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>>> Coming up next on "Arizona
Horizon," should medical
providers be required to post
direct-pay prices for common
medical procedures?
We will hear from both sides of
the issue.
>>> And should Phoenix move to
partially repeal the city's food
tax?
We'll ask mayor Greg Stanton who
joins us for his monthly visit.
Those stories next on "Arizona
Horizon."
>>> "Arizona Horizon" is made
possible by contributions from
the friends of 8, members of
your Arizona PBS station.
Thank you.
>>> Good evening and welcome to
"Arizona Horizon."
I'm Ted Simons.
Republican state senator Al
Melvin of Tucson is forming an
exploratory committee for a
possible run for Governor.
Melvin joins what promises to be
a crowded race on the Republican
side.
Former Tempe mayor Hugh Hallman
has already announced his
candidacy.
Others likely to run include
Secretary of State Ken Bennett,
Mesa mayor Scott Smith, and
state treasurer Doug Ducey.
>>> And former Arizona
Congressman Jim Kolbe wants
immigration reform expanded to
include foreign-born partners of
gay Americans.
Kolbe, who is openly gay, has a
partner from Panama who had to
leave the U.S. after his work
visa expired.
Kolbe's partner was able to
return on a special visa for
immigrants that invest in a
business here.
Legislation separate from
comprehensive immigration reform
has been introduced to allow
foreign-born gay partners to be
brought into the U.S.
>>> 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.
>> Thank you.
>> Let's start with, what
exactly does this legislation
do.
>> 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.
>> Why is that a bad idea?
>> 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.
>> Is it difficult to get the
best information possible?
>> It is difficult.
When you have every patient is
different.
Their clinical presentation
varies so the costs may vary.
They also have different payor
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.
>> 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?
>> Sure.
We do it every day with
everything else that people
purchase.
And health care should be knew
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 cost it
-- 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, so they need
to know how best to spend their
own money.
>> 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?
>> 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?
>> Why not include a standard
price and take it from there?
>> 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 fry
to work that price out up front.
That's the best way to do it.
>> 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.
>> 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.
Look 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?
>> Please respond.
>> 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.
>> 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.
>> But we are trying to do,
Pete --
>> 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.
>> 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.
>> 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?
>> 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.
>> Something that helps folks
manage health care needs,
doesn't this do this that?
>> 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.
>> All right.
>> It's certainly going to pay
off.
>> All right.
Good to have you both here.
>> Thank you.
>> Thanks for joining us.
We appreciate it.
>>> 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.
>> Happy to be here again.
>> With these community hearings
on the budget, what we are
talking about here?
>> The city of Phoenix is
hyper-transparent.
Every year the city manager
proposes a budget 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 11 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.
>> What are you hearing?
>> 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 the
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
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.
>> Do they understand the
limitations of the budget as it
is?
And as it pertains to these
kinds of requests?
>> 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.
>> There's a move afoot by a
couple of council members,
Michael guarding a partial
repeal of the food tax.
What are they talking about?
How viable is such an idea?
>> 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 rifted 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.
>> Council woman 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?
>> 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 2014, 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.
>> How much has this issue
divided the city?
How much has it divided the
council?
>> 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.
>> Is it a healthy division on
this issue?
>> 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 wait 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.
>> 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?
>> 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.
>> 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?
>> 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.
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.
>> 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.
>> Well, I actually think it's
much ado about nothing what
Bisbee does D-
That's why when the attorney
general threatened a lawsuit, I
thought you mite 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.
Bills bee 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 neat lawsuits.
We need to work together to be
more supportive of the people
are our communities.
That's why I spoke on that
issue.
>> 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?
>> 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.
>> 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.
>> Yes.
I have no idea what Goldwater is
thinking.
I have spoken directly with
mayor john Lewis 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.
>> 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?
>> 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.
>> Speaking of priorities, ASU
baseball going to be playing at
Phoenix Muni?
>> Absolutely.
We have reached an agreement
with our friends at ASU, ASU
baseball is an awesome
institution in our community.
Literally championship level
baseball.
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.
>> Good to have you here.
>> Thanks very much.
>>> Expand your "Horizon" with
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To get there go to azpbs.org.
Click on the "Arizona Horizon"
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>>> Tomorrow on "Arizona
Horizon," famed physicist
Lawrence Krauss will talk about
the latest news in science,
including photos that could lead
to fresh information on the big
***.
And meet the new head of ASU's
Global Institute of
Sustainability.
and
10:00, on "Arizona Horizon."
That is it for now.
I'm Ted Simons.
Thank you so much for joining
us.
You have a great evening.
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>> The Persian room.
Travel to another world.
To a lands of exotic aromas and
period decor.
The Persian room in north
Scottsdale on Scottsdale road
one light north of Frank Lloyd
Wright boulevard.
Gourmet cuisine at its best.