2008 State of the City Health Care Webisode

(My Original Blog Post: -*http://api-madness.com/post/2008-state-of-the-city-health-care-webisode/)

Attention! API Garbage (might be unreadable):

health city million

Always sorry is a conspiracy with the most talked about are most needed and probably least acted upon issue in America today announced issue health care examines a strawberry proud that we re sitting I m just a dreamer s notice of your viewers city of innovators and entrepreneurs a city that tries to be on the leading and cutting-edge in that context tries to take responsibility and take account onto the wall we love the fact is we have more people becoming uninsured in this country not less we have more people coming uninsured in California not last and in San Francisco that had been the case until very recently our city decided to become the first city in United States of America should do something about the health insurance crisis and has now adopted what we commonly refer to here in our city is help these efforts is not its talk about what this means your 45.7 million Americans without health insurance we ve seen premiums rise by 78% in the last seven years national in California just to put in perspective premiums have risen 95.8% as wages have remained flat in San Francisco premiums are about consistent with the state of California but the reality is the gap again between those could afford healthcare and those that haven t continues to grow and those that need it continues to grow until we initiated our program 6.5 many as 7.2 million Californians don t have health insurance a largest pool of uninsured in America second is Texas examines Cisco we have when we started our program out roughly 125,000 of those uninsured until we realized that actually the number was a lot smaller and I guess this is a point I want to make as a movement of the slide in the presentation the old adage you need to know we are in order to get where you want to go I think comes to mind we estimate the uninsured in California as I said 6.5 million to 7.2 is an estimate because I can give you real for studies they give three or four different conclusions about the total number of uninsured in San Francisco when we initiated our health examines Cisco program we estimated again that hundred and 25,000 figure when in fact we did the analysis we did the work and we realize the number was actually much smaller than that fact turns out to be about 73,000 uninsured in city and County of San Francisco by the way there are five studies that show five different numbers but the study of studies the ultimate determination of the total number of uninsured and seven Cisco turns out to be 73,000 interestingly lower than we have rejected I don t know but extrapolates out into California s projections or US projects and some would argue it s the opposite than our city turned out to be a little bit lower and what that did his fact framework of understanding allowed us to initiate a program now we decided to do something differently in San Francisco that is rather than talk about how we can provide health insurance to the 73,000 uninsured we asked a very profoundly different question we asked how we could provide universal health care to the uninsured in San Francisco that simple distinction health insurance versus health care allowed us to act differently not just think differently about equating a solution to the challenge of the uninsured inner-city healthcare is exactly what providing as you can see from our current stats and this is remarkable 2008 has been remarkable healthcare year in seven Cisco we halfway there over 32,000 people are now in roles and are healthy for Cisco program the reason I say halfway a reference to 73,000 figure is that we estimate about 60,000 are actually do want to take advantage of this program so those in the pool but actually to take advantage we are already half way there a universal health care plan that doesn t care about pre-existing conditions universal health care plan that is a plan that incorporates the private sector not just the public sector we now have literally 28 clinics and public and private partners as part of this consortium support for healthy San Francisco maybe you can go to a city supported health clinic or you can go to private supported health clinic you can go to some a largest hospitals in California some largest in America that happen to have locations here in San Francisco St. Mary s St. Francis partnerships with the UC system partners with Sutter health care through their CPM seat locations in San Francisco 14 private 14 public complete choice within the system a system of universality for health care that s second to none in this country a model we believe to the nation not health insurance but health care what that does is nothing differently than my health insurance the downside of the healthcare versus health insurance is one thing it s not portable you can t take it with you but as a resident of San Francisco again regardless of pre-existing conditions you have HIV or AIDS you can have a chronic disease regardless of those pre-existing conditions based upon your ability to pay you are eligible for this program so the question is how you pay for a program like this were well on our way to getting everyone in roles and you ll see here that we expect by this time next year at December of next year almost a year from now that will have to sleep completed this program completely enrolled everyone that seeking health care in our city we pay for questionably to $200 million year program by the hundred $11 million comes from existing pool of money the reality is we were already taking care of the uninsured are said to be with all the talk you can t afford not to do health insurance or health care the fact is you re paying for it on the acute and you re paying for it in the same community clinics are paying for it at the hospitals and emergency rooms and exponentially more money will wear doing is redirecting the money that we were already spending hundred and 11 million of the $200 million program actually is that redirected money what we re also doing is drawing down state and federal dollars because this is the big ideas not health insurance people with HIV or AIDS that are eligible based upon income still can draw down federal dollars they can still draw down a lot of state dollars again because they re still uninsured even though they re on our health care plan so as a consequence last year we projected in the 2008 calendar year but through the fiscal year that goes into the middle of 2007 at about $200 million program on 11 three directed $69 million comes from state and federal resources in fact when I got Grant of $73.1 million over three year. Sealed idea of money you got off on the money to start a program of money is the excuse your number one start a new program you come up with a great idea the money will follow the same thing in the private sector in the business world put together great business plan you find investors to same idea with her healthcare plan we didn t know how we would pay for we just came up with a better plan than any that we aware of as a consequence again redirected money and new grants from state and federal government the money is now flowing in addition that gets us close to about 180 million of the $2 million cost we have $12 million coming from the private sector these are employers about 85% of the employers and services to our exempt 15% actually make a contribution to about $12 million in the current year and then finally the remaining eight or so million comes from point of service fees which are co-pays and monthly premiums that people pay again based on their ability peso for example yearning 0 to 100% of federal poverty you pay nothing for the program not a dollar premium 1 to 300% of federal poverty you pay a nominal fee 300+ to 500% of federal poverty to pay a little bit more again scaled based on ability to pay co-pays zero or very low focus on preventative care as opposed to acute care and I wanted to stop and pause and a focus on preventative care as opposed to emergency care that s the whole principle behind a people health care is to stabilize them and to deal with chronic disease management to focus on health and that is a big part of now our focus in San Francisco is a health care delivery as we got people rolled in our program now are focusing on prevention and misses the irony in this country fact verse number of studies on this but they are conclusive in this respect that the dominant and I mean overwhelming majority of our healthcare dollars that we spend his taxpayers goes not into prevention goes into treating people after their sick we believe it s cheaper to invest in people s health and to treat people sicknesses that s the principle of our plan but $.96 of your dollars today in this country go to treating people being sick as opposed to trading and investing peoples and peoples health four cents of every dollar that s it into prevention salmon Cisco wants to lead the way and move in a completely different direction the first event we got to get people enrolled in the program stabilizing the program then start redirecting that investment into the patients themselves into focusing again on their health will help you separate Cisco is one of the things I m most proud of his mayor we have a lot of support unanimous support from our elected family and not rare in America today that good folks of every ideological point of view all agree that this is the number one priority for our city and we achieved in the effects supervisor, meow for his leadership for his counsel and his constancy on this our friends in labor and the business community came together in this historic way and the best director of the Department of public health in the nation bar none Mitch Katz had not been for Dr. Mitch Katz we would never have this program and when I say it s a model for the nation I just reference once again you ll see that Connecticut and Philadelphia the state of Connecticut city of Philadelphia looking to replicate the small and already Howard County in Maryland has already adopted some of the core principles of this program this is something we can scale this is something we can advance this is something we can bring to cities across the state to California for that matter cities and counties across America helping San Francisco is one of the things again are most proud of in 2008 can we talk about a state of the city talk about the health of the city and I could tell you how this witness the lives of profound change in the lives of those 30,000 folks at the stat of the high next that are real people not just the individuals themselves but their family members have set there and they break down in tears because a lot of dramatically change because mom or dad now have healthcare and if something terrible goes all wrong in the lives of families not to be bankrupt this is life-changing information as an elected official life-affirming interview what it s all about the purpose of government and this is I think a big part of its overlooking Ford framing this issue more broadly looking forward to new president and new focus and energy on this issue 45.7 million Americans that s a national disgrace 7.7 million more since George Bush became president we could do more and better salmon Cisco s model something to look at as I think of several Cisco is well in the context of leaving away one of the principles behind our new strategy on health care is getting people to go online to get enrolled one of the things that is most significant upon her healthcare plan is a 24 clinics are part of this again 14 private 14 public they re all him on application process online web-based technology we fill out one form and we ask you communicate your specific healthcare stats and needs and qualifications eligibility and the like in real time all of these clinics in a to go in one click fill out forms going to another clinic of five .didn t technology a big part of the change of technology a big part of our efforts here locally we recognize old that is not good enough to does not a medical record that s why in March of next year were to be moving forward with an RFP a request for proposals basically same way we started the healthcare program will do an RFP setting the bar in this country for electronic medical records so that they could be shared in real time to get your entire medical history when you go in that community clinic in the entire medical history out when you go into an emergency room of God forbid you have an emergency this is an order of magnitude change that needs to happen and take shape in this country in terms of technology we did the one he application process now want to take it to the next level become the first city in this country not just with universal healthcare not just with technology being a partner and friend non-hindrance but now with a medical record again we believe we can lead by example of area that I m very proud that the city is adopted a strong investment and approach of support is our public hospital the anchor in this country are rather in this city for the delivery of our healthcare services is salmon Cisco General Hospital the voters just recently November 4 overwhelmingly passed an $887.4 million bond services to General Hospital but what s remarkable about this bond is not only doesn t secure the faded future of our emergency rooms the only level I trauma facility in the state are in the entire region and all he does it anchor our success as it relates to our ability to deliver against that quality healthcare in the universal care that were offering but it does something I think very significant in light of the economic on that way it actually trades jobs and creates opportunities for thousands of people working to start construction on this new hospital in just a few months they re actually about this time next year you ll see that construction in full swing other arty and start to grade the site and the reason we re able to move forward with brand-new hospital in real time in such short order is because we invested $28.8 million in the predevelopment work to make sure that this bond was an accurate bond that were asking the voters for $187.4 million that were really not asking him for $1.1 billion but that were asking for something that we believe we can come in under budget and on time and that we did all the environmental work not just the predevelopment work in the context of determining the exact design in some engineering specs but we did soil sampling we did traffic flow studies we actually did the work in advance so that again when this bond passed as it did recently in the start and will get the shovels out immediately and I again am very proud of this everyone came together they allowed us to put in 28 again $.8 million in the last three years to make sure that when we ask the voters to get to third support or 800+ million dollar bond that they did it with a faith and confidence that we actually know what we re doing and that s not always the case is on the reference here in a moment but you can see again some other Oscar Maddux of the rooms as the lead certified development is well behind us level of green building standards it is again a state-of-the-art facility that will anchor our faded future as it relates to our investment of public health for the next generation speaking of anchoring our faded future to next-generation guns and amazing thing we talk about 2008 in healthcare delivery system in our city that a year ago we literally when the mincing at St. Luke s Hospital was going to go out of business CPM since Sutter had taken over St. Luke s Hospital out the southeast part of San Francisco very close by the salmon Cisco General Hospital the demographics of St. Luke s not completely dissimilar from the demographics of San Francisco General Hospital is St. Luke s closed Cisco General Hospital in spite of that bond in spite of all of our investment and commitment would not be able to perform as it does today we simply couldn t handle the capacity which means one of two things you cut back on your service and people that lease can afford us to cut back on most impacted or second you create a system where people are moving throughout the region and creating a capacity problem not just in our city not just in other hospitals around the city but throughout the bay area we would believe that we do our part in some done little but more than others and that s why I m so pleased that we had this blue ribbon task force that met for three months led by supervisor Michaela Alioto has won a compliment Michaela for her leadership on this again Dr. Katz front and center Dr. Brockmann not often from CPSC making the commitment to the community making the commitment to the folks in the southeast sector particularly in the Mission Excelsior district to maintain the fate and future at St. Luke s Hospital so what a difference a year makes the 2007 State of the city we talked about lamenting about potentially losing St. Luke s now were talking about celebrating the commitment ongoing commitment and revitalization rebirth of this remarkable facility in our city good news now here s more in the way of good news but I frame it in the context of challenges and that is dealing with teenage immigrant population that is larger per capita than the rest of the state in the latest_what I mean by that you can see here this is all senses of the new Census numbers we think will make this arguably even more acute you can see here people 60 and over is that large bar 65 and over is the blue bar 85 and over is the gray bar in every single category without exception we have a population that is disproportionately older 60 and older 65 and older as well as 85 then the rest of the state is California your saffron Cisco and here s just the counties north and south and east of us practice more people living in the city again 6065 and 85 years older which is an extraordinary thing from our perspective but a humbling thing in the context of meeting the needs of a population that is getting older and living probably longer you can see here what I mean by that we have also a disproportionate number of seniors living below the poverty line so more people with more acute needs means that the concentration by the way in certain districts of the city you could see were those that concentration is out obviously on the west side of town that surprising a lot of folks but also perhaps surprising concentration of people in the tenderloin area districts etc. which means we need to respond to the needs of our seniors by allowing them to live with dignity to age in place from my perspective one of the most extraordinary programs is the one behind the up onscreen and that s our IHSS program or in-home support or service workers program were very proud to lead the state in terms of our commitment to the employees at IHSS in terms of the wages no more noble work and taking care of seniors in every capacity than the work that IHSS workers do that is costly but again they re underpaid by objective standards higher paid by California standards for the work they do is invaluable in the work they re doing is needed now more than ever you can see from this chart that just a few years ago in fact a specific chart references the caseload has increased 74% 74% of the last 6 1/2 years alone and that s a 12% annual growth rate again this bar this line continuing to go up to imagine extrapolating it out over the next years but just since I ve been there as the last five years we had about 15 or so thousand people in the caseload but now were projecting about 21 or so thousand folks on the caseload again a good thing because more people are getting in-home support services more seniors are getting it but again a challenging link because the budget of our city grows accordingly as the needs of our seniors and the acute needs again based on the poverty statistics grow along the same lines now we talk about investment of seniors we talk about aging in place in aging at home to the extent we can to get people to support services they need well that also needs to be reconciled in the context of providing adult day care centers providing transportation to adult day care centers providing support in the community and another area where we re actually committed beyond a skinny people enrolled in health care beyond is getting people in to some of the best hospitals and acute care facilities in this country because of General Hospital or St. Luke s and maintaining the status of having a St. Luke s Hospital beyond that we also want to invest in community based programs now this is in light of the investment in the Buddha Honda which again is second to none how many cities in America but on the state of California still unaccounted hospital but and are investing in long-term aging needs of their seniors in a skilled nursing facility like salmon Cisco Laguna Honda Hospital using the schematics of this hospital when it is completely built out we think of the early part of 2010 our seniors will be actually moving into this facility originally designed for 1200 beds and a $401 million budget realities the $594 million budget to 780 beds by the way there s a reason why is because everything I just said about Sam s General Hospital $28.8 million in pre-development work we did not do at Laguna Honda Hospital this is not to critique the investment in Laguna on the hospital I couldn t be more proud of again investing in the long-term needs of our aging population in the city but what we did is we estimated the costs and we were off by a huge factor I in 1 million for 1200 that s reality 584 for 780 beds I got a lot of grief when I came out against the original bond because I did not believe the numbers because we did not do that pre-development work I promised when I became mayor not to make the same mistake as salmon Cisco General Hospital in fact I don t know many people recall that four years ago they asked me to put that since the hospital bond on the ballot in my first year office on the refused because we re going down the same path in fact if you look at what the number was four years ago it was substantially smaller and I imagine we ll review today we would be making excuses about how we were so far off the estimates again for one reason when it do the work to justify the request and to dignify the taxpayers by making sure that we are investing their money wisely now are trying to do our best to fix this and we found that $594 million and were proud that we can open up in 2010 but let us not make this mistake ever again we didn t do it as a General Hospital as we do new bonds in the city last marked the example of SF General Hospital Lexmark not to critique but the observation of Laguna Honda Hospital but nonetheless let s celebrate as we are that investment into this extraordinary facility and having just recently toured we are going to be the envy of the nation and that again is go to the values of our city won t talk about Sam s values public health investment again not just when you re very young investment middle-aged but investment when you need us the most investment when you re 6575 8595 folks at Laguna Honda literally over 100 years old I couldn t be more proud of that but again lessons learned and we re going to get smarter in the future as I was referencing before that Laguna Honda slide a talk about aging a big aging in place outside your home in the community this is an investment we may we started a couple years ago we created a community living fund because not everyone believes that you need to be in a skilled nursing facility like Laguna Honda Hospital some people can t again as I said be at home and in-home supportive services he got that gap where people go when they can t or shouldn t be in a Smith environment or at home will we need to invest in creating the infrastructure to deal with the growing population and so couple years ago we put a $3 million Muslim and the community living fund we had another $3 million last remember these were big budget deficit years we still made those investments and you can see already that we have already advanced the needs for some 457 clients since we started that investment we can do a lot more women need to do a lot more on the continue to fight for more resources to the best of my ability recognizing economic climate were in to continue to invest in this community living fund on probably establish the framework I m proud that we re these marching down this direction or proud or raising awareness and were raising the resources to before you can see just some of our targets and goals that would actually exceeded him of folks in terms of percentages moving out of an institutionalized environment into the community living environment again not everyone has been an institutionalized marmot needed to be an institutionalized environment some prefer not to be but they didn t have that alternative now are starting to develop alternative nuts with this lot represents a again in 2008 I m very proud of and I describe entire again Board of Supervisors elected fairly everybody the spirit of cooperation spirit of commitment showing the resources and showing that we can again lead the way as the city other way when leading the way is our investment in the discoveries for Alzheimer s and Parkinson s and diabetes brain tumors and leukemia and other diseases HIV and AIDS we are so proud we went out there number of years ago we competed against cities all up and down the state California and we successfully got the California Institute of regenerative medicine CIR and or the stem cell institute to locate and salmon Cisco someone asking the basic laws great you got the man but what s happened I haven t been reading much I don t really know what s been going on while we thought we d give a little update 2000 acres this is the year that it s all happening you can see from the slide that 26 California institutions have been awarded grants totaling $614 million $614 million has been distributed member to $3 billion program and we ve got these grants already been distributed through UC staff or other Bay Area institutions use I m getting a good percentage of this money generating real jobs generating real opportunities in fact those opportunities I connect to the rest of the world and this is important we send this world are going after the Institute why was important Sam s s fate and future to get the institute in this international city is 24-hour global Gateway city we call San Francisco that was we wanted to reinforce that connection particularly again on these leading and cutting edge industries like stem cell research we wanted to connect it with the rest the world and by the way we are literally the heart and soul of stem cell research in the world meaning this is where the action is this is where people are anchored because of this Institute and because of the money it s distributing that s kind of change I m convinced with a new president will change very shortly after he takes over in early 2009 but in the absence of leadership at the federal level Californians stepped up a prop 71 and we stepped in to get that institute anchor here in San Francisco and you can see now at $600 million has been distributed not only those 26 institutions across the state California benefited by what those numbers by tiny watches upon the heart but also these animal users memorandums of understanding that are in place with countries like Canada and Australia the UK again these relationships were forming with some of the best and the brightest did not just the throwaway line best and the brightest with truly some of the best researchers are mine scientists in the world we were establishing this relationship we got five more that are coming up get California a focal point San Francisco hub of that focal point that spoke to that anchor of that focal point something again were very proud we thought we d celebrate that in the 2008 Center City and appropriately as relates to our health care initiatives in San Francisco leading the way I thought I d just conclude this section of the status city by talking about a few other initiatives where we re demonstrating that this is not just a slogan one of those areas is in trying again to focus on health and prevention and one of yours were really focused on is the health of our city employees and we start initiative called shape up San Francisco who actually engage your employees to get healthy we have almost 20,000 employees will largest employers in the state of California and as a consequence we need to lead by example and we do a lot of physical activity the California endowment has been very helpful this has become a model Clinton foundation and others taking a look at this initiative with also engaged in a while can challenge students to mop the Severus go unified school District and speaking of kids we also do a lot of things in relationship to shape up Safran Cisco to get our kids more engaged by focusing on getting rid of sugar sugary drinks soda free summer initiative that we launched the edible schoolyard which we are very strongly supportive of 30 of them down the school district will talk a lot more about that in the education section of the state of the city but again trying to build on the legacy again of health health care a focus on what we eat focus on what we drink a focus on the air we breathe focus on the environment in the broadest sense of the term and a true imagine going to schools like I did a number of months ago as I couldn t believe it until I saw it with these 25 salad bars in the schools I never thought I d say this in my life I had this young beautiful kid could ve been more than a nine years old and is run out they have played a broccoli of all things broccoli and he was very happy showing me that it is got broccoli in the Sala body was actually eating it I didn t have the guts to tell him not everyone loves broccoli but I couldn t be more proud he salad bars are working we got rid all those vending machines years ago we lead the nation into a mad mullahs those patsies and the court was sweetened beverages and the like Coke and all those others on a lot of lay those two out seven up all the others but now really starting to focus again on the alternatives to that so people can start changing their lifestyles little bitcan educate their parents when they come home but there s better ways of eating in one way we ve done it substantively is these 15 wellness centers to talk about that in the education section as well we put in wellness centers not just to deal with physical helpings but Alice and mental health needs in all our high schools were rolling them out out of five more going to the middle schools and again the wellness centers are about competence of health education the broadest sense of the term including what we eat physical activity etc. and something number out of shape up San Francisco something that I hope we can scale of vacancy replicated across the state so most revered Bogotxe1 Colombia mall prices Bogotxe1 many many decades decided to close down a big portion of their city streets other cities around the world have done similar things in America we really had it until recently and were I recognize it was particularly controversial because about 4/2 miles from there you_and only down to the ferry building a 5 miles to shot 5 miles of street closures recalled Sunday streets and the whole idea and you can see from the slide you could see people literally there on the Embarcadero and have a bike riding and they are walking on a street that has been historically dominated either by an over head freeway mother nature got that removed a little greater earthquake or again cars and soak the opportunity to democratize the streets the opportunity look at all the streets to represent a large percentage of the 2025% of the landmass of our city and look at them differently and veiled itself in this very successful to date effort can controversial and I respect the controversy but we push the bar forwarder push the proverbial initiative to new heights and raised that bar and I think that it s something we should do more of next year open by 2009 status city I talk about the program we did out there in the great Highway the program we get out the mission the program we didn t know if the program would in other parts of the city not just in the Embarcadero those are not literal example examples but figured it out I want to build this program to make it much bigger into the next year I think this is something the city again can lead the way on has been ported to the small version New York s talking about in Chicago but I want to take it again 2009 to hold the level something again in May 2000 and especially her controversial special nonetheless other area where we are trying to lead the Way in fact not just tried Ali Lake Mrs. controversial but it s something that I think is important in light of again a new president and a new day as we turn the page and this country know something Barack Obama championed as one of his promises during his campaign and that is to do a nationwide sickly board it s interestingly one could argue modeled after Safran Cisco sickly board as well affect those of a folks in the community that came to the Board of Supervisors and then went back to the voters with this initiative and was initiative in late 2006 November initiated to help advance the needs of 115,000 San Franciscans that had no sick days I don t know about you but I don t think it s right in this country that when a child is sick a mother can t take care of that child because that mother can t leave work because they don t have sick days 22 million working women in this country don t have a sick day afforded them rock Obama is right to try to change that examines Cisco we lead the way we are a model for the nation and Fiona Ma did an extraordinary job on a complementary summer when the law by trying to invent system to stay California she came up short but she raised the bar in terms of her effort a couple that that effort and I think it s an example dead were our city can have a resonance far outside its 47 Half Sq. miles and I look forward to the present Obama actually doing what he promised to do in the campaign recognizing the challenges of the macroeconomic situations but I d like him to help us example are a reference for our example again in a way that can have a much broader scale for those 22 million working a women that need it desperately interestingly or importantly rather this initiative is the following for every 30 hours you work you accrue one day of sick leave up to nine days that s the model again I think it s a framework that s a reasonable one and maybe a little more than they can bite off on the national level was so the more the state level but I hope it s a direction again next president can take maybe one extra here instead of Cisco s wealth were leading the way in Suppan let them get highlighted and I thought you why not take advantage of it in the state of the city and that s hepatitis B you know we lead the nation per capita and liver cancers people don t know that about San Francisco lead the nation and liver cancers it s disproportionately impacting the API community Asian Pacific Islander community we need to do more screening we need to do more in terms of prevention vaccinations San Francisco working out with people like Ted fang and others have guttural mark without again assemblywoman Fiona Ma who s been working hard in this our help Department to really wait raise awareness and again if you remember the API community I cannot impress upon you more importance of finding out about free screening finding out about ways of getting shots that can prevent hepatitis B and liver cancers it s something again that could be prevented Sam Cisco wants to lead the way of area as tobacco I know that s been legendary in our city and we were the first to fight to ban tobacco smoking in bars and restaurants I ve know some of those other cities like New York get a lot of attention to it years later but Sam Cisco truly lead the way we also led the way of banning outdoor advertising of tobacco products around schools and playgrounds as very proud as a supervisor Aaron Sam Cisco to offer that legislation recently I was very proud with Dr. Katz example again on director Department of public health and the Board of Supervisors concurrence in support not unanimous but almost unanimous support to ban tobacco sales cigarette sales and pharmacies that you think that that would have been self-evident to a lot of folks but this was wildly controversial diversity in America to do a bit order pharmacies if not health centers when you go to a pharmacy you get Nicorette gum you get a patch to deal with your addiction your smoking addiction that you go to get medications you go to get the things that can actually make you healthier yet the same time these same pharmacies were selling the same tool and weapon of destruction which were the cigarettes that people were on one asking for a solution for and on one hand actually contributing to their illness nothing is more dangerous in this country than tobacco with all due respect to the big tobacco companies shame on you for suggesting otherwise anonymous talking about the stuff you pulled off in Congress years ago of talking about what s happening around the world that you travel and you see the predatory nature this tobacco advertising in these tobacco companies and how the building market shares around the world took impoverished countries were not going to continue to allow that to happen in San Francisco and we ve been very aggressive leading the way were now doing at pharmacies and I know that they do not want to see this replicated in other cities and states who have pushed this because we believe in it I think people look back 1015 years now in the bewildered by the fact that we were ever selling cigarettes in the 1st Pl. in House-Senate interestingly nor this idea came from initially the pharmacist themselves they said they felt badly selling cigarettes and then selling pills for People s asthma and go away a second account understand are not just pills but asthma medication and other medication to deal with other ailments that were exacerbated by the tobacco use and they wanted to tell these people to stop but they have the right to to purchase those things out it is to feel good about it they asked us to do it Dr. Katz put together a team put together legislation with our city attorney s office we submitted to the board they passed the services below the way against up in a very proud of another area and I ll close this section with just a few more slides were leading the way is a Medi-Cal lawsuit in a state California cut $1.1 million as the Democrats and Republicans my friends in the Democratic Party are not difficult with this but I couldn t believe it when I heard about it but we willing to submit a cut of roughly half $1 billion from the city of from the state California of which another half $1 billion was matched from the federal government Treo killer cut of the billion plus dollars for America here in a state that already pays or invest 30% less than the 10 top most populous states in America in Medicaid or rather Medi-Cal we in California has 6.6 million people that rely on you the poorest of poor folks and we can t in this years budget that was wrong we felt powerless to get Democrats and Republicans making the cut so we initiated a lawsuit with the CMA and others we really initiated as a County they initiated we supported it as the first card is supported and we won a couldn t be more proud that he could see core role in the now requested to restore most of the cuts into March of next year hundred and 23,007 Cisco residents relied on Medi-Cal had we not help support that we are the champions up there the CMA and others we would ve had to deal with a $5.8 million cut locally just terrible again what s government for if not to help those least among us and Medi-Cal needs to be completely reformed its time to get serious about reforming it and not just championing cuts every year to get through the media fiscal crisis it needs reform I grant that the one way you do not reform it is by further eroding a system that is so vital for against 6+ million people in our state of final point in this section is federal advocacy we ve got a good president now we ve got the speaker of the House Nancy Pelosi we got senior senator from San Francisco happens to be a former state California were so uniquely positioned to venture federal advocacy in terms of healthcare and a lot of areas will be focused on is trying to restore civilization IV in its cuts as Ryan White care dollar cuts I tried it finally reconcile this is the low hanging fruit for Pres. Obama to get that S. Chip program reauthorized the president vetoed it now in Pres. Noble supported that s the first thing clearly to Duke zero 18 can work Missouri 65 but let s at least create a level playing field to rates in this country let s support again some changes in Medicaid and Medi-Cal must continue to work on prevention tickly obesity prevention chronic disease prevention again health care and prevention focus at the US, to nurse him that I ve been working on in my capacity as vice chair of the health committee at the Wisconsin mayors again I think a brighter days ahead of a soak against NSA and this relates to health I think is very positive we are investing $1.5 billion a year on the miniseries and do that but that investment has paid great dividends were forming our health care delivery system is a modern system to more dynamic system into systems coupled that with more information technology that s been used in the past it s a system that s focused on prevention not just acute care but a system that recognizes that acute care system still needs to be intact as well for long-term agent s infrastructure again behind in her community living funds I think we have a model for the nation as a guy grope your that always recognize that and now the privilege of being it s better I can t be more proud terms of status in 2008 that healthcare is improved or has improved dramatically in this last year and we permitted continued to in the years to come


~ by bitahatini on December 25, 2008.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s

%d bloggers like this: