Pacific Sun Weekly 07.06.2012 - Section 1

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county’s OB/GYN practice, which shifted responsibility to Marin Community Clinics. Although that saved the county health dollars, it also undercut the need for a dedicated local testing lab. “We were our own best customer,â€? says Meredith. A core issue now is whether the county should maintain its ďŹ nancial support for a testing facility that no longer performs as many tests as it once did. “We have the short term and the long term,â€? says Rienks. “When you dismantle an infrastructure, your chance of reassembling it [is small] because of the amount of money it would cost to go back and re-create it.â€? Rienks says that focusing too closely on budget numbers can obscure the possibility of taking a wider and more creative tack to look at “opportunities to preserve, to take a different approach to the process.â€? Meredith says he and his department have looked at ways that could lead to better long-term ďŹ nancial footing of the lab. But options seem limited. “Opportunities for [getting] other business and competing with the private sector are not realistic. They’re not possible. We can’t undercut the costs.â€? San Quentin and Marin Community Clinics already have contracts with Quest Diagnostics Inc. “They can’t contract with us. There are not the revenue opportunities that some people suggest.â€?

Critics of the proposal to close the lab have noted that one of its important functions is to train future professionals for labs in and beyond the Bay Area. But a regional lab could assume that responsibility. As with many recent contentious issues in Marin (SMART, Marin Clean Energy, Plan Bay Area), there are staunch proponents on each side of the debate table armed with competing sets of perceived facts. Sometimes a desired outcome is the ďŹ rst step. Finding corroborating facts to support a preconceived notion follows. “We seek out conďŹ rmatory information,â€? says Rienks. She and Meredith both say they have at least a sense of optimism that the lab-closure process, which essentially has undergone a reset, now can yield useful guidance when the health department makes its ďŹ nal recommendations to the board of supervisors. That could happen in autumn, possibly September. Meredith says the ultimate decision should focus on more than money. “The ďŹ nancial issue may be the least important part. The most important thing is that we would have new technology [in a regional lab system] to diagnose and analyze better and faster. If your interest is protecting the health and safety of all who live in Marin, then the regional approach trumps a local one.â€? ✚ Contact the writer at peter@pseidman.com.

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As part of the new two-year transportation bill, MAP 21 (Moving Ahead for Progress in the 21st Century), the Safe Routes program will be folded into a new program called Transportation Alternatives, and no longer will have dedicated funding. The bill also allows states to “opt out� of grant programs that have previously been crucial to funding local small-scale biking and walking projects. Despite the legislative setback, Hubsmith is trying to see the glass half full—or, better yet, the tires half pumped. Republicans in the House of Representatives “wanted to completely eliminate Safe Routes to School,� says Hubsmith.“We remain eligible for funding and our projects are likely to be very competitive in the new Transportation Alternatives program given our focus on the safety and the health of children.� Launched in 2000, Marin’s program began with an initial nine schools, but now includes 52 schools and more than 23,500 students, according to Transportation Authority of Marin statistics. More than 12,000 schools across the country currently have Safe Routes programs, writes Hubsmith.

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Supreme Court upholds health care mandate Chief Justice John Roberts turned out to be the somewhat surprising key vote in the Supreme Court’s narrow decision to uphold the constitutionality of President Obama’s signature piece of legislation—the Affordable Care Act. The 5-4 decision upheld Congress’s right to mandate a fee for citizens who choose not to have health insurance; Roberts, who wrote for the majority opinion, reasoned that such a “fee� is interchangeable with Congress’s right to “lay and collect taxes,� noting the penalty is collected by the IRS like any other tax. Passed by both houses of Congress and signed by the president in 2010, the Affordable Care Act is still being rolled out over the next few years—the hope is that it will eventually provide health insurance to more than 30 million Americans who currently have none. The Obama administration has estimated that around 4 million people will choose to pay the penalty rather than enroll in the health care plan. The ruling on the individual mandate not only reaffirms the ACA, but also means that beginning in 2014, the IRS can impose an annual penalty of $95 on folks who do not secure insurance; exemptions would be permitted for financial hardship. Also to be rolled out in January of 2014 is the private-insurer prohibition from discriminating or charging higher rates for individuals with pre-existing medical conditions. Lynn Woolsey, Marin’s 2nd District congresswoman, applauded the decision, saying “the Supreme Court put partisanship aside and affirmed the will of the people, as expressed through their elected representatives in Congress and the White House.� But, she added, the struggle isn’t over. “Republicans in Congress will still try to dismantle the Affordable Care Act piece by piece,� said Woolsey.“They still don’t get it. They are still nostalgic for the old, broken health care system that left millions without coverage; bankrupted families and small businesses; and put the middle class at the mercy of the insurance industry.�

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