San Francisco has a true “public option”

The following is a transcript of an interview between radio talk show host Thom Hartmann and San Francisco mayor Gavin Newsom from July 30. The first part is about San Francisco’s adoption of a true “public option” and its fallout. They go on to talk about California’s budget crisis – I transcribed the whole interview because it was so interesting, but am focused on the part about the public option, which is relatively brief.

TH: Gavin Newsom is with us, the mayor of San Francisco … the website for the San Francisco government SFgov.org. I’ve often about how San Francisco, one of the first cities in the country – major cities in the country – to have instant runoff voting. It’s a shining city on the hill. You also are, if I have this right, the first city in the country to have a genuine public plan.

GN: We have a public option. Imagine that, Thom. The sky has not fallen in, the world did not come to an end, bureaucracy has not run amok and we have not replaced our beautiful American flag with the Canadian flag in San Francisco. We have a public option that’s providing real choice, and more importantly, competition. We have not raised general taxes, people will have real choice within that plan, and it’s making a difference for at least 75% of those San Franciscans that years ago had no basic health care and now are fully enrolled in this universal health care plan.

TH: That’s remarkable, and it’s working well for you in San Francisco?

GN: I mean – objective minds – we just did an analysis that showed that we’re providing comprehensive quality health care regardless of preexisting conditions, and dare I say this, regardless of your immigration status, and I recognize the controversy around that, but those are the facts …

TH: It won’t play well in Orange County…

GN: No, it doesn’t. I was just down there coincidentally yesterday, but we’re providing it for roughly $279, the equivalent of $279 a month. If you had the ability to go out and find insurance, and you had no preexisting conditions, the least expensive plan we can find out there that provides equivalent care is north of $380. And for a real plan, that’s more comprehensive, a Blue Cross-type plan, it’s over $619. So we’re providing something that provides the same quality care with the same public/private choice, within this public option for substantially less money, reducing, ultimately, the cost to the taxpayers and putting pressure on the insurance companies – so much so, Thom, that Kaiser, one of the largest HMO’s in the country, has joined our public plan on July 1 and now are partnering with San Francisco’s public option.

TH: That’s great. In fact, Kaiser started in San Francisco, didn’t it?

GN: And that’s why we hoped that we could get them, but it took them two years to really analyze it, and I think fundamentally they realized that if they didn’t enroll in this plan, the competitive nature of the plan was such that they would start losing customers. And this is the big idea. That’s why it’s absolutely right and principled, especially if you’re a free marketer and believe that we need to create competition with some of these larger private sector entities – that we’ve got to hold them honest and we’ve got to being down the cost of care is we believe in reform. That’s why it’s so important that this public option remain in the national debate.

TH: Gavin Newsom, you’re looking at the governor’s seat in California …

GN: Yes.

TH: If my understanding is correct, the governor has twice vetoed a single payer system or public option or some variation – something in between the two in the state of California. What are your thoughts about where California’s at – we’re all hearing about the budget crisis, Arnold Schwarzenegger just signed a new budget on the backs of basically poor and the mentally ill and the sick and the homeless, and his popularity rating is down now 28% I read in a poll this morning. And what are your thoughts on the crisis were facing, the genesis of that crisis, and what you would do to solve it?

GN: Well, we’ve had a structural problem in this state for decades. If you think about the last twenty years, even before the current budget crisis, twelve of those twenty years we’ve had huge budget deficits. And in those years when we had surpluses, they were only modest. So we have a structural problem. We’ve gone through the defense boom-bust in the 1980’s, the boom-bust in the 1990’s with high tech, and now the boom-bust combined with this macroeconomic meltdown in the financial markets that really is part of the challenge we face today. But in each and every instance, we’ve come out of it, but only to realize, and I hope now rationalize, the structural inadequacy of our system. And that’s why we need real fundamental reform, and that’s not just a trite political throw-away line, but substantive reform. The question of Prop 13 is a question more and more people are asking about – the idea that you need two-thirds of the voters to get a budget passed, but you only need fifty per cent of the folks to change the constitution to take people’s rights away, is in and of itself an issue that people need to address. Only Rhode Island, and interestingly Arkansas, has a two-thirds budget requirement, and that’s exactly why you can’t get a budget deal done in California.

TH: We do in Oregon if it involves tax increases. This was again put on by a bunch of right wingers a couple of years ago with a ballot initiative.

GN: And that’s another problem. We have these initiatives, and the folks with the big money can almost put anything on. The constitution, in the last 130 years, has been changed over 500 times. The U.S. constitution, in its [224] years has only been changed about 27 times. Our constitution is eight times longer than the U.S. constitution. And so, again, when we talk about the need for reform, we can start right there, and the idea of this constitutional convention is getting a lot of attention. The concern is, what does that mean, and who are the players that get involved in that, and that’s the devil that needs to be advanced in the detail.

TH: This is why, whenever anybody talks about a Federal constitutional convention, I say wait, whoa whoa!, let’s first get the corporate personhood thing out of the way, because there’s some very big players who would say we want to sit at the table. For example, when South Africa wrote their first post-apartheid constitution, three very large American corporations volunteered their legal staffs to go over there. And written right into the constitution is that corporations are persons and have full civil rights. Right into their constitution. It’s just absolutely bizarre. And so we’ve got to be careful …

GN: I couldn’t agree more. And the reason people are talking about it is just the absence of any ability to rationalize any reforms. Even in the margins, every single reform initiative, even good or bad … have also been just defeated or rejected. And I feel that the voters now are feeling defeated and rejected. You noted the governor’s latest cuts. I mean these are … when we talk about draconian cuts – I think people listening really need to understand what the governor of California did. In this budget deal, he talked of eliminating Healthy Families, meaning health insurance to every child in the state – the first state in the nation that would have done that. He called to eliminate Calworks, our welfare in the state – just not cut it by fifty or ninety per cent, but eliminate it. That was fought back by the Democrats, but not a hundred percent of the way, and just two days ago, he line-itemed out more cuts to children’s health care, more cuts to welfare, beyond the cuts that were agreed to in this negotiation.

It’s serous. It’s real. And those folks, human beings, are ending up in cities and counties across the state. It’s an unfunded responsibility to do the right thing, and we’ll do it in San Francisco, but it puts extraordinary pressure on the local level, and that’s why we need real change up in Sacramento.

TH: And that’s the problem. The problem is when the state fails to deal with it, then it falls to the local communities and the local neighborhoods start falling apart

GN: You got it. And that’s the reason this health care reform is so important. It’s not the federal government and the states – it’s your neighborhood community clinics that are mostly impacted. We really need a voice of the cities now in this health care debate.