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April 22, 2013

Host: Ted Simons

Phoenix Mayor Greg Stanton

  |   Video
  • Phoenix Mayor Greg Stanton makes his monthly appearance on Arizona Horizon to talk about Phoenix issues.
  • Greg Stanton - Mayor, Phoenix
Category: Government   |   Keywords: phoenix, mayor, stanton,

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Ted Simons: Phoenix mayor Greg Stanton stops by the "Arizona Horizon" studios each month to discuss issues of importance to the state's largest city. Tonight we address a number of issues, including community budget hearings and a new proposal to reduce the city's food tax. Here now is Phoenix mayor Greg Stanton. Good to see you again.

Greg Stanton: Happy to be here again.

Ted Simons: With these community hearings on the budget, what we are talking about here?

Greg Stanton: The city of Phoenix is hyper-transparent. Every year the city manager proposes a budget for the city and we take that show on the road. We don't do late-night presentations of the budget and votes the next day like some other governmental entities do. We spend a month and a half on the road. We have do 20 budget hearings. I will personally have been to seven or eight of them. I am heading to one in the west Phoenix as well. We do a live online budget hearing tomorrow night on channel at the city of Phoenix. We really, really want to hear from the public as to what they think about the proposed budget and we will take that into consideration and ultimately change the proposed budget based upon what we hear at these hearings.

Ted Simons: What are you hearing?

Greg Stanton: Support for biking in Phoenix. Believe it or not the group that has showed up the most are people that want the city to become more bikeable. People that support parks and arts and libraries. These are well-organize groups that care passionately about the future of the city. After school programs, come up regularly. People need to see more and more after school programs particularly in these tough budget times. Those programs when done right and well really enhance the academic experience of our children and so they are very, very popular. So as you would expect it's people who come to these hearings that really like the programs that the city provides, believe in those programs. And hopefully that budget as it improves we are able to provide more of those programs to the people of Phoenix.

Ted Simons: Do they understand the limitations of the budget as it is? And as it pertains to these kinds of requests?

Greg Stanton: Sure. In fact, as you know the budget this year is essentially a break-even budget. There are some increases, small increases for things like arts and after-school programs. We are actually for the first time in many years going to be hiring new police officers under this proposed budget. But it's about $5 million in new programs on a budget of about $1 billion. So it is essentially a break-even budget. Obviously, I wish we were much further along economically, that our revenues were higher. We still have some budget challenges that we need to be cognizant of those budget challenges. There's a long term trust that builds up between the city and the residents of the city. And I certainly have inherited that trust as mayor of this city. And so when we say it's a break-even budget we can't do more, I think people are generally understanding of the situation.

Ted Simons: There's a move afoot by a couple of council members,regarding a partial repeal of the food tax. What are they talking about? How viable is such an idea?

Greg Stanton: Sure. At beginning of the budget cycle, of course, I asked the city manager to present a budget with the food tax and without the food tax because it's important. I think most people would agree in the city that they want to eliminate the food tax you this but they don't want to do it in the way that would hurt our core mission, public safety or our core services or a negatively impact our budget rating. There are some members of my council of course who want to get rid of the food tax tomorrow regardless of circumstances, even if it would require almost 100 police officers being laid off. That doesn't represent the majority of the council. What the councilor are asking for is to see if we can eliminate half the food tax on January 1st of 2014, but only if we can do it in a way that doesn't impact police, fire, and other community services. I think the majority of council agree with that sentiment that we should always be kicking the tires. We want to get rid of the food tax but we want to do it in the most responsible way. If the budget improves over the next eight months, and we can reduce the food tax in a way that does it so we don't hurt public safety or core services we ought to be open minded to that.

Ted Simons: Councilwoman Williams says she thinks you can find $25 million or so to cover the lost revenue and the police and fire and community service won't get hit. Again, is that realistic?

Greg Stanton: Well, we will see. That's the honest truth. By the way, they want to implementation of receipt do you said food tax to start January 1st of 2015, not immediately which means that instead of a $25 million hit on our budget it would be about a $12 million hit on our budget. And my position is, if we can do that responsibly in a way that doesn't impact public safety, we can do it in a way that doesn't negatively impact our core services, and we can protect our credit rating. Because that's important that we don't engage in budget tricks. As long as I have been in elected office in Phoenix we have maintained our triple A credit rating. We don't want to do anything that would put that at risk. If we can accomplish that of course we should be looking at ways to reduce the food tax.

Ted Simons: How much has this issue divided the city? How much has it divided the council?

Greg Stanton: We are in the business of making tough decisions. Yes, the food tax is a high-profile issue. It tends to make the front page of the paper on a regular basis. Ted, we deal with tough issues all the time at the City of Phoenix. We passed an access to care ordinance to provide Medicaid just like they are doing it with the state. We did it on a 6-3 vote. Guess what? I don't mind division on my council. In fact, I want my council members to lead with what they think is in the best interests of the city. As long as they are acting in good faith I don't mind division on the council. I think good solid division, we debate the issues in a healthy ways for the city.

Ted Simons: Is it a healthy division on this issue?

Greg Stanton: Yeah. I don't mind people speaking their mind and saying what they believe it. And I work closely with all of my members. I treat everyone professionally and I want everyone to present what they believe is in the best interests of the city. And I think if you talk to every member of the council you will find that is the way I operate as mayor. Division per se is not a bad thing. Negativity for the sake of negativity is not healthy for the city of Phoenix but, no, healthy division on a tough issue is not a problem as long as we are all professional and move forward in good faith.

Ted Simons: The State Senate is look at, actually OK'd a gun by buyback bill. That would be a bill that requires cities to sell guns from gun buy back programs, not destroy them. They say destroying is a waste of money and time, et cetera, et cetera. What are your thoughts on this?

Greg Stanton: I don't think that's good public policy. I actually think that law enforcement should make that decision. Local law enforcement. And so I think that any time our friends at the Legislature try to pass laws which take away local control, take away local decision-making, particularly in the area of public safety, I really think that public safety decision-making should be left in the hands of our police chief and the leadership of the Phoenix police department. We don't want to substitute a political agenda for a true law enforcement agenda. I actually defer and believe that law enforcement decisions are best made at the local level.

Ted Simons: How would this, let's say this gets through. Let's say it gets signed. How would it impact Phoenix and gun buy back programs in your city?

Greg Stanton: I am proposing a gun buy-back bill. This would have no impact on the bill I am proposing because it's privately funded. Money from our donor is going directly to Arizonans for gun safety. They will be the fun that actually is the entity is the receiver of the money and makes the decision of the disposition of the weapons. Obviously our friends at the Legislature have been strong proponents of private property rights and they would not want to violate people's private property rights by telling them how to dispose of their personal private property. City of Phoenix will be partnering because as weapons get handed in we want to see if it's been stolen so or if it's been used in a crime so we can help solve that crime. It's what we owe victims of crimes. So the city of Phoenix does have an important role to play in the gun buy back but it's important to know this is a private-public gun by buyback.
Greg Stanton:It starts the first Saturday in May. It will happen at churches in South Phoenix, Sunny Slope and in West Phoenix and we have a great team that's putting this together and we will obviously watch the news. There will be a lot more details about it but I expect it's going to be a huge, huge success.

Ted Simons: Couple of issues real quickly. The civil action about what happened in Bisbee with the attorney general has said and has done. What Bisbee wound up doing. And just what Phoenix has done.

Greg Stanton: Well, I actually think it's much ado about nothing what Bisbee did. That's why when the attorney general threatened a lawsuit, I thought you might as well sue the Phoenix. While they call theirs a civil union we have had a domestic partner registry. Which is used for a variety of sources including allowing couples, gay and lesbian couples, to have hospital visitation rights in the city of Phoenix. It allows companies who want to provide domestic partner benefits for their employees to use that as a legal basis if a couple is registered on our registry. And so my thought was if you are going to pick on Bisbee you might as well pick on the city of Phoenix. People are reasonable. Bisbee was trying to make a statement about their support for the gay and lesbian residents. Their community. I have tried to be very supportive of gay and lesbian residents in Phoenix. We don't need heavyhanded lawsuits. We need to work together to be more supportive of the people are our communities. That's why I spoke on that issue.

Ted Simons: The attorney general said basically you can't grant community property and inheritance rights the way Bisbee, Phoenix didn't do that. Bisbee did. That's how Bisbee overstepped its bounds. Valid?

Greg Stanton: If you read the actual ordinance that Bisbee had passed, it said it's only limited to rights that can be granted by the city. They may have listed some possible additions that they shouldn't have done. But why don't you call the city attorney and say, hey, there's a few issues here. I think it's fairly patently obvious what was going on and threats of lawsuits are very heavy handed and meant for front-page news. It's unfortunate. We need to be more supportive of again all the diverse communities within our cities including our gay and lesbian members of our citizenry. I thought Bisbee did the right thing in sending that message.

Ted Simons: Last question. It sounds like the Goldwater institute is tar getting the town of Gilbert over some city-run operations here. What are your thoughts there? Because everything from libraries to swimming pools, the whole nine yards could be affected here.

Greg Stanton: Yes. I have no idea what Goldwater is thinking. I have spoken directly with mayor john Lewis of Gilbert saying Phoenix and I as mayor stand with you. We are trying to organize all the mayors to get out there and do a little workout at that facility and send a message that good community services including recreation services is part and parcel of what cities do. We provide services for the people of our cities. And for the Goldwater institute to threaten a lawsuit against Gilbert for simply providing recreation services, I think most people are going to be angry about that. I am certainly angry about it because this again as you just said threatens so many core services that cities provide. And I think our friends at Goldwater may have overplayed their hand on this threatened lawsuit.

Ted Simons: Is there not a case for someone who runs a gym, a books store and they are look at the library saying what am I doing, what am I doing because they have this recreation center? Is there a case to be made that it's not fair to those businesses?

Greg Stanton: No. If libraries are a threat in our society, a threat to anyone, man, we are in trouble. Libraries are so, so important for our young people giving them an opportunity to read so many books that they otherwise wouldn't be able to read, providing reading programs for our kids. Community rec centers providing maybe an opportunity for people in a very cost effective way who have diabetes or other conditions where they need exercise. Let's be honest it's very different than the services provided at the private workout facilities. I respect those folks. But let's get our priorities straight. Providing library service, recreation services that's what cities do. That's why we exist.

Ted Simons: Speaking of priorities, ASU baseball going to be playing at Phoenix Muni?

Greg Stanton: Absolutely. We have reached an agreement with our friends at ASU, ASU baseball is an awesome institution in our community. Literally championship level baseball. One of the top countries in the country. I am super excited that Phoenix Muni will now be the home of ASU baseball. We got to get it all worked out. They will play a couple more sense there but we are preparing for that transition. You will see the ASU name all over Phoenix MUNI where I used to watch Phoenix giants games as a kid.

Ted Simons: Good to have you here.

Greg Stanton: Thanks very much.

Transparent Medical Pricing

  |   Video
  • Governor Jan Brewer vetoed a bill that would have required hospitals and other medical providers to list prices for common medical procedures. The Arizona Senate has revived the bill. Senator Nancy Barto, sponsor of the bill, will talk about her measure. Pete Wertheim, of the Arizona Hospital Association, will speak in opposition to the bill.
  • Nancy Barto - Senator, Arizona
  • Pete Wertheim - Arizona Hospital Association
Category: Law   |   Keywords: medical, cost, law,

View Transcript
Ted Simons: Governor Brewer recently vetoed a bill that would have required medical providers to list direct-pay prices for common procedures. That bill has been revived with changes aimed at the Governor's veto language. Here to talk about the bill is its sponsor, state senator Nancy Barto. And speaking against the measure is Pete Wertheim, vice president of strategic communications for the Arizona Hospital and Health Care Association. Good to have you both here.

Pete Wertheim: Thank you.

Ted Simons: Let's start with, what exactly does this legislation do.

Nancy Barto: Well, health care is the only arena in which, when people are purchasing a health care service they have no idea what it's going to cost them. Basically, what it will do is ensure that people that are paying directly or cash without a third party can get that health care price, that cash price for the service that they are seeking.

Ted Simons: Why is that a bad idea?

Pete Wertheim: The Arizona hospital and health care association and Arizona hospitals, we do support pricing transparency. The idea sounds good and -- but transparent means it's real and distinct to the consumer. We just want to make sure if we are going to impose a very large mandate on a very heavily regulated industry that the consumer who is getting that information is going to get the best information possible.

Ted Simons: Is it difficult to get the best information possible?

Pete Wertheim: It is difficult. When you have every patient is different. Their clinical presentation varies so the costs may vary. They also have different payer sources, Medicaid, Medicare, different types of health plans and some have no ability to pay. There's a lot of variance that has to be accounted for to come up with one single price which we appreciate the goal. And I think we support that effort. We just need to come to terms on how to get there.

Ted Simons: What about the variables what when it comes to pricing? Can that be pinned down to where you have a sheet of paper and here's what you got to charge?

Nancy Barto: Sure. We do it every day with everything else that people purchase. And health care should be no different. Think about, health care really is changing. And now people didn't used to be able to care. When someone else is paying for your gallbladder surgery -- whether it costs you $35,000 at one hospital and maybe half as much at another, now more and more people are paying themselves for health care services for a variety of reasons. Number one, a lot more people are uninsured. And/or they have medical savings accounts where they have a pretty high deductible, sometimes, $10,000, 12,000 so they need to know how best to spend their own money.

Ted Simons: But what I don't understand is when you look at a hospital, even within the hospital, the same procedure doesn't necessarily have standard pricing. How do you get from there to a checklist or a price list, if you will?

Nancy Barto: Well, we are talking about two different things. We are talking about the cost of health care. We are just asking hospitals, health care providers to go through the iterative process of finding out what does it cost? What does it cost? Now, it doesn't mean that it's not going to increase for, let's say, a basic surgery, an OB situation, for instance, that if there are complications that cost won't rise. But what's the basic cost if you are paying directly for cash on your own dime?

Ted Simons: Why not include a standard price and take it from there?

Pete Wertheim: Well, it would be nice -- it sounds simple. But the problem is, if you are going to give somebody a price, you would like to have it be close to that actual price when they ultimately receive the bill. 150-pound patient versus a 400-pound patient getting an appear pen detective me, the variance is huge. The anesthesia used, so to put a single price on a procedure may not help the consumer at all. So we advise consumers, talk to the physician, check out your clinical circumstances and try to work that price out up front. That's the best way to do it.

Ted Simons: Can there be a price? It's almost like buying a car, if you will, docking fees. Can there be a price if you say, well, it looks like that's lower. You find out it may be different but at least you have something to go on, somewhere to hang your hat on.

Pete Wertheim: There's ways to get you in the ballpark. But the other problem with the legislation it's requiring every hospital to provide 50 of the most common in-patient and outpatient procedures. Hospitals are not identical. So these procedures may not be the kind of procedures that a consumer even has the luxury to shop for. Looking at a level I trauma center you are going to read about heart conditions, seizures, neurosurgery. That price menu is not going to be helpful when you look at it to another hospital. So the question is, is this helpful to the consumer if they can't compare common procedures that consumers typically have the luxury to shop for, comparing one hospital to the next?

Ted Simons: Please respond.

Nancy Barto: Well, I just -- I am baffled that people even opposed price transparency at any level. Consumers are smart enough to figure it out, what they want, they will ask the question. And if we just open the door for hospitals and health care providers to start with their most commonly provided procedures, the consumers will take it from there and then the free market will fill the gap.

Pete Wertheim: Well, I think that's an important point. The free market. I think we need to come up with those solutions as an industry and keep working at providing that. But to put an unfunded mandate in statute of this type on an industry, we are not convinced that this is going to be ultimately helpful to the consumer.

Nancy Barto: But we are trying to do, Pete --

Pete Wertheim: We can be progressive. Certainly with the Affordable Care Act there's hundreds and thousands of new regulations, payments are being changed to hospitals. So let's make sure we have something that's going to be ongoing worth our time and energy to put together all threes lists.

Nancy Barto: What we are trying to do with Senate bill 1115 now, a house bill since we did amendment it on to another bill and making the changes the Governor wants. What we are trying to do is create a free market in the health care industry. And people need transparent prices for that to happen. So we're just cracking open the door a little bit in order to get there.

Ted Simons: Does it worry you or bother you at all that some see this legislation as ignoring industry concerns? The industry doesn't want this. Doesn't like this. Does that impact your decision-making process at all?

Nancy Barto: Well, we are certainly open to make sure we are listening to the industry and working with them. And I think that's part of what the veto was all about was making sure that we addressed some of the practicalities. I think it was a fine bill going up to her but the Governor did have some good ideas. I think we are going to get a better bill out of it. But, you know, we have had a lot of input since we've proposed this idea. Across the country, people are acknowledging that transparent pricing in health care is absolutely what people need in order to make sure that the dollars that they are spending, they can spend wisely. I mean, we have people now that are very concerned about health care. I mean, they can't afford insurance. The cost of insurance is going up eight, nine, 10% a year. Their hours are being cut back. We heard last week Maricopa County, Maricopa community colleges are cutting back hours in order to comply with Obamacare. Those people are going to be uninsured. They need to make sure they are spending their health care dollars wisely.

Ted Simons: Something that helps folks manage health care needs, doesn't this do that?

Pete Wertheim: I would say if it doesn't provide meaningful information to the consumer, I think it falls short. I believe we can resolve these differences we have talked about today. But before we embark on the hours it takes to produce something for the consumer, let's take a step back and make sure this is actually something that consumers will use and it will be helpful to them. I think we can get to that goal. Right now the way the bill is constructed -- we don't want to go through all the effort to put this together and not see patients using this tool.

Ted Simons: All right.

Nancy Barto: It's certainly going to pay off.

Ted Simons: All right. Good to have you both here.

Nancy Barto: Thank you.

Ted Simons: Thanks for joining us. We appreciate it.