thank you so much for being here at this important hearing, my name is ali and i've been a registered nurse here for 36 years now, to consider weakening any part of healthy san francisco now when there is so much that's unknown about the affordable care act is concerning. the employer spending requirement needs to remain in place and that's really important. i have a story i would like to tell you, i'm sure we all have stories but this is a friend of my daughter, a 28 year-old full time restaurant worker would was born and raised in san francisco, he was in a serious accident last year, on his way to work, he was on a scooter and a bicyclist ran a red light and he slammed into a post, so he was taken by ambulance to san francisco general, he suffered a severe concussion, had multiple abrasions, needed dozens stitches in his knee, his helmet saved him from more

serious injury, he was unable to work to work for several weeks, he received a bill for over 32 thousand dollars for his care which is more than what he made in a year, luckily he was enrolled in healthy sa*ns from paid 250 dollars of this bill, which if he had to pay the full amount would have put him in dire straits, he will be mandated to buy insurance now, but with his income, he would be able to afford a high deductible plan if he can afford any plan at all, we don't have medi cal yet, the aca is more about access to insurance, healthy san francisco is about access to health care, so let's leave it in tact. thank you. >> thank you, next speaker? >> hi, my name is claudia, i've

been a san francisco resident for 30 years and i'm a registered nurse at kaiser for 8 year, i work in adult medicine with the latino community and i also work with maternity child health or labor and delivery, so i'm here today for personal and professional reasons. if i can leave you with one message today, it would be prevention. i personally am from a migrant family, we came here when i was four, so i know extensively how important health care is, especially to families of migrant descent. from personal experience, i have two brothers who would have foregone care if it wasn't for healthy san francisco because their private insurance plans that are offered to them require expensive co-payments for themselves and for their families. my sister-in-law for example is

a cardiac surgery survivor and i say survivor because she has my niece and nephew and in my homeland and her hard condition was never detected, because my brother was the primary head of household was able to have her on healthy san francisco and have the children on healthy san francisco kids, there was preventive diagnostic testing which found a murmur and found a defect in her heart and had open heart surgery, if it wasn't detected, she would have died. on a professional level f, i work with the latino community, and they wait until they're completely sick because they can't afford the co-payments, they can't afford the medication, the doctors -- so, as i said, prevention, if we

can prevent them going to the emergency room. >> thank you. >> thank you. >> next speaker, please. >> my name is brian sang, i'm a volunteer with the physicians organizing committee speaking on behalf of whatever members dr, trys and i, i have to back up with what the nurse had to say with the community and such care, my name is michael, i'm a pediatrician at the mission, most of my patient ares on medi cal with a sizable number of family clients, the great number of my patient's parents are enrolled, [inaudible] perhaps in ants pace of the opening of the affordable care act, this is a disastrous idea, we'd be throwing people off an existing health care program in trade for vapor ware, real

people will suffer because of this, it is a bad idea to shut that down until there is a replacement for it. we have other members of ours in psychiatry at sf general, one has work witched the jail psych unit, he practices in the community, he say that is many of his patients receive their meds through healthy sf, if we cut healthy sf, we're going to be throwing a lot more people off of their psych medications and this results in yet another psych cut to a city that has been cutting care to psych for at least the past decade. >> thank you. 30 seconds, my apologies, it's been a long day. >> it's okay, supervisor. the last part of that is the bigger question is why health care costs so much. why should san franciscans and

local businesses be set up against each other when huge health care monopolies need a hospital corporations, like kaiser claim non-profit status, do not pay taxes and drive up the cost of care while local government then makes cuts because of the reduced budgets. thank you. >> thank you, sir, next speaker. >> (speaking spanish). >> good afternoon, supervisors, my name is maria, i'm a member of young workers united, we represent resident workers in san francisco, for the majority of our members, they're

undocumented and healthy san francisco is a program that is vital for them and their families. (speaking through an interpreter). as a restaurant worker and someone who works in the store and prepares food, i have presently benefit framed the healthy san francisco program and the contributions of my employers to my health care. in 2009, i suffered an

emergency due to -- access to healthy san francisco meant life or death to me. the idea that such program will be taken away from workers is terrible. our members and their health depend on this program. the health of workers who are undocumented who have very little resources and would work in restaurants should not be ignored. we need to conserve healthy san francisco. >> thank you, gracias.

next speaker. >> good evening, thanks for having us, supervisor, my name is jane sanderval, as i currently work in an emergency department, i know first hand how a reduction in community resources leads to an increased dependence in emergency departments, often the emergency department is used as a primary means of health care, i see this on a daily basis. the potential search in ed clientele due to a loss of nuances from the health care ordinance will tax an overloaded and overutilized and sometimes underfunded and understaffed department. i'm concerned ed wait times will increase, as they provide access to preventive services

sufns immunizations and health screening, i'm concerned without these sss, clientele may not seek care until they have a crisis in their life. it is unclear to me how mandating an uninsured person to purchase health care [inaudible] those less fortunate are not limit today the marginalized and people who have become a casualty, these people will not be able to afford the co-payment and is deductibles from the new insurance exchange. the loss of healthy san francisco would be a great disservice to the participants utilizing it, as the name imply, healthy san francisco promotes good health, all san franciscans have a right to affordable health care, let us maintain a healthy san francisco by not eliminating this program and by keeping the employee spending requirement

by protecting the health care security ordinance. thank you. >> thank you very much, next speaker. >> good afternoon, supervisors, thank you for having this hearing, thank you for your stamina. so, my name is romagi and i was on the health commission for 12 years, it felt like 20, under mayor brown, during that time as connie ford referred to, we try today do two things, one, equal access to health care for every resident in san francisco, two, universal access to affordability, and out of that came the health care services ordinance under the leadership of amiano, and by a vote of 11-0, signed by the mayor, it was passed in all of its lovely promises.

this still stands today, under aca and the exchange as you have already said, we will expand access and that's a great thing, but today we hear that the attack is really about affordability and that's what we have to pay attention to, and some of our partners are coming to us from the business community and saying they want out. well, there is no everyday that there's a need for them to be out. for affordability, we need them in, that should not change, i think the department of public health is not just a universal health council for the next four months when we're not going to get my mer evidence that we have today and the director of public health don't need to give you 45 more slides

and 10 more meetings that we don't have evidence and we won't have more evidence for at least four to five months. >> let me ask you to finish your thought. >> thank you, so i would ask you as leaders for our city to please reconsider this universal health council. i've heard the train is out of the station and my community would say the horse is out of the barn, please do what supervisor cohen said, have our tax paying health providers and service and non-profit groups go out there and expand, access instead of spending 150 thousand dollars or more to come and show you more slides on no new evidence. >> thank you very much. >> hi, i'm sar i with local

5299, we represent patient care and service workers at ucla medical center websinger ear here to support the health care security ordinance and healthy san francisco, while most of our members are fortunate enough to receive benefits, they have a class of secondhand workers who are hired at part time hours, they'll often work full time hours and they're not provided with health care, however, under the affordable care act, more employers will have incentive tos do exactly what uc is doing and cut employees's hours so they don't have to provide health insurance, healthy san francisco has the incentive to cut hours as well as to provide health insurance to the many san francisco residents who will not quality under the affordable care act. all residents deserve health

care. thank you. >> thank you very much. next speaker. >> good evening, thank you for your time. my name's kathy, i'm a part time teacher with the city college of san francisco and i'm a proud member of the activist committee with jobs with justice, as a teacher, i want to talk about our students, i'm aware that many of our students like my god children are lower income workers and i watch my god children, i watch other students struggle if you make 14 to 15 dollars an hour, it's hard to make ends meet and i don't believe that covered california is likely to make health care affordable for them, i believe healthy san francisco is essential to the well being of our lee -- low-income students, make health care affordable and

secure, making it secure for students who can't afford it or who won't be eligible under the aca act, my health care has never been so insecure. if i lose one class as a part timer, i'll lose my health care. i noted only lower my income, if i have to pay the affordable health care act, i may be forced into a situation where i have to choose between paying my own premiums or support my niece who doesn't have any health care at all. i had the second job at asf to provide my father with better health care. it's really important, people should not have to struggle for health care, it's a human right. >> thank you very much, next speaker, please. >> hello supervisors, my name is tammy and i'm with the training program director at the women's community clinic where we serve 4 thousand

uninsured women, we at the clinic celebrate the opportunity for 2 million california residents so have access to health care and insurance through the affordable care act legislation and we work tirelessly to enroll those who are qualified but we also see the health care security ordinance as an important complement, it provides a cohesive and multi-faceted health care institution that institutions the importance of quality preventive care, let me highlight prevention, the significant financial cost and abuser on all residences, in a recent 2012 needs assessment that focused on the western addition fill mer, they use the er as care, i also want to

reiterate to the supervisors, the lack of access to care impacts women, young women, poor communities and communities of color, so this ordinance is a women's health issue, they are the sole providers of their families and allows for their children to thrive, it creates a safety net and values health and wellness which impacts productivity and workplace excellence, it's an important safety net for young people, those who service self-oriented jobs, or have aged out of their present tam coverage and it creates a pathway to continuing to create a healthy and thriving san francisco workforce, a necessity that assure that is we in san francisco continue to be leaders in innovation and excellence. thank you so much for your support. >> thank you.

[inaudible]. >> i'm so excited about the affordable care act but so many san franciscans are going to be uninsured and wi need to care for them. i want to see us continue to be a model not only for the state of california, but also for the country and how we provide care to our constituents, thank you so much. >> thank you, next speaker. >> hi, i'm ellen shaffer, i'm

with the equal health network, i'm speaking in advocacy for a better health care system, one of the questions i get is how can we live in this great rich country and have such a screwed up health care system and sometimes i try to explain it to people and sometimes i reach back to a couple of lines from my favorite musicals, he's trying to organize some garment workers as their first time out on strike and he says, you have to speak up, you have to fiekt, and he says, things that a human heart would break at such a display at this, warmhearted men with money at stake can turn into heartless misbegun misers, i am so proud on days like this to live in a city where we know how to fiekt, we know what to fight for and i want to thank you supervisors

which i know you will do which is to ko*n to fight for us and keep these programs. thanks. >> thank you, ms. shaffer, next speaker. >> supervisors, my name is paul and i'm here representing only myself, i'm an independent health care analyst and someone who is involve ined the development of both healthy san francisco and the health care security ordinance, i want to talk about the history, they are not the same thing, health care security ordinance of which tom miano was the primary author started out as an effort to put a floor underneath the employer offered health insurance to san francisco workers, to stop them from bleeding people out by taking away their incentive to cut it and in an attempt to provide more resources to other san franciscans with other insurance, how they arose out of the niche yatd t*if from

pitch cats to make the best of those resources and use the public discussion as an opportunity to reorganize is health care system in a more rational fashion, so let me break this down quickly, this discussion is not about saving healthy san francisco because it would be political suicide to mismantle healthy san france, it's not going to be dismantled, whether it's going to be a money grab from workers, pure and simple, there are tens of millions of dollars that the small minority of the least responsible employers of san francisco stand to lose as they think about it in 2014 which they can no longer claw those dollars back, it's taking money from worker's pockets and gives it back. the employer spending requirement keeps employers from dropping insurance and

cutting hours preventing a cascade of [inaudible] that will hurt, not help san francisco's economy so i ask you to please look carefully through the untruths here in the business community and not only save healthy san francisco but save the employer spending requirement, thank you so much. >> thank you very much, next speaker, please. >> edward on [inaudible] i urge you to support healthy san francisco, thank you. >> thank you, sir. next speaker. >> [inaudible], national union of health care workers, we strongly support the health care ordinance and strongly encourages everyone to leave alone the employer mandate to pay for health care, but that aside, i just want to issue some concerns that i had about

-- that it was the business community talking about this universal health care committee and i want to strongly encourage, if that train has left the station, in her statement saying people should be paid -- naoubl as this committee is going forward, i just want to make sure if it does go forward, i want to make sure there are users involved as well as community organizations and labor involved with na because i don't want the [inaudible] in charge of the hen house at all. thank you. >> thank you very much. is there any other member of the public who would like to speak who has not spoken whether you signed up or not, if so, come forward. seeing none, public comment is closed. and i just want to take this

opportunity to thank all of the members of the public who have taken time out of their busy schedules to be here today, and i know that, you know, it was a long hearing, but i think that the fact that people were willing to sit through this hearing and speak tells you how strongly people feel about this, colleague, i want to give you an opportunity to say anything at this point. anyone want to -- supervisor mar? >> i'll just say that i was not looking forward to another long hearing since we started as supervisor cohen said and supervisor campos at 10:00 a.m., i'm always so honored to be here in this city with such great labor and community organizers that give us a sense of history of how we have different policies in our city that expand human rights for people and whether it's young

workers speaking up for themselves, immigrants and others, it's such a great experience, connie ford mentioned the years of struggle through the 90's for single parent health care system which i hope we still never give up the fiekt for that but our universal health care system in san francisco cannot be sidetracked by big business efforts here and i think the employer requirement to pay their fair share to me is the key issue so i'm appreciative from ken jacob's initial comments, that really the focus has to be on defending employers to pay their fair share in this process and not let them try to unraveler it under the guise of the affordable care act which is a good step forward for the city but i'm proud we have a city that is closer to an affordable health care system, and from all the struggle coming from the 90's to today, so thank you

for educating me more and i look forward to working with you to make sure we expand our health care service for everyone, not just undocumented and the current groups that will be expanded through the affordable care act but for everyone. er >> thank you, supervisor mar, supervisor cohen. >> thank you for sitting with us today and i was struck by ali shaffer's comments about -- she said the heart of a man but i'm going to say the heart of a human, and how we do know how to fielgt. this morning we were trying to fiekt city college and trying to find a strategy to ensure that san francisco city college is back on the right path, and then this afternoon, we get into a hearing about the implementations of the affordable care act and i think this is a testament to the heart and soul of san francisco, i also want to

acknowledge our public health representatives, colleen, thank you for staying the entire hearing, this is an interesting time that we're all living in and one thing that is evident is that this is the democratic process at work to the fullest definition where people are able to weigh in even if it is in two minute increments but they're able to weigh in on the process and have the ability to interact and shape the.public policy that we all are going to live by and i want to commend my colleague, the three of us today, whether we were in gio, and what committee is this, neighborhood services and safety committee, all of us are tackling really lofty policy discussions, earlier today, we heard supervisor mar's commitment to ensuring we have healthy and clean safe drinking

water in our city and our partners in public health were there at the table, supervisor campos was talking about the affordable health care and i forgot what i was talking about, but i think it was just as important. >> thank you. >> it's really truly been a very long day. i wanted to say thank you to all of our neighborhood leaders, our grass roots organizers, our labor leaders, everyone who comes out and makes this job so full and so dynamic and extremely rewarding, thank you. >> thank you very much, supervisor, i echo all of those comments and i especially want to thank my co