5 Things California: Debate, Sen. Holly Mitchell, MAT in Prisons

With less than three weeks left before Election Day, California has a handful of Congressional races and an initiative on the ballot, the outcomes for which could reverberate nationally.  But, what appears to have died down, given the dynamics in the governor’s race, is talk about health care in California. It’s a peculiar shift for a topic that was so prominent in the primary.

That’s one of the things – along with four others – that we’re keeping our eye on in California health care for October, 2018.

DJ 5 Things SignatureWith help from
Marjie High and Emily Boerger

 

1.  Gov. debate shies away from health care

In the only debate of the season on October 8th, Newsom and Cox only tangentially brushed the subject of health care. Prior to the primaries, the single-payer conversation looked poised to become the defining issue of the race, but since the announcement that single-payer could cost California upwards of $400 billion, both candidates have back away from the issue.

Cox has been a staunch opponant of single-payer, but hasn’t put forth many other proposals during the race. While Newsom, previously vocal on health care, appears poised to win out and may be trying to avoid having to walk back expensive election committments once in office.

 

2. Prop. 8 draws near record cash

Funding to oppose the dialysis center profit initiative Proposition 8, has reached a near record of $98 million. The measure seeks to limit the revenues for dialysis treatment to 115 percent of the costs of care and prohibits source of income discrimination.

The Yes on 8 campaign contend that a on revenue will protect patients by channeling profits back into care in clinics that registered more than 1,400 deficiencies in 2016-2017. Yes on 8 is largely supported by SEIU-UHW, the health care workers’ union.

Opponants of Prop 8, including for-profit giants DaVita Kidney Care and Fresenius Medical Care, argue caps will result in payments too low to cover the total costs of providing treatment and will result in clinic closures. Both companies have resisted staff efforts to unionize in the past.

 

3.  Creating places for constructive disagreement in health care

Regardless of what you thought about the outcome of the last few weeks’ Supreme Court hearings, it’s fair to say we’ve gone through an ugly time in our national politics.  Tom Friedman argues “We’ve moved from ‘partisanship,’ which still allowed for political compromises in the end, ‘to tribalism,’ which does not.”

Luckily, for the most part, California politics has stayed more respectable and reasonable than the national discourse. That’s a credit to elected, civic, and media leaders, across the political spectrum.  But moving forward, it’s clear things are getting worse, not better. So, creating spaces for constructive disagreement, where we leave the engagement with a better understanding of one another, is something we must do with intention.  If we don’t create those spaces, they won’t happen on their own.

 

4.  Video: State Senator Holly Mitchell

Senator Holly Mitchell is a member of the California Senate Committee on Health as well as the Chair of the Senate Committee on Budget and Fiscal Review. She joins us in this edition of “What They’re Watching” to discuss voting and civic engagement.

“Anyone who is involved in the health care delivery system in this state has to understand the important role public policy decisions — that are made everyday at the federal, state, and local level — have on their ability to do their job and do it well…You’ve got to engage in these midterms and help your friends and families and coworkers connect the dots between voting and access to critical healthcare services. There is a direct line that connects the two.”

5. Prison receiver announces plan for MAT in California prisons

The federal receiver appointed to oversee California Correctional Health Care Services, announced a plan last week to provide medication assisted treatment (MAT) to inmates in the state prison system. The plan could cost the state upwards of $250 million dollars to provide inmates with counseling and medications in an effort to curb the rising number of prison deaths from overdoses.

In 2014 the prison system began a $15.3 million dollar crackdown on prison contraband in aimed at stemming the flow of drugs into prisons in an effort to reduce drug use and overdoses, but it was criticized for not addressing demand by appropriately treating addicted prisoners. An estimated 80 percent of inmates, or approximately 100,000, are affected by Substance Use Disorder. Of the 100,000 inmates with SUD, approximately 26 percent are dependent on opioids.