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Roundtable: Expanding health care in California

Speaker 1: (00:00)

California might become the first date to provide universal health insurance. The governor says he has a plan, but some of his strongest supporters say it doesn't go far enough. Local blood banks say their supply is dwindling. What does it mean for San Diego's hospitals and a passing comment at a two of Vista restaurant leads to a big legal bill and a debate over for what is and isn't discrimination. I'm Matt Hoffman, and this is K PBS Roundtable.

Speaker 1: (00:37)

We've heard so much about COVID 19 this week. So we're gonna go a bit deeper for our first segment. Those privileged enough to have health insurance during a pandemic, know that it can be the difference between proactively seeking care or living in a state of worry and not knowing how you're gonna get better or how you're gonna pay for it. But now California might be on the verge of becoming the first us state to offer universal coverage. That's on top of calls by governor Gavin Newsom to expand us to the existing Mecal system. That would be for everyone living in California, even undocumented residents,

Speaker 2: (01:07)

But here's the big one California is poised to be. If this proposal is, uh, supported the first state, uh, in the country to achieve universal access to health coverage. So what does that mean means full scope Mecal including long term care, IHSS, behavioral health through all low income Californians, regardless of immigration status, regardless of their age, regardless of their immigration status full implementation will initiate January, 2024. If this is approved,

Speaker 1: (01:41)

Our first guest is Cal matters. Health reporter, Kristin Wong, who has had a very busy week following all the committees and hearings up in Sacramento as the legislature gets to work. Welcome back to round table. Kristin, thank

Speaker 3: (01:53)

You. It's great to be

Speaker 1: (01:53)

Back. Okay. So diving into this, there's sort of two proposals on the table here. Let's start with the more progressive one that's assembly, bill 1400, it's being called guaranteed healthcare for all. Now, how would this create something brand new for California

Speaker 3: (02:08)

Assembly? Bill 1400 would really dismantle the health insurance landscape. As we know it, there would no longer be sort of individual health insurance plans. You know, you wouldn't have Kaiser, you wouldn't have blue cross blue shield. You wouldn't even have Medicare or medical. What it would do is just create sort of one state run statewide health insurance plan that every single Californian is enrolled in.

Speaker 1: (02:35)

And we know that the term single payer it's often used to describe this form of universal healthcare. Can you explain to the audience what that means exactly this idea of a single payer system? Yeah,

Speaker 3: (02:45)

So the single payer system is a little bit of a confusing sort of jargony word, essentially what it means, um, particularly in this context is that the state of California picks up the tab for any sort of healthcare cost. So when you show up to, you know, have your broken arm fixed or to get a COVID test or to get eyeglasses, the state of CA there's no charge, the state of California will pay for the bill. Um, of course that comes with other funding mechanisms, which means in increased taxes to create a way to pay for this. But essentially nobody's paying sort of directly out of pocket at the time that they are receiving a service.

Speaker 1: (03:29)

As you were covering the assembly health committee this week, you mentioned that several of the major health organizations in California are opposed to this. Why did they say they are?

Speaker 3: (03:38)

Yeah. The health organizations that are opposed to this really sort of sweep the board. It includes the California medical association, which is doctors. It includes the hospital association. It includes the health insurance plan associations, um, and their main points of opposition really come from the unknowns that this bill brings to the table as it stands be it because it would totally transform the landscape of healthcare in California. Nobody really knows what that would look like or what it would take to implement it. Um, the author, um, assembly member Cora has said that there would be sort of this five year period to figure out what implementation looks like, but opponents have sort of held that up against, you know, if you get rid of say Medicare, which has been around in the us for 50 years or so, you know, what are we gonna do with people who are retirees or that have really spent their whole lives and generations paying into systems that currently exist and suddenly we take that away.

Speaker 1: (04:43)

So it sounds like there's definitely a lot of big question marks here. And one of the big questions is, is the governor on board with this? Here's what he said earlier in the week when he was asked about past support for a single payer model and sort of what's achievable. Now, the

Speaker 2: (04:56)

Difference here is when you are in a position of respond, its ability, you've gotta apply. You've gotta manifest the ideal. This is hard work. It's one thing to say it's another to do. And with respect, uh, there are many different pathways to achieve the goal

Speaker 1: (05:17)

I'm talking with Cal matters, health reporter, Kristin Wong, and Kristen. We also heard governor discussed this week, his budget proposal, he's branding at the California blueprint. And it's clearly operating on a different track here. Now, the centerpiece when it comes to his healthcare plan is expending access to the current state run system. So just generally what's different about Newsom's plan versus what AB 1400 is promising.

Speaker 3: (05:40)

There really are big differences between Newsom's plan and AB 1400. I know a lot of even democratic lawmakers in the health committee sort of brought up this idea that because Newsom has proposed expanding Mecal to everyone, including all undocumented immigrants, that there's no reason for single payer healthcare. But the key difference is that with single payer healthcare, nobody is paying outta pocket, regardless of income level level, you are of course paying increased taxes, but, but you don't have to, you know, hand over your credit card when you receive a service. The state is picking up that tab. On the other hand, with Medica, with expanded Medi-Cal for this sort of forgotten range of undocumented immigrants ages, I believe 26 to 49, they can now qualify. Or if the proposal goes through with eight budget in later in the summer, they can now qualify for Mecal, but it's really sort of this false equivalency, because you would still have in place this system where people who, um, have private insurance, they're paying out of pocket for their private insurance people who have employer insurance, they're paying their deductibles.

Speaker 3: (06:57)

And I thought one of the things, the notable things that was brought up during the committee meeting earlier in the week was that there are 30% of covered California and rollies have the cheapest plan. Um, and when you have the cheapest healthcare plan, that's usually because you have problems affording health insurance to begin with. And that cheapest quota cheapest healthcare plan still comes with a family deductible of more than $16,000 and an individual deductible of $8,000 annually. So should you have some sort of medical emergency? You might, we might have universal health insurance under this proposal where everybody in the state has access to health insurance that does not necessarily mean that everybody can afford their healthcare bills.

Speaker 1: (07:44)

The governor is getting some pushback here, the Los Angeles times, and others have commented this week that this falls short of Newsom's prior support for a single payer system. Uh, just generally like have his priorities changed. Is he backing down here or does he feel like this maybe is the easiest way to, to get people covered

Speaker 3: (08:00)

Really, you know, without reading his mind, but sort of looking at the actions and what has happened since the budget proposal has been released, it really does seem like this is the proposal for expanded Mecal is the path of least resistance. It does not necessarily fulfill his campaign promise of the single payer healthcare, which would be, nobody has to pay outta the pocket for healthcare, but it is something that even among the sort of democratic health committee members, they seem to support Newsom's proposal much more than they did AB AB 1400. So

Speaker 1: (08:36)

We have these two proposals here on the table. Is it likely that lawmakers governor will have to choose one or the other, or can they sort of both happen? I mean, we know that AB 1400 is clearing some hurdles, but if it gets to the governor's desk, what happens then?

Speaker 3: (08:50)

Um, you know, it's totally possible. I suppose, that both of these can move forward. They don't necessarily have to choose one or the other, although arguments were certainly made that Newsom's proposal of Mecal for all makes it makes AB 1400 less likely to move forward. But, um, say theoretically, it gets to the governor's desk and he does. So there's still the other half of it, which is going to face a lot more challenges. And that's the funding mechanism for 80 1400, which requires it has been introduced this session, but it requires a constitutional amendment because it would levy taxes on all Californians.

Speaker 1: (09:32)

And just to be clear here, the governor says that his proposal is all paid through, right?

Speaker 3: (09:36)

He does. Yes. That is part of he's accounted for the cost in the budget.

Speaker 1: (09:42)

We know that you're working on an upcoming story for Cal matters on the Aron variant. Now we know that this current peak is expected sometimes soon. Now I can always change, but what are you focusing on with this story?

Speaker 3: (09:53)

Um, what are we not focus on with Aron? Um, really the peak is expected to come in the next four to six weeks. Um, the California hospital association actually announced this morning, a pretty severe warning that the state hospital system is very close to collapse that they are expecting far more patients in the next four to six weeks than they, than we had last January. And that's with a 20% reduction in workforce. Um, and so the story is really looking at, you know, what, what does that mean? What does that, this sort of unprecedented amount of stress look like on the ground in our hospitals and also so in our nursing homes where we've had quite a few COVID outbreaks and where staffing is also under a very severely

Speaker 1: (10:44)

Short staffed, well, we'll definitely be watching your coverage in the days ahead to see how this all plays out. Kristen Wong is a health reporter for Cal matters. Always great to have you here, Kristen, and thanks so much for your time.

Speaker 3: (10:55)

Of course, great to be here.

Speaker 1: (10:57)

Speaking of healthcare, there are some things that most of us probably take for granted if we have to spend time in a hospital. And one of those is that staff will have one of the most essential supplies according to the American red cross, though, that's becoming less certain.

Speaker 4: (11:11)

The American red cross blood supply is at historically low levels this winter, and we are facing a dangerous situation of across the country without the blood they need. Hospitals may be forced to make tough decisions about patient

Speaker 1: (11:23)

Care. That's part of a video that the red cross put out earlier this week, urging people to donate blood. And yes, this is another consequence of the pandemic. Now in its third year, San Diego's donation centers, hope business picks up again soon, and those appointments will start to O up K PBS reporter kitty Alvarado caught up with some donors and doctors this week. Welcome to round table kitty. Thank you, Matt. So we hear about blood shortages from time to time in the news, but what makes this one different? This

Speaker 3: (11:50)

One is really different. You know, I really didn't understand

Speaker 5: (11:53)

The extent of the shortage until I did this story. Myself, things that are contributing to the shortage are of course, COVID counseled blood drives, flu and staffing shortages, and also in a lot of parts of the country, weather related closures.

Speaker 1: (12:08)

And before we dive into your full story, you visited the San Diego blood bank. And just to be clear, this is a different organization than the red cross, right? But their mission is similar. Yes.

Speaker 5: (12:17)

Their mission is similar except for that. The San Diego blood bank, uh, supplies blood to all of the hospitals in this region.

Speaker 1: (12:25)

Okay. And now let's hear from one of the donors that you met his name's David Carroll. He's a local man from Chula Vista that hit a big milestone on Tuesday here, he was talking about donating a hundred gallons of blood over the years. Here's a portion of your story that aired here on K PBS,

Speaker 5: (12:41)

David Carol just arrived for his regular visit to the San Diego blood bank in Chula Vista. He donates platelets every two weeks. And if I, but this visit is not typical. You see today, David is donating his hundredth gallon of blood. That means he's done this over 500 times

Speaker 6: (13:01)

Super donor, okay. That's just sort of letting my fire up. I said, oh right, super donor.

Speaker 5: (13:05)

But 100, isn't just a number or a milestone. His donations save lives the way he sees it. One of those he saved has surely given back to him and others donors

Speaker 6: (13:18)

Get to give and the recipients get to receive and things that I don't know that they've done that have benefited me. And we, it gets, we all benefit.

Speaker 1: (13:25)

Now that's a lot of blood. How are these super donors like David critical to the work being done at the San Diego blood bank?

Speaker 5: (13:32)

Well, donors like David are super important because above all, he's dependable. He donates regularly. He goes in every two weeks. He donates blood and platelets and platelets are super important. That takes about three hours. And so obviously a lot of people don't have time to do something like that. A lot of people, uh, children who get cancer treatments, anyone who gets a cancer treatment, they need those platelets in order to receive the treatment. So if there's not platelets there at the hospital, which a lot of times there aren't one of the mothers that I met who had a son and said, we regularly went to the, to the hospital. And sometimes they said, you know, we don't have the platelets right now. You guys have to wait. So I can don't even imagine being a mom and them telling me, you know, you, you have to wait. Your son has to wait because we don't have the platelets. That has to be devastating.

Speaker 1: (14:25)

I'm talking with kitty Alvarado. She's a reporter here at K PBS news. And getting back to the urgency of this shortage, kitty, the red cross says, this is a national problem. But while working on this story, did you, you get any sense or indication for the state of our local blood

Speaker 5: (14:38)

Supply? I did. And you know, it is in really bad shape. Uh, we should have a four day supply on hand and we only have one. The American red cross says that they only have a half day supply and they want to have seven days supply. So we are in just as bad shape as, as they are. But as I said earlier, it just means that people have to wait to get cancer treatments and often get turned away. So I can imagine if there's like a, a multi casualty incident that where a lot of people have to go into the hospital and get blood. That's going to be a major catastrophe because doctors are going to make, have to make really heart wrenching decisions. If the blood isn't there on the shelves, we've

Speaker 1: (15:20)

Reached out to one of our major providers, Scripps health. They operate several hospitals here in San Diego county. What did they say about a situation where they had to call around to get blood while in the middle of trying to patient,

Speaker 5: (15:32)

You know, this was a real wake up call for me. When I heard this interview, this doctor was explaining that they had two patients at the same time who needed major blood transfusions. And, uh, they did not have enough blood. So in the middle of that process, if you can imagine they're scrambling calling, uh, different hospitals around, can we borrow blood, but they were ultimately able to get that blood. But as this doctor said, Dr. Gonzalez Sharif said, this is not sustainable. And this could end up costing lives. What

Speaker 1: (16:03)

Do people need to know about the safety of donating blood during the

Speaker 5: (16:06)

Pandemic? I spoke with a representative from the San Diego blood bank. And that was a, a question. I had it safe. I mean, you're in a, you're in a room with a lot of people, but I saw firsthand what they do. They are really careful. They're constantly wiping everything down, sanitizing, everything down, but of course they follow all, uh, COVID protocols. And so she says it's pretty safe. I also was really curious to know just people who don't know they have COVID and donate. And she says, they screen the blood for all diseases, but this one is different because she said that because COVID is a respiratory illness, you don't get it through

Speaker 1: (16:42)

Blood and kitty we're setting records almost daily. Now it seems for the number of people contracting COVID 19, and these are all potential donors. Can they still give blood?

Speaker 5: (16:51)

Yes, you can give blood, but you just have to wait four weeks after you don't have any symptoms. And four weeks from the time you're exposed to COVID. But actually something that I found really interesting is that you do not have to wait after you get the vaccine.

Speaker 1: (17:07)

Well, this is definitely an important story that affects so many people in San Diego. I've been talking with K PBS reporter, kitty Verado and kitty. Thanks so much for your

Speaker 5: (17:14)

Time. Thank you, Matt.

Speaker 1: (17:23)

Let's take a moment to make mention of the alarming surge in local COVID cases. The numbers this week are unlike anything we've seen during the pandemic. And K PS news is covering the stories from all angles, radio TV, and on our website. All of our content is online@kpbs.org. Just go to our homepage and click on the tracking. COVID 19 link under the new section. You'll also find the latest information on testing locations across San Diego county.

Speaker 1: (17:55)

Now, for something totally unrelated to the pandemic, it's been a very busy week for politics here in San Diego. We had governor Gavin Newsom visiting Todd, Gloria state of the city speech. But it's a story from the south bay. That's exposing to visions at Juul Vista city hall that has our attention. It's all about the word gringo, whether it can be considered a Rachel slur and the five figure bill that the city spent trying to find out. Julia woo wrote the story for voice of San Diego. And she's here with us now. Hey Julia. Hi.

Speaker 7: (18:23)

Thank you for having

Speaker 1: (18:24)

Me. Of course. So we know this all goes back to a press conference almost a year ago at a Vista restaurant mayor, Mary Garcia, Salas, and Councilman John McCann were both there. So who or what set this off, or sort of set this in motion, right?

Speaker 7: (18:38)

So Mr. McCann filled out an equal employment opportunity complaint against mayor Mary Castilla Salas. And basically from what he put the complaint, council member, Jill Galvez, and the mayor were sitting at a table eating when he stopped to say goodbye. This was after the press conference. He said in the complaint that the mayor had called him AO twice, he said he felt insulted. And he also said that he felt shocked by her statements since it was aimed at diminishing him because of his ethnicity

Speaker 1: (19:11)

And sort of along those lines. Why did McCann think that gringo sort of crossed the line and how did he take action there?

Speaker 7: (19:17)

So again, he said he felt insulted and he said he followed the professional and appropriate channels and the city's proper complaint process. And they had an independent firm look into it. According him, this is something that the mayor has done before. So, you know, from the interview I had with him, he said that that was a word that offended him. And

Speaker 1: (19:42)

I'm, I'm just sort of curious, is any of this on tape or it'll be like proven

Speaker 7: (19:45)

There was an investigation conducted by Arlene PR from the law firm best. Uh, she interviewed both McCann and Salas and found both to be credible and truthful within significant differences in their versions of the event. So the investigation confirmed that the word gringo was used. However, according to the mayor, she said that it was a, a lighthearted convers station between two, uh, long time colleagues. And it was in reference to the restaurant's food. So from what I can gather from the investigation and the EEO complaint, what was said was something to him, Mr. McCann, commenting how spicy the food was and the mayor saying something to the likes of, you know, oh, uh, it's spicy to you because you're a Greeno, something along those lines. And

Speaker 1: (20:39)

You touched on that outside law firm that was hired to figure out if this rose to the level of workplace discrimination and harassment. What exactly did that investigation find?

Speaker 7: (20:48)

According to the investigator, in order for something to be considered workplace harassment or discrimination, it needs to rise to the level of unreasonable interference with someone's performance or create a hostile, intimidating, or offensive environment, which the investigator did not find. The investigator said that while it wasn't illegal, it was perhaps inappropriate to say something like

Speaker 1: (21:13)

That. And Julia, for those who may not be familiar with the word gringo, what does it mean? And does it have sort of multiple definitions

Speaker 7: (21:19)

Again? I think it really comes down to context. I'm actually both white and Mexican. So I've, I I'm a member of both communities and in my opinion, it, it refers to someone from the us I've grown up on the border on both sides of the border. And it's, it's often used as to refer to someone from the us, from the context I'm used to. So again, context is important. The tone, if you're attaching, uh, other adjectives before or after then I think that's when it can be insulting or offensive. But, you know, I think there's, there's a lot of debate whether whether or not it's offensive

Speaker 1: (22:03)

And we know that these investigators don't work for free, how much did all this cost tax

Speaker 7: (22:08)

Payers? It was around, uh, 16,000. The exact amount was 15,000 eight hundred and thirty eight fifty.

Speaker 1: (22:15)

I'm talking with Julia woo from the voice of San Diego and Julia. This is not the first time that McCann has sort of clashed with some of his colleagues at the Juli Vista city council. How would you describe the dynamic between him and those? He works with,

Speaker 7: (22:27)

Uh, from what I, and see, it appears to be strained definitely in my interview with council member Galvez, she made it known that there, there was a lot of contention there.

Speaker 1: (22:40)

And do we know if McCann has any aspirations for higher office in Juul Vista? From what I was able

Speaker 7: (22:45)

To, um, investigate, he has filed paperwork to run for mayor in 2022.

Speaker 1: (22:51)

And is there any indication, or did he tell you that this is somehow, you know, being used to get in the public eye or anything?

Speaker 7: (22:57)

Well, he did mention that he thought this was going to be a private HR matter, which I understand, but I, in my opinion, the moment that tax payer resource are used now, it, it becomes a public matter because taxpayers are entitled to know what is being done with their money. You know, it, it comes down to transparency and accountability.

Speaker 1: (23:22)

And, you know, occasionally we see this in public discourse, this notion of reverse discrimination, but when we're talking about words that truly harm or hurt marginalized people, there's a history and abuse is connected to those words. Now, Julia does a term like gringo fit into that category.

Speaker 7: (23:37)

So I think it's really important to think of context, uh, how it's being used. And, you know, in speaking with a friend, she brought up a really important point. Uh, she referred to a standup comedian who said something along the lines, if we are comparing to words and we can't even say one of them, the one we can't say is worse. So I, I think that's something really important for people to remember.

Speaker 1: (24:03)

And does the investigation, is the book on this or is there more to come here? The

Speaker 7: (24:06)

Investigation concluded that the use of wor of the word Dingle or on one occasion in an informal setting to describe a person's attribute of whether or not they're able to eat spicy food does not rise to the level of interfering with someone's performance or creating an intimate dating hostile or offensive environment as required to find as a violation of, of law

Speaker 1: (24:31)

Here on Roundtable, we get a chance to talk with young journalists a lot. And Julia, you are a reporting intern with voice, and recently served as the editor in chief at the Southwestern college son. What should people know about the work that's happening there to develop the next generat of reporters?

Speaker 7: (24:46)

You know, I, I feel that community colleges are often overlooked. They offer accessible prices with at least in my experience, amazing faculty and curriculum. The year I was editor in chief, we won best newspaper in the nation. I don't think anyone saw us really as a contender because we're a community college, but the sun does a great job in training. The next generation of journalists, sons as, uh, a lot of the alum referred to are really successful in the journalism field. They're working for the San Diego union Tribune, Politico, voice of San Diego. And honestly, I think the sun is a really great place to learn how cover your community.

Speaker 1: (25:28)

I've been speaking with Julia woo from voice of San Diego. We really hope to get another chance to talk with you soon, Julia, and thanks so much for your time. Thank you. Thanks so much for tuning into this week's edition of K PBS round table. And thank you to my guests. Kristin Wong from Cal Matt, kitty Alvarado from K PBS news and Julia woo on voice of San Diego. If you missed any part of our show, you can listen anytime on the KPBS round table podcast, I'm Matt Hoffman. Join us next week on the round table.

SCRIPPS MERCY 2021 01 07.jpg
Matthew Bowler
Ten ambulances wait outside the Scripps Mercy Hospital emergency room in the Hillcrest neighborhood of San Diego on January 7, 2022.

KPBS health reporter Matt Hoffman hosts a discussion with CalMatters health reporter Kristen Hwang on the proposals by Gov. Gavin Newsom and democratic lawmakers that would either greatly expand access to Medi-Cal or create a brand new single-payer system. Also, KPBS reporter Kitty Alvarado joins us to talk about the critically low supplies local blood banks are dealing with. And, Voice of San Diego reporting intern Julia Woock talks about a complaint filed by a Chula Vista city councilmember after he was called a "gringo" by the city's mayor.