On Oct. 6, I attended a public forum at Antioch University Santa Barbara for a discussion on the Patient Protection and Affordable Care Act. The title was “What does the Affordable Care Act Mean for California, Santa Barbara, and You?”
More than 100 people packed the main auditorium at AUSB, with a few dozen more in a spill-over room watching on a live feed. The forum participants were state Insurance Commissioner Dave Jones; Dr. Kurt Ransohoff, CEO and chief medical officer of Sansum Clinic; Dr. Cynder Sinclair, CEO of Santa Barbara Neigborhood Clinics; Dr. Takashi Wada, director of the Santa Barbara County Public Health Department; and Ron Werft, CEO of Cottage Health System and board chairman of the California Hospital Association.
In the audience were Santa Barbara Mayor Helene Schneider, county Supervisor Salud Carbajal, former Supervisor Susan Rose and state Senate candidate Hannah-Beth Jackson, among other dignitaries, professionals and concerned citizens. (I saw nobody under the age of 40 in the room.)
I attended as chairman of the county Advisory Board on Alcohol and Drug Problems, as an Antioch alumnus, and as a concerned citizen and voter. As ADP chairman, I know we face many questions about the funding and subsequent treatmenf of various programs provided by agencies throughout our county. I’ve seen our budget for prevention, treatment, perinatal and detox range from $18 million per year to the current level of about $9 million. We expect funding levels to decrease, with some pending changes in income streams that could further impinge on treatment options for many in our community. With our budget constraints, I was hoping to glean some insights into how the Affordable Care Act might benefit or curtail our efforts.
Two of the important facts that came to light during the discussion were these: There are more than 7 million uninsured Californians and, in 2014, a new comparative-shopping “Insurance Exchange” will be available, using essential health benefits for consumers to compare and contrast options, and ultimately enable them to make informed decisions. One of the providers of insurance benefits, interestingly enough, will be the State of California, with its own Health Benefit Exchange, a consortium of insurance agencies that will be required to prove to a “board” that their costs and services meet certain standards.
This is where my eyes began to open. I had been struck by the fact that the main speaker was Jones. When he paused and said, “Does anyone have any questions?” the microphone was passed to other panel members who opined in favor of the Affordable Care Act and lobbed slow-pitch softball questions at him. The same pattern continued for the balance of the time. Audience members were asked to write their own questions on index cards and pass them in; I saw dozens of cards, with multiple questions, passed to the moderator, who asked two of those questions. Neither was a fastball or a curve.
In my opinion, the whole point of the evening was to sell the Affordable Care Act to the public — in its current form. Its attributes were amplified, and any negatives were pooh-poohed. Jones kept referring to his “friends,” Gov. Jerry Brown and President Barack Obama. It became blindingly clear that this was a liberal forum with a liberal agenda, politically motivated with clear outcomes intended. Jones “had a flight to catch” and disappeared immediately afterward; that could have been legitimate, but it deprived the audience of a chance to ask “the tough questions” of him.
It is clear to me that our health-care system needs reform. One of the points Jones tried to make was that “insurance costs have risen by up to 9.6 percent in some areas of our state.” We all know that inflation is not that high, so why have costs risen? He claimed that insurance companies were raising their rates to keep pace with rising costs. WHOA! They are clearly raising rates to keep their return on equity at high levels, as long as they can. Since all of the Affordable Care Act costs are supposedly being reimbursed by the insurance companies that consumers will “choose,” are Jones and the California Insurance Commission truly on the side of the consumer?
Finally, Jones mentioned the U.S. Supreme Court decision to impose a “tax” on consumers who do not have insurance coverage. I am dumbfounded by Chief Justice John Roberts’ confabulation (which is not a true word) of a new tax (which is not a true tax). How in the world can something that is not purchased, and a service not given, be taxed? Or in other words, how can something that is not consumed be taxed?
I understand that if our health-care system (however it is configured) is to survive, it must be reimbursed for services rendered. In our current system, those without insurance do receive health care when necessary; I am not begrudging them. Werft noted that Cottage Health System hospitals see some 64,000 emergency-room patients each year (many without insurance), and that this new “tax” would probably equate to $15 million in new revenues. Keep in mind that this nonprofit hospital already makes a profit on its existing model, and that I am actually in favor of profits to keep businesses alive, prospering, and providing services and products to its clients. But somehow this smacks of “corporate welfare.”
It doesn’t look like the Affordable Care Act can be repealed or unwound completely, and our health-care system needs changes, but this forum was not an open discussion of options for Santa Barbara County, California or the United States.
— Orcutt businessman John Richards was first appointed to the Santa Barbara County Advisory Board on Alcohol and Drug Problems by the late Supervisor Naomi Schwartz, then by Supervisor Salud Carbajal and, most recently, by Supervisor Joni Gray. He has lived in Santa Barbara County since 1988, is a graduate of Antioch University Santa Barbara and is a past chairman of Citizens for the Carpinteria Bluffs and the Santa Barbara Community Kitchen.