now we are going to hear from our very own catherine dodd. as was noted earlier, you will not find anyone who knows more about these issues than she does. so, to our wonderful director of san francisco health services. >> thank you very much. i have to say that the fix sort of precluded me from even speaking to her before this, i had nothing to do with that comment. [laughter] it is great to be here, and i want to thank you for shedding light and shining a light on the increasing cost of health care for our own employees, but also for employers and employees throughout the bay area. the health services system provides coverage for not just city and county employees, but also the community college district and the superior court.

catherine dodd. we also have the chief office of health office administration for calpers. the focus of this last set of presentations are options for action to protect payers, consumers, the public interest from the actual and potential negative impacts of increasing costs, specifically, a market consolidation. >> thank you very much, mr. chairman, members of the committee. i am grateful for this chance to talk to you, and to hillary, for making it easy for me to do. i have been listening with a great deal of interest and pleasure, realizing you have been told a great many things that i will not have to repeat. so i will focus on a very wide but singular aspect of the question of system performance and the role of view, as legislators, that will involve. there are some major issues. we just talked about some of them but it repairs being -- bears repeating. this is a market that is almost worthless as quality assurance or price protector. it is so shrouded in secrecy, and in many cases, blatant dishonesty on the part of some of the parties, that it is very difficult, if not

catherine dog is about as knowledgeable as you can get, and you do need to rely on her and trust her judgment -- kathryn dodd. she in turn talked to people constantly. people like her need to be available at all times to address what is the problem, what are the remedies, and what are the advantages and disadvantages and movements. anything you do in health care, almost anything is going to cost both ways. you are right about being concerned about unintended consequences, but there is lots of us out here who can tell you if you do this, this is likely, or the probability is xyz. and this possibility also exists. every decision is a trade-off. the best way to make decisions under extreme uncertainty is to have the best staff and outside counsel that you can find. supervisor campos: thank you. i know we have a number of speakers, so why don't we move on to the second speaker who is here to talk about the issue, or at least begin discussion of the issue of hospital market consolidation in san francisco between northern california -- in northern california between 1990 and 2010. thank you for being here today. >

catherine dog is about as knowledgeable as you can get, and you do need to rely on her and trust her judgment -- kathryn dodd. she in turn talked to people constantly. people like her need to be available at all times to address what is the problem, what are the remedies, and what are the advantages and disadvantages and movements. anything you do in health care, almost anything is going to cost both ways. you are right about being concerned about unintended consequences, but there is lots of us out here who can tell you if you do this, this is likely, or the probability is xyz. and this possibility also exists. every decision is a trade-off. the best way to make decisions under extreme uncertainty is to have the best staff and outside counsel that you can find.