By Allen Cooper, MD, Professor of Medicine, Emeritus

Medicare, created in 1965, revolutionized health care for the elderly and those with disabilities.    There has always been Republican opposition because it is “socialism.”  In 1997 what is now called Medicare Advantage paid private insurers per enrollee (capitation) for seniors who opted out of traditional Medicare, thus beginning privatization.

The Affordable Care Act established the Innovation center to new payment and service delivery models. Using this, the Trump administration created Direct Contracting Entities (DCEs). These provide capitation payments to groups of physicians and allow up to 40% for profit and administration compared to traditional Medicare’s 2-4% for administration!!! 

Private equity and insurers recruited medical groups to form DCE’s. The Biden administration rebranded the plans as Accountable Care Organizations Realizing Equity Access and Community Health (ACOREACH). Elizabeth Fowler who worked on the ACA and in the pharmaceutical industry was appointed to run this program. Her explicit goal is to privatize all of Medicare by 2030. 

When a patient’s physician becomes part of an ACOREACH capitation plan they must find a new primary care doctor who is not a member of the ACOREACH medical group if they want the flexibility of traditional Medicare. To increase profits the plans attempt to keep patient referrals in their network and minimize expense on medical care. 

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By Richard Ivanhoe, HANC Board

Although we’ve used this phrase before, 2022 was a year like no other.  We had four elections, Federal, State, and local redistricting, and the Covid pandemic entered its third year.  Still, HANC managed to have 11 monthly meetings, and we printed 12 issues of the Voice.

In January, with recall elections on the horizon, Tim Redmond provided a lesson on the history of recalls in California and Supervisor Aaron Peskin discussed his recall reform ballot measure for the June election.  Unfortunately, the measure was defeated in a low turnout election.  In February, we discussed the Mayor’s declaration of a second emergency (while the first emergency declaration was still in effect).  We also discussed other ways the Mayor’s Office has used and extended its powers.  February also saw the year’s first election, the release of UCSF’s draft EIR for its new Parnassus hospital and the Coalition for a Complete Community’s first one-day demonstration that interim uses for 730 Stanyan are both possible and popular.

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By David Woo, HANC President

On November 15th HANC joined the Race and Equity in All Planning Coalition (REP) in a rally and hearing at City Hall calling for the Citywide People’s Plan (www.repsf.org/citywide-peoples-plan) to be adopted and incorporated into the city’s Housing Element. The REP coalition (HANC is a member organization) demanded that the Housing Element, which currently focuses on market-rate housing, instead center racial and social equity and meet the needs of working class communities and communities of color by putting affordable housing first.

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By Lisa Awbrey, HANC Vice-President

On Wednesday November 16, approximately 45 local community members attended an in person meeting held at the Park branch library, hosted by the Coalition for a Complete Community at 730 Stanyan (CCC). All attendees wore masks. 

The CCC’s update to the public on the development at 730 Stanyan included a timeline of events at the site over the past 5 years. In December 2017, the City negotiated the purchase of the land at 730 Stanyan for $15.5 million so that it could re-develop the parcel with the stated goal of building “100% affordable housing.” Since the purchase of the site, plans have moved in fits and starts with local residents left to wonder when construction would begin at the now vacant and blighted site; the City spends $27,000 each month to guard an empty parking lot.

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By Christin Evans, HANC Board

In the United States, private for-profit banks have evolved the products they offer and the customers they serve to maximize profits leaving significant gaps in products and services for San Francisco’s low income workers, affordable housing projects, and small businesses.  While the Bay Area has a relatively large number of community banks and credit unions, these institutions lack the scale and reach to adequately meet the needs of this vastly underserved market. 

The San Francisco Reinvestment Working Group convened by LAFCO (Local Agency Formation Commission) earlier this year has been writing the business plan for a public bank to seek to create the foundation for a municipal bank which has a primary goal of serving its community over the interest of profits.  The Working Group, given a mandate by a unanimous vote of the Board of Supervisors last year, has been developing a plan to use city assets currently stored in private market banks to capitalize a municipal benefit corporation or private bank within the next few years. 

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By Calvin Welch, HANC Board

This November’s election was held in the new Supervisor districts created earlier this year which divided the Haight-Ashbury into three districts: 1 precinct in District 1, 7 precincts in District 5 and 5 precincts in District 8. The  three sub areas of the neighborhood used in previous "How the Haight Voted" presentations--the North Panhandle (from Fulton to Fell, Stanyan to Baker ), the Flatlands (Oak to Frederick, Stanyan to Baker) and the Hills (Frederick to 17th, Stanyan to Upper Ashbury)--will continue to be used, but the precincts have been reconfigured.  For example in the Hill precincts, three previous precincts have not only been re-numbered but also combined into a single new precinct (9802) that includes streets on the west side of Stanyan and are now part of District 8.  Our neighborhood now has 1 precinct in the North Panhandle in District 1 (9147), 5, all except 9803 in the Hills  in D8 (9802-06) and 7 precincts (9501-06) remaining in the North Panhandle and Flatland precincts ( where 9803 now sits).  Thus under the new precinct lines there are four precincts in the North Panhandle, five in the Flatlands and four in the Hill precincts.

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By Tab Buckner, HANC Board

When Haight-Ashbury residents voted in the November 8th General Election, they participated in a 19th Assembly District race for the first time. California’s legislative district lines were redrawn for the next decade and AD19’s new boundaries were moved eastward to include most of the Haight.

As of December 5th, AD 19 Assemblyman Phil Ting will begin his final two-year term. Ting was first elected in 2012 and his district has encompassed the western side of San Francisco as well as Broadmoor, Colma, Daly City and South San Francisco. He lives in the Sunset District and serves as Chair of the Assembly Budget Committee after having been Chair of the Assembly Committee on Revenue and Taxation. Prior to joining the State Legislature, Ting served as San Francisco’s Assessor-Recorder since 2005.

Assemblyman Ting is scheduled to speak and answer questions at HANC’s General Meeting on Thursday, December 8th.