California’s 23-campus state university system can’t seem to function as it is currently structured. The system’s centralized administration is doing more harm than good. Maybe we should blow it apart and let each campus control its own future.
Anthem Blue Cross has been under scrutiny for its recent rate hikes. But that scrutiny should go beyond the rate hikes to their overall business practices—and the broken health system that rewards bad behavior. The company has perfected a business model based on collecting premiums from the healthy and avoiding as much as possible actually providing coverage to those who are sick.
California is experiencing a worsening shortage of doctors in rural and low-income communities, in part because of decades-old laws that no longer serve our needs. I have worked as a “country doctor” for 22 years. It’s the kind of work I always wanted to do, but it’s a tough sell for younger doctors today – even for those who see it as their professional calling. College and medical school tuition and subsequent debt are exorbitant. More patients in rural communities are uninsured or on Medi-Cal than privately insured. The doctors who treat them are routinely paid less than half of the cost of care.
California’s Air Resources Board is coming under increasing pressure from construction industry contractors seeking to roll back regulations adopted three years ago to sharply reduce the amount of diesel pollution from big off-road tractors, scrapers and earth-movers. The agency has acknowledged that it underestimated the effects of the recession on diesel emissions and is also studying claims that assumptions in a faulty computer model further inflated estimates of pollution caused by the vehicles.
Bob Cohen saw a problem and vowed to correct it. He saw a need and wanted to fill it. Today, thousands of people across the country are getting tax refunds and credits easily and without charge because of his work and the Legal Aid Society of Orange County, which Cohen directs. The problem Cohen saw was desperate low-income people, often people with little knowledge of the government or tax system, losing much of their refunds to tax preparers who offered them instant money while taking a huge cut of their check. The need he wanted to fill was for an easy, online program that would allow people to skip the commercial tax preparers, file their taxes themselves and get their money almost as quickly.
The overhaul of America’s health care system may be stalled in Washington, but in San Francisco, a new method of delivering health care is already in place. Known as Healthy San Francisco, it is designed to care for the poor and under-served. It provides universal access to health care, comes with a public option, and has no exclusion for prior medical conditions.
A middle-aged man who is a life-long smoker shows up in the doctor’s office after suffering a shortness of breath. His declining health has put his job in jeopardy, but he is addicted to tobacco and unlikely to kick the habit any time soon. He is also short of money. His physician wonders whether the patient will take a generic medication she prescribes for him or return soon to the ER with another expensive-to-treat medical crisis.
The news has been full of stories in recent weeks of how Anthem Blue Cross has been trying to increase health insurance premiums by as much as 39 percent for some people who buy insurance on their own, outside of the kind of group coverage a person gets from an employer. Almost entirely unnoticed, meanwhile, has been a more newsworthy development: in a time when medical costs have been rising rapidly, premiums for many public sector workers enrolled in a Blue Shield of California HMO have actually gone down.
The Clean Slate Practice at the East Bay Community Law Center in Berkeley aims to increase employment opportunities for individuals with prior convictions by dismissing their criminal records after they demonstrate rehabilitation. The group has urged lawmakers to ‘ban the box,’ or exclude inquiries on prior convictions, on employment applications. They argue that such remedies will make our communities safer by making it easier for people with criminal records to get jobs and re-enter mainstream society.
A little more than five years ago, visions of seemingly magical stem cell cures danced in the minds of California voters. Lured by the promise of human embryonic stem cells and the intransigence of the Bush administration, Californians voted to borrow $3 billion and give it away to scientists to come up with therapies for ailments ranging from Alzheimer’s to diabetes. In approving Prop. 71, voters repudiated the Bush administration ban on funding of human embryonic stem cell research. The voter initiative also created the California Institute for Regenerative Medicine, an enterprise unlike any in state history and one that is uniquely independent of the governor and the legislature. It is also an agency that is facing a new set of challenges as it enters its second five years of existence.