Issue Position: Fighting for Health Care for All

Issue Position

California is taking an important and necessary look at universal health care and creating a single-payer system. Making that happen will mean making some difficult choices in our budget and tax policies. I believe California can and should be committed to providing single-payer health care for its residents. I am ready to be bold, tackle tough spending questions, and keep California moving towards a stable single-payer health care system -- while immediately moving to protect vulnerable Californians from the Trump administration's plans to take critical medical coverage from millions.

In 2003, I got an urgent call from a friend. He had just tested positive for HIV. We went together to a clinic in San Francisco, where we learned about T-cell counts and viral loads, and where my friend confided in me that he didn't have health insurance. Health insurance corporations could now use his diagnosis to deny my friend health care on the basis of his "preexisting condition.'
That same week, we began bombing in Iraq.
Our nation's leaders could find the money to fund an unjust foreign war but not basic health care for American citizens. I couldn't sit idly by in the face of such lopsided policy priorities. If I was going to help people like my friend, I had to roll up my sleeves and get to work. This experience set me on a path to fight for the rights and benefits of working-class people and families as an organizer, to work for President Obama, from the campaign trail to the White House, and champion the fight to pass the Affordable Care Act (ACA). Twenty million Americans, including my friend, now have access to health care for the first time thanks to the ACA, and can no longer be denied care based on preexisting conditions.
Fundamentally, my two decades-long career as an organizer, my work on the ACA and in politics, and my decision to run for this Assembly seat, has been driven by this experience with my friend, and my steadfast belief that access to quality health care is a basic human right.
If elected, here's how I will fight to preserve all Californians' right to quality health care:
Pathway to Single-Payer Health Care: Start with a Medi-Cal Public Option
Currently, the American health care industry consumes a significantly higher percentage of our country's GDP than other comparable industrialized nations, but has comparatively mediocre services and patient care and lower citizen access to covered care. In a nutshell, we're currently spending more and getting less than other countries. And significant health disparities exist throughout this system that we must address-- more than half of all uninsured people in California are Latino/a, almost twice as many of women of color self-report their health as "fair or poor" as white women, and asthma is three times more deadly for black children as white children.
Today, California is taking an important and necessary look at universal health care and creating a single-payer system. I believe California can and should be committed to providing single-payer health care for its residents, and I fully support Medicare for All federally. A single- payer system has the potential to lower cost, confusion, and uncertainty for our citizens. It would ensure health care security for working people and health equity for all communities, make our companies more competitive, and free Californians from being tethered to their employer for health care, thereby allowing them to do what they do best -- take risks, innovate, and change the world. This is the vision we should all be striving for, and as someone who has spent her career bringing people together to pass progressive policy, I believe I'm uniquely suited to push us towards a single-payer health care system in Sacramento.
While we work towards single-payer, there is an intermediate and immediate step I believe we must take now to ensure our citizens are protected from Trump's disastrous policies- we should immediately create a "Medi-Cal public option" to ensure affordable and quality care open to all state residents.
While California has one of the strongest and most competitive exchanges set up by the ACA, Trump's actions threaten to destabilize people's access to health care and our robust social safety net. A Medi-Cal public option would mean the government would take the risks, set the rules and pay out the claims. This would live on the exchanges and compete with private insurers, many of whom are risk-averse and could leave the marketplace at any moment. Any state resident could opt for this plan, receiving the same quality care that that current Medicare recipients receive. This could serve as an important and necessary next step on our way toward a single payer plan, while at the same time stabilizing our exchanges and protecting us from the President Trump's power grab aimed at helping the wealthy at the expense of the poor. I strongly support AB2472, which would push us forward on this important step by enabling Covered California to conduct a feasibility study for a California public option.
In conjunction with implementing a public option, we need to take immediate steps to reduce medical price gouging to bring down health care costs. California can also lead the way in exploring a transition to a value-based care system, which could help us prioritize preventative care and reduce hospital readmissions rates and long-term health care expenditures.
Once Californians' access to quality health care is protected through these steps, we must take creative and bold action to explore additional revenue streams to fully fund a single-payer system, which could include closing the corporate loophole in Prop 13, reducing our prisons and corrections expenditures, and reassessing inequitable tax policies. We will need to conduct a more robust analysis of expected costs and savings to get a clear roadmap of how much money we will need and how we should allocate it. And we'll also have to get a federal waiver to reallocate Medicare funding into a single-payer system-- a move that will take time, given our current federal administration.
Throughout all of these steps, I will tackle tough spending questions and champion creative policy solutions to keep moving us towards a full single-payer system where every Californian has access to quality health care.
Protecting East Bay Access to Emergency Health Care: Saving Alta Bates
I will work tirelessly to prevent the closure or relocation of services from the Alta Bates Medical Center in Berkeley. I am deeply opposed to the removal of this important resource for inpatient care and emergency services for East Bay residents. We have a moral imperative to preserve emergency care for East Bay residents. Moreover, health care providers should be able to work in the communities where they live -- at Alta Bates, saving jobs means saving lives.
The potential removal of Alta Bates is part of a broader existential threat that puts the East Bay at risk of becoming a hospital desert. When communities have to travel great distances to access quality hospital care and especially emergencies, patient safety is jeopardized and lives are put at risk. Richmond residents and the whole of West Contra Costa already suffer from the absence of a fully functional emergency room. The I-80 corridor between Richmond and Oakland can take an hour to travel during rush-hour traffic -- those 11 miles are fatal to anyone who needs immediate, on-site emergency care. If elected to represent the District 15, I will do everything in my power to make sure that emergency rooms, inpatient care, and all other necessary services remain present and fully functional in our East Bay community.
Bolstering Our Public Health System: Championing Our Safety Net Health Providers
As a state, we must continue to lead the country on taking a public health approach to our opioid and other addiction crises. The best way we can support our community members suffering from substance use disorders and drug dependency is by leveraging and expanding our rehabilitation and public health programs as alternatives to incarceration--see my criminal justice platform for more on my ideas on decriminalization and rehabilitation.
We must bolster funding for safety net health providers like Highland Hospital in Oakland, which is using innovative programs and medication-assisted treatment practices to help their patients end drug dependencies. Such providers prioritize essential services and care for our most vulnerable populations as part of their core missions- such as the LifeLong TRUST Center in Oakland, which provides affordable health care to those experiencing homelessness in the East Bay, as well as other critical supportive services such as access to showers, food, and housing assistance.
These hospitals and community clinics who serve primarily low-income communities need the financial and staffing capacity to be able to meet the physical health and mental needs of their patients, who are often overexposed to environmental hazards, behavioral health needs and substance abuse risks because of the glaring inequities in our other public systems. Mental health services, especially, are too often unavailable for those who need them: recent research shows that about two-thirds of California adults with a mental illness, and two-thirds of adolescents with major depressive episodes, did not get treatment. Increased state support for our safety net providers, in addition to better statewide structure and strategy around how we spend Mental Health Services Act revenue, can help hospitals and community clinics better integrate their mental and physical care services and make these services more robust.
I see these safety net hospitals and community clinics as essential defenders of health care and health equity, often for our lowest income residents and most vulnerable populations. They have played a crucial role in my life from the time my friend was diagnosed at a community clinic in San Francisco with HIV to my collaboration with Planned Parenthood, while at the Center for American Progress, in launching a national initiative to better conditions for women and their families. While working in Obama's White House to pass the Affordable Care Act, I found that California had more uninsured people than any other state, and Medicaid failed to cover many vulnerable groups who overwhelmingly rely on community health centers for their health care. I am proud of the steps we were able to take through the ACA Medicaid expansion to protect and bolster the operations and capacity of community health centers all across the state and country. Today, I am just as committed to increasing their funding, availability, and accessibility to ensure that we take a compassionate public health approach to growing rates of drug addiction, behavioral health needs, homelessness, and poverty across California. Safety net providers and community clinics are a centerpiece of my health care platform because they don't just serve our communities -- they are an integral part of them.
Supporting Our Primary Care Providers
The United States faces a looming shortage of primary care providers -- by 2030, we may face a deficit of 100,000 physicians. One in eight infants is born in California, and by 2020, 14 percent of the U.S. population is expected to live here. In Alameda and Contra Costa Counties, the elder population is expected to grow by as much as 150 percent. Moreover, recent data shows that approximately 1 in 6 adults in California is diagnosed with a mental illness. Our growing and aging population demands increased numbers of physicians, psychiatrists, clinical social workers, nurses, and other health care providers that can meet our physical and behavioral health care needs.
We can begin to assuage the primary care physician shortage by increasing the number of residency positions available in California -- without these positions, medical school graduates lack the ability to become independent, practicing providers of physical and behavioral health care. I would likewise support exploring more legislation that encourages California-based providers to work in areas of unmet need, such as the Steven M. Thompson Loan Repayment Program and the Conrad 30 Waiver Program, which helps immigrant physicians secure work in California's high-need communities.
We must also strengthen and add vocational training programs that help students enter and succeed in the medical industry, which can happen through investments at our community colleges. We need to create financial incentives for students to pursue nursing and physician's assistant training programs, and ensure that they have access to competitive California wages and sufficient scope of practice after they graduate. Our home care providers and caretakers, who are too often under-compensated for their important work taking care of our loved ones, also deserve significant wage increases, possibly partially-subsidized by the state.
As our economy evolves with greater use of automation and technology, we must monitor the use of telehealth services and work to make them an effective tool that supports, rather than replaces, our primary care providers. When used with patient safety and quality care as the standards, telehealth services can serve to enhance clinical practice and improve patient care, especially in circumstances where direct patient/provider interaction is not readily available.
Ensuring Health Care for all Californians, Regardless of Residency Status
As Washington leaders continue to threaten our immigrant communities, California's legislature must defend our friends and neighbors from unjustified deportation and discrimination. I am incredibly proud to run for office in a state that has been so outspoken in its commitment to protecting immigrant communities. If elected, I will not only work to uphold California's status as a sanctuary state but will also build on the values of inclusion and diversity that make California a beacon of hope for this country.
California is home to more immigrants than any other state, nearly 2 million of whom are uninsured. Approximately 1.2 million of those individuals are from low-income backgrounds and should qualify for Medi-Cal. I strongly support AB 2965 and SB974, both of which would help low-income undocumented immigrants gain access to Medi-Cal. I will work closely with my colleagues to ensure that all Californians, regardless of residency status, have access to the health care they deserve.
Promoting Responsible Use of Advancements in Medical Technology
California has long been a global leader in medical research and technological advancement. From our major public research institutions like UC Berkeley to hubs of innovation like Silicon Valley, our capacity for medical breakthroughs is in many ways an emblem of California's exceptional character. 3D printing holds the promise of creating organs that could grow and develop with the body, supplementing or even replacing organ transplants. Robotic surgery may reduce surgical site infection and recovery time. Artificial intelligence can be integrated into health management systems to create better diagnostic tools, predict patient outcomes, and pinpoint cures for the most resistant and deadly diseases.
As we look towards a new age of medical technology, our legislature must be forward thinking in its approach to medical development. We should be open to and capable of evaluating new technologies, creating funding for innovative medical research, and even passing legislation that would incorporate medical improvements into Medi-cal and other state programs. And we need to include a more diverse population in our health research and clinical trials, so that new medical findings and treatments are effective for all racial and ethnic groups. At the same time, we need to be careful to protect people's privacy and data and make sure that these new tools assist but do not replace the care best administered by trained health care professionals. If elected, I hope to help lead the legislature in partnering with the scientific community to usher in an era of thoughtful medical advancement that will improve the lives of citizens in California and beyond.

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