The American Public on Health Care-The Missing Perspective - (Page 68)

Town Hall Snapshot: San Francisco On June 17, 2008, the Council held its third town hall meeting in the series The American Public on Health Care: The Missing Perspective at the University of California–San Francisco’s Mission Bay Conference Center. Cost continued to be a major theme, with panelists focusing on system inefficiencies and the fragile nature of the current employer-based model. “Those of us who are fortunate enough to have insurance understand that it is not secure. We can lose it or we can get sick and find out that they are going to rescind our policy or they are not going to give us the access to the specialists or the care that we need. So we are all in a crisis. There is no question about it,” noted Senior Advisor to Governor Schwarzenegger Daniel Zingale. Institute of Medicine President Dr. Harvey Fineberg added, “we have to figure out how to align all the incentives so that people get the basic coverage that they need, catastrophic coverage that everyone deserves, and insurance that stays with the individual and family when they need it.” The discussion also highlighted numerous innovative programs in the Bay Area including the Veteran’s Health Administration’s VistA system. Panelists and participants continued to challenge the employer-based system, but remained cautious as to what the alternative would look like. Accenture’s Ken Dineen added “Yes. It is completely unsustainable. We are operating under a system today that was devised 40 years ago and yet our social habits, our job locations, our mobility, our portability really has changed dramatically. So we have a complete disconnect between a system that is really outdated with the way our lifestyles have taken us.” Zingale ended the meeting with a stark message to Presidential candidates: “I think the most important thing is a measure of political courage, which means them telling people what they do not want to hear. They have to tell HMOs that their profits are too high. They have to tell doctors that they have to bear some responsibility for everybody being covered. They are the highest paid profession in the state and the nation. They have to tell all of us as patients we have to do better in staying well and not just focus on end of life treatments that are more expensive and give us less quality of life. It means staring down every single one of us and the interest group involved and telling us what we do not want to hear.” area is poor. Four in ten say the availability of quality health care in the region is poor or just fair. In contrast, 80% say they are pleased with the quality of care they personally receive. Those surveyed are also paying attention to the candidates’ positions on health care and overwhelmingly say that the candidates priorities on this issue should be controlling the rising cost of health care (86%), providing health insurance for all children (83%), and improving the quality and safety of medical care (79%). They also want straight answers from the candidates as far as how much their reforms would be paid for and how much they would cost individual taxpayers. Health Care Spotlight: San Francisco, California The San Francisco Bay Area, with a 2006 population of more than 7 million, encompasses large cities such as San Francisco, Oakland, and San Jose, along with smaller urban and rural areas. Overall, the Bay Area consists of nine counties, 101 cities, and 7,000 square miles. The city’s controversial “universal” health coverage has drawn attention from across the country and is one of the many innovative ideas being put into practice in the Bay Area. What Matters to the People of the Bay Area? According to our survey research, Bay Area residents express concern about the cost and availability of quality health care in the region, with more than seven out of 10 rating the affordability of care as only fair or poor and nearly half (49%) saying that access to care for the uninsured in the 68

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