Americans’ Views on Healthcare

At the root, healthcare is a pocketbook issue. An increasing share of insured Americans report difficulty affording healthcare. Deductibles are rising – growing more than four times faster than wages – and causing worry, especially over unexpected medical bills that ripple families and their budgets.

Drew Altman, President and CEO of the Henry J. Kaiser Family Foundation, provides an analysis of the public’s priorities and opinions in healthcare as the new congress takes shape and the 2020 presidential campaign begins.

Using polling data, he shows that in the midterms, healthcare was a top issue for Democrats and Independents but not for Republicans. The Democrats perceived that the ACA was under threat and rallied behind that issue. That helped propel them to large gains in the House.

Altman predicts that with that new Democratic-majority some of the big moves proposed in the last two years will not happen. These include repeal and replace of the ACA, changing Medicaid to include caps or block grants, and changing Medicare to a voucher system. He further predicts that no major health legislation will be passed at all except perhaps some bipartisan legislation on drugs.

With the huge partisan divide on the ACA – 81% of Democrats approve versus only 17% of Republicans – there are obvious limits to passing any national health care reform, even though generally the public highly values many of the key benefits of the ACA. Simultaneously, public knowledge about what the ACA does is actually spotty. For example, Altman cites polls that show that 41% wrongly believe that the ACA established “death panels.”

As the 2020 presidential election heats up, Altman shows that healthcare will continue to be a big issue with Medicare-for-all perhaps out in front of the others. There are many misconceptions about this kind of plan including the costs and benefits of a single-payer system.

When it comes to Medicaid, sweeping change proposed by the Republicans is unlikely. Polls show that it is generally more well-liked than some people acknowledge, almost as popular as other big programs like Medicare and Social Security, in part because it covers almost 75 million people. There are lurking issues such as work requirements but most Americas want to keep it as it is, affordable insurance for low income people.

Watch The Pulse of the Public on Health Policy and Politics – The Chancellor’s Health Policy Lecture Series

Food Industry Manipulation

Do you want to find out how various food and beverage manufacturers have manipulated science and public health policy over the last 50 years? Now you can with the new searchable archive of food industry documents at the UCSF Industry Documents Library. The Food Industry Documents Archive https://www.industrydocumentslibrary.ucsf.edu/ is a brand-new collection of over 30,000 documents related to the food industry and its impact on public health.

This new archive builds on the long history at UCSF of caring for those suffering from obesity and helps researchers get at the root causes that contribute to the disease. This archive comes at an important time as researchers and policy experts take great strides to address problems of industry influence on our health, food and human rights. Data is powerful in creating change and now documents that the industry wanted secret are safe and available.

Existing archives of Chemical, Drug, and Tobacco Industry collections at UCSF have saved millions of lives. The future research with the Food Industry Documents Archive materials will have a dramatic impact on human health and policy changes.

Find out more about these documents that highlight marketing, research, and policy strategies used by food companies and trade groups, and reveal the communications and connections between industry, academic, and regulatory organizations.

These two programs feature speeches and presentations from the unveiling of the archive.

Watch UCSF’s New Food Industry Documents Archive, Part 1
Watch UCSF’s New Food Industry Documents Archive, Part 2

The Future of Single-Payer Health Care in California

Health care is one of the hottest issues in California politics. Last year, state lawmakers shelved a controversial single-payer bill. So, what’s next? California State Assembly Member David Chiu sat down with Dr. Andrew Bindman at UCSF to discuss the complex realities of health care reform.

Chiu represents the 17th Assembly District, which covers eastern San Francisco. He’s also one of eight members of the Select Committee on Health Care Delivery Systems and Universal Coverage, formed in the wake of the failed single-payer bill. Chiu and his colleagues on the committee have proposed 16 bills aimed at increasing health care access for Californians. But, he says there is still a long way to go to achieve universal coverage.

Just over 93 percent of Californians currently have health insurance. Chiu says getting that number to 100 percent, would cost billions of dollars. Switching all Californians to a single-payer system, would cost an estimated $400 billion a year – $200 billion of that needed from new taxes. And, Chiu says the cost is just one major challenge. There are also legal hurdles, including the need for federal tax waivers, which he calls a non-starter under the current administration. But, that doesn’t mean single-payer is dead in California. Chiu talks about the impact the upcoming election could have, and who he thinks should really be leading the conversation.

Watch The Landscape for Health Care Reform in California

Guns, Obesity, and Opioids

They may not seem related, but Dr. Sandro Galea, Dean of the Boston University School of Public Health, says we can approach guns, obesity and opioids in the same manner: population health. Dr. Galea breaks down the key concepts of population health – a relatively new field – during the inaugural Colloquium on Population Health and Health Equity at the UCSF School of Medicine.

Dr. Galea argues guns, obesity and opioids are the three epidemics of our time, and three of the main reasons life expectancy is declining in the United States. They also share three key characteristics: They are important, costly health concerns. They are complex. They are resistant to simple solutions. The key to overcoming these challenges Dr. Galea says, is using the population health approach.

He lists nine principles of population health, but focuses on four, including the concept that small changes in ubiquitous causes of health problems can have a greater impact than big changes to rare causes. Dr. Galea uses the example that while much has been done to curb the overprescription of opioids, the epidemic continues to grow. That’s because other options, like synthetic opioids, have become more widely available. Dr. Galea says that’s where population health comes in – finding ways to improve health on a large scale, and addressing epidemics from every angle.

Watch Guns, Obesity, and Opioids: A Population Health Science Approach to Contemporary Concerns