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George Boardman: Republicans need to address medical costs

Observations from the center stripe: Garbage edition

YOU WOULD think somebody in the garbage business — like Waste Management — wouldn’t need two weeks to get garbage cans to a new customer… WHAT DOES it tell you about Grass Valley City Council candidates who won’t tell you their age or hometown?... IF THE first presidential debate proved anything, it’s that the debates have outlived their usefulness… BASED ON the ads I’ve seen so far, minorities are either the benefactors or victims of every state proposition on the ballot… ANY FOOD item that’s “infused” with something is probably going to be expensive… I FAVOR gas stations with squeegies on handles long enough to cover the entire windshield …

Republicans seem to have a hard time getting their arms around America’s health care crisis. They profess to hate Obamacare and have no interest in replacing it with another government-run system.

But since it’s clear the cost of health care is a major issue for a lot of Americans, they have to pretend they can come up with a solution. President Trump has promised something better than Obamacare for four years, but has yet to deliver.

The average American pays $1,200 a year for medicine, and Congressional Republicans sort of made a stab at holding down drug prices until Big Pharma started wielding its check book. Trump is promising a $200 gift card to every senior citizen to apply against prescription co-pays. The card will arrive after Election Day and the money will drain another Medicare trust fund — at least they’re doing something.



But that doesn’t mean every Republican has given up on the idea of getting behind new initiatives that can start chipping away at our health care cost issues. For example, our very own first-term Republican Assemblywoman Megan Dahle.

I first became aware of Dahle’s interest in the issue when a postcard from her arrived in the mail last month. The card headlined, “Lower Health Care Costs Bring Prescription Drug Manufacturing to California” said the following:



“From 2017 to 2019, generic drug costs have risen by 37.6% in California. Three out of 10 Americans don’t take their medicine as prescribed due to cost. Lawmakers in California are working to make health care more affordable for everyone. Bringing prescription drug manufacturing to California will reduce costs and save lives. Please contact the district office at 530.223.6300 or go online at asmrc.orgiza (sic) to be part of the conversation.”

The postcard arrived shortly after the state Legislature approved SB 852, a bill that puts California in direct competition with major generic and brand-name manufacturers that dominate the market, allowing the state to use its massive purchasing power to drive down drug prices.

Under the measure, state-developed generics would be “widely” available to private and public purchasers within California. Taxpayers would pick up costs for startup funding, plus ongoing staff costs. The bill specifically calls for the production of “at least one form of insulin, provided that a viable pathway for manufacturing a more affordable form of insulin exists at a price that results in savings.”

Three major drug companies control the insulin market in the U.S., and they make sure the life-saving drug doesn’t come cheap. A 2019 report by the Health Care Cost Institute found that average prices for insulin doubled from 2016 to 2019. California regulators found last year that diabetes medications accounted for nine of the 25 costliest brand-name drugs sold in the state.

“It’s a big deal — diabetes affects a lot of people who rely on insulin for their very lives,” said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation. “Insulin has probably been the poster child for unreasonable drug pricing.”

Being the skeptic that I am, I decided to find out how Dahle voted on SB 852, sponsored by Democratic state Senator Richard Pan. She opposed the bill in committee because of stakeholder issues, but some changes by the Democratic sponsors drew Dahle’s support in the measure’s final vote on the last day of the session, according to Tess Scherkenback, Dahle’s legislative director.

“(Dahle) understands that the cost of medically necessary prescriptions is extreme in California, and is an issue that is especially challenging for rural residents who lack access to treatment and resources,” said Scherkenback said it an email. “SB 852 is an important step in bringing focus to the problem and beginning to address the extreme cost of health care and prescription medication in California.”

This is an interesting change for a state party that trails the Democrats and independents when it comes to registered voters in California, and has become desperate enough to start endorsing candidates who embrace the QAnon conspiracies — at least four congressional candidates in the state this year, according to Media Matters.

Then there’s the party’s insistence on Republican orthodoxy — or else, as Assemblyman Chad Mayes found out in 2017. Mayes was ousted as head of the Assembly Republican Caucus because he voted for an extension of Gov. Jerry Brown’s cap-and-trade program. He was replaced by former Assemblyman Brian Dahle.

This approach has not been working well for the California Republican Party. Maybe it’s time for them to reach out to Democrats on measures they can both agree on. And maybe Congressional Republicans can learn a few things about addressing the nation’s health issues out here in the hinterlands.

Leadership?

Various Nevada County officials are patting themselves on the back now that the Board of Supervisors managed to find money to try closing the homework gap for students who lack good broadband access in our era of remote learning.

But parents and students who have to live with our tin can and string communications technology will not celebrate the fact that much of the school year will have been lost by the time the new technology is in place.

The supervisors announced last month a $1 million grant to Race Communications to speed up installation of fiber optic connections for 500 homes in the Peardale area, part of a $27 million effort to connect nearly 2,000 homes and businesses along Highway 174.

“That was the region that was identified by the school district as well as local residents as not having service,” said Jim Miller, vice president of sales and marketing for Race. “That was the purpose of that grant, to get service to people who need it now.”

None of this is new to anybody who has been paying attention. “Before March we knew we had issues with internet connectivity in the county,” Superintendent of Schools Scott Lay told supervisors. “Since we closed the schools in March it has exposed a huge inequity that we have here in Nevada County.”

Lay said last spring that it wasn’t feasible to go to 100% online education, and Superintendent Brett McFadden estimated that 15 to 20% of the students in the Nevada Joint Union High School District “do not have reliable internet at home.”

This is reality for us because county leaders have been asleep at the switch during the 20 years the internet has become an increasingly important part of our lives. Now that the supervisors have been aroused from their slumber, they are trying to put together a patchwork broadband system that may serve our needs in the future.

Not that they’re doing any of this at breakneck speed. Everybody knew we had a problem in the spring, but supervisors didn’t find the money until July and awarded the grant in September. With any luck, those 500 connections will be operational in December, about halfway through the school year.

But some people can always find a silver lining: “We’re rolling along, but we’re rolling along in a manner that I think most rural counties would be envious of,” said Supervisor Dan Miller.

People living in the Peardale area might want to ask the supervisors why they didn’t get started on this when Miller joined the board six years ago.

George Boardman lives in Nevada City. His column is published biweekly on Tuesdays by The Union. Write him at boredgeorgeman@gmail.com.


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