Roundtable: Senate Healthcare Bill, Algae As Fuel, Getting To Zero Traffic Deaths

MS: The health plan or massive tax cut. They revealed their proposal to replace Obamacare. A company takes a big step forward this week toward making a viable fuel source. We check in on ascending a program that says yes. I am Mark Sauer. The roundtable starts right now. MS: Welcome to our discussion. Joining me at the roundtable are Kenny Goldberg, David Wagner, and Andrew Bowen. The Republican secret build to repeal the affordable care act disposed -- expose a scrutiny. Here Senate majority leader Mitch McConnell. [Clip] Because Obamacare is it working by nearly any measure. It has failed and no amount of our reality denying or passing by Democrats is going to change the fact that more Americans are going to get hurt unless we do something. MSSenate Republicans promised to top-down revamp of a bill that passed last month. Democrats are going for a fierce fight and some Republicans waver in their support. Kenny start with the basic changes here. The high points of this plan. KG: First of all, the whole effort is based on a false premise. The false premise is that Obamacare is collapsing and it's just going to be dissolved. That is not true. California's Obamacare market is flourishing and there are other states where they are doing fine. That is number one. Number two is to fabricate an entire health care reform plan based around the concept of cutting healthcare to the poor -- for an disabled I don't even understand what they're doing. MS: Some critics have pointed out we should not call this a healthcare plan. Was to call a tax reform plan. KG: That is right. I think it is window dressing the healthcare thing. The extent that you can take at these value the Senate plan is more severe than the house plan and that it makes deeper cuts to the Medicaid program although it doesn't start until 2020 and it allows states to waive some of the Obamacare requirements that they have to provide. Maternity care and preventive care allow states to waive those requirements. That was to pass, insurance companies can sell these junk insurance plans that don't have that many benefits. MS: The cost will be relatively low but the coverage tax... KG: You will have no premiums but if you get sick maybe it will be covered or maybe it wall. If you are a woman, you will not have maternity care. We've had these fights in California and settled them but the federal government under this plan would enter this stuff all over again. MS: Give us an idea of the impact of this. We are talking about the economy in a lot of Americans are ensued by Medicaid. KG: We have expended Medi-Cal to the extent that 13 million will have Medi-Cal now. So if the federal government were to severely curtail federal funding for Medi-Cal, it would have an enormous impact in California. In San Diego, we have more than 900,000 people that have Medi-Cal coverage. In some counties in California, there's even higher percentage of residents are Medi-Cal. So this would have a devastating effect in California and not only on the Medi-Cal situation, but on people uncover California because you're talking about reducing some of the federal assistance for people that get Obamacare. AB: So what is it that makes us successful state exchange which Mike you see that California's driving and there are other states that they don't have them. What is not working in those states where the exchanges are kind of collapsing? KG: That is a good question. Some states do not take the federal law to expand their program so there's a lot more pressure and people uninsured. You've got a lot of health insurers pulling some of out of the states. I think it is because of the federal government has been undermining Obamacare since the Trump administration took power. They been sending mixed messages and talking about we may enforce the mandate or we may not. We may penalize people who don't get insurance. They been sending mixed messages about this all the time. AB: Some of it is uncertainty whether or not Obamacare will survive and the insurance providers are unwilling to take a step into that exchanges. KG: That is right. Insurance companies want to make money. So they are not going to jump into the states where it seems murky. MS: Both the house and in the Senate, the process was heavily criticized by Democrats and other critics. In the house, it was that they had passed this bill before it was scored by the nonpartisan Congressional Budget Office. What was a complete over the Senate question? KG: The complaint was that it was drawn up by 12 or 15 senders in secret behind closed doors. There was no outside input and no input from stakeholder groups. It was not an open process by any stretch of the imagination. Their argument was okay now we've introduced this bill and we are going to listen to all the amendments and input. That is not quite the same thing. MS: I want to turn back to California for a moment. The state Senate here passed a single-payer health bill for California. We would set up our own version of a single-payer government-sponsored plan to cover everybody. Tell us more about that and how likely it is that it would passing California. KG: The single player taxpayer had been going around for some time. Under this plan people in California there would be no more Medicare, Medicaid, private insurance. It would be this big one state ran program. The problem is in the Senate bill there was no finance for it. So they just passed it with the concept but without the nuts and bolts. Basically to make the thing happen they're going to have to come up with three or four billion dollars. MS: They are assuming they're going to get all the federal money for Medicaid. KG: That is an excellent point. To dissolve Medicare and Medicaid, they would had to get -- have to get a federal waiver. MS: Getting back to the Republican plan to get rid of Obamacare, the opioid epidemic has been in the news lately. There had been tragic stories about deaths and people addicted in the cost of this. This bill looks like it would go to the heart of taken away money from these various programs that help these people. KG: That is right. That is just what example of some of the cuts and effects of the cards. I think it's important to point out that I don't think there's any interest group trade group, patient group that I've seen that has supported. DW: It's been interesting to see both parties have a crack at health care reform. Obamacare was always designed to be a compromise solution. It was driving toward universal coverage but it was a right wing idea which is mandating that people buy healthcare. Now the Republicans are in control and they are not interested in a compromise solution at all. We've seen what changes they have made. It is to appease their most conservative members in Congress. I'm wondering if the effects of this and if this is going to cost Democrats to give up the compromise. KG: That is a very interesting question. There has been a lot of discussion about that that they should embrace this idea and bring liberals and millennial into the fold and show up to vote. You mentioned something about the Senate plan would eliminate the mandate. People would no longer be required to buy insurance and they would not be penalize. That is going to foul up and it -- the insurance networks. Because it doesn't work. You have to have a mix to make insurance work. If the only had people that are going to file claims and sick people were insurance companies would want to be involved in that? MS: It was the green bullet the biotech solution to global warming. Algae the clean fuel that could wean us off of oil and gasoline while utilizing the pipeline some pumps. San Diego will be the Houston of algae. Dates back more than a decade. There was a scientific breakthrough that is fired the flames of promised for algae. Start with the basics. Why was algae is so promising to researchers? DW: It is alternative to fossil fuels because you can use things like sunlight, salty water, algae and grow the stuff outdoors and the idea is a big volumes and produce fats and oils that you can go want to refine to refuel and this would be something that is renewable and something that is carbon neutral. It would emit carbon when you combust it but the algae would absorb that carbon itself. That is attractiveness of algae. The problem is is it economically feasible to scale this up to compete with oil? MS: In the opening it's been going around here for a long time. A lot of scientists have been involved. A lot of mayors said it was coming but they would never be able to make it. DW: The science on the states back to the 70s. The signs of algae biofuel has been around for a while. Here in San Diego when algae biofuel got going here about a decade ago, I think the assumption was that oil prices were going to keep going up and algae was the cost was going to creep down. Algae would become competitive with oil. That has not happened. Oil has stayed cheap and algae has not become competitive with it. So we are dealing with a situation where it is not exactly a scientific problem it to economic problems. MS: Let's talk about science. Tell us about the store you did this week on the breakthrough in San Diego and why it is exciting question. DW: The biology here is moving forward. So I did a story about a local company and what they did is they created a new GMO strain of algae that does something -- they've modified a strain of allergy test algae that scientists have been trying to do for long time. It produces double the amount of oil is a natural strain but it does it slow down the growth. It still grows at a healthy rate comparable to what we see in the natural strain. More fat, more oil, means more energy for fuel. MS: This stuff does grow like crazy. KG: What kind of interest have any of the energy companies or oil companies shown in this technology? DW: This work that we are talking about this week is supported by ExxonMobil. So they are working with the world's biggest oil companies on this. Our listeners and viewers might have seen Exxon is running a lot of ads on TV lately featuring people and scientists and algae labs. So there by -- they are very much highlighting this work. Scientifically it's really a question of economics and skill and also a lot of regulatory hurdles. These are GMO's and synthetic GMO makes. If they want to try testing these large outdoor ponds and a real large-scale situation, they will have to get permits and get the public on board with that a lot of people have a lot of feelings about GMO's. MS: They’ve done demonstrations -- they have done demonstrations already. We have this huge infrastructure that we can use it with algae. I did want to say Greg Mitchell is a Scripps institution of oceanography researcher. You interviewed him and he is not optimistic about how soon this might become commercially viable. [Clip] As much as we can accelerate this, we would like to. DW: People might be familiar with him. He cofounded this company. So he is very interested in seeing what tools we can use on algae to get it to be more productive and maybe viable as a biofuel. The clip from Greg Mitchell I think he essentially in the clip we did not hear was saying even on a optimistic timeline, this is something 20 or 30 years down the line we are going to pull up to the pump and fuel algae. MS: That is very discouraging because for people like you and I stories on this and it is an exciting thing even for late journalist who drive cars. That timeline gets discouraging. It is a wet blanket in the research. DW: Usually when I asked people for a timeline of when the technology is going to actually hit the road world, they will tell me 5 to 10 years. MS: Will keep going. Perhaps if there were some crisis or spike in oil, we don't know but something is going to have to move to change the commercial aspects. Will move on, it's been more than a century since Americans first fell in love with the automobile and car crashes are fatal. It's a price we've been willing to pay for the convenience of cars. They've become more safer over the years. Some believe much more can be done especially when it comes to street design. Explain the odd name vision zero. AB: San Diego city Council passed their own vision zero plan in 2015 with the support of the mayor. It started in Sweden back in the 90s but it spread to a lot of American cities. It is the idea that all traffic deaths are preventable and we can achieve that goal of zero traffic deaths if we enforce our laws, educator public about the safe behaviors that pedestrians and bicyclists and motorists should be practicing on the road, and if we reengineer our streets and make them safer so that even when crashes do happen, they will not actually kill someone. MS: We have a bite here Kathleen is the director. [Clip] Our culture has decided that traffic crashes are part of modern life. We drive and therefore there will be traffic -- crashes. This is unacceptable. The numbers keep going up and worse the people who are getting hit more often getting killed are older adults, children, people of color and living in low income neighborhoods. MS: It is an interesting point she makes. To think of all things that are democratic it was like anybody can be in a car crash but the statistics bear that out? AB: Absolutely. It has a do with equity and infrastructure. It's where infrastructure has been decaying and the city has not kept up with it. Those are areas where there's not a lot of traffic safety and safety designs that are built into the streets. You think about bird rock in La Jolla. There are roundabouts there and it is very safe and it makes it easier to cross the street. In City Heights in southeastern San Diego and Solvay areas you still have these very wide lanes of cars that they can still drive pretties fast. The conflicts keep on happening. KG: They talk about redesigning streets to make them safer. Does the city have the budget for that given the fact that they have not fixed potholes. AB: The designs are coming from grant money. So the city has put up money to improve intersections and create high visibility crosswalks where there's this white paint on the ground that is thicker and those can have a substantial impact on safety and visibility of pedestrians. With the bigger designs, the city has not put up a lot of money. Have been getting grant money from the state and from Sandag but not enough to make a huge difference in the street network. DW: Something you been reporting on a lot lately is the climate action plan, which has these huge goals of getting more people walking to work and biking to work. It seems like with your reporter test reporting here at the city doesn't start taking traffic safety more seriously, we can end up in a situation where we are succeeding at getting people to take more climate friendly commutes bumping them at more danger. AB: Whether or not we are going to succeed at those schools, I think it's a big open question how much the city is doing to encourage public transit and biking and walking. I think that part -- there is a lot of synergy that happens between fridge -- Vision Zero. A lot of times they're put together in the same sentence. Part of something that could help traffic safety if more people start biking and walking is safety in numbers. If you have more bicyclists on the streets, the motors will be more aware. Maybe I should pay closer attention to them. You are right if they continue to be a lot of cash if the number of pedestrians are growing and bicyclists are growing and nothing changes with behavior, then that will be a problem. KG: I would be interested to know what percentage of fatal accidents happen on city streets and what percentage happened on highways. AB: It's about twice as many that happen on city streets per year that on highways. I'm talking about the city of San Diego. What I think an interesting point that I found in this reporting was that the number of traffic deaths when you include highways and city streets together is more than double the murder rate over the last five years. KG: That is a remarkable figure. AB: It is. There are a lot of cars out there and a lot of people are driving and driving long distances and all in a hurry to get somewhere. The probability of the next happening is a lot higher than somebody getting murdered because that is a premeditation. I think there is a question about where we are devoting most of our resources if our goal is to save lives. We need to put a big emphasis on public safety in preventing murder and solving murders and preventing violent crime. When you look at the numbers if you want to keep the population safe, you have to maybe place a greater emphasis on safety on the streets. MS: Has Vision Zero worked in other places? It's been adopted by two dozen cities in the United States so far. San Diego is one of the later adapters had been slower ongoing on projects. Cities like New York and Seattle who've been investing quite a bit in street projects and safer streets and redesigning them and they have already seen a decrease in overall crashes and decrease in crashes with pedestrians and fatalities. When you invest the money in the right infrastructure, it can save lives and work but you have to make that investment. MS: The mayor is behind this? Is it something that people are going to need to get more more aware of? AB: Later this year we will see a public campaign from the medications apartment. We will see how that plays out. A lot of these solutions -- everyone wants safer streets. MS: We will see what happens as we move bored. But doesn't wrap up another week of stories at the KPBS Roundtable. I would like to say thank you to all my guests Kenny Goldberg, David Wagner, and Andrew Bowen. A reminder of the stories that we discussed are available on our website KPBS.org. I am Mark Sauer. Thank you for joining us today on the Roundtable.