By Emily J. Plympton


Dear Dr. Ghaly,

We are writing to you on behalf of Healthcare For All – Los Angeles to express our grave concerns regarding the conduct and efficacy of this Commission. Thus far, it has failed to produce any policy directives or legislative suggestions to support its mission of exploring unified finance healthcare mechanisms, including, but not limited, to single payer healthcare, as defined in its remit.
The Commission appears to have made a deliberate decision to bypass robust discussion of AB 1400, single payer legislation to ensure the delivery of comprehensive, cost-effective healthcare to every Californian. Not only has the Commission essentially ignored single-payer reform, but it has failed to offer any viable policy alternatives. 
Since the experience in the industrialized world has repeatedly confirmed that single payer is the most cost-effective and efficient way to deliver quality healthcare, it is unclear what the Commission hopes to achieve by ignoring AB 1400. 
Every healthcare financing model in the developed world that includes unregulated health insurance has worse health outcomes and is substantially more expensive. “Market choice” does not materially exist in the realm of intermittent, immediate, and unexpected human health care needs. People are patients not customers who can shop around for the best deals. They either need healthcare or they don’t.
We also, express our grave objections to certain vested interests in this Commission whose testimony and commentary border on the absurd. In particular, the ex officio member Dr. Richard Pan, who has received over $1.6 million in contributions from the Health care sector/insurance/ pharmaceutical/ hospital/ nursing home sectors profiting in the current system. Why are ex-officios with obvious conflicts of interest sitting on this Commission?  
For instance, Dr. Richard Pan MD has claimed many Taiwanese doctors desperately want to flee Taiwan to practice in America to avoid their healthcare system and its alleged widespread problems with integrated care. He has only provided anecdotal hearsay to support his claims.
Dr. Pan also indicated that the Taiwanese healthcare system is only good for very basic healthcare. This is demonstrably false because it comprehensively covers primary and preventative care, clinical and hospital care, and pharmaceuticals. He even casually dismissed the fact that the overwhelming majority of Taiwanese citizens approve of their healthcare system. This approval rating is also mirrored by evidence in the rest of the developed world. 
During the Commission meeting on July 9, Dr. Pan commented that “Details matter,” but failed to offer any solutions whatsoever. He later unfurled an irrelevant discussion regarding surplus obstetric nurses when babies weren’t born at a given point in time to argue a theoretical point that this waste would not be reduced in a single payer system if in fact, it is waste at all.
Please consider the administrative waste generated by the health insurance billing and approval processes. Not to mention the waste on unnecessary and costly E.R. visits which would better be served in a clinical setting.
Taxpayers expect relevant, fact-based commentary supported by research and data, not personal opinions and musings. We expect that Commission members make solid, rational contributions to these discussions. Ex officio members with no observable contribution to the Commission mission should be removed. They waste time, taxpayer money, and erode public confidence in this process.   
Dr. Jim Wood DDS has run on a single (albeit valid) concern of cost control and price inflation. This question has an abundance of real-world answers via bulk purchasing of pharmaceuticals, hospital, clinical, and preventative care services with pricing caps… as in Medi-care (except for pharmaceuticals). The single payer savings of price control and reduction of administrative waste has been demonstrated with reliable data in every available policy recommendation from health care experts, economists, and policy experts. 
The healthcare systems in the developed world have uniformly confirmed this conclusion by demonstrating lower costs with better outcomes once the profit motive has been removed from healthcare and once rational, equitable expenditures are implemented. It is disingenuous that Dr. Wood has repeatedly litigated this question because it appears he is either unwilling or incapable of accepting professional recommendations and actual global evidence.
The introduction of global budgets for hospitals and large scale service providers and fee for service for independent practitioners and physician groups will curb the inflation-busting, runaway price inflation of the unregulated private sector. Competition has not lowered prices. This is a hallmark of AB 1400 legislation.
The private sector repeatedly claims that artificially high prices are essential for medical innovation, yet fail to acknowledge their highly favorable tax treatment, corporate investment, and the substantial injection of public research funds via universities, research institutes, and medical and healthcare charities into that innovation. 
The pharmaceutical industry has repeatedly lobbied against the importation of drugs for “fear of persistent quality issues” of which they have failed to provide any large scale evidence, and despite the fact that a substantial number of their own products sold in the US are produced in overseas laboratories.
Carmen Comsti and Dr. Rupa Marya have made reasoned cases regarding costs, inflation, innovation, and integration of care, so much of the counter discussion of these topics during these Commission hearings is duplicative, wasteful, and irrelevant. Public confidence in the integrity of this process is at risk.  
Diversionary and obfuscatory tactics, allowing incoherent and unfounded commentary, and denying the prominence of qualified discussion about the global successes of single payer reform are examples of poor governance, wasted time, misuse of tax dollars, and the exhaustion of public tolerance. 
We propose that the Commission solution is to focus on a solid discussion of the CalCare AB 1400 legislation at hand that incorporates the decades-long global successes of single payer systems into state based reform.  
This Commission under your leadership, Dr. Ghaly, has the opportunity to become champions of the people by addressing our most vital needs, currently ignored, which have been codified as human rights in the 1947 Declaration of Human Rights. That right is violated everyday in our current deplorable system of extraction of resources away from the delivery of necessary care to our CA population. This is the State’s chance to lead the country in healthcare reform. It is not experimental or filled with untested variables.
The genuine answer to reforming our unsustainable health insurance system and determining the finance model is for this Commission to examine current AB 1400 legislation, offer improvements, and provide support and assistance to the CA legislature in attaching a finance portion to AB 1400, the Guaranteed Health Care for All Act (CalCare).  
We need to hear more from Carmen Comsti JD as a principal speaker.  Esquire Comsti is the voice with expertise on developing and explaining this current CA AB 1400 single payer legislation, awaiting reintroduction in January.  
Now is the time for AB 1400 CalCare information to be presented for robust discussion. And now is the time for providing guidance in developing a solid finance plan for that legislation. This would be meaningful Commission work in service of CA residents. Rehashing the  decades-old rationale for the type of reform is unnecessary. We don’t need another study. What we need is a financing plan for what we know works all over the world for over 100 years, single payer. 
The case for health care system reform is urgent. Everyday is a life-altering emergency for numerous individuals, families and entire communities suffering the consequences of our abhorrent for profit insurance system, draining finances, bankrupting families, and destroying lives while enriching stakeholders. 
Please act on this urgency and schedule Carmen Comsti as a principal presenter for AB 1400 discussion in the next meeting. We must move on this reform. Lives depend on it. Every day matters. And it matters to all of us, everyday.
Yours sincerely
Emily J. Plympton
Correspondence Secretary
Healthcare For All – Los Angeles