Category Archives: Health Policy

The Future of Single-Payer Health Care in California

Health care is one of the hottest issues in California politics. Last year, state lawmakers shelved a controversial single-payer bill. So, what’s next? California State Assembly Member David Chiu sat down with Dr. Andrew Bindman at UCSF to discuss the complex realities of health care reform.

Chiu represents the 17th Assembly District, which covers eastern San Francisco. He’s also one of eight members of the Select Committee on Health Care Delivery Systems and Universal Coverage, formed in the wake of the failed single-payer bill. Chiu and his colleagues on the committee have proposed 16 bills aimed at increasing health care access for Californians. But, he says there is still a long way to go to achieve universal coverage.

Just over 93 percent of Californians currently have health insurance. Chiu says getting that number to 100 percent, would cost billions of dollars. Switching all Californians to a single-payer system, would cost an estimated $400 billion a year – $200 billion of that needed from new taxes. And, Chiu says the cost is just one major challenge. There are also legal hurdles, including the need for federal tax waivers, which he calls a non-starter under the current administration. But, that doesn’t mean single-payer is dead in California. Chiu talks about the impact the upcoming election could have, and who he thinks should really be leading the conversation.

Watch The Landscape for Health Care Reform in California

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FoodGate: The Problem with the US Food System

You can’t fix healthcare until you fix health. You can’t fix health until you fix the diet. And you can’t fix the diet until you know what’s wrong. What went wrong? FoodGate.

Endocrinologist Robert Lustig, Dentist Cristen Kearns and Health Policy Expert Laura Schmidt team up to explore how the US food system has led to higher rates in obesity and related metabolic diseases in the last 50 years.

Preventable disease rates keep going up, even while behaviors have improved: smoking rates are down, cholesterol and blood pressure are down, and physical activity is up. We should be reaping a health benefit, but we’re not. The primary reason: we’re eating too many refined carbohydrates and too much sugar.

How did the food system come to encourage this? Pharmaceutical companies benefit from long-term drug treatment of metabolic diseases. Organizations such as the Sugar Association and the Beverage Association fund questionable scientific studies to convince the public that obesity and sugar are not related. These efforts include funding aggressive marketing campaigns to influence public policy. According to Schmidt, they spent 31 million dollars in a single election to convince voters in San Francisco and Oakland not to support a soda tax.

But there is hope. Research into the effects of too much sugar is getting attention, thanks to the efforts of Dr. Lustig and others. There are many parallels between this issue and smoking. According to Schmidt, we’re about where we were in 1970. The tide is slowly shifting, but we have a long way to go. Policy-makers are just now beginning to recognize the negative consequences of an unhealthy populace on healthcare costs and future social security benefits. Lustig advises, “You want social security? Stop drinking soda and tell all your friends to do so, too.”

Watch FoodGate: The Break-in, the Cover-up, and the Aftermath.

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Superbugs and Antibiotics

32822We’ve all heard about superbugs, bacterial infections that don’t respond to antibiotic treatment and wondered what’s going on.

When someone falls ill with one of these infections doctors determine which antibiotic to use based on a standard test. But UC Santa Barbara biologist Michael Moore says we may be relying on the wrong test when identifying the antibiotic to treat an infected patient.

The current test was developed in 1961 and is used throughout the world but it’s based on how well drugs kill bacteria on petri plates — not how well they kill bacteria in the body. Moore’s lab has developed a new test that mimics conditions in the body, potentially transforming the way antibiotics are developed, tested and prescribed.

His lab has identified antibiotics that effectively treat infections caused by diverse bacteria, including MRSA, the cause of deadly Staphylococcal infections. These antibiotics are often not prescribed because they failed the standard tests, despite being inexpensive, nontoxic, widely available and often effective.

He is working to modify the existing test so that it can be widely adapted to give doctors better tools and information when battling superbugs.

Drugs that pass the standard test often fail to treat bacterial infections, whereas drugs identified by Moore’s test have been effective.

Learn more and watch Why Antibiotics Fail – People Are Not Petri Plates

For more talks in this series, click here.

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A Life in Medicine

8232Healthcare has never been as important to peoples’ lives as it is today. Staggering advances in technology and science stand alongside major changes — and controversies — in policy and payment. In this new series, Dr. Robert Wachter, chair of UCSF’s Department of Medicine, bestselling author, and rated in 2015 by Modern Healthcare magazine as the most influential physician-executive in the U.S., interviews leading lights in medicine and healthcare.

In addition to finding out what’s happening now and where medicine is going, these individuals talk about the experiences that shaped their careers.

The first two programs are available now with more coming monthly to UCTV.

Dr. Kirsten Bibbins-Domingo
From self-described army brat to a renowned physician and scientist, Dr. Bibbins-Domingo is the immediate past-chair of the US Preventive Services Task Force. Find out how she balances the various demands on her time, including being a mom.

Dr. Lloyd “Holly” Smith
Dr. Smith came to San Francisco in 1964 and transformed UCSF into a world leader. His ability to steer that change is as much about management as medicine.

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Health Reform at the Crossroads

779Democrats and Republicans have been working to create laws that reform the American health care system for decades. The Patient Protection and Affordable Care Act, also known as ObamaCare, is the first successful major overhaul of health care since Medicare in 1965.

The Act affirms “the core principle that everybody should have some basic security when it comes to their health care,” as Obama said at the signing. It’s impossible to have missed the drama of getting the law enacted, from the Supreme Court ruling upholding the law to the government shut down over its implementation.

The latest programs from UCSF’s Mini Medical School for the Public is coordinated by the Philip R. Lee Institute for Health Policy Studies and looks at the cutting-edge issues concerning health reform and what the ACA actually does. Why was it necessary? What were the competing proposals? How will we know if it’s working?

If you want to learn more about health reform, and the challenges that lie ahead to advance the science of health care delivery and public health – these programs are for you!

Watch the latest videos on Health Reform, now, and stay tuned for more programs throughout the month.

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