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Livermore, California, Measure U, Healthcare Cost Limitations (November 2018)
| Measure U: Livermore Healthcare Cost Limitations |
|---|
|
| The basics |
| Election date: |
| November 6, 2018 |
| Status: |
 Defeated
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| Topic: |
| Local healthcare |
| Related articles |
| Local healthcare on the ballot November 6, 2018 ballot measures in California Alameda County, California ballot measures Local business regulation on the ballot |
| See also |
| Livermore, California |
A measure designed to limit the amount that healthcare providers may charge was on the ballot for Livermore voters in Alameda County, California, on November 6, 2018. It was defeated.
| A yes vote was a vote in favor of limiting healthcare charges to 115 percent of the costs of direct patient care by requiring healthcare providers to supply rebates or cost reductions to those who pay for or are financially responsible for patient services when the predetermined cost is exceeded. |
| A no vote was a vote against limiting healthcare charges to 115 percent of the costs of direct patient care by requiring healthcare providers to supply rebates or cost reductions to those who pay for or are financially responsible for patient services when the predetermined cost is exceeded. |
Election results
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Livermore, California, Measure U, Healthcare Cost Limitations (November 2018) |
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|---|---|---|---|---|
| Result | Votes | Percentage | ||
| Yes | 6,516 | 18.49% | ||
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28,721 | 81.51% | ||
Text of measure
Ballot question
The ballot question was as follows:[1]
| “ |
Shall the measure requiring the City of Livermore to bear the cost of developing and enforcing regulations limiting the amounts for medical services that specified hospitals, medical clinics, dentists, and other health care providers in Livermore may bill patients, or insurers, excluding Medicare and Medicaid, be adopted?[2] |
” |
Impartial analysis
The following impartial analysis of the measure was prepared by the office of the Livermore City Attorney:
| “ |
The measure proposes to limit the costs that medical, dental, and other health care providers in the City of Livermore may charge for patient health care services. The measure purportedly provides for the regulation of hospitals and health facilities, and for investment in health care quality, but it does not contain any such regulations. The measure requires Livermore’s Community Development Department to implement and enforce a program to ensure that health care providers covered by the measure issue a rebate for the amount paid, or reduce the amount billed, for each service provided to a patient in Livermore that exceeds a predetermined amount. For patients with medical insurance, the rebate or reduction will most likely go to the patient’s primary or secondary insurer, or other entity that is financially responsible for paying for the patient’s services. The predetermined amount is defined as 115% of the sum of the cost of “direct patient care,” plus a proportionate share of a provider’s costs for items such as information technologies, training non-managerial personnel, and providing patient-centered education. The measure restricts the City’s ability to determine what costs are included in the predetermined amount. The measure contains two different definitions for “direct patient care.” One definition defines it to mean the provider’s reasonable operating costs, and costs to provide care to patients, in Livermore. The other defines it to mean specific items, including: salaries, wages, and benefits of non-managerial staff; staff training and development; pharmaceuticals and supplies; facility costs; laboratory testing; and, property depreciation. The measure does not indicate whether a cost meeting one definition for “direct patient care” but not the other can be included in the predetermined amount. The measure requires providers to report information to the Community Development Department concerning the services provided to each patient in Livermore, including the predetermined amounts for each service, and the amounts paid or billed. The Community Development Department must make the report available to the public consistent with the California Public Records Act. The City will be responsible for ensuring providers pay a fine for each rebate or reduction that is due but not issued within the specified time. The measure permits the City and individuals to enforce the measure through civil lawsuits, and allows the City to seek misdemeanor criminal prosecution. It also allows the City to revoke a provider’s permits or other licenses, but it is unclear whether those remedies are enforceable. Economic Impact: A City report analyzing the measure’s economic impact estimates the program’s initial costs to be over $750,000, with annual operating costs of approximately $1,900,000. Existing Law: This appears to be the first ordinance of its kind. A lawsuit was filed in the Alameda County Superior Court, City of Livermore v. Dupuis, Case No. RG18911516, seeking a judicial determination whether the City of Livermore has the authority to adopt it. The measure contains a severability clause if any of its provisions are determined to be invalid. This measure is placed on the ballot by a petition signed by the requisite number of voters.[2] |
” |
| —Livermore City Attorney[3] | ||
Full text
The full text of the measure is available here.
Support
Supporters
The following individuals signed the official argument in favor of the measure:[3]
- Olga Hurtado, hospital housekeeping assistant
- Ryan Dinwiddie, hospital materials specialist
- Linda Guthrie, retired early childhood educator
Arguments in favor
Official argument
The following official argument was submitted in favor of the measure:[3]
| “ |
Your YES vote on Measure U will help ensure patients receive quality healthcare that is fair and affordable by prohibiting hospitals from charging patients more than 15% above the actual cost of care and quality improvements. Healthcare costs are skyrocketing. Meanwhile, the owners of ValleyCare Hospital, Stanford Health Care, are making hundreds of millions of dollars in profits every year while being subsidized by taxpayers and sitting on $700 million in reserves. At the same time, some of their hospitals have among the worst records on hospital-acquired conditions, including patient infections, in the state. Here are the facts:
Measure U brings high healthcare costs under control, treating patients fairly and with dignity by ensuring they can’t be gouged for care they desperately need. If Measure U passes, hospitals like ValleyCare can still make a profit while its patients benefit from lower healthcare costs and increased investment in patient care. Measure U also requires healthcare providers who overcharge patients to rebate money paid for healthcare services. As frontline healthcare providers and community leaders, we believe our patients deserve quality care that is safe, fair and affordable. Measure U places a critically needed check on local hospitals that put profits over patient care. Join thousands of patients, healthcare providers and others by voting YES on Measure U.[2] |
” |
Opposition
Opponents
The following individuals signed the official argument against the measure:[3]
- John Marchand, mayor
- Bob Woerner, vice mayor
- Bob Carling, council member
- Bob Coomber, council member
- Steven Spedowfski, council member
Arguments against
Official argument
The following official argument was submitted in opposition to the measure:[3]
| “ |
The proponents of this measure claim that this ordinance will reduce your health care costs. In reality, there is little chance that you will see any savings and it will actually increase city expenses. This measure will require that the City of Livermore create an additional bureaucracy costing the tax payers millions of dollars. A recent study showed that if the measure passed, it would likely result in our community losing many medical service providers. This measure requires that the City of Livermore establish and maintain a new administrative division to gather health care information from providers, determine if all health care providers are meeting their responsibilities, levy fines for those who are not, and then seek to collect those fines. The cost to operate this new burdensome bureaucracy will be significant and could result in the City being forced to reduce critical services that are needed by our community such as police, fire, libraries, and public works. Our local health care providers (such as physicians, dentists, optometrists, etc.) and all the citizens of Livermore are caught in the middle of a contentious labor dispute and are in danger of being irreparably harmed. Please VOTE NO on this measure. (see Economic Impact Report, 9212, on the City’s web site)[2] |
” |
Background
The SEIU-UHW West, a labor union based in California, backed a statewide ballot initiative and two local ballot initiatives designed to limit healthcare costs. Proposition 8, the statewide initiative, would have required dialysis clinics to issue refunds to patients or patients' payers, such as insurance companies, for revenue above 115 percent of the costs of what the initiative termed direct patient care and healthcare improvements. The SEIU-UHW West also proposed ballot initiatives similar to Proposition 8 in Ohio and Arizona, but neither of the initiatives were certified for the ballot.[4]
The two local initiatives were on the ballot in Livermore and Palo Alto. The SEIU-UHW West proposed additional local initiatives in Emeryville, Pleasanton, Redwood City, and Watsonville, but those initiatives did not make the ballot. Both Livermore Measure U and Palo Alto Measure F were designed to limit healthcare charges to 115 percent of the costs of what the initiatives termed the reasonable cost of direct patient care. Proponents aimed to require healthcare providers within the local jurisdictions to provide rebates or cost reductions when billing exceeds the predetermined amount.[5] Stanford University Medical Center (SUMC), the headquarters of Stanford Health, is located in Palo Alto. Branches of Stanford Health are located in four of the five cities where the local initiatives were filed.[6][7]
Proposition 8 was not the first conflict between the SEIU-UHW West and dialysis firms, nor were the local ballot initiatives the first conflict between the labor union and Stanford Health. The SEIU-UHW West said workers at dialysis clinics have been attempting to unionize since 2016, but that their employers were retaliating against pro-union employees. Kathy Fairbanks, a spokesperson for the campaign opposed to Proposition 8, said the union is using the ballot initiative as leverage.[8] Wherley, a spokesperson for the SEIU-UHW West, contended that dialysis workers "want these [initiative] reforms regardless of what happens with their union efforts."[9] The SEIU-UHW West had more than 1,800 members who are employees of SUMC.[10] Other Stanford Health facilities were not unionized workplaces in 2018/ Wherley said the local initiatives are not bargaining chips, saying that the union signed a three-year contract with SUMC in December 2017 and that there was no active organizing at other Stanford Health facilities.[11]
Dave Regan, president of the SEIU-UHW West, discussed the union's initiatives, saying, "Ballot initiatives are an important part of the public policy debate. We believe the system would be better if it produced outcomes that reflect what the majority of Californians and the majority of Americans want, which is less expensive health care that is accessible and high quality."[12] Patients and Caregivers to Protect Dialysis Patients, the committee leading the campaign in opposition to California Proposition 8, said the ballot initiative would result in clinic closures and reduced patient access.[13] Stanford University, which is affiliated with Stanford Health, opposed Livermore Measure U and Palo Alto Measure F, saying the ballot initiatives would lead to the cutback and possible closure of healthcare services and programs.[14]
Path to the ballot
This measure was put on the ballot through a successful initiative petition campaign led by Service Employees International Union (SEIU) - United Healthcare Workers West.[15]
Related measures
Statewide measures
- California Proposition 8, Limits on Dialysis Clinics' Revenue and Required Refunds Initiative (2018)
Local measures
Not on the ballot
See also
External links
Footnotes
- ↑ Alameda County, "Election Information," accessed September 5, 2018
- ↑ 2.0 2.1 2.2 2.3 Note: This text is quoted verbatim from the original source. Any inconsistencies are attributable to the original source.
- ↑ 3.0 3.1 3.2 3.3 3.4 Alameda County, "Measure U Text," accessed September 6, 2018
- ↑ Kaiser Health News, "Patient Advocacy Or Political Ploy? Union, Industry Square Off Over Dialysis Initiative," October 5, 2018
- ↑ East Bay Times, “Livermore sued over city measure for healthcare costs; asks court to rule on legality,” August 10, 2018
- ↑ The Mercury News, "Ballot initiatives in 5 Bay Area cities aim to lower costs at Stanford Health Care facilities," December 19, 2017
- ↑ Palo Alto Business Journal, "Palo Alto ballot measure targeting Stanford hospital's health care costs moves forward," May 23, 2018
- ↑ CAL Matters, "In California, a fight over clinics for kidney patients," May 30, 2018
- ↑ Los Angeles Times, "While dialysis clinic battle brews at state Capitol, healthcare workers look to the ballot," August 9, 2017
- ↑ Becker's Hospital Review, "Healthcare workers buy $882k radio ad to highlight high infection rates at Stanford University Medical Center," March 20, 2018
- ↑ Palo Alto Online, "Opponents gear up for battle over health care," September 14, 2018
- ↑ Politico, "California union leverages ballot initiatives for health care on its own terms," February 5, 2018
- ↑ Patients and Caregivers to Protect Dialysis Patients, "Get the Facts," accessed May 30, 2018
- ↑ Stanford University, "Stanford University statement on Measure F in Palo Alto," September 28, 2018
- ↑ The Independent, "Health Care Initiative Placed on November Ballot," July 26, 2018
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