Health care

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07/22/10--15:03: SF hospitality workers to protest Hyatt today (chan 1844055)

San Francisco hospitality workers will join hotel employees in 14 other cities across the United States and Canada today, July 22, in a protest and civil disobedience demonstration against the Hyatt Corporation. The action in San Francisco begins at Local 2 Plaza, between 3rd and 4th streets on Market, at 4 p.m. The demonstration will eventually move toward Union Square and the Grand Hyatt San Francisco hotel, organizers said.

<!--break-->More than 1,000 protesters are expected in San Francisco, with approximately 150 prepared to be arrested, hospitality union Unite Here Local 2 spokeswoman Riddhi Mehta told the Guardian. Tens of thousands of hotel workers are anticipated to participate in protests across North America, and more than 1,000 plan to be arrested.

The union is demanding a contract with the Hyatt Corporation that does not unduly burden middle-class workers with health care costs, Mehta said.

“The Hyatt Corporation has repeatedly said they want workers to pay hundreds of dollars per month for family medical,” Mehta told the Guardian. “Workers have sacrificed wages for decades to keep health care, to the point that their average income is $30,000 to $35,000 per year.”

Union hospitality workers have been without a contract in the city for nearly a year, resulting in an organized boycott of eight San Francisco hotels, including the three owned by the Hyatt Corporation. Union leaders criticize Hyatt’s attempts to “lock workers into recession” while the corporation has made windfall profits since the company first offered public sale of stock last November, according to the Hotel Workers Rising website.




12/08/10--16:19: Elizabeth Edwards, breast cancer and the battle for a cure (chan 1844055)



News of Elizabeth Edwards' death quickly went viral

At the Board, supervisors learned about it online, and the rest of us quickly followed suit

When the news hit that Elizabeth Edwards had died at 61, I was sitting in the press box at San Francisco City Hall listening to the supervisors debate the merits of local hire legislation. In fact, I only became aware that Edwards had passed away, because Sup. Michela Alioto-Pier, who was sitting in front of me, was surfing the Internet on her laptop and I happened to see the headline.

The news immediately reminded me, all too powerfully, of the brave fight that my sister-in-law Leila, 47, lost last year after a six-year battle with the disease. She left behind a husband and two young sons, and I always feel a mix of pride at how hard she fought and desperation at how she still wasn't able to win, whenever I remember her long slide towards death last fall.

“I have so much to live for,” Leila often told me, reflecting on how much she loved her husband and sons, how she wanted to finish her novel (which she managed to wrap up in the last months of her life) and how she still wanted to visit so many places and people in the world.

An avid advocate for peace, especially in the Middle East, where her father’s family came from, Leila was not one to give up on a cause, once she had it in her crosshairs. She attacked breast cancer with that same dogged determination. She read everything she could on the topic, changing her diet, modifying her lifestyle, going through chemo and the inevitable loss of her beautiful hair, and, at the end, taking a chance with experimental drugs.

I will never forget her telling me, one gut-wrenching afternoon last September, that the doctors had told her there was nothing more they could do. The disease had gone to her liver, and that she was beginning to feel panic and fear. It wasn't easy to hear that admission, it must have been even harder for her to share it, and it left me hoping that one day, no other woman would ever have to go through this painful battle again.

I wanted Leila to live to see her sons grow up, to enjoy the company of her husband, to write, travel and work for her goal of world peace. But eventually, it became clear that she was not going to make it. When her death finally came, last October, I felt relief that she was no longer suffering, even as I shed tears for her, her family, and all the folks in the world who are going through similar battles.

So, when I got home last night, I immediately went online and wallowed in the huge wave of grief that Edwards' death evoked as a symbol of the millions of women who live with and die from cancer worldwide.

Some noted that Edwards had not been conducting regular check ups when she found a lump in her breast (an uncomfortable reminder to all of us who haven't got a check up recently). Others observed that her diagnosis likely fueled her passion for universal health care and helped the passage of Obamacare (a more welcome reminder that despite all the criticisms of Obama, he has pushed through monumental reforms that many will benefit from).

Some wrote about the ever-present fear for survivors that the cancer could come back, and how this awareness had  served to make them more fully appreciate every moment that they do have. Others pointed to the grim reality that even with access to great doctors, advanced treatment options and money, Edwards still could not prevail, because a cure has still not been found.

I’ll end this tribute to Edwards, my sister-in-law, and all the women who have struggled with this terrible disease with a message that landed in my inbox Dec. 7 from California’s First Lady Maria Shriver:

"I was deeply saddened to learn of the passing of my dear friend, Elizabeth Edwards,” Shriver wrote. “My heart goes out to her loving family. Elizabeth was a mighty warrior, and I've long admired her courage, her compassion and her personal quest for truth. She was a public servant, a dedicated mother, a tireless advocate and a loyal friend. She showed up to speak at The Women's Conference every time I asked, and our audience was always moved by the open and honest way she would share the struggles she faced along her journey. I hope her children know their mother was an inspiration to women everywhere -- a truly great woman."

And I'll add my hope that this nation will intensify its search for a cure for a disease that is the second leading cause of cancer deaths in women today (after lung cancer) and the most common cancer among women, excluding nonmelanoma skin cancers. According to the American Cancer Society, 1.3 million women will be diagnosed with breast cancer annually worldwide, 465,000 will die from the disease, and about 1 in 35 women die from breast cancer in the U.S. Scary? Yes. Curable? Hell, yeah (I hope and pray). Let's just make sure it remains a national priority.




06/09/11--13:27: Campos plans to plug loophole in SF health care law (chan 1844055)



Back in 2006, when Tom Ammiano was a supervisor, the Board approved his trailblazing San Francisco Health Care Security Ordinance (HCSO).  But the Golden Gate Restaurant Association, which presumably prefers you get served by folks who don’t have health insurance (“Waiter, there’s a booger in my soup!”) sued the city over the program. GRRA was hoping to invalidate the employer spending requirements of the City's ordinance on the grounds that it violated the federal Employee Retirement Income Security Act. And in its quest, GGRA, which represents restaurants statewide and was concerned that Ammiano’s citywide legislation would spread to other municipalities, tried to take its case all the way to the U.S. Supreme Court. But in June 2010, the "Supremes" denied review to GGRA’s legal challenge, ending a contentious four-year legal battle over "Healthy San Francisco." Or so everybody thought.But according to Sup. David Campos, who succeeded Ammiano as D9 supervisor and champion of the city’s health care legislation, some employers have been exploiting a loophole in the HCSo legislation to avoid their obligations under the law. And Campos now plans to stick a cork in this loophole.<!--break-->

Since 2008, HCSO has mandated that private businesses with 20 or more employees make minimum health care expenditures to, or on behalf of, their covered employees each quarter. But instead of paying for health insurance or paying into Healthy San Francisco (which provides workers with free or reduced-cost enrollment) some employers allocated money on paper to an account workers can access to reimburse out-of-pocket medical expenses.

“The problem is that most of these accounts are set up with ‘use-it-or-lose it’ provisions, “ a press release from Campos’ office explains. “The employers are credited with making the expenditures, but the balances in the accounts are wiped-out at the end of every year (or when the worker quits or gets fired) and the employers keep the money.” Oops.

So, Campos is introducing an amendment to the HCSO that would close what he's calling a “don’t get sick in January” loophole (when employers zero-out the account balance at the end of the year, their employees begin the next year without any money available to reimburse health care costs). 

According to Campos, only 20 percent of the $62 million allocated to such reimbursement plans last year was actually reimbursed to the employees.“This means that $50 million, or 80 percent, of the health care expenditure was not spent on employee health care,” Campos stated. “Moreover, employers that meet the spending requirement via use-it-or-lose-it reimbursement accounts have a financial incentive to limit their use (in order to retain more funds at the end of the year).”

Campos’ office cites the words of auto mechanic Ron (who prefers not to use his last name for fear of retaliation by his employer) to explain this problem.

 “My employer provides me and my co-workers with a use-it-or-lose-it reimbursement account to satisfy part of its spending requirement under the Health Care Security Ordinance,” Ron stated. “But the employer does not allow us to use the money to pay for health insurance premiums and has limited the services eligible for reimbursement to such an extent that it is difficult to make good use of the account. As a result, we use a small portion of the money and lose the rest every year.  I finally decided to join Kaiser as a dependent of my wife who is a city employee.” 
 
Campos' proposed amendment would close the loophole by re-affirming the traditional understanding of a "health care expenditure.": employers will not be credited with making mandatory health care expenditures unless the expenditure is "irrevocably paid" (the money carries over from quarter to quarter and year to year to the employee.)

Campos’ proposed legislation also requires employers to provide written notice to their employees explaining how they are meeting their health care expenditure, and it streamlines penalties for noncompliant employers.

Zazie restaurant owner Jennifer Piallat says she supports the amendment because it “levels the playing field” for the vast majority of businesses in San Francisco that provide health insurance to their employees.

“A loophole should not disadvantage those of us who agree with the spirit of the Health Care Security Ordinance and who believe that employers should contribute to the well being of our employees,” Piallat stated.

Whether this loophole means that restaurants that were allegedly adding up to 4 percent in surcharges to customers’ bill to cover the alleged cost of paying contributions to their employees’ healthcare costs, have been pocketing the difference remains to be seen. An HCSO analysis by the city’s Office of Labor Standards Enforcement notes that the city’s Treasurer and Tax Collector did not collect industry data from businesses in 2009 and 2010, and therefore expenditures by industry are not available for those years.

But i industry data from 2008 shows that the “accommodations and food services” industry (think hotels and restaurants) “elected reimbursement plans as their primary expenditure at a substantially higher rate than any other industry in 2008," the OLSE report states. (A table atttached to OLSE's report shows that this rate was 47 percent in 2008—which was 36 percent more than the next highest ranking industry group listed.)

OLSE’s analysis also reveals that in 2010, 90 percent of all health care dollars were spent on health insurance, 3 percent were spent on Healthy San Francisco (the health access program San Francisco established as an option within HCSO) and only & percent were allocated to reimbursement plans. So, in other words, in 2010, most employers were doing the right thing by their employees, at least in terms of making required health care expenditures.

“The average reimbursement rate of money allocated to reimbursement plans in 2010 was low: only 20 percent of the $62.5 million allocated to such plans in 2010 was actually reimbursed to employees,” states the executive summary of OLSE’s analysis. “The remaining 80 percent, or $50.1 million, went unutilized. The median reimbursement rate for the 29 percent of employers (860 in total) that allocated money to a reimbursement plan in 2010 was even lower, just 12 percent.

OLSE’s report notes that this low utilization rate of reimbursement dollars is consistent with prior years.
“For example, in each of the past three years, over 50 percent of such plans (53 percent in 2008, 52 percent in 2009, and 57 percent in 2010) had a reimbursement rate of between 0 and 10 percent,” OLSE observed. “In other words, more than half of the employers who elected to meet their health care expenditure requirement (entirely or in part) by providing reimbursement plans retained over 90 percent of the money allocated to reimbursement plans. The increase in the percentage of employers utilizing reimbursement plans coupled with continued low reimbursement rates raises public policy concerns.”

Campos will be holding a press conference tomorrow (Friday June 10) at 11.30 a.m. in his office (Room 279 in City Hall) to flesh out the gory details. He’ll be joined by Tim Paulson, Executive Director of the Labor Council; Jennifer Piallat, owner of Zazie; Ron, auto mechanic; Tiffany Crain, Young Workers United; and Matt Goldberg, from the city’s Office of Labor Standards Enforcement.
 




09/22/11--15:37: SF restaurants cheat on health care (chan 1844055)



For years, I've wondered about those "health-care surcharges" that pop up on menus at local restaurants. The owners say they have to charge extra to pay for the city's health-care ordinance, which always struck me as odd: You don't see "avocado price hike surcharge" or "rent-went-up" surcharge or "PG&E rate hike" surcharge -- restaurants, like other businesses, typically roll those factors into their normal prices.

This is political: A lot of restaurants opposed the law, which requires employers to pay for health insurance, and they're sticking that little sign out there to make San Franciscans think the government is driving up the price of a meal.

Now: I would actually be willing to pay an extra 3 percent or even 5 percent for a nice dinner if I thought that money was going to make sure the cooks and waiters and bus staff could go to the doctor when they get sick. But it turns out, according to the Wall Street Journal, that we're getting scammed -- the surcharges often don't go for health care at all. The restaurants just pocket the money.

In an investigation of 40 local restaurants -- most of them high-end places where dinner for two can cost $100 or more -- the Journal found that the vast majority of the money collected for health care never goes to the employees:

One Market, which says its annual revenue exceeds $5 million, is one of at least 40 San Francisco restaurants identified by The Wall Street Journal that tell customers they are charging extra in the name of health-care benefits, but which end up spending less than a third of what they allocate. The data come from forms that restaurants filed with the city, which the Journal obtained under California's public records law. No restaurant mentioned in this article disputed the data.

Wayfare Tavern, the downtown restaurant owned by celebrity chef Tyler Florence, says on its menu that it adds 3.5% to every bill to cover health-care costs. Last year, it earmarked $63,724 for health care but only spent $6,013, the city data show. Café Flore, which adds 35 cents to every bill in the name of health care, spent nothing on health expenses for its employees last year. Trademark, which has a 3.5% surcharge, also spent nothing on employee health expenses last year, the data show.

Worse, this appears to be an intentional way to skirt the law:

In most cases, the plans are administered by a third party. Some of these companies tout how HRAs are a loophole around the San Francisco Heath Care Ordinance. "If the funds are not needed (And many are not!!!) the employer wins because the unused funds stay with them…not the City," says a brochure from BeneFlex HR Resources Inc.

BeneFlex ensures restaurants inform workers about the HRA to "make sure it's handled the way it's supposed to," says Mark Schmersahl, the firm's vice president. Still, he says, "There are going to be times when the employer comes out ahead."

I recognize that the city puts a lot of demands on small business, and a lot of them are expensive -- and again, if a restaurant owner has to raise prices a few percentage points to pay for health insurance, I'll pay -- that's the price of eating out in San Francisco.

But this isn't how the health-care law was supposed to work -- and it's the reason Sup. David Campos is trying to change it. Campos has a bill that would stop employers from keeping money that was supposed to go for health care. "It's also a consumer-protection law," Campos told me. "People are being defrauded here."




09/29/11--13:57: Progressives battle downtown over economic and political reforms (chan 1844055)



A four-alarm fire that displaced 31 residents of an apartment building at Fillmore and Haight helped create a political drama.

James Miller

Battles between progressive members of the Board of Supervisors and downtown power brokers such as the San Francisco Chamber of Commerce defined City Hall politics for much of the last decade, until the new politics of “civility” and compromise took hold this year, a dynamic that has favored downtown interests. But now, a pair of important, high-profile issues headed to the full board on Tuesday has revived the old dynamic. And in both cases, wealthy interests are putting enormous pressure on the board.

The first involves a proposal – put forward by Sups. Sean Elsbernd and Mark Farrell, the two most conservative supervisors – to gut the city's system for publicly financing campaigns because downtown is threatening a lawsuit. They propose to end San Francisco's program of giving publicly financed candidates more money when a privately funded candidate exceeds the spending cap because the Supreme Court recently struck down similar provisions in Arizona.

This week, after convening in closed session to discuss the threat of litigation by downtown groups, the board voted 7-3 – with Sups. David Campos, Jane Kim, and Eric Mar opposed, and Sup. Ross Mirkarimi absent because he rushed out to large structure fire in his district – for the Elsbernd/Farrell measure, one vote short of the supermajority needed to amend the current city law.

Campaign finance reform advocates such as Steven Hill argue that it's unfair to modify the city program right in the middle of an election season in which Mayor Ed Lee and the wealthy independent expenditure groups supporting him are poised to spend millions of dollars to defeat a large field of mostly publicly funded mayoral candidates.

Hill and his allies are appealing to Mirkarimi – who told the Chronicle that he is leaning toward supporting the amendment when the measure returns to the board on Tuesday – not to support what they consider an overly broad capitulation to downtown's threats. They're also lobbying Sup. John Avalos to switch his vote, while downtown players are putting the screws to supervisors as well.

In an interview with the Guardian, Mirkarimi clarified his stance, noting that he was the sponsor of the original public financing law and his goal is to protect it, even if it needs to be modified to withstand a legal challenge. “I'm looking for alternatives to fortify San Francisco's program,” he told us, noting that he missed some of this week's discussion and he's hoping something can be done to retain provisions that level the financial playing field with wealthy candidates.

Meanwhile, downtown forces are pulling out the stops to kill Sup. David Campos' legislation that would prevent San Francisco businesses from pocketing money they set aside for their employees' health care under a city mandate that they provide health coverage – totaling about $50 million last year – legislation that gets its first hearing tomorrow (Friday/30) at 10 am.

Board President David Chiu has put forward competing legislation that is more to the Chamber's liking, letting businesses (mostly restaurants that are even placing surcharges of customers' bills, ostensibly to subsidize their legal obligations) keep the money. But Campos and his labor allies believe they have the six votes they need to pass the legislation, thanks largely to moderate Sup. Malia Cohen's pledge to support the measure.

While even some supporters have quibbled with the timing of this measure, Campos notes the urgency of keeping money intended for workers in their hands. “It's an outrage and the longer we wait, the worse it gets,” Campos tells us, noting that the practice, “is what many of us consider fraud.”

Unfortunately, even if the board approves the measure this Tuesday, it will still need the signature of Mayor Lee to become law. While he hasn't formally taken a position, given that his political base is the downtown crowd, he's expected to veto the measure. But we'll ask him about it tomorrow when he's scheduled to meet with the Guardian for an endorsement interview at 2 pm.