State Assembly Speaker Fabian Núñez (D-Los Angeles) led a candid discussion on how to fix the ailing health care system during a town hall meeting at UCSF on Saturday.
Núñez is conducting a series of town hall meetings to explain his "Fair Share Health Care" plan and to get input from the public.
Joining Núñez for the town hall meeting and a tour of UCSF Children's Hospital on Feb. 3 were assembly members Jim T. Beall, (D-San Jose), Mary Hayashi (D-Hayward), Mark Leno (D-San Francisco), John Laird (D-Santa Cruz) and Fiona Ma (D-San Francisco).
See video.
Reforming Health Care
The speaker's proposal is one of several health care reform plans under consideration this year as the Legislature and Gov. Arnold Schwarzenegger work on expanding and improving health care coverage in California. Schwarzenegger offered his own plan to expand health coverage in January.
Democratic leaders consider health care a top priority this year, Núñez said, noting that there is political will in Sacramento to expand health care coverage.
"First, we believe as Democrats in the Democratic Assembly that health care too often has now [grown] into a privilege that a few can have," Núñez said at the start of the town hall meeting. "We're seeing an increase in your premiums; we're seeing a diminution in the quality of service and access to health care. And yet we're seeing that 6.5 million people in California don't have health insurance.
"To put it real bluntly, we believe that access to health care -- and that's the premise of our proposal -- is not a privilege; it is a right that ought to be afforded in modern society to each and every Californian."
At several points in the town hall meeting, the audience of about 150 people, which included UCSF neighbors, union members, seniors, health care providers and educators, applauded the idea of providing single payer health care in California. Single-payer is a universal health care insurance system like those offered in most other industrial countries, under which everyone pays a premium into one health care trust fund and everyone gets health care coverage paid out of that fund. State Senator Sheila Kuehl, (D-Santa Monica) authored Senate Bill 840 to provide single payer coverage, but it was vetoed by the governor last year. She plans to reintroduce a single payer bill in this year's legislative session.
Núñez said he considers his plan a starting point for health care reform. "This is not a perfect plan," he acknowledged. "There are some of us, certainly, in my caucus that would prefer a single-payer plan for California. But we know that it's going to be a long haul to get to single-payer. In the meantime, we've got to do something to improve upon the system that we currently have."
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State Assembly Speaker Fabian Núñez toured UCSF Children's Hospital before he led a town hall meeting on health care reform. |
Núñez, who said he felt a bit like a TV talk show host during the town hall meeting, looked comfortable in that role, asking questions and answering others in an informal and friendly exchange with the audience and the panelists.
The panel of speakers included a small-business owner, an uninsured 34-year-old health care worker with a family history of diabetes, children's health advocates and Andrew Bindman, MD, a UCSF professor and chief of internal medicine at San Francisco General Hospital (SFGH).
For his part, Bindman emphasized the importance of expanding health care coverage so that people can get the primary care and routine screenings needed to detect disease as early as possible. He recounted a recent case of an uninsured woman who was brought to SFGH's Emergency Department after she fainted at home. The woman was later diagnosed as having a huge, inoperable tumor in her abdomen. All hospital staff could do was provide her with comfort care because her condition was so far advanced.
"This is the kind of thing that we see regularly," Bindman said. "This is a complete travesty. We have the capacity. We have all the elements of the single best medical care in the world, but we don't have the single best medical care system in the world. We have pieces that are not integrated and working to keep our population as healthy as it has the right and the opportunity to be."
Elected to the California State Assembly in 2002, Núñez said an important part of his proposal calls for focusing more on covering primary and preventive care and on better treatment of chronic diseases. Núñez's district includes East Los Angeles, where children suffer from high rates of asthma, obesity and diabetes. His plan also includes adopting strategies to encourage fitness, wellness and health promotion programs to improve health.
Núñez explained that his multi-year plan aims to share responsibility for expanding health care coverage among individuals, employers and the government. The plan seeks to reduce health care costs, reform the health insurance market, strengthen public coverage programs, improve access to coverage for low-income people, and level the playing field for companies and workers who are now paying for health coverage. The proposal is designed so that employers who already provide coverage and families who receive it will encounter few if any changes, he said.
One of the first priorities of his plan is to enroll all children who are eligible for existing programs and to cover the remaining uninsured children by July 1, 2008.
Visiting Children's Hospital
In the morning, Núñez toured UCSF Children's Hospital, where Executive Director Roxanne Fernandes, RN, described how UCSF is recognized as a national leader in the care of children with life-threatening conditions.
UCSF Children's Hospital, she explained, operates one of the nation's three National Institutes of Health-funded Pediatric Clinical Research Centers, where children are receiving treatment for neuroblastomas, an often deadly cancer that affects infants and young children. The survival rate of this disease has improved from 10 percent in the 1980s to 40 percent today, Fernandes said.
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San Francisco Mayor Gavin Newsom |
Later, she took the group into the pediatric playroom, where child-life specialists help minimize the stress of illness by providing opportunities for hospitalized children to learn and play.
San Francisco Mayor Gavin Newsom also stopped by the children's hospital playroom and shook hands with patients, parents and others.
Outside the playroom, Mayor Newsom and Fernandes talked with state legislators briefly about the remarkable growth at Mission Bay and UCSF's plan to build a hospital complex for children, women and cancer services near the existing UCSF campus. Newsom mentioned that Diane "Dede" Wilsey, who last week was named by UCSF to lead the philanthropic effort for this new hospital complex, is eager to work on the project.
Last February, Mayor Newsom unveiled his plan to provide low-cost health care to the city's uninsured adults, estimated to number 82,000. Those covered under the
Health Access Program (HAP) will be able to access primary care through San Francisco's existing network of public and nonprofit community health clinics, and to get secondary care at the UCSF-affiliated San Francisco General Hospital.
The San Francisco Department of Public Health is currently developing implementation plans for HAP, which will be phased in incrementally beginning on July 1, 2007. HAP will be funded through a combination of public funds, employer contributions and payments from individual participants.
Photos and Video/Lisa Cisneros
Related Links:
Video Coverage of Health
Care Town Hall
KTVU.com
San Francisco Health Access Program
Status
Report on the Implementation of the San Francisco Health Care Security Ordinance,
Jan. 31, 2007 (PDF)
Speaker
Fabian Núñez website
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"Fair Share" Health Care Plan That Puts Children FirstCalifornia Progress Report, Dec. 21, 2006
Governor's
Proposal: Coverage for All Californians - Everyone to Share CostSan Francisco Chronicle, Jan. 9, 2007
