Welcome to Day 7 of the SDFP Virtual Mayoral Forum. (See Day 1, Asking about managed competition, here , Day 2, Looking back on the Plaza de Panama controversy, here, Day 3, The Building Permit Process is a Hot Mess and Plans for the Planning Department, here. Day 4. Walkable/Bikeable Neighborhoods and Public Transit, here. Day 5, Fixing the Infrastructure, here. Day 6, What About the Homeless?, here.)
With input from our many contributors, editors put together a series of eight questions we felt were unique, not too open ended and not trite. We’re publishing one response from the candidates per day (Monday-Friday) so readers can see the verbatim responses side by side.
We emailed the questions to the addresses listed with the City Clerk’s office as contact points, knowing most of the minor candidates wouldn’t respond. Kevin Faulconer’s campaign is refusing to participate. We can only assume–and, believe me we’ve tried to get them involved– their non-response sends a message about their openness to the citizens in this city. You can decide what that message is.
The complete questionnaire can be found here.
SDFP editor Doug Porter provides context for today’s question: What about the Affordable Care Act?
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The concept of universal healthcare, while widespread throughout the rest of the industrial world, has had a difficult time working its way into our national consciousness. While many Presidents (including at least one Republican) thought something ought to be done to improve access and affordability for medical services, the obstacles to actual implementation were many and fraught with political landmines.
President Obama made getting a healthcare plan a priority. The Affordable Care Act (aka Obamacare) was cobbled together out of collection of mostly Republican proposals floated during the 1990’s coupled with compromises, political time bombs and gifts to special interests. What came out of the Congressional sausage machine was a Rube Goldberg-esque conflagration that made nobody happy (except the insurance industry, which despite their protests stands to be the eventual big winner in this deal.)
Now we’re coming down to actually implementing some kind of health insurance reform that does make the process more equitable. And the same sorts of people who have fought every single advance in US History from slavery to Social Security, from integrating schools to Medicare are doing everything in their power to stop it.
Are there problems with rolling out this program? You betcha!, as Sarah the “Death Panel” lady says. But 95% of what you’re hearing is just.plain. horsepoop. And for all its faults Obamacare is a whole lot better than the Republican alternative, which is: Just Don’t Get Sick.
Which is why we wanted to know if these guys running for mayor knew just how important implementation of this program is to Americans. See what you think…
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7. The Affordable Care Act
San Diegans can now enroll in the individual option of the Affordable Care Act (Obamacare). What will you do as mayor to inform citizens about this healthcare option?
Mike Aguirre___________________________________
While most of the effects of the Affordable Care Act (aka “Obamacare”) are beyond the control of local communities, there is a very important role for local government to play in the implementation process. Local leaders can help their constituents understand what is going to happen in 2014.
This will include helping citizens find resources on how to get covered, connecting them with “navigators”—or outreach specialists—who can field complaints and troubleshoot problems, and provide general information on what the law does or doesn’t do.
Second, and most importantly, it is the duty of everyone—employers, municipalities, health care advocates, insurers, doctors—to build a growing perception within the City that if we are going to move toward a sustainable health care system, we must all take responsibility for our own health. That means an increased focus on wellness and prevention.
For example, under the Affordable Care Act, many people with health insurance will be able to get diabetes screenings, cholesterol tests, and blood pressure readings at no cost. Seniors will have access to mammograms and colonoscopies with no co-pays. Smokers will get free access to smoking cessation programs, provided they have insurance. Everyone with coverage—men, women and children—will have access to free yearly wellness exams.
In addition to the preventative services paid for by insurance, local communities can implement campaigns and programs to help residents move wellness beyond the doctor’s office and into their daily lives. There are many cost-drivers making health care unaffordable, and while the Affordable Care Act attempts to address some, others—like the fact that our population is getting older and less healthy —require community involvement. People need to be more aware of health risks and unhealthy behaviors, and be willing to change their habits.
Programs should be developed in partnership with health care providers, employers, the state and the federal government to offer communities the tools to develop and implement active-living initiatives. Through these programs, mayors and business owners all over the state can leverage free resources to create wellness initiatives that can have a lasting impact among citizens and employees.
The City, through a wellness program implemented at the local level, can create social pressure, build awareness, and change behavior. When people see a certain behavior modeled and embraced by their neighbors, they are far more likely to adopt that behavior themselves.
There are countless examples of programs that can make a real difference. Walking programs are a simple, low cost way that communities and businesses can encourage exercise. In a recent study by Duke University found that walking for 30 minutes every day lowers your odds of developing heart disease, diabetes, and stroke. Walking for just 5-minutes can even cut down on cigarette cravings for those who are trying to quit smoking.
The bottom line is that our health care system is changing. We need to help people be informed consumers in that system—and being informed means understanding what it means to live a healthy life.
As the Affordable Care Act goes into full effect at the end of this year, there will be renewed noise as to whether the law is good, bad, or indifferent.
There will be misinformation and people will continue to be confused to a certain degree. However, two things have not and likely will not change. Obamacare is the law of the land and it’s going to be implemented regardless of it’s opposition. The other thing that doesn’t change, the one certainty that everyone should internalize and understand, is that we all have a responsibility to be proactive about our own health.
David Alvarez_________________________________
The implementation of the Affordable Care Act is a once in a lifetime occasion to fundamentally change the lives of thousands of San Diego families. But it won’t be easy. The law is incredibly complex and presents individuals, families, and business owners with a wide range of options that can be tremendously complicated.
ACA is the law of the land, and while there are elected officials in some parts of the country who are refusing to educate the public about how that law works, my administration will not be one of them. The City will be equipped to connect citizens with resources to navigate the new law, and work closely with administrators to provide both positive and negative feedback to improve implementation however possible.
There are a number of organizations already working in San Diego to provide outreach and information about the ACA to both employers and potential recipients, and we will work with those organizations to ensure that outreach finds as many people as possible to educate and empower them through the process. We owe it to every San Diegan to make this process as smooth as possible and maximize the positive impacts of the new healthcare law.
Hud Collins________________________________________
Coordinate with County & State.
Nathan Fletcher__________________________________
All Americans deserve affordable, quality health care, and the ACA is a good step toward making that possible. While the city has no role in administering health care, as mayor I would be happy to provide whatever support the county, state or federal government needs in their outreach in order to ensure San Diegans know their options and can benefit from them.
Kevin Faulconer__________________________________