIBILITY TO THEIR.
THEIR CITIZENS THANK YOU.
GOOD AFTERNOON THAT REALISTS ART
FROM THE LOS ANGELES
HEADQUARTERS OF THE NATIONAL
IMMIGRATION LAW CENTER. I AM
SPEAKING IN SUPPORT OF THE
PROPOSAL ADVANCED BY MISSUS
VIDEO OF CALIFORNIA BEGIN POLICY
CENTER AND INCLUDED IN THE
ASSEMBLY BUDGET BLUEPRINT. WHICH
IS TO EXTEND ELIGIBILITY FOR
MEDICAID ALL TO ALL INCOME
ELIGIBLE CALIFORNIANS REGARDLESS
OF THEIR IMMIGRATION STATUS.
I DOCUMENTED IMMIGRANTS ARE
AMONG OUR MOST VULNERABLE
RESIDENTS
AND EXCLUDING THEM FOR
AFFORDABLE HEALTH CARE OPTIONS
COMPOUNDS THAT VULNERABILITY
HARMING THEIR ENTIRE FAMILY AND
EVERYONE WHO DEPENDS ON THEIR
LABOR AND ECONOMIC CONTRIBUTIONS.
AND AS WAS NOTED EARLIER DENYING
ACCESS TO A SEGMENT OF THE
COMMUNITY ALSO CONTRIBUTES TO
THE INSTABILITY OF THE
HEALTHCARE SYSTEM WHICH AFFECTS
US ALL.
COVERING UNDOCUMENTED RESIDENTS
IS A CONCRETE PRACTICAL AND
HUMANE STEP TOWARDS ACCESS TO
AFFORDABLE HEALTHCARE FOR ALL
AND I ENCOURAGED LEGISLATURE TO
MOVE MINISTER STINKY SINGER I AM A
DELEGATE TO CALIFORNIA
DEMOCRATIC PARTY. AYE IN
ADDITION I AM DISABLED ARE AYE.
WELL IT IS A PUBLIC SCHOOL
TEACHER WE HAVE ONE OF THE BEST
HEALTHCARE PLANS OUT THERE.
AND.
WE HAVE DRAINED OUR SAVINGS ON
MY DISABILITY.
MY MOTHER IS DISABLED AND HAS A
HEART DEFECT THAT WILL KILL HER.
SHE DOES NOT GET MONTHLY
INJECTIONS.
SHE CAN AFFORD THESE INJECTIONS
THERE TWELVE HUNDRED DOLLARS A
MONTH.
PER DOCTOR PEAS OUT OF POCKET.
SO THAT SHE CAN SURVIVE.
MY ROOMMATE HAS A TUMOR ON HIS
BACK.
THAT HE HASN'T REMOVED IN YEARS.
BECAUSE HE CAN'T AFFORD THE
SURGERY.
HE HAS ACCESS TO HEALTHCARE.
I HAVE ACCESS TO HEALTH CARE MY
MOTHER HAS ACCESS TO HEALTH CARE.
AXIS IS A MEANINGLESS WORD.
AND YOU SHOULD STOP USING IT.
RELEASE THE BILL NOW.
AND I WANT TO SAY ONE LAST THING.
I WOULD LIKE TO THANK EVERYONE
HERE FOR ALLOWING US THIS
OPPORTUNITY A TALK I WOULD
SPECIFICALLY LIKE TO THANK.
CHAIRMAN WHAT.
FOR.
MOTIVATING SO MANY OF US YOU YOU
SEE HERE TODAY.
BY HIS PALACE AND DISGUSTING
ATTACKS AGAINST THE SEA IN A ON.
THANK YOU VERY MUCH.
HELLO AYE ENGINE MEDINA ASIAN
AMERICANS ADVANCING JUSTICE
CALIFORNIA TO PROJECT OF
ADVANCING JUSTICE ASIAN LAW
CAUCUS THAT DISCO. IN A NOTHING
JUSTICE LOS ANGELES AND NOW
WE'RE HEARING STUNT PART OF
EFFECTIVE UNIVERSAL COVERAGE OF
PARTICULAR FOR HEALTH FOR ALL
PROPOSALS OUT LIKE TODAY BY
HEALTH ACCESS AND THE CALIFORNIA
MARKET POLICY CENTER. AS NOTED
BY CA PC A FIFTY EIGHT PERCENT
OF THE UNINSURED ARE UNABLE TO
YOU.
GET COVERAGE BECAUSE OF THEIR
IMMIGRATION STATUS LOOKING AT
THE ASIAN AMERICAN IT WANTS TO
BE ON A COMMUNITY IN CALIFORNIA
OVER FOR YOUR SIXTY THOUSAND OF
OUR COMMITTEE MEMBERS
UNDOCUMENTED WE NEED IS ORGANIZATIONS.
THAT ARE MADE UP OF YOUNG
ADULTS AND.
YOUTH WHO ARE UNDOCUMENTED.
AND TO WORKING WITH THESE
COMMITTEES WE FOUND THAT A LOT
OF OUR CAMINO WAS REALLY
CONCERNED ABOUT. HOW THEIR
PARENTS OR ADULT FAMILY MEMBERS
AND AND ABLE TO EX ACCESS HEALTH
CARE AND BECAUSE OF THEIR
IMMIGRATION STATUS? I'M SO WE
KNOW IN THE GROUND THAT IS A
VERY IMPORTANT ISSUE FOR OUR
COMMUNITIES AND WE CALL ON THE
ASSEMBLY. AND THE LEGISLATURE TO
SUPPORT HEALTH FOR ALL AND
THAT'S MOVING THROUGH THE
PROCESS OF THE LEGISLATIVE AND
BUDGET SESSIONS.
AND A IN ADDITION TO THAT.
ROSSO VERY CONCERNED AND ENDS
WERE MOVING TO DISCUSSION I TO
LOOK AT EXPANDING ITS ACCURATE
DATA FOR COMMUNITIES ARE LOOKING
AT CLOSING SPEAKING FOR THE DEMOCRATS IN
THE HOUSE.
WE ALL BELIEVE.
HEALTHCARE IS A HUMAN RIGHTS I
WOULD LIKE TO ASK THOSE OUT
THERE WHO DO BELIEVE THAT TO
RAISE THEIR HANDS SO WE ALL KNOW.
WHERE YOU STAND NO AND REYES A
HOTTIE AYE IT WE WANT WE NEED TO
SEE YOU? OKAY SO THREE. AND WE
ALSO HEARD THAT YOU KNOW EVERY
DAY IN THIS STATE.
EVERY DAY EIGHT PEOPLE DIED SO
WOULD ONLY TAKE US A DAY IN A
QUARTER TO GET RID OF ALL OF YOU.
HOW CAN YOU BE SO MISS
UNDERSTANDING AND HEARTLESS?
HOW SINGLE PAYER HEALTHCARE IS
THE ONLY WAY YOU CAN TINKER WITH
INCREMENTAL STEPS IF YOU WANT?
BUT I AM A RETIRED SOCIAL WORKER.
IN NINETEEN EIGHTY TWO I WORKED
IN PRISONS IN FLORIDA AIDS CAME
IN.
IT EXPLODED IF WE HAD HEALTH
CARE.
YOU WOULD HAVE ALLEVIATED A LOT
OF BANKRUPTCIES A LOT OF PEOPLE
LIVING ON THE STREETS AND A LOT
OF PREMATURE DEATHS AND THE
PUBLIC HEALTH CRISIS.
S. B. FIVE SIX TWO.
IF.
YOU DON'T HAVE TO BE ROCKET
SCIENTISTS YOU KNOW WHAT KENNEDY
DID ONE IS EVER GOING TO GET TO
THE MOON AND SEVEN OR NINE YEARS.
AND THEY SAID YOU'RE A FULL.
HE WENT TO THE EXPERTS APPOINTED
PEOPLE HE KNEW WHO HAD THE
INTEREST AND THE DOTS
THE PLAN THE PROGRAM SET UP S.
B. FIVE SIX TWO SO YOU APPOINT A
BOARD.
YOU KNOW THAT RIGHT AWAY THAT'S
ABOUT PAIN GET THAT THE CRIMINAL.
MAFIA.
OR THE INSURANCE COMPANIES OUT
OF IT.
WHO ELSE COULD GO WHAT YOU WOULD
SAY GIVE ME A DOLLAR IF EVERY
DOLLAR I MIGHT GIVE YOU BACK
SEVENTY CENTS WHO CAN DO THAT?
BUT LAW HAS SET THAT UP BEFORE
SEVENTY TWO IT WAS NOT THAT WAY.
SINGLE PAYER HEALTH CARE
EMBODIED SP FIVE SIX TWO IS THE
WAY SET THE THING UP BUT THE
EXPERTS DETERMINE HOW BEST TO DO
IT OTHERWISE PEOPLE ARE DYING.
NEEDLESSLY HOW CAN YOU LIVE WITH
THAT.
GOOD EVENING COULD LOSE ALL AND
AVE TO THE FASTER PROJECT
CALIFORNIA.
.
I THINK AFTER TODAY'S HEARING
IT'S CLEAR ON I THINK IT'S CLEAR
THAT WE'RE ALL THE SAME TEAM.
.
WE HAVE DIFFERENCES ON HOW TO
GET THERE BUT I THINK I THINK
OUR GOAL IS THE SAME.
UNIVERSAL COVERAGE OF FOR ALL.
AT THIS POINT ARE AT BEST A
PUBLIC CALIFORNIA'S IN SUPPORT
OF CA PC'S.
PROPOSAL ON HEALTH FOR ALL. OF
IT TO SHORE.
AND ACCESS TO COVERAGE TO A
DOCUMENT CITIZENS.
THANK YOU FOR YOUR TIME AND FOR
ALL HIS EFFORTS THAT YOU HAVE
DONE OVER THE COURSE OF MONTH.
WE LOOK FORWARD TO WORKING WITH
THIS COMMITTEE AND THE BUDGET
COMMITTEE TO MAKING THAT A
REALITY THANK YOU.
HI I MARC SAMASHKI I'M HERE
REPRESENTING THE AMERICAN
FEDERATION OF MUSICIANS ALL THE
LOCALS IN CALIFORNIA. WHO ARE IN
SUPPORT?
OF S. B. FIVE SIXTY TWO.
AND GETTING IT OUT OF THE RULES
COMMITTEE. AND OUT IN THE TO THE
ASSEMBLY FOR TO PAY.
I DON'T HOW MUCH I CAN ADD TO
THOSE WONDERFUL NURSES HERE THAT
HAVE MADE THEIR POINTS SO
ELOQUENTLY.
.
I DID.
OF.
I'VE BEEN HERE FOR OF FOUR OF
THESE MEETINGS AND OF THIS ONE
ESPECIALLY. WAS OF ENERGIZING TO
ME BECAUSE THEY WERE ABLE TO.
OF.
ROBERT POLAND WAS ABLE TO.
PRESENT OPTIONS THAT ARE
AVAILABLE TO A SINGLE PAYER
SYSTEM WHICH SEEMS TO BE.
WHERE ALL LOGIC TAKES EVERYBODY
FOR A UNIVERSAL SYSTEM THAT'LL
WORK?
ON.
TO.
MOVE AHEAD THE VOTER FELL DOWN
HERE THAT WAS THE LONGSHOREMEN.
MADE AN INTERESTING POINT ABOUT
CALIFORNIA BEING. OF THE SIX
LARGEST ECONOMY IN THE WORLD.
I DON'T SEE AYE GIVEN HOW THINGS
WORK IN OTHER. FIRST WORLD
COUNTRIES
WHERE THEY CAN SPEND HALF THE
MONEY AND GET BETTER RESULTS.
WHY WE CAN'T DO THAT HERE AND
GIVEN CALIFORNIA'S ECONOMY? THIS
IS THIS IS CALIFORNIA'S
SASKATCHEWAN MOMENT AND YOUR.
TOMMY DOUGLAS MOMENTS TO BECOME.
THE GREATEST AMERICAN CITIZEN
BECAUSE LOVE CBC DID ALL POLL ON
WHO WAS THE GREATEST CANADIAN.
AND THE WINNER WAS TOMMY DOUGLAS.
THANK YOU.
NANCY FORMING A FROM NEVADA CITY
CALIFORNIA.
THIS IS MY STORY.
BACK IN NINETEEN SEVENTY SIX I
WAS A JUNIOR IN COLLEGE.
AND I WAS STRUCK WITH A VERY
SERIOUS.
AUTOIMMUNE CHRONIC CONDITIONS.
AND I IMMEDIATELY BECAME.
UNINSURABLE.
AND A YEAR LATER. WHEN I
GRADUATED COLLEGE.
I FIND MYSELF DECIDING WHERE TO
PURSUE MY CAREER NOT BASED ON
WHAT'S THE BEST FIRM FOR ME TO
BE AT. OR HEAVEN FOR BED TO EVEN
BE ABLE TO START MY OWN BUSINESS
I HAD NO CHOICE.
MY CRITERIA WAS FINDING A FIRM
THAT HAD.
GROUP COVERAGE UNDER WHICH I
COULD BE COVERED MY ONLY OPTION.
SO FOR FORTY YEARS IN THAT
SITUATION.
I YES HAD COVERAGE BUT I FOUGHT
WITH INSURANCE COMPANIES ON A
REGULAR BASIS DENIED COVERAGE
I'VE SPENT.
HOURS MONTHS YEARS ON IN
TELEPHONE CALLS WITH INSURANCE
COMPANIES.
AND WHAT I FIND THE MOST
DISGUSTING ABOUT THAT WHOLE
SITUATION IS THAT.
IT IT'S NOT BECAUSE OF MY CARE
IT WAS ABOUT.
SOME SHAREHOLDER MAKING A PROFIT
OR SOME C. E. O. THAT NEEDED A
NEW YACHT OR WHATEVER IT WAS.
FORTUNATELY AND THE LAST YEAR
I'VE BEEN FINALLY ABLE TO MAKE A
DECISION TO NOT WORK ANYMORE
BECAUSE I CAN GET COVERED UNDER
THE A. C. I.
BUT ALL TOO YOU WHAT IT IS NOT
PERFECT IT IS FAR FROM PERFECT I
HAVE INSURANCE COVERAGE IT IS
OBSCENELY EXPENSIVE MY PREMIUM
LAST YEAR WENT UP TWENTY EIGHT
PERCENT AS OF JANUARY FIRST.
AND AND I'M STILL FIGHTING WITH
INSURANCE COMPANIES.
SO.
I WANT TO SUGGEST THAT WE GET.
INSURANCE PROFIT OUT OF THE
SYSTEM.
IT'S THE ONLY WAY THIS IS GOING
TO WORK.
BRING S. B. FIVE SIXTY TWO TO
THE FLOOR.
THANK YOU.
HELLO MISTER.
MISTER CHAIR AND MEMBERS OF MY
NAME SALINAS CENTURY A WITH NEXT
IN AMERICA WHERE NONPROFIT
ORGANIZATION THAT FOCUSES ON OF
SOCIAL JUSTICE ISSUES AND INCOME
INEQUALITY. SPECIFICALLY AS IT
RELATES TO HEALTH CARE NEXT ON
IS HERE TODAY TO SUPPORT EXPRESS
SUPPORT FOR THE HEALTH FOR ALL
PROPOSAL.
PRESENTED BY THE CALIFORNIA
POLICY IMMIGRANT POLICY CENTER
AND INCLUDED IN THE ASSEMBLY
BUDGET BLUEPRINT. OUT WE LOOK
FORWARD TO WORKING WITH THE
LEGISLATURE IMPROVING OUR
HEALTHCARE SYSTEM TO PROVIDE
EQUITABLE EQUITABLE AND
AFFORDABLE HEALTHCARE FOR
CALIFORNIANS THINK YOU.
I CAME.
HI I'M DOCTOR ELIZABETH TO MY
I'M REPRESENTING SINGLE PAYER
NOW ON FROM BERKELEY. I'M A
CLINICAL PSYCHOLOGISTS I
GRADUATED FROM SCHOOL WITH TWO
HUNDRED AND THIRTY TWO THOUSAND
DOLLARS A SCHOOL DAY.
AND MY CURRENT HEALTH OF PLAN
DEDUCTIBLES SIX THOUSAND DOLLARS.
OUR HEALTH CARE SYSTEM CLEARLY
DOESN'T WORK AND IN MY OPINION A
SINGLE PAYER SYSTEM IS SO SO
OBVIOUSLY THE ONLY THING THAT
MAKES SENSE GETTING INSURANCE
COMPANIES. OUT OF OUR HEALTH
CARE SO I ASK YOU TO BE LEADERS
IN THIS MOST IMPORTANT MOMENT IN
OUR HISTORY WHERE IT'S SO
CLEARLY TIME FOR US TO TAKE A
STAND. AND DO THE ONLY THING
THAT MAKES SENSE I THINK YOU FOR
YOUR TIME.
THANK YOU MA'AM.
GOOD AFTERNOON A MY NAME IS GINA
GATES I TOO AM ELECTED I'M
ELECTED DELEGATE FROM SAN JOSE
CALIFORNIA. FOR A DE TWENTY
SEVEN WITH ONE OF THE MOST
PROGRESSIVE LEADERS ARM OUR OUR
SCHOLAR WHO WE HAVE SENT TO YOU
TO DO SOME FANTASTIC WORK.
I'M HERE TO TELL YOU THAT
THERE'S A LOT OF AUDACITY THAT'S
GOING ON HERE.
AND I JUST LIKE I TELL MY KIDS
YOU WANT SOMETHING DONE LOOK IN
THE MIRROR.
AND I'M TELLING YOU YOU ALL NEED
TO LOOK IN THE MIRROR WHO ARE
NOT GETTING THIS.
WHY IS IT THAT YOU SAY THERE IS
NO MONEY WHEN YOU GUYS CANNOT
PASS?
AND THE TAX ON OIL EXTRACTION
TAX.
I MEAN EVEN PALE IN FROM ALASKA
WHO I CALLED CATWOMAN WITH THOSE
BOOTS OF HERS IS GETTING MONEY.
FROM OIL EXTRACTION BUT YOU GUYS
CAN'T FIND THE MONEY AND YOU
GUYS CAN PASS IT BECAUSE.
TOO MANY OF YOU ARE BOUGHT AND
BOSTON.
I'M JUST GOING TO SAY IT BUT IN
BOTCHED YOUR NOT LOOKING AT THE
DOLLARS THAT'S OUR MONEY. THAT'S
YOUR MONEY TO DO YOUR JOB.
I WANT TO POINT OUT TO THE
AUDACITY.
SENATE ACTOR NEEDS TO PULL THIS
BILL.
AND NOT MOVE IT FORWARD.
AND NOT TO PAY ATTENTION TO
THESE NURSES.
AND THE DOCTORS.
YOU NEED TO LOOK AT THE ENTIRE
PICTURE FRIENDS TO LIVE IN SANTA
CLARA COUNTY WE'RE LOSING OUR
DOCTORS BECAUSE THEY CAN'T
AFFORD TO LIVE THERE. THAT'S
WHAT'S GOING ON IN OUR STATE WE
CAN'T FIND PEOPLE TO FILL I MEAN
THERE'S A LOT OF MY SISTERS
HEARING YOU KNOW WHAT. WHERE
YOUNG TECH?
WE ARE NOT AND. BILL THEIR JOBS
HOOPLA TO INVEST IN OUR
COMMUNITY SO BASED THIS PEOPLE
CAN BECOME NURSES TO WHEN. THEY
CAN'T EVEN AFFORD TO GET AN UP
TO GREET BECAUSE THEY CAN'T
AFFORD THE DEBT.
YOU ALL NEED TO LOOK AT WHAT IT
TAKES TO BE A NURSE WHAT IT
TAKES TO BE A DOCTOR. THEY NEED
TO BE ABLE TO GET OUT FROM UNDER
THAT DEBT AND PRIDE.
I'M ASKING YOU HAVE THE AUDACITY
TO DO WHAT'S RIGHT.
THANK YOU.
HELLO MY NAME IS DESERT IT'LL
HAAS AND I COME FROM A FAMILY OF
FARM WORKERS I ALSO COME FOR I
AM THE DAUGHTER OF THE CO
FOUNDER THE UNITED FARM WORKERS
UNION. I COME FROM A LONG
HISTORY OF FIGHTING FOR FARM
WORKER RIGHTS AND FOR POOR
PEOPLE. AND I HAVE TO SAY THAT I
AM ABSOLUTELY DISGUSTED THAT S.
B. FIVE SIXTY TWO WAS FROZEN
HERE'S THE BOTTOM LINE YOU KNOW
IT AS WELL AS I DO YOU'VE HEARD
IT FROM THE. PEOPLE ON THE
FRONTLINE NURSES TEACHERS PEOPLE
IN EDUCATION WHO SEE CHILDREN
GOING TO SCHOOL HUNGRY THE ONLY
MEAL THAT THEY HAVE IN SCHOOL
OFTEN IS THEIR LUNCH.
AND I'M GONNA TELL YOU I'M
ABSOLUTELY DISGUSTED IT DOESN'T
TAKE A ROCKET SCIENTIST TO
UNDERSTAND THAT WE CAN DO THIS.
THIS BILL WAS FROZEN BECAUSE IT
WAS THROWN UNDER THE BUS BECAUSE
IT WAS POLITICAL BECAUSE WE ARE
OWNED BICU OUR OWN NOT BECAUSE
PEOPLE BUT OUR OWN BY TRI
NATIONAL CORPORATIONS AND
CORPORATIONS WERE DRIVING OUR
STATE. DOWN THE MUD DOWN THE
TUBES.
I WROTE IT HAD A RESOLUTION
PASSED WITH THE DEMOCRATIC PARTY
FOR OIL EXTRACTION SERB REALLY
CAN GET IT DONE IN THE LAST.
WEEK INSURANCE NOBODY DOWN HERE
CALIFORNIA SEE MY TEE SHIRT IT'S
CALLED THE POOR PEOPLE'S
CAMPAIGN THE REVIVALS HERE IN
YOUR MORAL GOODNESS RIGHT NOW IS
IS V. BEING VIEWED Y.
CALIFORNIANS. ANIME WE'RE GOING
TO TAKE A LOT OF ACTION ACROSS
THIS COUNTRY BECAUSE PEOPLE ARE
GETTING POORER AND POORER AND
BAR. AND WITHOUT HEALTH CARE.
WHAT'S OUR SOCIETY INCOME GET
COMMUNITIES AT RISK.
AND WE'RE TALKING ABOUT PEOPLE
STAVING CHILDREN AND FAMILIES
WHENEVER THERE'S. A FAMILY
MEMBER THAT CANNOT GET OUT CARE
IF THAT'S THE WHOLE FAMILY.
FOR GOOD THIS IS YOUR MORAL
WELL MY NAME IS ROBIN WALLACE I
THAT THE NEVADA CITY.
I AM A RETIRED NURSE IN VERY
PROUD OF THE CN A AND ALL THAT
YOU'VE DONE.
ALL THAT THEY'VE DONE.
THAT'S WHY I'M HERE.
.
I'M ALSO A NATURALIZED CITIZEN
FROM CANADA.
I'VE LIVED HERE FOR A LONG TIME
AND I GO BACK AND FORTH TO
CANADA BECAUSE I HAVE LOTS OF
FRIENDS AND FAMILY THERE.
NOW I CAME THREE WEEKS AGO WITH
NANCY FLEMING YOU MIGHT'VE SEEN
HER BEFORE SHE IS SLOWING HONOR
ARM.
AND WE WERE HERE AND ON HER WAY
HOME.
SHE FELL IN HER DRIVEWAY AND
BROKE HER.
ELBOW LEFT ELBOW.
OF SINCE THENTWO WEEKS LATER
SHE HAD SURGERY A PLATE TO SCREW
PRAYER PUT IN.
AND A PROBABLY ANOTHER WEEK OR
SO SHE'LL GET IT REMOVED AND
SHALL BE GOOD. NOW
COINCIDENTALLY I WAS BACK IN
CANADA IN TRONG TOLL.
LAST SEPTEMBER. OF WITH MY VERY
GOOD FRIEND AND SHE FELL AND
BROKE HER ELBOW.
AND I SPENT HOURS WITH HER IN
THE EMERGENCY ROOM PADDED CAST
APPLAUDED THEN A REFERRAL TO. GO
TO AN ORTHOPEDIC CLINIC
WHICH WE DID MANY HOURS LATER.
SHE HAD AN APPOINTMENT FOR
SURGERY. SHE HAD THAT TWO WEEKS
LATER.
AND TO A WITH A PLATE AND TWO
SCREWS.
AND THEN SHE.
HAD THAT REMOVED AND SHE'S FINE.
WHAT?
SHOULDN'T WAIT.
HOW MANY MONTHS EIGHT?
MONTHS FOR AN ORTHOPEDIC SURGERY
NO SHE HAD IN EXACTLY THE SAME
TIME. AS MY FRIEND NANCY.
THE OTHER THING I WANT TO SAY
ONE GOING THROUGH. A IN TORONTO
ON A BIG BIG HOSPITAL SAINT
MIKE'S
AND.
VERY VERY CROWDED VERY VERY BUSY.
THERE WAS NO MENTION THERE IS
NOT EVEN A WHISPER OF COST.
THERE IS NO MENTION OF
DEDUCTIBLES.
I HOPE PAY.
PREMIUM
THIS IS WHAT CANADIANS ARE.
THEY EXPECT.
AND.
THAT'S WHAT THEY GET.
I DO NOT.
GOOD AFTERNOON I THANKS AGAIN
FOR HAVING THIS HEARING I'M ERIC
LEAN SOON CO DIRECTOR OF THE
BUSINESS ALLIANCE FOR HEALTHY
CALIFORNIA. WE ARE BUSINESSES
THAT SUPPORT S. B. FIVE SIXTY
TWO. AND THAT SHOULD BE A LITTLE
SURPRISED.
THERE HAS BEEN MORE BUSINESS
REPRESENTATION TO TESTIFY WHAT
THE ISSUES ARE FACING BUSINESS
YOU HAVEN'T HAD A PARTICULARLY
SYMPATHETIC BUSINESS CROWD. IN
THE AUDIENCE I'VE NOTICED BUT I
THINK YOU HAVE TO UNDERSTAND
THAT AS BUSINESSES WE SHARE MANY
OF THE SAME CONCERNS AS A
GRASSROOTS ACTIVISTS BECAUSE
WHAT WE'RE SEEING. IS THAT
HEALTH INSURANCE.
COSTS
PART EATING AWAY AT OUR ABILITY
TO SURVIVE TO PROVIDE FOR
EMPLOYEES
PEOPLE IN BUSINESS ARE GETTING
ANGRIER AND ANGRIER ABOUT WHERE
THINGS HAD GONE BECAUSE THE
PRICES DON'T SEEM TO STOP GOING
UPS YOU HAVE THE HIGH COST.
BUT YOU ALSO HAVE THE ISSUE OF
LACK OF RECOGNITION OF WHAT OUR
NEW ECONOMY.
IS DOING.
MORE AND MORE PEOPLE ARE BEING
FORCED INTO THE SO CALLED GIG
ECONOMY WE'VE HEARD A LITTLE BIT
ABOUT THAT BUT HOW ARE THESE
FOLKS.
WHETHER THEY'RE ENTREPRENEURS
ARE NOT.
GOING TO SURVIVE IN AN ECONOMY
WHERE THEY DO NOT HAVE READY
ACCESS TO HEALTH INSURANCE.
I MEAN I THINK WE HAVE TO REALLY
LOOK.
AT THIS ISSUE WHO WON UNLEASH
ENTREPRENEURIAL SKILLS IN THE
STATE I THINK ONE OF THE
INNOVATIVE THINGS THAT WE CAN DO
HERE IN CALIFORNIA. IS UNTIE.
THE QUESTION OF HEALTH INSURANCE
HEALTH ACCESS FROM EMPLOYMENT.
I DON'T SEE WHERE AT THIS POINT
A TWENTY FIRST CENTURY IT REALLY
IS VERY USEFUL.
AS A SYSTEM IT HAS NOT WORKED
FOR A LONG TIME AND I THINK IF
WE WANT TO GROW THIS ECONOMY. WE
BE WELL SERVED UNDERSTAND
BUSINESS CAN PAY ITS RIGHTFUL
SHARE OF HEALTH COSTS BUT LET'S
NOT CONTINUE SADDLING BUSINESS
WITH THE NEED TO OPERATE THE
SYSTEM. THANK YOU.
HELLO MY NAME IS JACOB MILLER
I'M WITH THE SEIU LOCAL SEVEN
TWENTY ONE. I'M AN ANIMAL CARE
TECHNICIAN FOR THE CITY OF LOS
ANGELES DEPARTMENT THEM SERVICES
FOR THE LAST SIXTEEN YEARS.
WHEN I GOT MY JOB AS A CIVIL
SERVANT I ONE OF THE MAIN
REASONS WHY I WENT TO WAS
BECAUSE OF THE GOOD HEALTH
BENEFITS THAT CAME ALONG WITH IT.
HOWEVER I THOUGHT YOU KNOW THESE
ALL COME AT A COST AND AS THE
RISING HEALTHCARE COSTS GO UP.
WE HAVE DIFFICULTY BARGAINING
FOR HIGHER WAGE TO BE ABLE TO
COVER THESE COSTS AND BE ABLE TO
TAKE CARE OF EVERYTHING THAT
GOES ON WITH MY LIFE.
I'M THE FATHER OF A SPECIAL
NEEDS ARE SUNG HE'S ARTISTICA
SPECTRUM DISORDER.
AND ALTHOUGH WE HAD HAVE IN HOME
HEALTH CARE WORKERS ARE COMING
TO THE HOUSE.
AND THANKS TO HOPE FOR MY
PARENTS AND THROUGH THE ARE
REGIONAL CENTERS WE'RE ABLE TO
COVER THE COPAYS HOWEVER MY
INSURANCE COMPANY WOULD HAVE
CHARGED ME. A COPAYS FOR EVERY
SINGLE VISIT WHICH WOULD NUMBER
ABOUT THREE TIMES A WEEK AND
WOULD HAVE BEEN VERY ON
AFFORDABLE MY SON WOULDN'T BE
ABLE TO BE IN THE POSITION THAT
HE IS RIGHT NOW.
A WHICH IS UNRECOGNIZABLE FROM.
BACK THEN.
HEALTHCARE WORKERS AND OUR CHILD
CARE WORKERS VERY NEAR AND DEAR
TO ME MY MOTHER IN LAW'S A.
CHILDCARE WORKER ON.
SHE HAS A DIFFICULT TIME THEY
HAVE A DIFFICULT TIME OF YEAR OF
GETTING THERE A HEALTH CARE DONE.
AND.
.
AT ANY RATE.
IT COSTS A LOT OF MONEY TO OUR
CARE FOR OURSELVES
AND.
IT'S HARD TO MAKE ENDS MEET ON
A WHEN I WAS IN THE EMERGENCY
ROOM. COUPLE WEEKS AGO I TO THE
FLU. I HAD AN EMERGENCY ROOM I
VISIT COSTS THE UP PAY FOR THAT.
A BASICALLY MEANT THAT OF YOU
KNOW I HAD TO SKIP A NUMBER OF
LUNCHES AND BREAKFASTS JUST SO I
COULD NOT MAKE SURE I KEPT FOOD
ON THE TABLE.
ANYWAYS ARM.
I HOPE YOU GUYS CAN KNOCK DO
WHAT'S NECESSARY IN ORDER TO OUR
STOP THE RUNAWAY COSTS THANK YOU
VERY MUCH FOR YOUR TIME.
I'M HENRY ABRAMSON A PHYSICIAN.
A FORMER BOARD CHAIR OF THE
CALIFORNIA CHAPTER PHYSICIANS
FOR A NATIONAL HEALTH PROGRAM.
AN ORGANIZATION FOUNDED THIRTY
FIVE YEARS AGO. TO FOCUS SOLELY
ON THE DEVELOPMENT OF SINGLE
PAYER. WE DO RESEARCH WE DO
ADVOCACY AND WE DO EDUCATION.
IT'S REALLY GRATIFYING TO HAVE
HEARD SINGLE PAYER MENTIONED SO
MANY TIMES DURING THESE HEARINGS.
BY THE AUDIENCE BY THE WITNESSES
AND BY THE COMMITTEE.
I HAVE TO SAY AS A STUDENT. OF
SINGLE PAYER FOR MANY DECADES.
THAT I FEEL LIKE THERE'S A LACK
OF UNDERSTANDING OF REALLY WHAT
SINGLE PAYER IS.
I THINK THAT THE COMMITTEE GETS
A GRADE OF SOMEWHERE BETWEEN SHE
PLUS AND THE MINUS.
BUT DON'T BE DISCOURAGED YOU'RE
ALL SMART ENOUGH TO UNDERSTAND
IT BUT YOU NEED TO KEEP STUDYING
IT.
WE ASKED TO TESTIFY AND WE WERE
ARE POLITELY REJECTED BUT I
THINK THAT WOULD LIKE TO BE A
RESOURCE TO THE COMMITTEE SO
THAT YOU TRULY UNDERSTAND SINGLE
PAYER POLICY FOR EXAMPLE.
THE TALK ABOUT COST CONTROL
SINGLE PAYER IS COST CONTROL.
IT'S SETTING PRICES.
AND IT'S SETTING A BUDGET.
AND THEN IT'S RUNNING A HEALTH
CARE SYSTEM ON BEHALF OF THE
PUBLIC AS CUSTODIANS OF THEIR
MONEY.
AND STAYING WITHIN BUDGET.
IT'S VERY EASY TO DO
CONCEPTUALLY I'M NOT SAYING IT'S
EASY TO DO DAY IN AND DAY OUT.
OF THE LAST COMMENT IS ABOUT THE
TWO TRACKS THAT THE COMMITTEE
INVASIONS AT LEAST SOME OF THE
COMMITTEE MEMBERS ENVISIONED
WORKING ON.
ONE OF THOSE TRACKS CONTINUES TO
BE INCREMENTAL REFORM AND I'M
NOT OPPOSED TO INCREMENTAL
REFORM.
BUT I THINK WE NEED TO KEEP OUR
ATTENTION ON THE OTHER TRACK
BECAUSE THE OTHER TRACK LEASE TO
THE TOP OF THE MOUNTAIN THAT
ANTHONY WRIGHT TALKED ABOUT.
THE INCREMENTAL REFORM TRACK
LEADS FROM ONE OBSTACLE TO THE
NEXT OBSTACLE TO THE NAFT NEXT
OBSTACLE. IT WAS CHARACTERIZED
DECADES AGO AS BILLIONS FOR
BANDAIDS AND THAT'S WHAT IT IS
IT'S VERY HONORABLE. TO TAKE OUT
A BANDAID AND PUT IT ON A LOOM.
BUT IT'S NOT GOING TO SOLVE THE
PROBLEM WE NEED A TRANSFORMATION
OF OUR HEALTHCARE SYSTEM.
SO I HOPE THAT YOU'LL TAKE
ADVANTAGE OF OUR OPPORTUNITY TO
LEARN MORE ABOUT SINGLE PAYER.
MY NAME IS RYAN SKOLNICK I'M
ALSO ELECTED DELEGATE TO THE
CALIFORNIA DEMOCRATIC PARTY AND
THERE ARE A FEW TRUTHS THAT NEED
TO BE BROUGHT FORWARD RIGHT NOW.
FIRST
THE PREMISE OF THIS COMMITTEE TO
BE FRANK IS A SHAM.
WE HAD AN AWESOME CONVERSATION
WITH ROBERT POLLIN WHO WROTE THE
STUDY WHICH UNTIL RECENTLY A LOT
OF YOU REFUSE TO ACKNOWLEDGE
EVEN EXISTED.
WHY ON EARTH WAS THAT
CONVERSATION NOT HELD WITH THE
STAKEHOLDERS AND THE MEMBERS OF
THE ASSEMBLY APPROPRIATIONS
COMMITTEE WHERE FINDING COULD
ACTUALLY BEEN ADDED TO THE BILL
AND WE COULD HAVE SOLVED A LOT
OF THE PROBLEMS? THAT RED DAWN
USES AS A JUSTIFICATION TO
SHELVE THE BILL.
MICHAEL LADY TALKED ABOUT A LOT
OF THE POLICY ISSUES WITH THE
BILL ADDRESS A LOT YOUR
QUESTIONS WHY ON EARTH WAS THAT
CONVERSATION NOT HELD IN CHAIR
WOODS HEALTH COMMITTEE.
THAT'S YOUR JOB AS LEGISLATORS
NOT A SINGLE PERSON HERE I KNOW
THAT THIS IS THE NARRATIVE SOME
OF YOU LIKE TO PUSH.
NOT A SINGLE PERSON HERE
BELIEVES THAT S. B. FIVE SIXTY
TWO CAN BE SIGNED INTO LAW THE
WAY IT IS NOW.
IT NEEDS TO GO THROUGH THE
LEGISLATIVE PROCESS AND AT THE
END OF THE JOY OUT OF THE DAY AS
LEGISLATORS THAT'S YOUR JOB. TO
LEGISLATE.
WE HEARD EARLIER TODAY
THAT THERE ARE EIGHT PEOPLE IN
THIS STATE THAT DIE EVERY DAY
FROM LACK OF HEALTH CARE.
THEY DON'T NEED TO DIE.
THE REST ALL NEED TO SUFFER
EVERYONE HERE KNOWS OF AT LEAST
SOMEONE WHO WAS AT LEAST
SUFFERING BECAUSE THEY DON'T GET
ADEQUATE HEALTHCARE.
IT DOESN'T NEED TO BE THAT WAY.
IN THOSE PEOPLE NEED FIGHTERS
THEY DON'T NEED EXCUSES.
INSTEAD OF SHOWING THE BILL AND
SAYING WELL WHAT ABOUT WAIVERS
WE WANT YOU TO WORK TO CREATE
THAT PARALLEL FUNDING STRUCTURE
THAT MICHAEL LIGHT HE TALKED
ABOUT EARLIER.
INSTEAD OF TALKING ABOUT HOW
FUNDING MECHANISMS MAY NOT BE
GOOD OR NOT WE WANT YOU TO GO TO
APPROPRIATIONS AND PUT
EVERYTHING ON THE TABLE SO WE
CAN COME TO A BILL THAT TRULY
GUARANTEES HEALTH CARE. NOT
COVERAGE CARE TO EVERYONE IS A
RIGHT SO I'M ASKING YOU ALL
PLEASE
DO THE RIGHT THING. PRESSURE
AROUND DAWN RELEASE S. B. FIVE
SIXTY TWO.
ANTHONY GLAS A WITH THE GREEN
LINING INSTITUTE. BUT I'D LIKE
TO MAKE TWO BRIEF COMMENTS.
FIRST HOW WE PROBABLY SUPPORT
THE HEALTH FROM PROPOSAL
INCLUDED ME ASSEMBLY BUDGET
BLUEPRINT UP PRESENTED BY MR
STUDIO AND THE CALIFORNIA GROUP
POLICY CENTER.
WE BELIEVE THIS IS A VITAL
OPPORTUNITY TO CREATE A
HEALTHCARE SYSTEM THAT ABOLISHES
MEDICAL REDLINING AND WELCOMES
ALL CALIFORNIANS REGARDLESS OF
RACE IMMIGRATION STATUS IN
INCOME.
BUT SECONDLY AND THIS HAS BEEN
BROUGHT UP A LOT TODAY UNIVERSAL
COVERAGE WILL ALSO CREATE
THOUSANDS OF HIGH QUALITY
HEALTHCARE JOBS THAT WE NEED TO
MAKE SURE. GOES TOWARDS THE
COMMUNITIES THAT WE'RE ACTUALLY
TALKING ABOUT WHEN WE DISCUSS
THE REMAINING ON SHORT. BY
ENGAGING IN THE DISCUSSION WITH
HOSPITALS AND CLINICS WITH
DOCTORS AND NURSES AND ALLIED
HEALTH PROFESSIONALS. WITH
EDUCATORS ADVOCATES ACROSS THE
STATE WE CAN MAKE SURE THAT THE
POPULATIONS WERE SEEKING TO
UPLIFT AND COVER WITH HEALTH
CARE ARE THE ONES WORK CARING
FOR POP OUR COMMUNITIES AS WELL.
ANY SERIOUS PROPOSAL TO ACHIEVE
UNIVERSAL COVERAGE HAS TO
INCLUDE PATHWAYS OF OPPORTUNITY
OUT INTO THE HEALTH SECTOR
ESPECIALLY FOR YOUNG PEOPLE OF
COLOR. AND BY THAT BY DOING THIS
WE CAN ENSURE WE CAN MAKE SURE
THAT. UNIVERSAL COVERAGE
ACTUALLY LEADS TO BETTER CARE
THANK YOU.
GOOD AFTERNOON MY NAME IS
CHRISTINE THE DETAIL THAT THE
COMMUNITY ADVOCATE.
WITH THE SILICON VALLEY
INDEPENDENT LIVING CENTER.
WE'RE ONE OF TO ANY LIT
INDEPENDENT LIVING CENTERS
THROUGHOUT CALIFORNIA.
FROM HUMBLE DOWN TO SEND THE.
SAN DIEGO.
ALL OF US HERE AND THREE THINGS
IN COMMON RIGHT OFF THE BAT.
WE NEED UNIVERSAL HEALTHCARE.
THIS. AND DO HAPPEN TO ANYONE.
ACROSS THE BOARD DOESN'T MATTER
GENDER RACE CREED.
ORIENTATION DOESN'T MATTER.
AND.
THERE'S RED BLOOD RUNNING
THROUGH ALL OF OUR VEINS SO WE
HAVE.
MUCH IN COMMON.
I AM THE GENTLEMAN WITHIN YOUR
LRHL.
THAT WAS SPOKEN OF A LITTLE BIT
EARLIER AYE ISABELLA.
I OBSERVABLE THE LEG SHE DOES.
SHE IS GOING OBSERVERS SUB
SERIOUS CHALLENGES TRYING TO GET.
BETTER GO GROWING.
I ON THE OTHER HAND.
HAVE MEDICAL COVERAGE THROUGH
MILLING COMPANY.
THANK GOD FOR THAT.
PLEDGES RECENTLY HAD THIS BILL
THE ENTIRE THEY IT IN THE.
ER BECAUSE AT THE END OF HER
DEATH.
LUCKILY NO THAT WASN'T IT.
SORRY.
I THINK AND I AM I WAS FINE.
ISABELLA IS A GOOD THE THINGS A
LOT OF DIFFERENT CHALLENGES OVER
THE YEARS SOMETIMES OR.
PERHAPS SHE MAY NEED ON.
IN HOME SUPPORTIVE SERVICES ON
AN ONGOING BASIS.
THAT ISN'T ACHIEVED PROPOSITION.
THAT'S VERY EXPENSIVE.
ESPECIALLY WHEN YOU. TAKE INTO
ACCOUNT THE NUMBER HOURS.
NINA.
A LETTER THAT HE CAN RECEIVE
MEDI CAL.
THE LARGEST BECAUSE.
.
THEIR FINANCIAL STATUS BUT
BECAUSE OF THEIR IMMIGRANT
STATUS.
HEALTHCARE IS FOR EVERYBODY AND
IS BE. ENGINE MEAN ISSUE MONEY.
THANK YOU.
THANK YOU I'M BRIAN STUMP FROM
THE BOTTLE CALIFORNIA HAD SMALL
CORPORATION HER I TWENTY SEVEN
YEARS. EYES SINGLE PAYER NEEDS
TO BE DONE.
INSISTS SKETCH ONE CANADA WHICH
IS A RELATIVELY SMALL PROVINCE
POPULATION WISE.
THEY GOT IT DONE UP THERE AND
TOMMY DOUGLAS WHO WAS THE
GOVERNOR OF SASKATCHEWAN WAS
VOTED THE GREATEST CANADIAN OF
ALL TIME.
THEY DIDN'T THINK THEY COULD
GET IT DONE SOME DOCTORS WALKED
OUT SOME OTHER DOCTORS WALKED IN
THEIR WORK SO WELL THAT THE REST
OF CANADA FOLLOWED SUIT. I DID A
A TRIP ACROSS CANADA JUST TO
FIND OUT WHAT CANADA'S CANADIANS
THOUGHT ABOUT THEIR HEALTHCARE
SYSTEM. I STARTED IN QUEBEC AND
ONE ACROSS ONTARIO I TALKED WITH
PEOPLE.
IN STORES AND RESTAURANTS AND
GAS STATIONS EVERY KIND OF TOM
DICK AND HARRY. JUST WALKED UP
TO HIM AND ASKED HIM WHAT DO YOU
THINK YOUR CANADIAN HEALTH CARE
SYSTEM.
I TALKED OVER A HUNDRED
CANADIANS.
ALL FIVE SAID IT'S EXCELLENT
EVERYONE ELSE THAT IS GOOD NO
ONE WAS COMING TO THE UNITED
STATES FOR HEALTH CARE. OF THE
WHEN I ASKED HIM ABOUT THAT THEY
SAID WE GOT GOOD DOCTORS APPEAR
IF WE HAVE SOMETHING WRONG WE
GOING TO SEE THE DOCTOR. THAT'S
TAKEN CARE OF RIGHT NOW ENDIVE
WE HAVE SOMETHING ELECTED THAT
MIGHT TAKE TWO THREE MONTHS. OR
SO OH THAT'S WHAT THEY THINK
ABOUT THEIR HEALTHCARE SYSTEM.
ARE REGARDING.
MEDICARE.
WANT YOU GUYS JUST LET MEDICARE
A BILL ON THE HEALTHY CALIFORNIA
DOCTORS. YOU HAVE SINGLE PAYER
HEALTHCARE LET MEDICARE BILL ON.
IF THERE'S AN ADDITIONAL
BILLING HEALTHY CALIFORNIA TAKE
CARE OF IT I DON'T SEE THERE'S
ANY PROBLEM WITH MEDICARE ROOM
MAKING SOME KIND OF. YOU KNOW A
CHANGE TO HER MANICURE SYSTEM.
JUST YOU KNOW LEAVE MEDICARE
ALONE.
A HEALTH CARE.
IS HEALTH CARE AND INSURANCE IS
A PROFIT MAKING A DEAL I HAD A
BUSINESS I KNOW WHAT MARK UP
BILLS. AND INSURANCE SIMPLY
MARKS UP SOMETHING THAT'S
ALREADY EXPENSIVE AND MAKES A
LOT MORE EXPENSIVE AND YOU GUYS
GOT FOUR HUNDRED AND FIFTY
THOUSAND EMPLOYEES.
THEATER YOUR YEAH BUYING HEALTH
INSURANCE FOR AND.
YOU NEED TO GO DIRECT AND BY AM
HEALTH CARE SAVE A BUNDLE.
MY NAME IS DOCTOR MARY BOGLE.
I'M A FAMILY PHYSICIAN WHO
TRAINED AND PRACTICED IN
CALIFORNIA FOR TWENTY FIVE YEARS.
AND THEN FOUR YEARS AGO I MOVED
TO BRITISH COLUMBIA.
I WANTED TO PRACTICE IN A SINGLE
PAYER UNIVERSAL HEALTHCARE
SYSTEM.
IT'S BEEN A VERY DIFFERENT AND
MUCH MORE EFFICIENT WAY TO
PRACTICE MEDICINE AND I'M SORRY
MISS WALDRON HAD TO STEP OUT
THERE WANTED TO ADDRESS SOME OF
HER CONCERNS ABOUT THE CANADIAN
SYSTEM WHICH SOME OF. THE OTHER
SPEAKERS HAVE ADDRESSED AS WELL.
REGARDING EFFICIENCY.
I HAVE AN ASSISTANT WHO WORKS
ABOUT FOUR HOURS PER WEEK TO DO
THE BILLING FOR MYSELF. MY
PHYSICIAN COLLEAGUE AT OUR NURSE
PRACTITIONER.
I DON'T HAVE TO PAY MULTIPLE
FULL TIME EMPLOYEES TO BILL
FIRST MEDICARE OR THE PRIMARY
INSURER.
AND IN THE SECONDARY JUROR AND
THEN CHASES THE PATIENT DOWN FOR
THE LAST FEW DOLLARS.
ALL THAT WASTE IS NOT.
NOT WASTED IN CANADA IT'S WASTED
HERE.
THERE'S NO DEDUCTIBLE THERE'S
NO CO PAYMENT.
PATIENTS DON'T GET A MEDICAL
BILL THERE'S NO MEDICAL
BANKRUPTCY.
I REGARDING QUALITY OF CARE I
DON'T HAVE TO LIMIT THE
SPECIALIST I SEND DEPICTION TO
BECAUSE THE BEST DOCTOR IS NOT
COVERED BY MY PATIENTS PLAN.
I DON'T HAVE TO WORRY THAT MY
PATIENT DOESN'T HAVE INSURANCE
EVERYBODY'S GOT INSURANCE.
YES SIR AWAITS OF MY PATIENT
WITH CHRONIC KNEE ARTHRITIS
NEEDS A NEW REPLACEMENT SHE MAY
NEED TO WAIT FOR MONTHS OR A
YEAR.
ABOUT ONE MY PATIENT FELL LAST
MONTH AND HAD A COMPLEX FRACTURE
RANKLE SHE HAD IMMEDIATE SURGERY
BY AN EXCELLENT ORTHOPEDIST.
AND SHE DIDN'T HAVE ANY
COPAYMENTS OR DEDUCTIBLES AND NO
COST OTHER THAN HER SEVENTY
SEVEN DOLLARS PER MONTH
INSURANCE PAYMENT.
SO MY CANCER PATIENTS OR SEEN AS
QUICKLY IS NEEDED BY AN
EXCELLENT TEAM OF ON COLLEGES
AND THEY GET WORLD CLASS CARE.
ANY PATIENT WITH AN URGENT OR
LIFE THREATENING CONDITION IS
CARED FOR IN A VERY TIMELY
FASHION SET A PERFECT SYSTEM.
OF THOSE PATIENTS WHO HAVE
ELECTED PROBLEMS MAY HAVE TO
WAIT.
ENDS AND SO I THINK WE CAN DO
IT HEARING KICK IN CALIFORNIA WE
CAN DO IT BETTER THAN THEY DID
IN IN CANADA.
SO LET'S DO IT.
GOOD AFTERNOON I'M LOOSELY
ESTHER I AM A REGISTERED NURSE
FROM EUREKA CALIFORNIA I
PRACTICE IN AN IN PATIENT
REHABILITATION.
UNIT.
WE PRIMARILY HAVE PATIENTS THAT
ARE STROKE.
MAJOR TRAUMA OR TRAUMATIC BRAIN
INJURY.
I'VE BEEN.
ABLE TO COME TO A SEVERAL OF
THESE.
HEARING SO FAR AND I THANK YOU
FOR THE THIRTY PLUS HOURS THAT
YOU'VE PUT IN LISTENING TO ALL
THE TESTIMONY. BECAUSE NOW YOU
KNOW WHAT THE NURSES ALREADY
KNEW WE LIVE WITH A BROKEN
HEALTH CARE SYSTEM IT IS NOT
DOING THE JOB IT SHOULD FOR ALL
CALIFORNIANS.
QUITE A BIT EARLIER IN THE IN
THE TESTIMONY HERE WITH THE
PUBLIC SPEAKERS SOME HE SAID
THAT WE ARE ALL ON THE SAME TEAM.
I LIKE TO SAY I AM NOT ON THE
SAME TEAM I AM NOT ON THE SAME
TEAM WITH ANY. HEALTH INSURANCE
COMPANY THAT BRINGS NO VALUE TO
OUR SYSTEM BUT MAKES BILLIONS OF
DOLLARS A YEAR I AM NOT ON THAT
TEAM. THIS HEALTHCARE SYSTEM IS
BROKEN WE HAVE ON THE TABLE
RIGHT NOW A VERY SIMPLE VERY
ELEGANT VERY WONDERFUL FIX FOR
ALL CALIFORNIANS BE THEY
DOCUMENTED OR UNDOCUMENTED.
THAT'S S. B. FIVE SIXTY TWO NOW
IS THE TIME FOR YOU ALL TO STAND
UP. LEGISLATE DO YOUR JOB
PROTECT CALIFORNIANS AND GET US
HEALTH CARE NOT HEALTH ACCESS
THANK YOU.
MY NAME IS SHEILA MERTON'S. AND
THE SYSTEM OF BROKEN OF
CORPORATE HEALTH CARE AFFECTS MY
FAMILY AND AS WE'VE HEARD TODAY
IS FIGHTING LIVES OF ALL OUR
CALIFORNIANS CITIZENS.
I SAID ON THE LOCAL BOARD IN
NEVADA COUNTY AND I UNDERSTAND
THE RESPONSIBILITY OF THE BOARD
TO CHECK INTO EVERY ANGLE AND
CONSEQUENCES OF YOUR ACTIONS AND
YOUR DECISIONS. AND YOU DO YOUR
DUE DILIGENCE AND I THANK YOU
LIKE EVERYONE ELSE FOR. BIRD
LOOKING AT ALL THE DIFFERENT
THINGS IN WAYS THAT YOU WANT TO
MAKE THIS GO FORWARD. HOWEVER
WHEN THERE'S SOMETHING BROKEN
YOU DON'T GO TO THE PEOPLE THAT
ARE NAY SAYERS AND SAY WHY WE
CAN'T DO THIS YOU GO TO THE
PEOPLE THAT HAVE SOLUTIONS AND
THEIR SOLUTIONS OF SINGLE PAYER
AND HEALTH CARE'S. SYSTEMS THAT
WORK ALL AROUND THE WORLD. MY
SON MARRIED A GERMAN WOMAN SO
NOW I HAVE INTIMATE.
EXPERIENCE AND KNOWLEDGE OF
WHAT EUROPEANS ARE EXPERIENCE
AND I'M ASKING WHY OR WHY DOZEN.
CALIFORNIA TO ONE OF THE LARGEST
ECONOMIES IN THE WORLD WHY DON'T
WE HAVE WHAT THESE OTHER
COUNTRIES HAVE.
I ALSO WANT TO SAY THAT.
.
A DEAR STE YOU'VE HEARD THE
STUDIES TODAY AND INFORMATION ON
COSTS YEAR.
SAVING AND ANSWERS TO THE
QUESTIONS THAT SIR S. B. FIVE
FIFTY TWO WOULD BE POSSIBLE AND
AFFORDABLE I DON'T UNDERSTAND
WHY YOU KEEP IGNORING THOSE
THOSE THOSE POSSIBILITIES AND
THOSE ANSWERS.
AND I ALSO WOULD LIKE TO SAY
THAT.
I'M SORRY ALSO SHE'S GONE
BECAUSE.
WE'VE HEARD TODAY ABOUT HOW
MANY PEOPLE CAN'T AFFORD THEIR
DEDUCTIBLE DEDUCTIBLES AND
CHOOSE TO EAT OR PAY THEIR RENT
BEFORE THEY TAKE HEALTH CARE.
AND I HAVE TO ASK MYSELF AND I
WISH YOU WOULD ALL ASK YOURSELF
TO WHICH IS MORE SERIOUS LIFE OR
DEATH OR WAITING A FEW WEEKS OR
MONTHS FOR SOME SOME SERVICE.
I MEAN IF WE WE HAVE TO I ASK
YOU TO BE RESPONSIBLE TO GUESS
S. B. FIVE SIXTY TWO GOING AND I
ASK YOU TO MAKE IT WORK.
THANK YOU.
HI HOME MY NAME IS PAT CANCER ON
FREDERICA CALIFORNIA AT THE
DINNER SO FOR THIRTY YEARS. IN
THE I SEE YOU IN THE BURN CENTER
NOW I WORK WITH DISABLED ADULTS.
.
PRESIDENT TRUMP AND THE GOP
AGGRESSIVELY TRYING TO DISMANTLE
THE A CA AND THEN WITH THEIR TAX
BILL THEY'RE JUST DESTROYING IT
USING FUNDING. AND.
I FIVE I GOTTA BE HONEST GUYS
ON. MY COLLEAGUES ARE BOTH WERE
VERY ARTICULATE IN THEIR VERY
POLITE. AND I'M NOT.
I DON'T APPRECIATE THE SELECT
COMMITTEE. YOU NOT DOING
ANYTHING YOU'RE BLOWING UP A
BUNCH UP HOT AIR AROUND AND
THAT'S WHAT YOU'RE DOING.
YOU'RE NOT DOING WHAT YOU'RE
BEING PAID TO DO.
YOU'RE YOU'RE MY LEGISLATURE
LEGISLATURE OR I IN OUR
CONSTITUENTS WILL YOU PLEASE
RELEASE THE BILL AND WORKED ON
IT ALREADY.
THIS THIS IS NOTHING NEW YOU'RE
DOING YOU'RE TALKING ABOUT
THINGS
THE ONLY IT AND YOU'RE NOT
MAKING ANY SENSE AND THE THING
IS YOU ONLY LISTENED ABOUT S. B.
FIVE SIXTY TO FOR LIKE ONE POINT
FIVE PERCENT OF THE TIME. AND
THAT IS THE ANSWER.
WE HAD WE HAVE THE ANSWER RIGHT
IN FRONT OF US AND I ALSO WANT
TO MENTION THE PEOPLE WHO RAISED
THEIR HAND. AND SAID THAT A WELL
YOU NAM HEALTH CARE IS A HUMAN
RIGHT YOUR BUDGET HYPOCRITES.
IF HEALTH CARE IF YOU REALLY
THOUGHT THAT HEALTHCARE WAS A
HUMAN RIGHT IF YOU REALLY
BELIEVED IN SINGLE PAYER YOU BE
WORKING ON IT RIGHT NOW AND YOU
WOULDN'T BE SITTING HERE.
BLOWING HOT AIR THANK YOU VERY
MUCH.
THERE'S NOT MUCH ELSE TO SAY
AFTER YOU'VE HEARD THAT.
I'D LIKE TO EXPRESS MY
CONDOLENCES THAT YOU'VE BEEN
MANIPULATED.
IN TO COVERING OVER FOR WHATEVER
THE GOVERNOR AND THE SPEAKER
HAVE FELT WAS IMPORTANT IN ORDER
TO PROTECT THE MONEY THAT
THEY'VE BEEN GETTING WHICH WE
HAVE RECORDED.
IN TERMS OF THEIR CAMPAIGN AND
THEY'RE THEIR THEIR. THEIR ROUTE
RESOURCES. HEALTH INDUSTRY.
IT'S REALLY OBJECTIONABLE AND
IT'S VERY VERY CLEAR I LIKE TO
BE BLUNT ABOUT A FEW THINGS
NUMBER ONE WE DO NOT HAVE A
BROKEN HEALTHCARE SYSTEM.
IT'S WORKING PERFECTLY
IT'S WORKING PERFECTLY FOR THE
ARCHITECTS OF THAT SYSTEM THE
BILLIONAIRES AND THE PLUTOCRACY
IN THIS COUNTRY. THAT HAVE A
MUCH HIGHER OBJECTIVE THAN MONEY
THEIR OBJECTIVE IS POLITICAL
CONTROL AND WE ARE IN A CRISIS
RIGHT NOW WITH THE CURRENT
FEDERAL ADMINISTRATION THAT HAS
FUNDAMENTALLY BEEN BOUGHT. BY
THE COKE NETWORK
TO ESSENTIALLY OVERCOME THE
DEMOCRATIC FOUNDATION OF THIS
COUNTRY.
SINGLE PAYER HEALTHCARE IS THE
ONE AND ONLY UNIVERSAL WEDGE.
AGAINST THAT ANTI DEMOCRATIC
INITIATIVE THAT IS SWAMPING US
WE DO NOT HAVE A BROKEN SYSTEM
IT IS A BREAKING SYSTEM WE DO
NOT HAVE A HEALTHCARE SYSTEM WE
HAVE A MEDICAL MANAGEMENT RANSOM
SYSTEM. HEALTH CARE IS NOT FOR
SALE.
IT IS NOT FOR SALE WE DON'T HAVE
A VOCABULARY FOR HEALTH CARE.
I'M A PHYSICIAN I'M A MEMBER OF
THE STATE.
POSITIONS FOR A NATIONAL
HEALTHCARE PROGRAM STEERING
COMMITTEE WE HAVE THE CHAPTER
HERE IN THE CAPITAL WE'RE
AVAILABLE TO YOU I URGE YOU AS
ALL OF THE PEOPLE WHO HAVE STOOD
UP TO SPEAK. LET THIS BILL GO
FORCED RENDON TO PUT THIS BILL
INTO A PLACE WHERE THIS KIND OF
HEARING CAN REALLY MATTER. THANK
YOU VERY MUCH.
HI MY NAME IS MODEST HIM ATHENA
FROM ASSEMBLY DISTRICTS SIXTY
THREE WHICH ANTHONY RENDON
REPRESENTS.
IF YOU.
IF YOU IF IT'S SOUND LIKE A
REPEATING MYSELF FROM THE OTHER
TIMES AT A SPOKEN AT THE HEARING
A PROBABLY IS BECAUSE I AM
REPEATING MYSELF ON THE ONLY ONE
HERE REPRESENTING MY ASSEMBLY
DISTRICT AND I WAS KEEP ON
SHOWING UP. AND SPEAKING ABOUT
THE PROBLEMS IN THE PEOPLE IN MY
COMMUNITY FACE AT EVERY SINGLE
TIME YOU HAVE A HEARING.
I WAS BORN RAISED AND LIVE IN
AN AREA THAT WAS CONTAMINATED BY
EXCITE TECHNOLOGIES FOR ALMOST A
HUNDRED YEARS.
OUR SOIL IS STILL CONTAMINATED
TO THIS DAY WITH TOXIC WASTE
DUMP LEVELS OF LEAD ARSENIC
BENZENE CADMIUM CHROMIUM SIX ONE
THREE BUTADIENE JUST TO MENTION
A FEW. ALL OF THESE CHEMICALS AS
YOU KNOW BECAUSE DIFFERENT KINDS
OF CANCERS MISCARRIAGES BIRTH
DEFECTS LIFELONG DEVELOPMENTAL
DELAYS AND BEHAVIOR PROBLEMS IN
CHILDREN. OUR COMMUNITY IS HARD
WORKING PREDOMINANTLY LATINO
WORKING CLASS LOWER MIDDLE CLASS
DOCUMENTED UNDOCUMENTED INICIA
UNINSURED AND UNDERINSURED.
WHEN WE SPEAK OF UNDER INSURED
THERE ARE MANY PEOPLE LIKE
MYSELF THAT THE ACA HAS NOT
HELPED.
INSURANCE IS NOT EQUAL TO HEALTH
CARE.
I AM SELF EMPLOYED AND DO NOT
QUALIFY FOR ANY ASSISTANCE MY
PREMIUM JUST RECENTLY INCREASED
TO TWENTY THREE POINT THREE
PERCENT THIS JANUARY FROM THREE
HUNDRED AND SEVENTY NINE DOLLARS.
TO FOUR HUNDRED AND SIXTY FOUR
DOLLARS A MONTH AND MY
DEDUCTIBLE IS SIXTY EIGHT
HUNDRED DOLLARS THAT SIX
THOUSAND EIGHT HUNDRED DOLLARS
WITH THE FORTY FIVE DOLLAR COPAY
WITH RATES LIKE THESE I THINK
TWICE ABOUT GETTING THE
PREVENTIVE CARE SHOULD BE
GETTING. AND I'M ONE OF THE
LUCKY ONES IN MY COMMUNITY
BECAUSE I'M INSURED.
IMPORTANT TO CONSIDER IS THAT
WITH THESE RESIDENT HAVING MOVED
IN AND OUT OF OUR DISTRICT
THROUGHOUT THE DECADES THE ONLY
WAY TO COVER ALL OF THE PEOPLE
THAT HAVE BEEN AFFECTED BY THIS
ON GOING ENVIRONMENTAL INJUSTICE.
IS THROUGH THE SINGLE PAYER
UNIVERSAL COMPREHENSIVE
INCLUDING MENTAL HEALTH
PREVENTIVE HEALTH CARE S. B.
FIVE SIX TWO OFFERS PLEASE HERTZ
RENT ON TO FREE THE BELL AND
ALLOW IT TO GO THROUGH THE
LEGISLATIVE PROCESS PLEADS.
HELLO DOCTOR ARAMBULA.
HI IT'S MY BIRTHDAY TODAY I JUST
TURNED FORTY YEARS OLD BIRTHDAY.
OKAY NOW TO THAT TO WHY I'M
HERE.
FIRST OFF.
I WOULD YOU KNOW JUST WANT TO
REITERATE I CAN'T HELP BUT DO SO.
THAT WE ARE TO.
IN AN ORDER FOR MORE INSURANCE
IN ORDER FOR MORE.
PHYSICIANS TO TAKE MEDI CAL.
WHICH IS OUR MEDICAID PROGRAM
HERE IN CALIFORNIA THAT WE NEED
TO SUBSIDIZE THEIR EDUCATION.
THIS ALSO SHOULD BE APPLIED TO.
PSYCHOLOGISTS NURSES AND SOCIAL
WORKERS.
SECOND.
.
IF YOU. GOT ELECTED TO THE
LEGISLATURE BECAUSE OF MONEY
THAT YOU RECEIVED FROM INSURANCE
COMPANIES.
IT'S PROBABLY NOT A GOOD IDEA
BECAUSE INSURANCE COMPANIES.
SUCK IT JUST AS PRESIDENT TRUMP
SOCKS WITH A CAPITAL S. U. C. K.
S. IT'S VERY VERY.
YET I'M AGAINST THE INSURANCE
COMPANY WE NEED TO TAKE THE FOR
PROFITS OUT OF IT.
AND YOU KNOW WHY WE HAVE THE
DEPARTMENT OF MANAGED HEALTHCARE
D. MH SEE. IS BECAUSE THEY
OVERSEE ALL OF THE INSURANCE
COMPANIES THAT WHICH WE WANT TO
GET RID OF.
WHY NOT GET RID OF THE MANAGED
CARE OF GET RID OF ALL INSURANCE
COMPANIES?
I'LL GET RID OF D. MHC AND.
PUT ALL OF THE SINGLE PAYER
UNIVERSAL HEALTHCARE.
IN TO THE DEPARTMENT OF HEALTH
CARE SERVICES.
THE SAME ONE THAT DOES MEDICARE
OWL AND ENTER CAO.
AND I'M TRYING TO BE BRIEF
BECAUSE I WANT TO GET OUT OF
HERE.
SECOND.
I BELIEVE THAT HEALTHCARE IS A
RIGHT NOT A PRIVILEGE.
AND.
I WANT TO ALSO LET YOU KNOW THAT
AS A MEDIC HELP PATIENT I HAVE
MEDI CAL AND MEDICARE WITH
MEDICARE BEING MY PRIMARY
INSURANCE. I CANNOT GET ANY
COUNSELING SERVICES PAID UNDER
MEDI CAL I CAN UNDER MEDICARE
BUT THAT THERE'S A CO PAY IN
FACT ONLY FEDERALLY QUALIFIED
CENTERS.
CAN GIVE ME COUNSELING AND IT'S
NOT REALLY THEY DON'T WORK WITH
ANY SPECIALIZED POPULATION THEY
WORK. FOR THE GENERAL PUBLIC AND
I NEED SOMEONE WHO WORKS WITH
THE DEVELOPMENTALLY. DISABLED SO
AGAIN. IF YOU'RE TAKING MONEY
FROM INSURANCE COMPANIES JUST SO
YOU CAN GET ELECTED. THAT'S NOT
A GOOD IDEA LOOK.
YOU WORK FOR THE PEOPLE WHO
ELECT YOU NOT FOR THOSE THAT WHO
GAVE YOU MONEY I'M ACTUALLY
THINKING ABOUT RUNNING FOR.
OFFICE MYSELF IN AND FOR TO.
IMPORT IN.
.
FOUR TO SIX YEARS FOR EITHER
SENATE OR ASSEMBLY AND I WILL
NOT BE ASKING INSURANCE
COMPANIES FOR MONEY AND FINALLY
I WANTED.
ASK A QUESTION OF THE COMMITTEE
AS WELL AS TO THE WITNESSES WHO
SPOKE IN WHAT ABOUT.
WHAT ABOUT?
COMMUNICATE ALL AND CAL MANY
CAN THAT.
MAYBE WE NEED TO GET RID OF THEM
AS WELL THANKS.
THANK YOU RECKON HAVE TO PROTECT.
THANK YOU CHAIRS AND COMMITTEE
MEMBERS MAY CONSUMERS HERE ON
BEHALF OF CALIFORNIA HEALTH PLUS
ADVOCATES THE THIRTEEN HUNDRED
COMMUNITY HEALTH CENTERS AND
CLINICS WHO SERVED SIX AND A
HALF MILLION PATIENTS.
COMPREHENSIVE HEALTHCARE IN
CALIFORNIA VERSUS MY THANK YOU
ALL FOR THE CONVENING OF THE
SELECT COMMITTEE ON THE HEARINGS
THAT YOU'VE BEEN HOLDING ON THIS
ISSUE THIS IS A CRITICAL ISSUE.
AND THE CHALLENGE I WE ALL
APPRECIATE THE CHALLENGE BEFORE
YOU AND WE WANT TO BE PARTNERS.
WITH YOU ON THIS CONVERSATION.
I JUST WANTED TO HIT TWO QUICK
POINTS.
.
FIRST OF ALL IN LIGHT OF THE
HEARINGS THAT YOU ALL HAVE
CONVENED AND THE INTERACTION OF
S. B. FIVE SIX TWO AS OF THE
HEALTH CENTERS TO CONVENE. SORT
OF A A TABLE OF THEIR OWN TO
TALK ABOUT WHAT THE DELIVERY
SYSTEM SHOULD LOOK LIKE.
GOINGFORWARD IN THE FUTURE AND
THAT BABY THEY THINK THAT A GOOD
MODEL TO PERHAPS LOOK AT IN THIS
INSTANCE IS THE COMMUNITY HEALTH
CENTER MODEL. WHICH IS THE MODEL
THAT THE.
THAT FOR PRIMARY HELD FOR EXCUSE
ME PRIMARY CARE HEALTH DELIVERY
AVAILABLE TO ALL PEOPLE A SYSTEM
THAT PROVIDES OPEN DOOR ACCESS
COMPREHENSIVE SERVICES LOCATED
WHERE THE PATIENT IS LOCATED.
CULTURAL CULTURALLY COMPETENT
AND CONSUMER DIRECTED AND
SECONDLY I JUST WANTED TO ALSO
EXPRESS OUR SUPPORT FOR THE
WHOLE FOR ALL PROPOSAL THAT YOU
ALL.
WERE PRESENTED WITH EARLIER TO
EXPAND MEDICAL ACCESS TO
UNDOCUMENTED ADULTS WE CONTINUE
TO BE SUPPORTIVE OF THAT
PROPOSAL THANK YOU.
THE HUMAN.
HI EVERYONE.
.
MY NAME IS JUSTIN SAMPSON I CAME
UP HERE FROM ORANGE COUNTY I
TRAVEL TEN HOURS BY BUS AND
CARPOOL JUST TO GET HERE. JUST
TO LET YOU ALL KNOW STOP MAKING
IT FEW FIFTH IN RELEASED THE
BILL NOW.
.
BEING SOMEBODY WHO IS AN
ACTIVIST IN ORANGE COUNTY AND A
CANDIDATE FOR THE STATE SENATE
AYE I FIRST WANTED TO ADDRESS
THE FACT THAT.
THE NURSES HERE HAVE BEEN DOING
GREAT WORK AND UNFORTUNATELY.
CERTAIN INDIVIDUALS IN THE
STATE LEGISLATURE COULD JUST JIM
WOOD ANTHONY RENDON HAVE REALLY
SHOWN THEM NOT THE RESPECT THAT
THEY DESERVE SO. I'M HERE TO LET
THEM KNOW THAT I WANT TO THANK
THEM FOR ALL THE WORK THEY'VE
DONE I RESPECT EVERYTHING YOU'VE
DONE. AND THAT WE NEED TO MOVE
FORWARD LOOK MOVE FORWARD IN
PASSED SINGLE PAYER RIGHT NOW.
THE REASON I'M HERE OF FIGHTING
FOR SINGLE PAYER IT'S VERY
SIMPLE IT'S A VERY PERSONAL
ISSUE FOR ME.
IN TWO THOUSAND EIGHT MY MOM WAS
DIAGNOSED WITH END STAGE BREAST
CANCER RATHER THAN SPENDING HER
TIME FIGHTING.
HER CONDITION SHE SPENT PART OF
HER TIME FIGHTING HEALTH CARE
INSURANCE COMPANIES MAKING SURE
THAT SHE GOT THE TREATMENT THAT
SHE NEEDED.
SHE ALSO HAD.
TO DEAL WITH COPAYS MY MOM AND I
A WHERE.
.
WE'RE DEALING WITH FINANCIALLY
PRECARIOUS LE CONDITIONS AND WE
WERE NEARLY HOMELESS.
MY SO WE HAVE TO MAKE VERY
DIFFICULT CHOICES DO WE PAY THE
TWENTY DOLLARS TO GO SEE THE
DOCTOR OR. IF IT.
GROCERIES FOR THE WEEK OR THE
RENT OR OR WHAT NOT.
BUT IF THE CHOICE THAT NOBODY
HAS.
THE MAKING I BEEN WALKING
TALKING TO COMMUNITY BE OF. IN
RESIDENCE IN MY IN MY MY
DISTRICT TALKING TO THEM ABOUT.
THEIR NEEDS AND THESE ARE
CHOICES THAT THEY PASSED TO MAKE
TO.
BOB THEY'RE FED UP WITH THE
SYSTEM THAT TO HAVE PUT
CORPORATIONS AHEAD OF THEM THAT.
AND PUT.
THE MILLIONS OF DOLLARS IN
CAMPAIGN CONTRIBUTIONS THEY HAVE
GOTTEN FROM HEALTH CARE.
COMPANIES BEFORE THEY HAVE. PUT
NEEDS OF THE PEOPLE.
AND FINALLY WHAT THE FINAL%
SECONDS I'VE GOT LEFT I'D REALLY
WANT TO REALLY STRESS THE IDEA
THAT. MANY PEOPLE HERE SUCH AS
JIM WOULD HAVE STRENGTHENED IDEA
THAT THEY BELIEVE HEALTH CARE.
IF THE HUMAN RIGHT
WELL.
IF YOU BELIEVE THAT HERE'S FOR
WORKS FOR YOU PUT UP OR SHUT UP
RELIEF THE BILL RESPECT THE
LEGISLATIVE PROCESS KNUCKLE FOR
RENDON TOO BY THE WAY.
REALLY THE BILL RESPECT THE
LEGISLATIVE PROCESS AND LET'S
GET TO WORK NEED NURSES MYSELF
EVERYONE ELSE IS WILLING TO WORK
WITH THE THANK YOU.
MARY WE'RE NOT NEVADA COUNTY AND
MY BEEN DEAD EVERY ONE OF THESE
MEETINGS AND. I I JUST WANT TO
TELL FOLKS EYES SPECIALLY THOSE
THAT ARE WATCHING FOR THE FIRST
TIME THAT. I'M TO DAYS WAS THE
FIRST TIME THE COMMITTEE ALLOWED
SINGLE PAYER SENATE BILL FIVE
SIX TWO TO BE PRESENTED.
ALL THESE HOURS AND I DON'T EVEN
KNOW HOW MANY MILLIONS OF
DOLLARS HAVE BEEN SPENT IN
DEFENDING THE STATUS QUO.
SO PLEASE RELEASE THE BALLOT
THANK YOU. THANK YOU.
HELLO MY NAME IS CYNTHIA BROWN
I'M A CANCER PATIENT FROM LOS
ANGELES WAS OPTED FOR SURGERY
WITHOUT CHEMO OR RADIATION.
I'VE GONE THROUGH TO PAINFUL
SURGERIES AND IS A LOW INCOME
MEDI CAL PATIENTS.
IT IS NO PROBLEM TO OBTAIN
INSURANCE COVERAGE FOR ADDICTIVE
OPIOID PAINKILLERS.
HOWEVER IF I CHOOSE A SAFER
ALTERNATIVE OF T. T. CBD OIL
THAT WILL COST ME SIX HUNDRED
EIGHTY ONE DOLLARS PER MONTH IN
OUT OF POCKET EXPENSES FROM A
NONPROFIT.
FIFTY EIGHT C. CBD OIL MEDICAL
MARIJUANA WERE INTEGRATED INTO
THE SINGLE PAYER HEALTHCARE
SYSTEM FOR CANCER PATIENTS AND
OTHERS WITH SERIOUS AILMENTS.
VAST SUMS OF MONEY WOULD BE SAFE
BECAUSE COSTLY REHAB FOR OPIOID
ADDICTS WOULD NOT BE NEEDED
ADDITIONALLY LONG TERM EFFECTS
WOULD BE AVOIDED.
ESTABLISHED FINANCIAL INTEREST
WOULD OPPOSE THIS REFORM FOR
OBVIOUS REASONS.
OPIOIDS YIELD BIG MONEY FOR THE
PHARMACEUTICAL INDUSTRY.
BLOOD TEST TO SCREEN FOR CANCER
ARE ACCORDING TO MY ONCOLOGIST
ONLY THIRTY FIVE PERCENT
ACCURATE HE INFORMED ME THAT THE
PHARMACEUTICAL CANCER INDUSTRY
DOES NOT CARE TO PUT ANY MONEY
INTO IMPROVING THE ACCURACY OF
CANCER SCREENING. BECAUSE IT IS
NOT AS PROFITABLE AS TREATING
PEOPLE WITH ADVANCED CANCER.
I HOPE THAT UNDER A SINGLE PAYER
SYSTEM THIS COULD BE REFORM
SAVING BILLIONS OF DOLLARS I
IMAGINE. LET'S REFORM THIS
BROKEN SYSTEM IS MORALLY
REPREHENSIBLE.
I GOOD AFTERNOON AND MEMBERS OF
THE COMMITTEE MY NAME IS ADRIANA
MORA AND HERE ON THE BEHALF
FOR THAT THE NO COALITION FOR
HEALTHY CALIFORNIA. FOR OVER
TWENTY FIVE YEARS ORGANIZATION
HAS BEEN WORKING TO ADVANCE TO
PROTECT WHAT THEY KNOW HOW. TO
POLICY ADVOCACY TO BUILD HEALTHY
COMMUNITIES WE BELIEVE AT THE
WELLNESS AND HEALTH CALIFORNIANS
DEPENDS ON ALL INDIVIDUALS
HAVING ACCESS TO MEDICAL CARE
AND SUPPORT SERVICES. WITH
REGULAR MEDICAL CARE AND VISITS
TO THE DOCTOR WE CAN PROTECT ALL
CALIFORNIANS FROM PAINFUL
EXPENSIVE AND PREVENTABLE
MEDICAL CONDITIONS WITHOUT
HEALTHCARE ACCESS MANY
VULNERABLE POPULATIONS INCLUDING
UNDOCUMENTED IMMIGRANTS. DO NOT
SEE CARE BECAUSE OF FEAR
DEPUTATION THEY SUFFER FROM
CHRONIC PAIN A COULD BE EASILY
TREATABLE. REMAIN UNAWARE OF
EXISTING CONDITIONS SUCH AS TYPE
TWO DIABETES AND THEY END UP
RELYING ON BENDED CARE FOR ALL
HEALTH NEEDS.
AND END UP ACCUMULATING
THOUSANDS OF DOLLARS IN MEDICAL
DEBT. AND DELAY CARE WHICH MAY
LEAD TO DEATH IN A TIME WHERE
OUR NATIONAL LEADERS SEEK TO
TARGET THE POOR AND DENIES BONA
POPULATIONS CALIFORNIA KNOWS
BETTER.
CALIFORNIA HAS BEEN A LEADER FOR
CHANGE WE MUST CONTINUE TO PUSH
FORWARD AND ASSURE THAT EVERYONE
HAS ACCESS TO HEALTH CARE
REGARDLESS OF IMMIGRATION STATUS.
WE AT THE LATINO COALITION FOR
HEALTHY CALIFORNIA ARE LOOKING
FORWARD TO WORKING WITH THIS
COMMITTEE AND THE LEGISLATOR. TO
IS THE CHIEF HEALTH FOR.
THANK YOU.
MY NAME IS PAUL BROOKS A RETIREE
FROM THE UNIVERSITY OF
CALIFORNIA AND A MEMBER OF THE
UNIVERSITY OF PROFESSIONAL AND
TECHNICAL EMPLOYEES CW A NINE
ONE ONE NIGHT.
I'M ALSO THE UNION
REPRESENTATIVE ON THE UC WORKING
GROUP ON RETIREE HEALTH
INSURANCE.
MANY EMPLOYEES ARE LAID OFF
YOUNGER THAN AGE SIXTY FIVE
THROUGH NO FAULT OF THEIR OWN
IRONICALLY. SUCH AS PROBLEMS
LIKE HEALTHCARE.
WELL HEALTH ISSUES.
MY.
THAT FIND AT THEIR AGE THEY
CANNOT BE REHIRED CANNOT AFFORD
HEALTH CARE AND DESCENDED TO
BANKRUPTCY AND POVERTY.
THE INCREASING COST OF
HEALTHCARE IS CONTINUE TO
CONTINUAL ISSUE BOTH OF THE
UNION BARGAINING TABLE AND WITH
FACULTY WHERE IT'S CLEAR
EMPLOYEES SUCH AS THE UNIVERSITY
CAN NO LONGER AFFORD THE
INCREASE.
THE CURRENT PROPOSAL FROM YOU
SEE AND OTHER EMPLOYEES OF
PLAYERS IS TO REDUCE PLANS
COVERAGE OR PUSH THE COSTS ON TO
RETIREES WHO COULD NOT AFFORD
THE INCREASED COST.
SINGLE PAYER SOLVES THESE
PROBLEMS AND REMOVES THE
HEALTHCARE ISSUE FROM THE UNION
BARGAINING TABLE SUPPORT SINGLE
PAYER HEALTHCARE AND RELEASE. S.
B. FIVE SIX TWO.
GOOD EVENING MY NAME IS PAUL
ROCKED AB I HAVE BEEN A NURSE
PRACTITIONER IN THE STATE OF
CALIFORNIA FIRST INTO A LAKE AND
THEN IN CHICO AND THEN AND
WILLIAMS FOR. SINCE NINETEEN
EIGHTY SIX
I AM WEIRDLY TO DO ANY KIND OF
TESTIMONY ON THE NUMBER OF
THINGS I'D LIKE TO COVER FEELS A
LITTLE BIT LIKE I WHAT I WOULD
IMAGINE SPEED DATING MUST BE
LIKE.
BUT I'LL TRY TO COVER A FEW
THINGS HERE I'VE BEEN A MEMBER
OF P. NH P. PHYSICIANS FOR
NATIONAL HEALTH PROGRAM SINCE
NINETEEN NINETY TWO AS A NURSE
PRACTITIONER. I AM ALSO A SECRET
PATIENT VICTIM. OF WHAT WE
ERRONEOUSLY CALLED.
A HEALTH CARE SYSTEM OUT RATHER
THAN A PROFIT CENTER FOR ILLNESS
IN THIS COUNTRY AND I WILL TELL
YOU THAT YOU HAVE NEVER HAD. A
GREATER POPULAR SUPPORT FOR
DOING THE RIGHT THING VIA THE.
SENATE BILL FIVE SIXTY TWO IN
THIS STATE THAN YOU'VE EVER HAD
FOR ANYTHING A PLURALITY OF
REPUBLICAN VOTERS ARE FOR WHAT
WE'RE TALKING ABOUT. EIGHTY FIVE
PERCENT OF DEMOCRATIC VOTERS ARE
FOR OUR FOR WHAT WE'RE TALKING
ABOUT. OWNER FIRST STATE THAT
THE EVIDENCE AS OPPOSED TO THE
ADVERTISING NARRATIVE DISAGREES
WITH ANTHONY RIGHTS HOWEVER WELL
INTENTIONED. ASSERTION THAT THE
ACA AND SINGLE PAYER ARE SOMEHOW
ON A CONTINUING.
THE ACA WAS A MARKET ADJUSTMENT.
PLAIN AND SIMPLE.
DID BENEFIT MANY PEOPLE YES.
DID A QUESTION THE BASIC
FOUNDATION OF.
THAT ACCESS IS A PRIVILEGE BASED
ON ABILITY TO PAY SUBSIDIZED OR
NOT. NO.
YOU HEARD ABOUT SOME CLINICIAN
BURNOUT I'LL TELL YOU THAT
MARKET ADJUSTMENTS LIKE THE ACA
OCCUPIED AN INCREASINGLY LARGE
AMOUNT OF MY LIFE AND MY STAFF'S
LIFE.
IN DIRECT CARE TIME AND NO
AMOUNT OF TWEAKING THAT SYSTEM
WILL IMPROVE EITHER MY PATIENTS
ABILITY TO GET CARE WHEN THEY
NEED IT. OR MY ABILITY TO
PROVIDE THAT CARE.
AND THAT'S.
PART OF AN AND I'LL TRY TO MAKE
THIS QUICK BUT I REALLY WANT TO
CONTINUE. WHAT MY REMARKS ARE
SENATE BILL FIVE SIXTY TWO
PROVIDES A FOUNDATION AND A
FRAMEWORK TO ELIMINATE THE LABOR
WOES AND SMALL BUSINESS
CONSTRUCTION THAT YOU WERE
ALERTED TO?
AND ON THE ISSUE OF MD INCOMES.
I LOOKED IT UP TWO THOUSAND
SEVENTEEN FAMILY PRACTICE
AVERAGES IN CANADA. ARE TWO
HUNDRED AND SEVENTY FOUR
THOUSAND DOLLARS A YEAR.
THEY'RE COMPARABLE IF NOT
SUPERIOR TO THOSE IN THE UNITED
STATES.
PLEASE PASS FIVE SIXTY TWO.
A HELLO ESTEEMED COMMITTEE MY
NAME IS AMY HINDSIGHT ON THE MOM
AND I AM THE LEGISLATIVE AND
POLITICAL DIRECTOR. FOR A DE CW
A LOCAL NINETY ONE NINETEEN
WHERE THE UNION FOR. DATA
RESEARCHERS IN THAT CAMPUSES OF
THE TEN CAMPUSES AND FIVE
MEDICAL CENTERS OF THE UC SYSTEM.
I AND THREE NATIONAL
LABORATORIES IN THREE COMMUNITY
COLLEGES I WANTED TO SEE.
ECHO THE REMARKS THAT ARE
RETIREE PAUL BROOKS HAD
MENTIONED AS FAR AS COLLECTIVE
BARGAINING AGREEMENTS.
IT THE HEALTHCARE COSTS AND
COST SHIFTING REALLY HARMS LABOR
PEACE IN A VERY SUBSTANTIVE WAY
AND TRUST ME WE RATHER BE
BARGAINING ABOUT OTHER ISSUES.
BUT WE'RE FORCED INTO A CORNER
IN THIS WAY TO REALLY FOCUS
RIGHT NOW WHERE IT GO IN THE
MIDDLE OF BARGAINING CNA AND
ALSO ASKED ME LOCAL THIRTY TWO
NINETY NINE IS IN THE MIDDLE OF
BARGAINING IN THIS IS A VERY BIG
STICKING POINT.
YOU SEE IS NOW CONTEMPLATING
TUITION INCREASES AND THE OVERLY
OWNER ONEROUS NATURE OF THE
MAJOR HEALTH CARE COSTS IS
FORCING THEM IN ADDITION TO
STATE DIVESTMENT. IS HARMING THE
YOU SEE MISSION AS AN
EDUCATIONAL INSTITUTION TEACHING
RESEARCH AND SERVICE IN FACT YOU
SEE HAS CREATED ITS OWN
INSURANCE COMPANY TO SOBER THE
INCREASING COST CALLED YOU SEE
CARES. AND I DON'T KNOW WHAT
TYPE OF PERVERTED SYSTEM WERE
UNDER WHERE IF THE UNIVERSITY OF
CALIFORNIA HAS TO CREATE ITS OWN
INSURANCE COMPANY TO TRY AND
SUPPORT THE COST OVERRUNS OF
OTHER INSURANCE COMPANIES WE'D
RATHER BE HAVING TEACHING.
RESEARCH PUBLIC SERVICE MISSION
THAT'S WHAT WE REALLY WANT TO BE
ATTAINING SO WE HAD A GREAT
DISCUSSION I'VE BEEN TO ALL OF
THE SELECT COMMITTEE MEETINGS.
I LEARNED A LOT THAT WAS GREAT
BUT I THINK THAT WHAT THEY
REVEALED IS THAT WE HAD A GREAT
DISCUSSION AND THERE'S MORE TO
TALK ABOUT AND WHAT WE CAN DO TO
TALK ABOUT THOSE THINGS MORE.
ITS RELEASE THE BELL S. B. FIVE
SIX TWO WERE STRONG SUPPORTERS
AND WE HOPE TO CONTINUE THIS
DISCUSSION THANK YOU.
HELLO MY NAME IS DAWN BENKLER
MATURE SINGLE PAYER NO WE HAVE
THIRTY THREE THOUSAND SINGLE
PAYER NOW SO SINGLE PAYER
SUPPORTERS IN CALIFORNIA.
.
I WATCHED A BIT ALL THE HEARINGS.
AND.
THE QUESTION I HAVE IS.
WHERE HAVE YOU BEEN IN THE LAST
TWENTY FIVE YEARS THIS IS NOT
THE FIRST TIME THIS HAS BEEN
DISCUSSED?
ON ALL THESE QUESTIONS HAVE COME
UP BEFORE IN NINETEEN NINETY ONE
THAT PICKED PERCENT A SINGLE
PAYER BILL BILL HEARINGS.
BRINGING IN PEOPLE FROM ALL OVER
THE PLACE TO TALK ABOUT THESE
QUESTIONS.
IN NINETEEN NINETY ONE THE A
CONTRARIAN NATIONALLY THE
CONGRESSIONAL BUDGET OFFICE HAD.
PUT OUT A STUDY THAT SAID IF WE
WOULD NOT STATE'S ADOPTED A
CANADIAN STYLE HEALTHCARE SYSTEM
THAT WE CAN ENSURING BODY AND
SAVE MONEY TO VOTE.
IN NINETEEN NINETY FOUR WE HAD
AN INITIATIVE ON THE BALLOT HERE
THAT. ON HAD ITS OWN STUDIES AND
EVERYBODY WAS YOU KNOW EVERY
EVERYBODY TOOK HAD A LOOK AT IT.
SHEILA KILLED INTRODUCED.
ALL LEGISLATION FOR SINGLE PAYER
IN CALIFORNIA FOR OVER A PERIOD
OF TEN YEARS AND EVERY TIME
THERE WERE STUDIES. AND
AUTHORITIES TALKING ABOUT WHAT
WOULD HAPPEN AND THEY ALWAYS
CAME OUT SINGLE PAYER WAS THE
BEST WAY TO GO.
PALM.
AND. IT'S NOT JUST PEOPLE
TALKING ABOUT IT.
WE HAVE LIVE MODELS AROUND THE
WORLD IN EVERY INDUSTRIALIZED
NATION THAT SHOWS THROUGH STUFF
WORKS WE ARE CUTTING NEW GROUND
BUT. WE SEEM TO BE YET THAT AND
YAK AND YAK AND AND IF THIS%
APPROACH WOULD BEEN TAKEN TO
SHOULD WE ABOLISH SLAVERY WOULD
STILL HAVE SLAVERY. IF THIS
APPROACH OF BEEN TAKEN TO SHOULD
WE GIVE WOMEN THE RIGHT TO VOTE
BY YAKKING AND YET THAT WOULD
STAY STILL WOULDN HAVE THE RIGHT
TO VOTE THIS TIME TO PUSH
HISTORY FORWARD.
DO YOUR DAY JOBS RELEASED THE
BILL SO WE COULD HAVE A REAL
DISCUSSION THAT MEANS SOMETHING
WITH FIVE SIXTY TWO WHEN.
WHEN YOU SEE IT YOU EVER ON THE
LEGISLATIVE COMMITTEE CHAIR OF
THE SUPREME COURT OF CALIFORNIA.
ASSEMBLY WILL COST THE OUR IT
WAS PART OF CALIFORNIA.
AND I'D LIKE TO THINK THAT IF.
WE HAD MAJORITY THE LEGISLATURE
THAT WE HAVE HAD.
A BILL LIKE AB.
.
FIVE SIXTY TWO AND.
TEXACO.
YEAH CASE.
.
WE NEED A.
PRE Y. SE FREE I MEAN FREE TO
THE USERS OF THE SYSTEM CA
REALIZES COSTS INVOLVED. MERELY
FREE HIGH QUALITY.
UNIVERSAL SINGLE PAYER
HEALTHCARE SYSTEM.
WE SHOULD HAVE A LONG AGO.
AND NOW I THINK IS THE TIME TO
PUSH FORWARD WITH IT.
PLEASE ASK THE RENDON TO REDUCE
REDUCE THE BILL ALSO WOULD THERE
CAN BE. OPEN DEBATE AND VOTING
AND SO WE KNOW HOW EVERYBODY
VOTES THANKS VERY MUCH.
TIED.
WHEN HE WAS ALISON BISHOP AND
RESIDENT OF SAN FRANCISCO IN A
SINGLE PAYER ACTIVIST.
MY MESSAGE IS PRETTY SIMPLE WE
HAVE A CONCRETE PROPOSAL S. B.
FIVE SIX TWO. WE HAVE SOLID
METHODS FOR MOVING FORWARD WHICH
HAVE BEEN PRESENTED.
THE ECONOMICS OF PURCHASING
POWER ARE ON OUR SIDE.
AND WE'RE TIRED OF SUBSIDIZING
THE HEALTH INSURANCE COMPANIES
PROFITS WITH OUR TAX DOLLARS
WITH THE ACA.
IT'S BEEN SAID MANY TIMES TODAY
THAT YOU WANT TO HELP FAMILIES
THE POOR THE MIDDLE CLASS SMALL
BUSINESSES. MEDIUM BUSINESSES
AND ALL OTHER CALIFORNIA
RESIDENTS THEN MOVE FORWARD
ESPY'S FIVE SIX TWO.
GLORIA PURCELL FROM BELMONT I
ONLY SPEAK FOR MYSELF BUT I
WOULD LIKE TO LET YOU KNOW THAT
THE GREEN PARTY OF CALIFORNIA
HAS. ENDORSED AND SUPPORTS S. B.
FIVE SIXTY TWO.
AND WOOD TO TO THE.
HISTORY OF THE INSURANCE
COMPANIES AND THE.
AND THE SOCIALIZED ASPECT OF OF
A.
FIRE DEPARTMENTS ETCETERA JUST
TO HARK BACK TO THAT COMMENT
THAT WAS MADE BY THAT YOUNG LADY
THERE I DON'T KNOW HER NAME.
.
THE.
IN LONDON THOUGH IT THE FIRST
INSURANCE COMPANIES WOULD GO IN
STRONG ARM THE PEOPLE IN THE
BUSINESSES ON THE STREET AND SAY.
YOU REALLY NEED OUR FIRE
INSURANCE BECAUSE OTHERWISE YOU
KNOW YOU JUST MIGHT HAVE A FIRE.
AND SOME OF THEM DID SO THAT WAS
FORCING PEOPLE TO BUY FIRE
INSURANCE AND IF YOU DIDN'T HAVE.
THE PARTICULAR COMPANIES FIRE
INSURANCE THEY WOULD NOT INDEED.
FIRE.
NEED INSURANCE COMPANIES AS
THEY WERE THEN OF WORK CROOKS
AND. THEY STILL ARE.
THANK YOU PLEASE PLEASE SUPPORT
THIS AND OF PASSED THE BILL
FORWARD.
HUMAN.
HI CHRIS FOR SCIENCES POLICY
ADVOCATE WITH TRAILER THE
COALITION FOR HUMANE IMMIGRANT
RIGHTS HERE TO SPEAK ON THE
HOUSE FOR ALL.
PROPOSAL THAT'S GOING TO THE
BUDGET PROCESS AS WE KNOW
THROUGH OUR CONVERSATION THAT WE
HAVE WITH OUR MEMBERSHIP THROUGH
ACROSS THE STATE OF CALIFORNIA.
IMMIGRANTS TYPICALLY I HAPPEN TO
WORK IN VARIOUS AYE SECTORS BUT
SOMETIMES I'LL WORK IN SECTORS
THAT DON'T HAPPEN TO HAVE
INSURANCE OR. ANY TYPE OF ALL
FORMAL CARE FOR THEM.
WE KNOW THIS THROUGH THE ORGAN
ORGANIZING THAT WE DO WITH WITH
DAY LABORERS AND ALSO DOMESTIC
WORKERS. I'LL BE NOT SUCH WE
WOULD. URGE THAT WE WOULD STRONG
AND URGE LA THAT LEGISLATORS
SUPPORT THE HOUSE FOR ALL HOW
PROPOSAL.
AND I THAT'S ABOUT IT TO GIVE A
GOOD DAY.
SUSAN COLOR I'M A REGISTERED
NURSE I'VE BEEN A NURSE FOR OVER
THIRTY FIVE YEARS AND MOSTLY IN
INTENSIVE CARE SO YOU CAN
IMAGINE I'VE SEEN A FEW THINGS.
COM AND IT HASN'T GOTTEN ANY
BETTER SPEAKER RENDON OWN AND
YOU CO CHAIRS HAVE SAID PUBLICLY
THAT THE DOLLARS ARE NOT
OUTLINED FOR S. B. FIVE SIX TWO.
ACTUALLY IN FACT TO SEE
COMMISSIONED A COMPREHENSIVE
ECONOMIC ANALYSIS THAT OFFER
DETAILED SUGGESTIONS FOR THE
FINANCING OF S. B. FIVE SIX TWO.
AS THE SPEAKER KNOWS GIVEN THE
NEED FOR A PROPER STUDY AND THE
TIGHT TIMELINES FOR ACTION IN
THE SENATE. IN THE IN THE YEAH
IN THE SENATE IT WAS NOT
POSSIBLE TO INCLUDE A FULL
FINANCING PROPOSAL BEFORE THE
SENATE BUT IT WAS FULLY OUR
INTENT TO INCLUDE FINANCIAL
PROPOSAL. AS THE BILL WAS
CONSIDERED AN AMENDED IN THE
ASSEMBLY. IN FACT THE SPEAKER'S
OWN STAFF MEMBER TOLD CNA NOT TO
PUT THE FINANCING IN THE BILL
UNTIL IT GOT TO THE PROCREATION
IS.
COMMITTEE AND THEN THE SPEAKER.
FROZE THE BILL IN THE RULES
COMMITTEE.
THAT IS A TRULY DISINGENUOUS WAY
TO DEAL WITH US
THE PUBLIC
TELL A BILL SPONSOR NOT TO PUT
FINANCING IN THE BILL UNTIL MUCH
LATER IN THE LEGISLATIVE PROCESS
AND THEN SUBSEQUENTLY FREEZE THE
BILL. PREVENTING THE FINANCING
BEING PUT IN THE BILL AND THEN
DISHONESTLY CLAIMED THAT THE
BILL IS IN ADEQUATE BECAUSE IT
HAS NO FINANCING UNIT. YOU ARE
NOT FOOLING ANYONE WE'RE
WATCHING YOU AND WE KNOW WHAT
YOU DID.
S. B. FIVE SIX TWO NEEDS TO BE
ALLOWED TO PROCEED THROUGH THE
LEGISLATIVE PROCESS AND NOT ON
DEMOCRATICALLY BOTTLED UP YOU
SAY YOU BELIEVE IN HEALTHCARE IS
A RIGHT.
THE DEFINITION OF A RIGHT IS
SOMETHING THAT'S MORAL ETHICAL
AND JOTS.
SO DO THE RIGHT THING.
PAST
S. B. FIVE SIX TWO.
WE NEED GUARANTEED HEALTHCARE
FOR ALL NOT GUARANTEED INSURANCE
THANK YOU.
HI MY NAME IS JACOB MASON I AM
RUNNING FOR THE CALIFORNIA
SENATE AGAINST DOCTOR RICHARD
PAN HERE IN DISTRICT SIX ARM.
AND THERE'S OTHER PEOPLE RUNNING
AS WELL.
THE SP FIVE SIXTY TWO ISSUE HE
IS AGAINST IT IS PROBABLY THE
REASON HE'S GONNA LOSE IN THE
PRIMARY I WOULD SAY I IN JUNE
HOPEFULLY.
.
SO ARE AYE I'VE BEEN FOLLOWING
JOHN CHIANG WHO IS RUNNING FOR
GOVERNOR USE THE TREASURER
BECAUSE HE FOLLOW ME ON TWITTER
AND HE'S SAID RECENTLY I THINK
LAST WEEK.
THAT HE KNOWS HOW CALIFORNIA
CAN MOVE FORWARD SINGLE PAYER
AND HE KNOWS HOW TO BUDGET IS SO
JUST TALK TO THE TREASURER
CALIFORNIA BECAUSE.
ACCORDING TO HIM HE KNOWS
EXACTLY HOW TO DO THIS.
.
COURTING IS TWITTER IT'S RIGHT
ON THEIR.
SO UNIVERSAL HEALTHCARE IS
SIGNIFICANTLY CHEAPER PER CAPITA
THAN ON THE CURRENT SYSTEM.
NOW I I DON'T KNOW WHO LOSES
WHEN YOU TAKE OUT THE COSTS I'M
NOT. THAT MUCH OF AN EXPERT BUT.
.
IF YOU LOOK AT ITALY.
FOR EXAMPLE.
PULLING UP THE STATISTIC HERE.
THEY SPEND ABOUT THREE THOUSAND
TWO HUNDRED PER CAPITA FOR TOTAL
UNIVERSAL COVERAGE WE SPEND
ABOUT NINE THOUSAND DOLLARS PER
CAPITA UNITED STATES ALMOST
THREE TIMES MORE FOR ONLY SOME
PEOPLE HAVE PERFECT COVERAGE I
MEAN NO ONE HAS UNIVERSAL
COVERAGE IN THE UNITED STATES SO.
BUT IT.
I GUESS SOMEONE TIME HERE.
I DID NOTICE SOME THINGS THAT I
THINK OR NEED TO BE LOOKED AT
WITH THIS WHICH IS.
WORDEN DOT SAME RING TO COVER
PEOPLE IN THE TRAVEL
INTERNATIONALLY WITH THIS THE I
SAW AND OF SO THAT WOULD BE A
DOWNGRADE SO THAT NEEDS I THINK
COVERAGE.
AND I'M CONCERNED ABOUT.
.
ARE WE GOING TO USE THIS FOR
SOME TYPE A GUN CONTROL THING
WHICH I'D BE AGAINST PERSONALLY
BECAUSE I I JUST CAN'T MAKE THEM
FRENCH CANADA HERE BUT. SO I I
DON'T WANT TO SEE THAT HAPPEN I
THINK CALIFORNIA'S ON THE TORIES
FOR GUN CONTROL LIKE IT TO SEE
THAT HAPPENING WITH A WHAT'S A
GOVERNMENT DO HEALTH CARE.
THEREFORE WILL USE IT FOR GUN
CONTROL ANYWAYS I IN FACT HURTS
ON TALK ABOUT THEIR DAY.
.
JUST MY OPINION OKAY.
OKAY THANK YOU.
MY NAME IS GAIL PENA RHONDA I'M
A VOLUNTEER FOR SHE AND I.
I JUST WANT TO TALK ABOUT ONE
MORE.
NO WORD IS OXYMORON.
IT'S ONE OF THE. WORDS.
ONE OF THE FIRST WORDS ACCURATE
THE LEARN.
WHEN I WAS TRYING TO I SPEAK
ENGLISH.
IT MEANS YOU.
OUR THE WEIRDNESS OF TOWARD
TWENTY PUTTING TOGETHER LIGHT.
COLD FIRE DOES MAKE SENSE RIGHT.
AFFORDABLE HOUSING YOU CAN THE
BAY AREA THIS MAKES SENSE. RIGHT.
WELL THEY SHOULDN'T BE TOGETHER.
THAT'S WHY I'M ASKING PLEASE.
ASSEMBLYMAN RENTON.
RELEASED S. B. FIVE SIXTY TWO.
OTHERWISE RENTON AND ASSEMBLYMAN
WILL BE AN OXYMORON THANK YOU.
COMMITTEE MEMBERS MY NAME IS
DIANE TWERKIN THANK YOU FOR YOUR
TIME. I WANTED TO GIVE YOU SOME
REAL NUMBERS ON HEALTHCARE COSTS.
OF MY HAS WAS FORCED TO RETIRE
AFTER A NEAR FATAL HEART ATTACK.
HE DIDN'T HAVE MEDICAL INSURANCE
AFTER RETIREMENT BUT I WAS
WORKING WAS ABLE ENSURE HIM TO
MY EMPLOYER.
I SEPARATED FROM MY JOB IN
JANUARY OF TWENTY SEVENTEEN.
RICKOVER APPEAR PREMIUMS WERE
ASTRONOMICAL.
WE LOOK TOWARD COVER CALIFORNIA
THE LEAST EXPENSIVE PLAN I COULD
OBTAIN WHICH WAS A BRONZE PLAN.
AN ANNUAL PREMIUM TOTALS OF
SIXTEEN THOUSAND NINE HUNDRED
DOLLARS.
IT WAS A FORTY EIGHT HUNDRED
DOLLAR DEDUCTIBLE PER PERSON.
IT WORKED OUT TO BE THIRTY SIX
PERCENT OF OUR GROSS.
YES GROSS INCOME IN PREMIUMS AND
DEDUCTIBLES.
THE PREMIUMS WERE MORE THAN A
HOUSE PAYMENT.
FORTUNATELY HE BECAME ELIGIBLE
FOR MEDICARE DISABILITY LAST
FALL.
ON ANTHEM BLUE CROSS PULLED OUT
OF MY COUNTY AT THE END A TWENTY
SEVENTEEN. BLUESHIELD IS MY ONLY
OPTION AND THERE IS NO
COMPETITION.
MY PREMIUM FOR INSURANCE JUST
FOR MYSELF IS NINE HUNDRED AND
FIFTY EIGHT DOLLARS. A MONTH.
AND IF WE WERE BOTH ON THE
PLANET WOULD BE NINETEEN HUNDRED
AND SEVENTY FIVE DOLLARS A MONTH
ONCE AGAIN FOR A BRONZE PLAN.
OVER TWENTY THREE THOUSAND
DOLLARS ANNUALLY.
I HAVE A SIXTYTHREE HUNDRED
DOLLAR DEDUCTIBLE.
OF.
I WORKED.
I CONTRIBUTED TO FOR OWING KAY'S
BUT IT LOOKS LIKE ALL OF THAT
WORK IS ARE GOING TO PAY
INSURANCE PREMIUMS IN RETIREMENT.
PLEASE RELEASE S. B. FIVE SIXTY
TWO.
THE UP MOVED I'M DOCTOR RUN BURN
BOMBING THE PHYSICIAN IN LOS
ANGELES AND I WANT TO THANK THE
COMMITTEE.
.
I IN MY WORK I TAKE CARE OF.
LARGELY.
IMMIGRANTS AND UNDOCUMENTED
COMMUNITY AND I WHAT SHE WANTED
TO TALK A LITTLE BIT ABOUT
SOMETHING THAT CAME UP AT A
PASSED.
.
SESSION.
BUT IS TO BE INTRODUCED AGAIN
TODAY A DIFFERENT WAY WHICH IS
THE ISSUE OF I WELCOME JUST CALL
MEDICAL APARTHEID IN THE STATE
OF CALIFORNIA.
SO ASSEMBLY MEMBER WOULD.
YOU BROUGHT UP AN INTERESTING
THING WHICH IS THE PROBLEM OF
THE SUPPLY.
OF HEALTHCARE PROVIDERS.
AND HOW YOU THOUGHT WELL WE'RE
GONNA WE'RE GONNA COVER
EVERYBODY BUT THEN I HAVE THE
SUPPLY THAT'S IN PLACE.
WELL LET'S APPLY PROBLEM IS IN
PLACE NOW IN THE REASON.
THAT.
SOME PEOPLE FEEL IT AND SOME
PEOPLE DON'T IS THAT THERE'S NOT
A LOT OF PEOPLE WHO WILL TAKE
MEDI CAL.
SO.
PEOPLE WHO TAKE ME WHO HAVE MEDI
CAL.
ARE.
IT WOULD MANY KIDS ARE ARE THE
VICTIMS I WOULD SAY OF APARTHEID
OF MEDICAL PARTED IN THE STATE
ARE THE ONES FEELING THAT RIGHT
NOW.
SO.
I THINK THE PEOPLE HAVE SAID
TODAY THAT MAYBE WE SHOULD TRY
TO DO INCREMENTAL REFORMS AND
LOOK FOR A BIG PICTURE THING.
ALL AT ONCE.
I'M NOT CONVINCED THAT ACTUALLY
THE LEGISLATURE HAS THE BAND
WITH TO DO ALL THOSE THINGS.
FINALLY I WOULD SAY THAT WHILE
WELL INTENDED SOMETIMES YOU GET
THE RIGHT.
DIAGNOSIS IN THE WRONG DIRE
TREATMENT.
RECOMMENDED
THAT THE IMMIGRATION AT
ADVOCATES WHO ARE HERE TODAY WHO
ARE ADVOCATING MEDI CAL EXPO.
AS THE SOLUTION TO THE ON
DOCUMENT IT'S PROBLEM ARE IN ARE
MAKING A MISTAKE.
BECAUSE THEY ARE TAKING THAT.
APARTHEID SYSTEM IN OUR STATE
AND WANT TO EXPAND.
SO. I WOULD INVITE.
THE COMMITTEE.
ANALYSTS IMMIGRATION ADVOCATES
TO CONSIDER S. B. FIVE SIXTY TWO
AS THE RIGHT APPROACH.
UP FOR THE UNDOCUMENTED AND
IMMIGRANTS IN OUR STATE.
THANK YOU.
GOOD EVENING I'M JUST LOOK BONTA
HIM ON A UTILITY WORKER FROM
WALNUT CREEK AND UP MY
GENERATION IS LOSING HOPE ON OUR
LEGISLATORS THIS THESE DAYS AND
I WAS PARTICULARLY DISTRESSED
THAT. THE ONLY ACTUAL ITEM THAT
I COULD GET FROM THIS NEXT
COMMITTEE.
HEARING THAT'S ABOUT TO AND IS
THAT WE NEED MORE MODELS AND
SPECIFICS.
AND I FEEL LIKE WE'VE BEEN GOING
AT THAT IF WHATEVER MILES YOU
NEAR SPECIFICS I'LL TAKE IT HOME
TO WORK ON IT THERE'S PLENTY OF
PEOPLE IN THIS ROOM THAT'LL
START. OUR THERE'S GREAT MODELS
OUT THERE TO START FOR
HEALTHCARE SYSTEM.
WE COULD START BY BUILDING OFF
MEDICARE OR WERE EITHER SINGLE
PAYER SYSTEMS THAT ARE OUT THERE.
ARE IF YOU NEED MORE CRAFTS LIKE
ISSUE GRAPHS ABOUT ENTREPRENEURS
OTHER SILICON VALLEY TECHNOLOGY
FOLKS AND PROGRAMMERS THAT NEW
INVENTIONS AND NEW IDEAS BUT
THEY'RE SCARED TO START NEW
BUSINESSES AND HIRE PEOPLE
BECAUSE THEY DON'T WANT TO LOSE
THEIR EXISTING HEALTH CARE.
I CAN SHOW YOU GRAPHS AND PIE
CHARTS ABOUT HOW THE PLAYERS ARE
SPENDING MORE AND MORE AND.
GETTING CLOSE TO TWENTY FIVE
PERCENT OF THEIR PAYROLL I'M
JUST HEALTH INSURANCE AND THAT'S
NOT TO PROVIDE A PLATINUM PLAN
THAT'S BARELY TO PROVIDE ON
AVERAGE JUST SILVER LEVEL PLAN.
I CAN SHOW YOU PIE CHARTS OF HOW
FAMILIES ARE SPENDING MORE AND
MORE EVERY YEAR AND THAT FIVE
HUNDRED DOLLAR FIGURE THAT WAS
QUOTED EARLIER BY A PANELIST WAS
ALARMING TO ME.
.
THIS HEALTHCARE BILL THAT I
SUPPORT S. B. SPIKE SIXTY TWO
WOULD REPRESENT. THE LARGEST
BENEFIT TO CALIFORNIA ECONOMY
AND FAMILIES THAT. WOULD.
FAR BENEFIT LARGER THAT ANY TAX
CUT OR INCENTIVE THIS LEGISLATOR
LEGISLATION COULD EVER PASS.
IT WOULD SPUR OUR ECONOMY AND
SPORTRESS PARA ARE ENTREPRENEURS
AND I HOPE WE CAN GET IT DONE.
PLEASE LET'S LET'S RELEASED S.
B. FIVE SIXTY TWO AND LET'S GET
IT TO A VOTE. THANK YOU.
HELLO MY NAME IS STEPHANIE OF
I'M A RETIREE I LIVE IN DISTRICT
TWO OF DOCTOR WOODS DISTRICT.
OF. MONEY.
FAMILY WAS A MILITARY FAMILY MY
DAD WAS ARMY MY HUSBAND WAS
AIRFORCE.
AND WE LIVED TEN YEARS IN EUROPE
WHEN HE WAS STATIONED IN GERMANY.
WOULDN'T BE HIS SEPARATED FROM
THE SERVICE WE CAME BACK FROM
THE STATES THAT WAS.
A GAP BETWEEN HIS MEDICAL
COVERAGE KICKING IN.
AND HIS MILITARY OF.
BENEFITS OF DROPPING AND SO. HE
PLAYED BASKETBALL WITH MY
BROTHERS AND BROKE HIS LEG AND
WE HAD OUR VERY FIRST MEDICAL
BILL FROM THE EMERGENCY ROOM IT
WAS A REAL SHOCK TO US.
NEVER HAVING HAD.
THE EXPERIENCE OF BEING IN.
WITHOUT A MEDICAL COVERAGE IN
OUR LIVES.
.
WE'RE RETIRED NOW WE PLANS
REALLY WELL FOR A RETIREMENT WE
HAVE LIFETIME MEDICAL CARE.
ARE RETIREMENT INCOME THIS
PORTABLE WE COULD LIVE ANYWHERE
IN THE WORLD.
AND WE CAN TAKE YOUR HEALTH
CARE WITH US.
.
TAXES ARE HARD IN CALIFORNIA THE
COST OF LIVING IN SNOW MCCOWN IS
HIGH.
AND IT WOULD BE A KIND OF A GOOD
IDEA TO FIND SOMEPLACE WHERE ARE
PENSION WOULD GO FURTHER.
BUT IF CALIFORNIA WERE ACTUALLY
TO PUMP UP TO PASS REAL.
SINGLE CARRIER PAYER HEALTHCARE
SYSTEM.
I'D BE SO PROUD TO BE A
CALIFORNIA RESIDENT AND WOULD
EVEN CONSIDER LEAVING.
A DOCTOR WOULD.
I WOULD APPRECIATE IT VERY MUCH
IF YOU DID EVERYTHING IN YOUR
POWER TO MAKE SURE THAT SINGLE
PAYER HEALTHCARE PASSES IN
CALIFORNIA IN WHATEVER WAY THAT
YOU CAN MANAGE IT.
THANK YOU.
MY NAME IS PATRICIA JOHNSON I'VE
BEEN AND OUR AND FOR MORE THAN
THIRTY YEARS.
I'VE WORKED MOSTLY IN PUBLIC
HEALTH.
I'M COMPELLED TO RESPOND TO THAT
SPEAKER ABOUT DENTISTRY.
THEIR ST NINE YEAR OLD THAT I'M
AWARE OF THAT HAD A ROOT CANAL
THE DENTIST WAS NOT PAID FOR THE
ROOT CANAL THE CHILD'S RECEIVED
THREE DENIALS FOR A CROWN.
I'M IN THIS IS ON A NINE YEAR
OLD WHO NEEDS A PERMANENT TO.
I'M SO THAT DATA CAL IS NOT VERY
GOOD.
I'M IN AS DR BERND BOND SAID ITS
APARTHEID.
I HAVE A TWENTY TWO YEAR OLD
THAT WAS JUST.
.
ACCEPTED INTO THE LONDON SCHOOL
OF ECONOMICS.
AND.
WHILE HE'S IN BRITAIN HILL HAVE
FREE MEDICAL CARE.
.
SO I HOPE YOU'LL COME BACK TO
CALIFORNIA AND I'M HELP PASS SB
FIVE SIXTY TWO.
OR HE'LL BECOME ASSEMBLY MEN
LIKE HIS GRANDFATHER WAS.
ANY OTHER PUBLIC COMMENT AT THIS
TIME.
SEEING NONE AND.
THIS HEARING BEING ON FOR EIGHT
HOURS I THINK AT THIS POINT.
WE'RE GOING TO CLOSE IT DOWN I
WANT TO THANK EVERYBODY WHO
SPENT THE TIME TO COME HERE.
TO TESTIFY TO HAVE THEIR VOICES
BE HEARD IT'S IMPORTANT FOR US
AS PUBLIC SERVANTS TO HEAR FROM
OUR COMMUNITIES. AND I
APPRECIATE YOU TAKING THE TIME
TO COME HERE TODAY. THANK YOU
ALL VERY MUCH