THIS TIME ON CODE WACK!
Can California’s new Office of Health Care Affordability stem the rising tide of healthcare inflation? Are similar efforts to rein in healthcare costs happening in other states? And what does the creation of the Office mean about the chance for single-payer, Medicare for All in the Golden State?
To find out we spoke to Ian Lewis, the policy director for Unite Here Local 2, a union of over 15,000 hospitality workers in the San Francisco Bay Area. Ian previously served as a research director for the National Union of Healthcare Workers and is a board member of California’s Office of Health Care Affordability established in 2022. This is the second episode in a two-part series.
SHOW NOTES
WE DISCUSS
The Office of Health Care Affordability regularly hosts public hearings. What are you hearing?
“… we’ve heard from patients who have driven, you know, an hour and a half away to get basic health services at Stanford Hospital because it is cheaper than the hospitals in Monterey [where they live] and you can’t help but hear those stories – and the personal struggle that it puts people through – and not recognize what a real problem we have. ” – Ian Lewis
Do you think the Office has the power to meaningfully affect the health insurance market? In other words, can we regulate our way out of our inequitable and unaffordable healthcare system?
“Whether we can regulate our way out of the affordability crisis, I don’t know. I have my doubts. But certainly this office has a great deal more power and enforcement authority than its peers in Massachusetts or Oregon or some of the other states that have set up similar bodies so we are making the road by walking ….
“But we can’t let the perfect be the enemy of the good here. There really is a severe crisis facing our state. And I’m optimistic that we’re going to at least bend the curve. ”– Ian Lewis
Studies have shown that single-payer systems can keep healthcare costs down while offering universal affordable coverage. Can you briefly and simply explain how?
“This is a passion of mine. My family comes from countries that have had single-payer health systems for the better part of 75 years. I think at the core of it, there are two key features of a single-payer system that keep costs down. One is the simplification of the healthcare market. Instead of having thousands of purchasers piecing together funds to pay for people’s health care, you have one purchaser, which is the state or the government.
“And secondly, the decisions that go into how much we’re going to spend, and how much we’re going to pay for services are made by people who are accountable to democratically elected representatives instead of insurance companies.
“You know, a lot of critics of single-payer health systems claim that they lead to waiting lists and withheld care and inferior quality care and yet we have abundant waiting lists in this country waiting for care. We have poor quality care because the money isn’t being used in the best way and we have poorer outcomes than other countries. People see doctors less here than they do in Europe, and they live less here than they do in Europe.” – Ian Lewis
Helpful Links
California Office of Health Care Affordability (OHCA)
Massachusetts Health Policy Commission (HPC)
Oregon Health Policy Board (OHPB)
CBO Publishes New Health Insurance Coverage Projections for 2023 to 2033, Congressional Budget Office
Newsom signs unified healthcare financing bill SB 770 into law, State of Reform
Episode Transcript
Read the full episode transcript.
Biography: Ian Lewis
Ian Lewis is the Policy Director for Unite Here Local 2, a union of over 15,000 hospitality workers in San Francisco, San Mateo County, and the East and North Bay. He has previously served as the Research Director for the National Union of Healthcare Workers where he directed research and political staff to support policy initiatives, collective bargaining, and electoral efforts including policy research & advocacy, health industry corporate analysis, quantitative support for collective bargaining with health employers, and organizing community and political relationships. Lewis is a trustee of a multi-employer health benefits fund covering thousands of participants in the San Francisco Bay Area.
Lewis is appointed to the Health Care Affordability Board by the Speaker of the California Assembly, Anthony Rendon, required by The Office of Health Care Affordability’s enabling statute (SB 184, Chapter 47, Statutes of 2022).
Lewis has been in the labor movement for twenty-five years, much of that time making the best of a broken health care system for low wage workers. Prior to joining the National Union of Healthcare Workers, Lewis was the Research Director for Unite Here Local 2 coordinating political and community activities for collective bargaining and legislative efforts. Lewis’ experience includes bargaining for health benefits in both the US and Canada, administration of not-for-profit health funds, as well as regulatory and legislative strategies. He has been closely involved in legislative efforts to expand transparency of large group health plan pricing, and to advance the work of the Healthy California for All Commission.
Lewis has a bachelor’s degree in Government and Africana studies from Cornell University.
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