February 14, 2005

The Feb. 9 Health Benefits Forum was a big success. Elected officials and senior managers from more than a dozen local jurisdictions participated, including the County of Santa Clara, the cities of Palo Alto, Redwood City, Saratoga, Sunnyvale, Los Altos, Los Altos Hills, Santa Clara, as well as representatives from Cabrillo College, City College of San Francisco, West Valley-Mission College, and the Sunnyvale School District. Elected or appointed officials from the following agencies also joined us: the California Medical Board, SEIU, the Palo Alto Firefighters, the office of state Senator Joe Simitian, the office of Assemblywoman Rebecca Cohn, the office of San Jose City Councilmember Linda Lezotte, and the 6th District PTA. I hope everyone else who was there will forgive me for leaving them out!

The presentations and panel discussions were lively and informative. My co-moderator, Los Altos Hills councilman and VTA Advisory Board member Breene Kerr, arranged to have D.R. & Associates videotape most of the proceedings. I understand arrangements are being made to make highlights available on the web shortly.

One of the key presentations came from Sally Covington, director of the California Works Foundation, which is a project of the California Labor Federation. Covington outlined an ambitious plan to form statewide civic coalitions to help local government agencies combine their purchasing power in order to obtain better deals on health care insurance for their employees. Several specific strategies to accomplish this objective were discussed. Here is an excerpt from her email to me on the general goals of her group:

"The members of our coalition purchase health services for about 500,000
beneficiaries in Northern California, including school employees, grocery
clerks, carpenters, tower crane operators, and other workers employed in a
mix of industries. We are eager to participate in broader public forums
that focus on the adverse impact of rising health care costs on public
health and finance systems, workers' wages, health care access, and health
care quality. We are also eager to disseminate information about the
Coalition's basic strategy -- namely, to organize major public and private
purchasers to get behind a set of common demands, or performance standards,
aimed at improving the transparency and accountability of the health care

One of the other highlights was a presentation from Dr. Peter Boland, a leading healthcare industry consultant, author and speaker. Boland provided a ten-point outline of the major challenges confronting the health care system and those who depend on it. He favored the idea of creating local civic coalitions to press for positive change in the health care system but strongly urged our group to also include health care providers (as in physicians, physician groups, and hospitals) in the discussions.

Many of those present were interested in exploring the idea of forming a local health care benefits civic coalition. I'll be meeting shortly with Los Altos Councilmember Breene Kerr, Foothill-De Anza Chancellor Martha Kanter and De Anza College President Brian Murphy to determine how we can best support that effort. We'll also be working closely with Santa Clara County Supervisor Jim Beall, who spoke at the event and volunteered to help with the effort. Stay tuned. This could get interesting.

Earlier this month, County Supervisor Jim Beall and I sent written invitations to the leadership of every public agency in our County, including cities, school districts and special districts inviting them to designate a representative to attend the initial organizing meeting of the Santa Clara County Health Benefits Coalition, the need for which was first discussed earlier this year. The meeting will take place Friday, January 6, 2006 from 2:00 to 4:00PM in the Kirsch Environmental Studies Building at De Anza College in Cupertino. De Anza College President Dr. Brian Murphy will be the facilitator of the meeting.

Here is what Jim and I hope we can accomplish:

First, we are hoping we can get attendees to agree to take a resolution back to their public agencies for approval asap. The resolution indicates their public agencies' support and intent to participate in the Health Benefits Coalition and conveys a willingness on the part of their agency to contribute a modest sum of money, based on a sliding scale, to a coordinating local non-profit organization to be identified later the proceeds of which will be used to hire a qualified grant writer to solicit grants for a two-year Health Benefits Coalition regional pilot project. Second, we hope to get attendees to agree to a mission statement for the Health Benefits Coalition. There will also be presentations from others who are working to increase quality and lower costs connected to providing health care benefits to local public employees. We will also get information about the benefits of linking this local coalition with one currently operating at the state level.

Personally, one of my biggest initial hopes for this local coalition, if we can in fact bring it together, will be to press local health care providers to post the prices they charge for the most common medical procedures on their web sites in a common format. This approach has worked, meaning it has helped drive down or contain prices, in other areas. The reform is similar to the consumer protection laws put in place decades ago that require the operators of gas stations to post their prices in a common format that everyone can see. That law helped create price competition in the retail gasoline industry, which, up until then, was free to charge different prices to different customers, who often learned the cost only after the fuel was pumped. The same practices currently apply in the health care industry. And they will go on until and unless the consumers of those services band together to demand greater degrees of openness and transparency in the billing procedures for medical services. That is something no city or other public agency can hope to accomplish on its own. But, working together regionally, we might just be able to make it happen.

February 03, 2005

I am one of the organizers of an upcoming free public forum at Foothill College in Los Altos Hills (February 9, 1-4:30PM, in Appreciation Hall) that is designed to bring local government decision-makers and health care industry experts together to explore the question of how we can keep health care benefits affordable for public sector employees.

Paying for health care benefits for government employees is one of the biggest challenges faced by local elected officials. Public agency budgets have not kept pace with health care premium increases, which have been going up by double-digits for years. Frequently, this leaves local elected officials with limited options: cut benefits and/or increase the fees paid by employees, or layoff employees, which reduces the level and quality of public services. Quite obviously, local elected officials can't keep raising fees for public employee health care insurance, cutting benefits and reducing services indefinitely.

We've organized the Feb. 9 forum in hopes of shining a spotlight on this problem, sharing ideas, and increasing collaboration at the local level.

The target participants are local elected officials, benefits managers at local public agencies, and experts in health care and insurance best practices. Confirmed speakers include experts in all these areas.

Here is the official press release annoucing the event. Members of the general public are also welcome to attend. I hope to see you there.