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
They may not seem related, but Dr. Sandro Galea, Dean of the Boston University School of Public Health, says we can approach guns, obesity and opioids in the same manner: population health. Dr. Galea breaks down the key concepts of population health – a relatively new field – during the inaugural Colloquium on Population Health and Health Equity at the UCSF School of Medicine.
Dr. Galea argues guns, obesity and opioids are the three epidemics of our time, and three of the main reasons life expectancy is declining in the United States. They also share three key characteristics: They are important, costly health concerns. They are complex. They are resistant to simple solutions. The key to overcoming these challenges Dr. Galea says, is using the population health approach.
He lists nine principles of population health, but focuses on four, including the concept that small changes in ubiquitous causes of health problems can have a greater impact than big changes to rare causes. Dr. Galea uses the example that while much has been done to curb the overprescription of opioids, the epidemic continues to grow. That’s because other options, like synthetic opioids, have become more widely available. Dr. Galea says that’s where population health comes in – finding ways to improve health on a large scale, and addressing epidemics from every angle.
Watch Guns, Obesity, and Opioids: A Population Health Science Approach to Contemporary Concerns
Evidence is building for the importance of physical and social activity as the way to optimize wellbeing in older age. UCSF Geriatrics faculty review their research and cutting-edge work on improving physical, social and emotional wellbeing in older adults.
Explore topics on the myths of aging, improving surgical outcomes, the science of longevity, social connection in older adults, and tools for comprehensive advance care planning.
If you are an older adult, caregiver or anyone interested in optimizing well-being as you get older, this is for you.
Browse more programs in Aging, Activity, and Community: The Science Behind Function and Social Connections in Older Age
Starting at about 30 years old, the density of bones begins to decline. As a result, bones become more fragile and are more likely to break. There are over seven million fractures in the United States every year. With a more physically active and increasingly aging population, we are seeing an increasing number of fractures in the elderly. Treatment of older patients, however, often requires different approaches than similar injuries in younger adults.
This series features orthopedists from UCSF who discuss common fractures in the elderly throughout the body: knee, ankle, spine, pelvis, wrist, elbow, shoulder and hip. They address common issues in bone injuries, how they are treated and what you can do to help prevent fractures.
Get an in-depth update as to what is being done to improve the care of geriatric patients with fractures.
Browse the series of programs in Aging Bones: Understanding Fractures, Healing, and Repair
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.