News


Spending soars on health care ballot measure

Each side raises millions to promote its position on Measure F

The two sides in the battle over Measure F, which would cap how much Palo Alto medical practitioners can charge their patients, have collectively spent more than $7.3 million to spread their messages both here and in Livermore, where a similar measure is also going to the voters, according to campaign-finance documents.

The eye-popping numbers underscore the high-stakes nature of the contest and the regional scope of the measure, which is being spearheaded by the Service Employees International Union-United Health Workers West and which is facing stiff resistance from Stanford Health Care and other area hospitals. As of Oct. 20, the union's campaign committee had spent $2.4 million in support of Measure F and Measure U (the Livermore measure). The hospitals, for their part, have spent $4.9 million as of Oct. 20 to combat the two measures.

Titled the "Palo Alto Accountable and Affordable Health Care Initiative," Measure F would cap how much most local health care providers can charge patients and insurers for medical care. It would limit their charges to no more than 115 percent of the "reasonable cost of direct patient care" and would put the city in charge of regulating the new provisions.

Measure F's sponsor, SEIU-UHW, has argued that the measure is necessary to combat Stanford Health System's high costs and to ensure that Stanford invests money in patient care and addresses its high hospital-infection rate. Measure F, they say, would improve accountability and lower health care costs.

Stanford has argued that the measure would accomplish nothing of that sort. Instead, it would punish medical practitioners by requiring them to meet a narrow definition of "reasonable costs" that does not include necessary components like the salaries of managers and supervisors, audit fees, travel expenses and other expenditures that hospitals need to make.

Opponents also note that while the "Yes on F" campaign focuses on Stanford, the measure would apply to many other medical practitioners, most of whom have no affiliation with Stanford (it does exempt children's hospitals, dialysis clinics, Department of Veterans Affairs clinics and several other categories of medical providers).

As such, several major medical providers have made six-digit contributions to fight the measure. As of Oct. 20, Stanford Health had kicked in $888,474 to oppose the measure; Kaiser Permanente had contributed $381,850; Sutter Health had chipped in $248,000; and John Muir Health, based in Walnut Creek, had contributed $240,000.

The biggest funder of the "No of F" campaign is the California Association of Hospitals and Health Systems, which contributed $3.55 million through the California Hospitals Committee on Issues, which focuses on ballot initiatives that affect area hospitals.

The amount of money being spent by each campaign is highly unusual for local measures, which typically get a few thousand dollars in contributions. Palo Alto's only other measure, Measure E, which would raise the city's hotel-tax rate from 14 percent to 15.5 percent, doesn't have any committees raising money in its support. The "No on E" campaign, meanwhile, has received a single contribution: $5,000 from Cardinal Hotel.

• For complete 2018 election information, check out our voters' guide.

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Editor's note: This story had an incorrect amount for how much Service Employees International Union-United Health Workers West's campaign committee spent in support of Measure F and Measure U. Palo Alto Online regrets the error.

Comments

31 people like this
Posted by Citizen
a resident of Another Palo Alto neighborhood
on Oct 31, 2018 at 6:05 pm

I was going to vote Yes on this because I think it's likely to fail and I just want to send a message to Stanford. However, I'm just as annoyed at the people who put this on the ballot.

Read TR Reid's The Healing of America -- we can't fix our cost problems so long as our system uses for-profit health insurers. It's no coincidence that we are the only advanced nation on earth without universal affordable health care and that allows for-profit insurance.

Many other nations still use private (non-profit) health insurers (NOT single payer), and allow for-profit CARE, yet they still cover everyone and for far less money than we spend per capita here, but no other first-world nation allows for-profit insurance. It doesn't work, because the insurers have a perverse incentive to maximize their control of a larger health care economy (hence the large administrative costs) in order to maximize profits. In other words, their incentives are to allow an expensive system that they control to best extract their profits. But this is not to save our system money, because they profit as a percentage of the healthcare economy. The denials come from the need for control to maximize profits, NOT to save the rest of us money.

I don't think we can control costs on the backs of patients or their providers. Until we address the problems that this nation uniquely has in the health insurance industry because of for-profit health insurers (that still cause a major percentage of health costs in healthcare administration for the abovesaid control), we will not be able to improve our system.

Thus, I reluctantly vote NO on Measure F (even though the ad with Mayor Liz Kniss makes me want to vote Yes -- what should the City government be doing exceptserving residents health and safety? Being lapdogs for developers?)


4 people like this
Posted by george drysdale
a resident of Professorville
on Oct 31, 2018 at 6:08 pm

Medical expenses are a major key to the economy. Medical expenses for the elderly are pushing all other items off the balance sheet. Medical expenses will tax the creativity of everybody. However, knowledge is exploding, can it move fast enough to prevent a Malthusian nightmare?

Geroge Drysdale economist


41 people like this
Posted by wasted money to insurers
a resident of Green Acres
on Oct 31, 2018 at 6:18 pm

"we can't fix our cost problems so long as our system uses for-profit health insurers"

Yup. We have the most EXPENSIVE healthcare costs in the world - the most expensive system money can buy.

- for-profit health insurers add 30-40% to total costs

- single payer (Medicare) add 3-4% to total costs

- socialized medicine (government owned, ie.. the VA) adds ~1% to total costs


21 people like this
Posted by Citizen
a resident of Another Palo Alto neighborhood
on Oct 31, 2018 at 7:19 pm

@wasted money to insurers,
Very good points. I do think single-payer in such a large divided nation is probably not going to get the best results. There are many countries around the globe that have universal affordable healthcare with private non-profit insurers, such as Germany (which is probably the next closest to our nation for comparison) and Japan.

I think single-payer suffers from lack of choice, because choice is a means of quality control at the level of every interaction. It turns out that healthcare that gets the best outcomes, per patients' judgment, is actually the cheapest, too. (See the TED Talk on What Doctors Can Learn from Each Other.) I think we would benefit from keeping an element of choice in our system, and I think it's probably the least disruptive. The Blues used to be all non-profit, and the only change would be that all insurers have to be non-profits. That one change fixes the warped incentive problem, and it doesn't have to be that disruptive.

I think trying to fix the cost problem by ballot box in these small ways is trying to fix the systemic problems on the backs of individuals' care. It's not fair and it won't work.


20 people like this
Posted by The Cowboy Way
a resident of another community
on Oct 31, 2018 at 7:34 pm

Being an old ranch hand, I've had my share of potential medical expenses. Fixed some of the problems myself...broken ankle, pulling teeth and some busted ribs. Even had a vet stitch me up once when I ran out of duct tape. Most of my repairs were ER kind of things and the only problem with pulling my teeth was finding the right sized pliers. Used some bourbon as an anesthetic and for sterilization. Got diabetes now and re-use the needles until they get dull and start to hurt. No swab of alcohol or anything, just shoot the insulin through my shirt.

Things are different nowadays and more expensive. Besides, sometimes it's too long a drive from rural Hollister just to get to the MD. Got other more important things to do.


11 people like this
Posted by palo alto citizen
a resident of Midtown
on Nov 1, 2018 at 10:42 am

I'm voting yes for all the reasons cited by "Citizen." I realize the Measure is flawed but we have the opportunity to take the lead in spearheading the much-needed change in US healthcare. Stanford has the opportunity to be a trailblazer. The status quo is not sustainable.


11 people like this
Posted by kya
a resident of Midtown
on Nov 1, 2018 at 10:55 am

I'm voting Yes. We need to send a message to Stanford, Sutter Health and others that we are sick of paying more for necessary medical coverage here in Northern California. Recently I have been applying for health care......First question is "Do you live in Northern or Southern California?". The health costs here are 20% or higher than southern California. This is not fair. Hospitals/medical costs should make a reasonable profit, not what they are now making here in Palo Alto!

Also, a relative just returned from Mass. He received a rebate, because medical profits are capped at a reasonable rate, NOT like here.


12 people like this
Posted by Measure F - Bad Idea
a resident of Community Center
on Nov 1, 2018 at 10:58 am

Measure F is a bad idea. It was put on the ballot by the unions and will hurt the quality of health care provided while refunding insurance providers (not you). The city of Palo Alto does not have the capacity to add an additional layer of bureaucracy to manage this. It will also force a lot of health care professionals to relocate outside of Palo Alto.


19 people like this
Posted by mauricio
a resident of Embarcadero Oaks/Leland
on Nov 1, 2018 at 10:59 am

mauricio is a registered user.

Sometime change starts with a symbolic vote. The US is the only first world nation that does not have some form of universal health care, and allows for-profit health insurers, which drive up the cost of healthcare by anywhere from 30 to 50 percent. It's impossible to have both affordable health care and for- profit private insurers at the same time. It's an oxymoron. Profit should be eliminated from healthcare. Would we allow a for-profit defense department?

I am voting YES, because we need to start somehwere.


13 people like this
Posted by TorreyaMan
a resident of Palo Verde
on Nov 1, 2018 at 11:02 am

TorreyaMan is a registered user.

This measure is just not the way to reduce health care costs. Voting for it just to send a message is not the answer.


9 people like this
Posted by dtnorth
a resident of Downtown North
on Nov 1, 2018 at 11:11 am

I think everyone to vote yes, just cuz is ridiculous. Our city of Palo Alto can't handle their own expenses and constantly our raising the prices of our infrastructure. The price to implement the health care will cost everyone a lot more. Running a medical institution is not that simple. The city of Palo Alto doesn't want the measure to pass. Vote NO


13 people like this
Posted by Ellen
a resident of College Terrace
on Nov 1, 2018 at 11:17 am

The fact that F was put on the ballot by the union is a GOOD thing. The union is close to the beating heart of healthcare. They see the high rates of infection. They, like the rest of us, suffer the exorbitant costs. And they, like the rest of us, see the massive salaries paid out to fat cat executives. A YES ON F would start the ball rolling towards a healthier system that will benefit us all.


6 people like this
Posted by Anon
a resident of Another Palo Alto neighborhood
on Nov 1, 2018 at 11:52 am

Posted by Ellen, a resident of College Terrace

>> A YES ON F would start the ball rolling towards a healthier system that will benefit us all.

How? I don't see it. First of all, the root of the corruption throughout the system starts with the insurance companies. I've posted on this before, so, I won't post references again.

Picking on local medical providers because the medical insurance system is corrupt, wasteful, and irrational, doesn't make sense. At best, it will just raise local costs further; it could have the result of forcing small local independent providers out of town rather than deal with the costs of additional paperwork compliance.


8 people like this
Posted by Voting YES
a resident of Downtown North
on Nov 1, 2018 at 12:00 pm

The onslaught of mail and TV ads by billion-dollar Stanford convinced me that this measure is a good thing.
Maybe not perfect, it can be fixed next time.

Stanford has way too much money and it spends a lot on advertising. Have you noticed the full page ads in all the newspapers and on TV? They have money to burn. They are advertising for patients to fill their over-expansion!
I'm voting Yes.


6 people like this
Posted by A Blue Cross Executive
a resident of another community
on Nov 1, 2018 at 12:39 pm

As health care needs expand (not only due to a growing population but added specialized needs as well), it is only natural that medical insurance and related costs for health care will increase.

As a Blue Cross executive, I can attest that the expenditures to administer such programs are constantly on the rise, the prices of which must be met by additional out-of-pocket payments for continued medical coverage. We have overhead just like a typical American family has a household budget.

To complain about the rising cost of medical care is akin to living in the past as we no longer have country doctors who accept chickens for payment.

Doctors also have salary and lifestyle expectations as well. One doesn't go to college for 10-12 years just to donate a life to pro bono services. There is an anticipated ROI for a medical education.

If people want low-cost medical insurance, I suggest they encourage their children to become MDs. That way certain services can be within the family and free of charge. The Chinese MDs are very adept at this particular practice and perhaps we can learn from them. Make the outside patients pay through the nose and meanwhile, keep the medical costs for one's own family at its minimum.

Enough said.


4 people like this
Posted by No-on-F
a resident of Another Palo Alto neighborhood
on Nov 1, 2018 at 2:19 pm

> The union is close to the beating heart of healthcare. They see the
> high rates of infection.

Having spent a couple years in the hands of "healthcare" I find myself almost terrified of "nurses". Tried to engage many of them about the healthcare environment where they work, and found that virtually none of them had any idea what I was talking about.

Maybe the union sees "infection"--but what do they do about it? Do they document this "infection" and publish peer-reviewed publications that provide details about how unsafe their hospitals are? No, they don't.

As to having Palo Alto be involved with the economics of the local healthcare system is more frightening than giving a two-year-old a gun. There are no Council Members sitting on the dias that have much of a clue about Palo Alto's finances--and how some people want to give them the power to curtail health care?

If Measure F passes, there will be recall initiated soon after the election is certified.


4 people like this
Posted by No on F
a resident of Barron Park
on Nov 1, 2018 at 2:41 pm

"The health costs here are 20% or higher than southern California. This is not fair."

That is because everything here is more expensive, starting with real estate, and salaries for employees who need to be able to afford to live here, etc... Housing in general is much more expensive in the bay area than any other part of the country.

"Also, a relative just returned from Mass. He received a rebate, because medical profits are capped at a reasonable rate, NOT like here."
Having moved from Mass, I can tell you that they have a single-payer system. ObamaCare was modeled after the Mass. system put together by Romney.

The problem with this measure is that it preys on the fears of the uninformed, just like how things are at the national level. The care providers are just trying to do their job. It's not their fault that we don't have a single-pay system. They are trying to operate in the most expensive part of the country. Stanford is trying to open up a new hospital with private rooms (which will cut down infections instead of the shared rooms), dumps tons of money into research to come up with new cures to help people, and people want to cut off their funding? Stanford, like any business, will do what it needs to stay profitable no matter what. That will just translate to less services that we benefit from.




5 people like this
Posted by Read the Article.
a resident of Fairmeadow
on Nov 1, 2018 at 2:50 pm

"Stanford has way too much money and it spends a lot on advertising. Have you noticed the full page ads in all the newspapers and on TV? They have money to burn. They are advertising for patients to fill their over-expansion!
I'm voting Yes."

Read the article. Stanford spent under 1mil on this campaign. The union spent 6M.
This same union is also trying to close dialysis clinics under prop8.

"The fact that F was put on the ballot by the union is a GOOD thing. The union is close to the beating heart of healthcare. They see the high rates of infection."
This is not the union that represents healthcare providers. In fact, this is a retaliatory move by this union because Stanford didn't want to agree to their demands about membership lists. The infection issue is a strawman that is cherry picked outdated data from many years ago. The current data shows that all of these issues are resolved. If a place really needed more help with infections, wouldn't you want them to have the resources to update facilities, training, etc...? This measure makes no sense. Anyone that can, will move out of town, leaving everyone else left to work with less.


Like this comment
Posted by outside the box
a resident of Palo Verde
on Nov 1, 2018 at 2:51 pm

F would be applicable only within Palo Alto city limits. How difficult is slightly redrawing our perimeter to exclude the Stanford Healthcare complex? Would that make economic sense?


5 people like this
Posted by Me 2
a resident of Old Palo Alto
on Nov 1, 2018 at 3:18 pm

With all the misinformation on this thread, it is a stark reminder of why propositions are such a terrible idea. Voting to send a message? That's what got us Trump in the White House.

"I am voting YES, because we need to start somehwere."

Wait. I thought you said you left Palo Alto. You voting here and in Monterey County?


13 people like this
Posted by DUVENECK
a resident of Duveneck/St. Francis
on Nov 1, 2018 at 4:21 pm

The fact that the city would be required to regulate this was a no-starter for me. They are challenged enough running Palo Alto.


14 people like this
Posted by Not on my tax dollar
a resident of Barron Park
on Nov 1, 2018 at 5:22 pm

I wonder how many people who comment here actually live in Palo Alto. I bet most people on this forum supporting this measure don't even live here and have got nothing to lose in trying to convince residents to vote YES. They get access to cheaper care and don't have to pay for it in any way.

If this passes, everyone in the state is going to rush to Stanford - top 10 ranked hospital (US News), for a fraction of the cost compared to other medical centers in the bay area. Might even work out great for Stanford. All the small practice folks move out of town and the big guys are the only ones left standing, and us with even fewer options.

Except all of the administrative costs of managing this (which the city already says they are incapable of handling) and is going to cost millions of dollars each year (way more than whatever the livermore estimate was) will be taken on by Palo Alto residents alone through increased taxes and cut/delayed services in other areas. Not people that live in MP, MV or other towns. Just us.

This money should be spent on our housing, schools, roads, and things that will actually help us. Most of Stanford's patients don't even live in Palo Alto. They come from all over the state, out of state, even from other countries as one of the main medical centers on the west coast. If this was a state-wide proposal where the costs would be shared equally by all cities, maybe this would be a different conversation.

Vote yes if you want Palo Alto to subsidize health care costs for everyone else... Otherwise vote No on F if you think our taxes should actually go towards those of us who actually live here. It's bad enough with all the traffic and RVs parked all over town. Just imagine what's going to happen once Stanford offers their care for way less than all the other medical centers.

Anyone else notice that Palo alto is measure F and the same measure in livermore is U? Put those letters together. Pretty much sums it up.


9 people like this
Posted by Dan
a resident of Midtown
on Nov 1, 2018 at 6:14 pm

No of F is a no-brainer. How about we have the Livermore school board regulate the US nuclear arsenal since Lawrence Livermore National Lab is within the city boundary... that makes about as much sense as measures FU.


7 people like this
Posted by CeCi Kettendorf
a resident of Adobe-Meadow
on Nov 2, 2018 at 12:20 am

I have posted this elsewhere, but you may find it useful to hear this perspective here:

I have worked as a Stanford critical care nurse for the past forty years and have lived here as long.
I see telling the CC to regulate health costs as akin to telling the school board to fix our pot holes. It is not within the jurisdiction or mission or expertise of the CC to regulate health care cost and it is likely illegal. It will also be a waste of money spent on a ridiculous bureaucracy.

To those who are angry at Stanford: Wouldn't the problems you perceive best be dealt by other means than an incredibly badly conceived measure, a measure that is Measure F? You cut off your nose to spite your face when you drive away providers. We will lose all our surgicenters, dentists, orthodontists, private practice MDs and nurses, psychiatric clinics, councelers and clinics of any kind,etc. if F passes. They can simply move to a surrounding city (where their employees and patients may actually find parking!) Stanford and Sutter are not the only players in this fiasco.

I certainly know there are legitimate concerns about health care costs....I have three adult under-uninsured sons......but Measure F is so laughable it cannot have been written by professionals.
I am a union supporter (I am a proud member of a nurses' collective bargaining agency) but the SEIU leadership, in creating Measure F, derailed into the river.


The SEIU leadership does a grave disservice to the high caliber SEIU workers at Stanford. The SEIU workers who are my friends are baffled by Measure F. The housekeepers, with whom this originated, will not benefit in any way nor will any SEIU member. They are feeling the heat of public disapproval. They are hurt by Measure F.

The nursing assistants and housekeepers RUN to clean and prepare a room for emergency admission. The transporters and Service Center employess RUN to bring blood and equipment in an emergency. The secretaries bring order to chaos on the unit. The SEIU workers are truly a part of a life saving team! I ask everyone to honor them for their contribution to your care and your loved ones' care when hospitalized.

I myself would ask an ambulance or Lifeflight to bypass all other hospitals to bring my husband or sons to Stanford. Stanford would save their lives. I say this as a critical care nurse who has seen it all and who works in the trauma/medical/surgical ICU. I want my loved ones there.



4 people like this
Posted by mauricio
a resident of Embarcadero Oaks/Leland
on Nov 2, 2018 at 5:48 am

mauricio is a registered user.

@Me2, since you asked, I haven't switched my registration yet. I wanted to be able to help defeat Cory Wolbach.


6 people like this
Posted by Insurance Companies are the real winners
a resident of Green Acres
on Nov 2, 2018 at 7:54 am

"The US is the only first world nation that does not have some form of universal health care, and allows for-profit health insurers, which drive up the cost of healthcare by anywhere from 30 to 50 percent. It's impossible to have both affordable health care and for- profit private insurers at the same time. It's an oxymoron. Profit should be eliminated from healthcare. Would we allow a for-profit defense department? I am voting YES, because we need to start somehwere."

Mauricio - I agree with your point about health insurers but you realize that the way this measure is written - anything that is an over-charge will be refunded back to the insurance companies? I don't quite understand your logic. How does using Palo Alto city funds to administer a program that will cut our services, and pay the greedy insurance companies even more, make any sense or end up benefiting any us? We are all pawns in this. Shady people are manipulating anger about a real issue (healthcare costs) to reward insurance companies who are the ones that will ultimately benefit from this. They could have written this measure to provide rebates back to patients but they didn't. I wonder how a union is getting the funding to outspend Stanford 6x on advertising. Makes you wonder who is really behind all of this. Voting No, but people are so misinformed these days I think there is a real chance we will all be looking back one day and asking why we did this to ourselves.


Like this comment
Posted by JR McDugan
a resident of Palo Verde
on Nov 2, 2018 at 8:00 am

JR McDugan is a registered user.

I wish this resolution could be re-written to only impact Stanford, who use their hospital as a cash cow (making hundreds of millions per year, look it up) even while sitting on a $24 billion endowment. That $24 billion was made by ripping off the sick and needy of Palo Alto.

It's not right to impact honest providers due to the actions of a single bad actor, but something needs to be done.


Like this comment
Posted by Not the same
a resident of Evergreen Park
on Nov 2, 2018 at 9:32 am

"I wish this resolution could be re-written to only impact Stanford, who use their hospital as a cash cow (making hundreds of millions per year, look it up) even while sitting on a $24 billion endowment. That $24 billion was made by ripping off the sick and needy of Palo Alto."

So many things wrong in these two sentences. Just shows how little people understand and people's emotions are being used in this campaign. Stanford hospital is not owned by Stanford University. They are not the same or even under the same organization. In fact, the hospital and university fight about things all the time. The hospital doesn't even get access to the university facilities or parking on campus.

On a completely unrelated issue, the hospital doesn't give the university a dime. The university endowment is the same as an other major university, making money on investments. Last year top 3 were Harvard (36Billion), Yale (27Billion), and Univ Texas (26 Billion).



4 people like this
Posted by SMH
a resident of Downtown North
on Nov 2, 2018 at 9:43 am

@JR McDugan: "I wish this resolution could be re-written to only impact Stanford"
If you dislike Stanford so much, then the best solution is to stop going there. They can't make money if nobody goes there.

We have so many choices. It's not like we are in out in the country somewhere. Go to Kaiser or go to PAMF or El Camino, Good Sam, etc.... Nobody is forcing anyone to go to Stanford.

If you think the iphone is too expensive, then don't buy an iphone. Get a samsung. You don't punish all cell phone makers just because you're mad at one company. Big companies will always be okay. They'll make do by cutting out features and services. In the end, you'll just wind up with a crappier phone.


10 people like this
Posted by RN
a resident of another community
on Nov 2, 2018 at 10:26 am

@JR McDugan

Web Link

I encourage you and others to take a look at how Stanford actually spends it's money, rather than making false claims to fit a narrative like people at the national level. You paint a picture of doctors and nurses sitting on a mountain of cash while in reality, most of us that actually work here have to commute many hours to work because we can't afford the 3-5 million dollar homes that you have the luxury of living in.

Almost a half-billion of Stanford's money is spent making up for costs that medi-care didn't pay for. $300 million is spent delivering free care to people without insurance at all, and almost $80 mil on research to develop cures for the future.

We don't have the ability (or the desire) to turn away people simply because they don't have insurance. The real front line care providers are worried because if measure F passes, the only way to balance our budget will be if we start rationing care/reducing services and spend less on medical research. That means a lot of us are going to get laid off. Thanks to a union that supposedly is representing all of us.

There are ways to express frustration with healthcare costs in a more productive manner that won't end up putting healthcare providers out of jobs, and put the patients we care for at risk. Please vote no on F


2 people like this
Posted by DT North
a resident of Downtown North
on Nov 2, 2018 at 2:05 pm

I'm finding many of these measures so confusing...probably purposefully so? Even within democratic voting recommendations they conflict ugh. On here the "No" people remain most convincing. We need to limit the profits of insurance companies is what we need to limit!


8 people like this
Posted by Beauty Runs Deep
a resident of another community
on Nov 2, 2018 at 2:16 pm

[Post removed.]


4 people like this
Posted by Looks Do Matter
a resident of Woodside
on Nov 2, 2018 at 5:58 pm

[Post removed.]


Like this comment
Posted by JR McDugan
a resident of Palo Verde
on Nov 2, 2018 at 7:54 pm

JR McDugan is a registered user.

Stanford Health Care, a so-called "non-profit", reported operating profits of $234 million last year, according to Palo Alto Weekly:

Web Link

Please explain to me how a "non-profit" turns of profit of $234 million. By over-charging their sick customers, that's how. Then they turn around and spend millions of dollars to defeat a ballot measure that would hold them accountable for their actions. It's a cycle of cruelty and dishonesty.

The only reason to vote against Measure F is to protect smaller Palo Alto health providers, which is a reasonable thing to do. If the measure fails to pass, the authors should try again, with clear language that exempts all except Stanford Health Care (maybe make it apply to only providers with 1,000 or more beds in the city).


6 people like this
Posted by Answering your Question
a resident of College Terrace
on Nov 2, 2018 at 10:57 pm

"Please explain to me how a "non-profit" turns of profit of $234 million...Then they turn around and spend millions of dollars to defeat a ballot measure that would hold them accountable for their actions.""

Non-Profit means that they take that $234 million and invest it back into healthcare. For example, to provide charity care, cover the services of people who don't have insurance, or invest in research or update medical equipment. This is different than a "for profit" organization which distributes it's extra earnings at the end of the year to shareholders or paying out dividends.

Also the article clearly says Stanford spent 800K, not millions like you say. And their hospital has 600 beds so a measure targeting 1000 bed hospitals would do nothing for anyone. Unfortunately, details matter which is exactly what makes this poorly written measure such a bad idea.


2 people like this
Posted by Me 2
a resident of Old Palo Alto
on Nov 3, 2018 at 10:50 am

"@Me2, since you asked, I haven't switched my registration yet. I wanted to be able to help defeat Cory Wolbach."

If you're going, why are you meddling with our politics?

So you're saying it's ok for Russia-style influencing on Palo Alto elections. Posting here on PAO is akin to sharing on Facebook.

And worse - you're voting and not having to bear the consequences on your actions.

I'm appalled at your actions.


2 people like this
Posted by Anon
a resident of Another Palo Alto neighborhood
on Nov 3, 2018 at 1:20 pm

It seems like the Weekly might want to do some real investigative journalism in this case. The amount of money SEIU is spending on this makes no sense to me. What is in it for the union rank-and-file? How would the union members benefit if a lot of money is spent on multiple legal battles, and/or, a massive paperwork exercise? The whole thing just doesn't add up.


6 people like this
Posted by Beginning to Make Sense
a resident of Barron Park
on Nov 3, 2018 at 1:48 pm

"The amount of money SEIU is spending on this makes no sense to me. What is in it for the union rank-and-file?"

I've been trying to figure out the same thing and was confused until I found this site (which may be biased, but if true, explains everything).

Web Link

This union has spent $30mil of union due on 20+ failed measures over the past 7 years as a negotiating tactic. SIEU wanted to unionize workers at their affiliated centers in other towns and when Stanford refused, they started this measure..

SIEU is also doing the same thing with Prop 8. They tried to organize dialysis workers and when they met resistance, came up with Prop8, and have spent over 20mil to push it. The reason they are spending this money is so they can get more union dues so that's their payoff.

One of the main criticisms of their president, Dave Regan, is that he spends more money on ballot measures (which almost always fail) than on the union members.


10 people like this
Posted by Saving My Money
a resident of Duveneck/St. Francis
on Nov 3, 2018 at 2:27 pm

I rarely go to the doctor anymore...too expensive and there's always a follow-up appointment which adds to the bill.

It's easier (and far more cost-effective) just to wait for the undertaker.

We're all going to end-up in his body shop anyway.


7 people like this
Posted by Sat What?
a resident of Community Center
on Nov 3, 2018 at 3:31 pm

I support most health care reforms and agree that Stanford Hospital has some shortcomings. However, this just seems to be a heavy handed union play and bad policy.
What surprised me was not just that the county Democratic Party supports the measure, I just saw that their chairman, Bill James wrote the ballot statements. As someone who has been a lifelong Democrat and who continues to support Democratic candidates financially, I am very disappointed in what the county Dem organization is doing. It makes me distrust any endorsement they make.


4 people like this
Posted by mauricio
a resident of Embarcadero Oaks/Leland
on Nov 3, 2018 at 5:07 pm

mauricio is a registered user.

Americans are like sheep being passively led to the slaughter house. The fact they are willing to accept the lack of universal health care is astonishing. When I travel globally people always ask me how is it possible that Americans don't demand and force their government to establish universal health care.


1 person likes this
Posted by Anon
a resident of Another Palo Alto neighborhood
on Nov 4, 2018 at 9:06 am

Posted by A Blue Cross Executive, a resident of another community

>> As health care needs expand (not only due to a growing population but added specialized needs as well), it is only natural that medical insurance and related costs for health care will increase.

It is only natural that as the population becomes less youthful, more labor/money will be required for health care. But, you presume that "medical insurance" will mediate that health care. I question the wisdom of the "universal insurance" model-- I see other countries, like Australia, that provide universal health -care- with a limited insurance system for the wealthy. For some reason Australia is #4 on the ranked list of life expectancy, while the US is ranked #31, below Costa Rica. Apparently, the health insurance -system- is not helping lower-income Americans live longer than lower-income Australians.

>> As a Blue Cross executive, I can attest that the expenditures to administer such programs are constantly on the rise,

Sure. The question is why do all those expenditures flow through insurance companies like Blue Cross?

>> To complain about the rising cost of medical care is akin to living in the past as we no longer have country doctors who accept chickens for payment.

The top countries on the list are Japan, Switzerland, Singapore, Australia. Chickens?

>> Doctors also have salary and lifestyle expectations as well.

As well as paying for medical school. Post WWII, the Federal Government and the States ended up paying for medical school for the majority of doctors. That has eroded in recent decades. I'm very aware that this restructuring has saddled many young doctors with almost a lifetime of loan payments.

>> One doesn't go to college for 10-12 years just to donate a life to pro bono services. There is an anticipated ROI for a medical education.

Strangely enough, while not pro-bono=free, I think most of the older generation did become doctors in order to do good. ROI-thinking is something that only became necessary in recent decades, as medical insurance took over everything. I'm old enough to remember $3 doctor's visits-- then, $5 with inflation. Again, $7 with inflation. Then, who knew-- it all started to go through the insurance companies. Back on a few years ago, and, paying "list price" for the first $15K or whatever, and, what should be $60 with inflation became $200+. And, the doctors seem to be spend as much time on accounting/insurance issues as they do on the patient-- I'm sure frustrating for them as well as the patients.

The US could re-think this-- just look at what the 30 other countries that are ahead of the US in life expectancy do. Web Link


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Posted by Anon
a resident of Another Palo Alto neighborhood
on Nov 4, 2018 at 11:10 am

Apologies for two posts in a row, but, on the subject of spending -too much money- on political campaigns, whoever thought it was a good idea to send out anti-"F" cell phone messages was completely mistaken. (I'm being far too polite, but, this is a mixed-company website.)

Of course, it could be a another false flag thing again, but, if the actual "No of F" folks are responsible for the message that I recently got on my phone-- be aware that, if anything, unsolicited cell phone messages create backlash. I'm not about to go out and vote for "F" because of the message, but, if someone did-- I could understand their misguided action.


4 people like this
Posted by A Blue Cross Executive
a resident of another community
on Nov 4, 2018 at 2:06 pm

> Apparently, the health insurance -system- is not helping lower-income Americans live longer than lower-income Australians.

Many lower income Americans lead unhealthy lifestyles when it comes to diet, exercise and 'moderation' and they've got to take some responsibility for their overall health as well. It's those with the unhealthy lifestyles who are 'sticking it' to the others...the ones who complain about the rising cost of healthcare in America.

> The question is why do all those expenditures flow through insurance companies like Blue Cross?

Because insurance companies are highly proficient at what they do...investing resources received from premium payments and paying-out insured expenditures only as needed. We also have a strong lobbyist force to ensure the best interests of our industry.

> Chickens?

Chickens were once a form of payment for medical expenses in rural parts of America. Today most physicians prefer money. They can buy their own chickens.

>...this restructuring has saddled many young doctors with almost a lifetime of loan payments.

Comes with the territory. If you want to be a doctor nowadays, it's gonna cost.

> ROI-thinking is something that only became necessary in recent decades, as medical insurance took over everything.

Medicine, dentistry and veterinarian services are a business. Most people tend to overlook that.

Health insurance simply ensures that the MDs get paid for their services and facilities are remunerated + it has to be profitable for the insurance companies as well.

Everything has gotten more expensive...cars, plumbing and electrician services et al. Blame it on inflation and cost-of-living indexes.


6 people like this
Posted by Jon Castor
a resident of Woodside
on Nov 4, 2018 at 6:57 pm

I hope the citizens of Palo Alto will not pass this measure. There is a healthcare crisis in the US, but driving providers to leave Palo Alto if they can, and encouraging others to avoid Palo Alto, is not the way to solve it. That issue is much larger than Stanford and Palo Alto. While no institution is perfect, Stanford overall is recognized as a high performing hospital and clinic. Other local providers also enable us to access critical and routine services. I'm grateful that we have such tremendous resources in our backyard. Finding a way to access services more cost effectively via changes to insurance and other means was and is a federal government, or at a minimum a state level issue.


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Posted by DT North
a resident of Downtown North
on Nov 4, 2018 at 8:22 pm

And what about 8?


6 people like this
Posted by It's the same
a resident of Green Acres
on Nov 4, 2018 at 9:16 pm

>>And what about 8?

It's the same SEIU union using the same tactic. It's almost the same proposal too.
Limit profits to 15% above costs, etc... They've been trying for years to unionize dialysis center employees without success so this is their response to that. Same as what they are doing to Stanford. They specifically went after the 5 cities where Stanford has a presence (only PA and Livermore made it to the ballot). If they were truly interested in improving healthcare costs, they wouldn't be going after just one institution. For most of your routine needs, you can go anywhere.
Stanford provides very specialized care when other options have been exhausted - drug trials for cancer, organ transplant, the only nearby trauma center, etc... I don't know what any of us have to gain when they are forced to scale things back and we are left with fewer options. It's honestly nice knowing there are specialists in our backyard, without having to go to UCSF or even further.

Prop 8 seems especially cruel. As a family member of someone with kidney disease, access to dialysis centers can be challenging, especially in remote areas of the state. A business will do what it needs to do to stay profitable, even if that means closing down some of their less profitable centers if their margins are affected. Dialysis patients really are dependent on these centers. If they miss just one of their 3x/week sessions, that can be enough to land them in a hospital. Unions have an important role, but this one does not seem to have employees or patients in mind.


5 people like this
Posted by City Council Report
a resident of Adobe-Meadow
on Nov 4, 2018 at 9:31 pm

What a disaster. Has anyone read the city council report on what approving this measure would do?

Web Link

In their own analysis, they state that this measure will push local providers out, they don't actually have the experience/ability to manage such a proposal, and even after all that, it's probably illegal for the city to make up it's own healthcare rules without state/federal involvement. So not only will this cost a ton to operate (beginning Jan 2019?!?!?), Palo Alto will get sucked into a healthcare legal battle costing even more. Shouldn't our tax dollars be used on things that might result in more meaningful change?


5 people like this
Posted by NO ON F
a resident of College Terrace
on Nov 6, 2018 at 11:49 am

An ill conceived proposal that will force independent medical practitioners out of the city, reduce access the critical medical services at Stanford, with the costs ultimately increased costs to be paid by patient forced to looks elsewhere for their medical care. For my family and community - NO ON F.


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