Aside from my service on the Richmond City Council, I work as a full-time children’s wrap-around mental health specialist for Contra Costa County. Every day I see the effects of poor health and rediscover the needs of our children and families in my day-to-day work. I will bring my ground-level experience to discussions and legislation in Sacramento aimed at improving Californians’ physical, mental, and economic health. I believe California needs to focus on five aspects of the healthcare problem right away: (1) working for a single-payer healthcare system, (2) retaining access and affordability even while working on single-payer, (3) preserving and enhancing healthcare access and delivery for all California residents, (4) promoting provider coordination, and (5) emphasizing preventive and community healthcare approaches.
1. Single Payer Healthcare
In April 2011, long before introduction of the current single-payer bill (SB 562 and its analogue in the Assembly), I co-authored a resolution adopted by the Richmond City Council supporting Senate Bill 810, the California Universal Health Care Act of 2011. In the intervening years, as single-payer has moved to the center of national debate and become supported by a majority of Americans, its urgency for California has only increased.
As a State Assembly member, I will do everything in my power to enact single-payer health coverage for all Californians as would happen with adoption and implementation of SB562. The Assembly should move ahead with its own hearings and draft legislation to implement a single-payer system. Few if any policy changes could do more to protect the health of our communities, lower costs and boost our economy than universal, single-payer healthcare.
If we instituted single-payer Health insurance coverage, we would not only reduce the costs of medical care, we would absolutely improve the health status of our communities. We could also begin to redirect money to prevent illnesses, rather than just waiting to treat people when they become chronically ill. We not only have a moral obligation to heal the sick, we also owe it to ourselves to improve the health of all of our residents. As somebody who works with the mentally ill, I see every day the consequences of the Health disparities in our communities that could be dramatically improved with equitable health insurance coverage for everyone. As the opioid epidemic claims and victims every day, we do not provide adequate funding for treating those with drug addiction disorders. Instead of criminalizing these victims, we could be providing appropriate and necessary treatment to help them overcome their addiction.
Physicians for a National Health Care Program (PNHCP), a physician-led organization, states, “We already pay enough for health care for all – we just don’t get it. Americans already have the highest health spending in the world, but we get less care (doctor, hospital, etc.) than people in many other industrialized countries. Because we pay for health care through a patchwork of private insurance companies, about one-third (31 percent) of our health spending goes to administration.”
PNHCP explains that single-payer
. . .is a system in which a single public or quasi-public agency organizes health care financing, but the delivery of care remains largely in private hands. Under a single-payer system, all residents . . . would be covered for all medically necessary services, including doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs. The program would be funded by the savings obtained from replacing today’s inefficient, profit-oriented, multiple insurance payers with a single streamlined, nonprofit, public payer, and by modest new taxes based on ability to pay. Premiums would disappear; 95 percent of all households would save money. Patients would no longer face financial barriers to care such as copays and deductibles, and would regain free choice of doctor and hospital. Doctors would regain autonomy over patient care. [http://www.pnhp.org/sites/default/files/faq_2018.pdf]
While I favor a national health-care system, California is certainly a large enough economic unit that we could embark on such a system even before the federal government does so. As in so many other areas, California could lead the country to better health. As the PNHCP says about the US as a whole, in a state system, “Replacing private insurers. . . would recover money currently squandered on billing, marketing, underwriting and other activities that sustain insurers’ profits but divert resources from care. . . . Combined with what we’re already spending, this is more than enough to provide comprehensive coverage for everyone.”
2. Retaining Access in Advance of Single-Payer
The Assembly and Senate will likely take some time to hone a single-payer system, and if experience with the current governor is any indicator, even passage would not guarantee rapid implementation. There are tremendously important things we need to do to retain broad access to healthcare for all Californians as we fight for, devise, and transition into a single-payer system (whether this takes place at the federal or state level).
Even as we seek improvements, our citizens are threatened by US Congress H.R. 1628, the American Health Care Act, which seeks to repeal and replace President Obama’s effort to improve health coverage for Americans, the Affordable Care Act.
California can protect its citizens from these federal misdeeds. Rather than destroying Medi-Cal by underfunding it, as the federal government is attempting to do, we must preserve Medi-Cal. Legislators need to establish protections and continue to expand services regardless of federal proposals as we continue our statewide mobilization for a single-payer system.
While working for single-payer, I will fight to ensure that workers’ wages cannot be continually cut to make up for rising healthcare costs. Employers’ cuts to employee healthcare benefits highlight the need for single payer healthcare.
California healthcare workers are facing understaffed departments and are forced to work overtime, putting patients and employees at risk. We must make sure healthcare employers commit to providing safe staffing levels and paying competitive wages to prevent a healthcare provider crisis. Sacramento needs to pay more attention to conditions of and compensation for our healthcare workers, including helping healthcare workers to find and afford housing within reasonable distances from their workplaces.
Nurse/patient ratios are established for patient and nurse health and safety; they must be followed or people will die. Nurses put their lives on the line to save other’s lives, and they have every right to refuse unsafe assignments. I would initiate or support legislation that upholds and strengthens these standards by increasing the number of inspectors and mandating stiff penalties for facilities that violate them.
3. Preserve and enhance healthcare access for all California residents
Throughout California there are healthcare deserts, communities that lack access to vital healthcare professionals and institutions. We must establish and preserve clinics, hospitals and transportation options to make sure that all Californians have the healthcare access they need.
The consolidation and centralization of healthcare providers – one of the consequences of corporatized health systems – is part of the reason hospitals and clinics have closed down in rural and outlying communities and even in locations in major cities that, for some reason, the big health companies find undesirable. California needs to develop compensatory financing systems so that all its citizens are close to needed healthcare services including clinics, urgent care and hospital facilities. In my own district, I’ll fight to preserve Alta Bates hospital in Berkeley.
4. provider coordination
Especially because healthcare has become a profession of usually dispersed specialties that individuals have to figure out how to navigate just at the worst time – when they need help – I believe it’s vital to improve coordination between the institutions that come most closely into contact especially with our neediest citizens in helping to determine individuals’ healthcare needs and ways to serve them. Community colleges, school districts, cities, counties and other agencies need to develop coordination and cooperation routines for the delivery of social, health, and mental health services.
5. Prevention and community health
Beyond trying to fix our very flawed sickness care delivery system, we must think about individual and community health in a very different way. Let’s think about preventing illness and keeping communities healthy in the first place. Even then-Senator Barack Obama voiced concern in 2008 with these very stark words: "Simply put, in the absence of a radical shift toward prevention and public health, we will not be successful in containing medical costs, and improving the health of the American people."
So what would preventing illness actually look like? Here are two examples that California could easily implement if the political will was present:
First, a state-funded public health media and nutrition campaign to counter the obesity epidemic, much as HIV has been addressed in the past. The obesity epidemic is causing catastrophic premature illness and mortality but it is entirely preventable!
The elements of nutritional health are well known. Whatever the fad diets of the day, the vast preponderance of scientific evidence shows that diets rich in fresh vegetables and fruit, with substantial protein (whether meat or vegetable) and whole grains and nuts, consumed in moderate portions and without significant amounts of added sugar or refined carbohydrates reduces obesity, heart disease, diabetes, and cancer. But on a day-to-day basis, many of California’s citizens don’t follow the experts’ advice. Advertising, ready and cheap availability of processed foods and sugar-laden treats are levying huge healthcare costs and individual suffering on our citizens. What can we do? Our schools can help with nutrition education; our state can adopt taxes that raise the prices of unhealthy foods just as they did with cigarettes; our healthcare providers can be urged to address their clients holistically and preventively, not just therapeutically. The state can help make Californians healthier!
Second, much as California has decriminalized marijuana, it should consider decriminalization of the use of illegal drugs. Drug addiction and use must be addressed as public health issues, not matters of criminal justice. This would improve outcomes and hugely reduce pressure on our justice and incarceration systems. Think of all the lives that could be saved, the needless victimization of addicts that could be avoided, and the billions of dollars that could be saved by dramatically reducing the prison industrial complex. With drug addiction considered a health problem within a framework of preventive healthcare built upon principles of benefit for patients rather than benefits for insurance companies and huge healthcare companies, drug treatment facilities could replace prisons for many people whose prospects now are being crushed by inappropriate punitive, rather than curative or maintenance approaches.
Corporate-free politics and California’s Health
Right now, legislation and legislative initiatives in California are dominated by lobbyists. These people have the expertise, the funding, the longevity in Sacramento and the dedication to delve deeply into their policy areas and to craft legislation that serves their employers. Unfortunately, their employers are mostly large corporations that have interests in legislation that protects their profits.
I’m running for Assembly District 15 as a corporate-free candidate. Having worked steadily in my day job as a mental health wrap-around specialist for children, spending much of my remaining time engaged in Richmond politics seeking to improve life in my community on the basis of grassroots, ground-level upward mobilization of people’s talents, I’m convinced that California as a whole could vastly improve its residents’ health by pursuing a single-payer, state-defended, highly accessible, coordinated and significantly preventive healthcare system.
These aren’t the innovations that the big corporations view as important to them. They aren’t necessarily profit centers. But for California’s people, they are vital and they are attainable. That’s what I plan to work on in Sacramento as a representative of Assembly District 15.
