Opinion and analysis for greater San Diego http://timesofsandiego.com/category/opinion/ Local News and Opinion for San Diego Tue, 28 May 2024 17:54:10 +0000 en-US hourly 1 https://timesofsandiego.com/wp-content/uploads/2021/01/cropped-TOSD-Favicon-512x512-1-100x100.png Opinion and analysis for greater San Diego http://timesofsandiego.com/category/opinion/ 32 32 181130289 Opinion: California’s Goal to Be Carbon-Neutral by 2045 Could Slow Growth of Logistics Industry https://timesofsandiego.com/opinion/2024/05/28/californias-goal-to-be-carbon-neutral-by-2045-could-slow-growth-of-logistics-industry/ Tue, 28 May 2024 17:54:02 +0000 https://timesofsandiego.com/?p=274067 Tesla electric semi-truckOne of the biggest unknowns about a carbon-neutral future is the impact on economic sectors that depend on transportation, especially Southern California’s logistics industry.]]> Tesla electric semi-truck
Tesla electric semi-truck
A prototype Tesla electric semi-truck at a charging station. Image from Tesla video

California’s governor, Gavin Newsom, flew more 6,000 miles to Rome this month to deliver a brief speech on climate change at a Vatican-sponsored conference.

Media reports of Newsom’s appearance centered on his verbal potshot at former President Donald Trump and his conversation with Pope Francis who, Newsom said, praised his unilateral suspension of executions in California.

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However, the governor did devote a little time to climate change, mostly reiterating his villainization of the oil industry.

“It’s because of the burning of gas, the burning of coal, the burning of oil,” Newsom said. “We have the tools. We have the technology. We have the capacity to address the issue at a global scale and they’ve been fighting every single advancement and we have got to call that out.”

At this point, we should remind ourselves that Newsom’s constant gallivanting to polish his image as a political heavyweight depends on planes and automobiles that burn petroleum. Nevertheless, he has proclaimed that California will by 2045, just 21 years hence, become carbon emission-neutral.

In 2022, the state Air Resources Board issued a “scoping plan” with multiple precise steps to achieve the goal. Newsom hailed it as “a comprehensive roadmap to achieve a pollution-free future” and, with characteristic hyperbole, “the most ambitious set of climate goals of any jurisdiction in the world … (that could) spur an economic transformation akin to the industrial revolution.”

That’s a lot to be done in just a couple of decades, and there’s not been a particularly noticeable amount of progress. In fact, there’s been some regression.

It’s questionable whether California will have enough power from solar panels and windmills not only to fill current demand but supply additional juice for the many millions of battery-powered cars and trucks that the plan envisions.

Fearing blackouts, Newsom pressed to keep some natural gas-fired power plants and the state’s only nuclear-powered plant operating past their planned phaseout dates. Electric car sales have languished, even though automakers are supposed to quit selling gasoline- and diesel-powered vehicles in just 11 years. Car buyers are leery because the state still has only a fraction of the recharging stations conversion requires.

Furthermore, to deal with a budget crisis, Newsom has slashed spending on climate change programs.

One of the biggest unknowns about a carbon-neutral future, however, is the impact on economic sectors that depend on transportation. A new report on one of those sectors, Southern California’s logistics industry, frames the issue.

A half-century ago, Southern California’s leaders bet the region’s future on the twin ports of Los Angeles and Long Beach becoming the nation’s primary conduit for trade with Asia, and the transportation and warehousing facilities to handle cargo.

The new report from the California Center for Jobs and the Economy, an offshoot of the California Business Roundtable, reveals how impressively that goal has been achieved.

What it terms the “regional trade cluster” is the region’s largest single source of employment, supporting 1.85 million jobs, two-thirds of which require only a high school education or less — an important characteristic given its huge immigrant population.

However, global transportation is a cutthroat business and the twin ports have seen their traffic decline in recent years due to competition from ports with lower operational costs. The sector is also being pressed by state and local authorities to convert ships, trucks, locomotives and other machinery to low- or no-emission propulsion, at huge cost. There has been a backlash against the massive warehouse complexes in inland areas.

Can the industry undergo the massive conversion Newsom’s plan envisions in just 21 years — without becoming terminally uncompetitive and shedding the jobs on which so many of the region’s families depend?

It’s a microcosm of the larger uncertainty.

CalMatters is a public interest journalism venture committed to explaining how California’s state Capitol works and why it matters.

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Opinion: San Diego Should Revert to Council-Manager System to Make Home Building Easier https://timesofsandiego.com/opinion/2024/05/27/san-diego-should-revert-to-council-manager-system-to-make-home-building-easier/ Tue, 28 May 2024 05:05:40 +0000 https://timesofsandiego.com/?p=274031 San Diego City HallHaving a professional city manager to oversee and run administrative operations may make local government more efficient and potentially help to make housing more affordable in San Diego. ]]> San Diego City Hall
San Diego City Hall
San Diego City Hall. Photo by Chris Stone

To make the home building process more efficient and housing more affordable, San Diego should consider reverting back to a “council-manager” system of governance and ditch the current “strong mayor” system. This change could potentially streamline city operations through professional management — something that the city critically needs.

San Diego faces a significant housing shortfall, with an estimated deficit of around 90,000 homes needed to meet regional demand, according to Ray Major, the chief economist at the San Diego Association of Governments. This gap in housing supply has emerged because the region has not kept pace with its job and population growth.

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The city’s 2023 housing report indicates that to meet the state’s annual housing needs, San Diego would need to triple its current rate of housing production. Interestingly, the decline in home building began around 2006, coinciding with the city’s switch from a “council-manager” system of government to a “strong mayor” system.

San Diego is the only city in the region that that operates under a strong mayor form of governance. The other 17 cities in the county generally follow a council-manager form of government, where the city council appoints a city manager to oversee administrative operations.

San Diego transitioned to a strong mayor form of government on Jan. 1, 2006, following a voter-approved change. This change was part of a five-year trial period. This system was made permanent in June 2010 after San Diego voters approved Proposition D, which solidified the strong mayor system beyond the trial period. 

A “strong mayor” form of government means the mayor also acts as the chief executive officer of the city, having significant administrative and executive powers, such as veto authority over council decisions and control over the city budget and staff. Under the “council-manager” system of government the mayor typically has a role similar to that of a council member, with some ceremonial duties and possibly some additional powers like presiding over council meetings and other official functions. It is clear that the current system of government is not working when it comes to making homes and rents affordable in San Diego.

Since the shift in government San Diego has not been able to keep up with housing demands. Building permits fees have skyrocketed to a point where it is almost impossible to build affordable housing. High permit fees are just one factor leading to the astronomical costs to build. Other reasons such as inflation, labor costs, and increases in building materials are also significant factors that raise the price to construct new homes.

Government has little or no control over these things. However, local government has the ability to manage regulatory costs that account for 34% and 51% of the average cost of building housing.

San Diego has made efforts to accelerate approvals of new housing and other projects, but the city increased developer fees to do so. The increases are to cover additional city workers, new technology and other efforts. Under the changes, the permit cost for a 500-square-foot ADU rose from $1,484 to $2,885. For a 3,000-square-foot house, the fee increased from $4,925 to $6,640.

The new fee structure also shifts to a per-hour formula. The city will now charge an applicant $145 per hour for staff time. These fees may speed up the permitting process but will do little to make homes more affordable.

There is no single solution to tackling the affordable housing and rental crisis in San Diego, and we will most likely need a multifaceted approach to increase the number and affordability of homes. Therefore, we must encourage our elected officials to take a second look at how government is currently being run in San Diego and consider reverting back to a council-manager system of governance as the strong mayor system has not delivered the results we had hoped for. With proper professional oversight a city manager could help streamline the building permit process using things such as AI technology or privatize building permitting to speed up the process as they did in Arizona.

The mayor’s role should be that of a visionary leader, someone who thinks outside conventional boundaries and is not afraid to take risks to achieve San Diego’s housing goals. The city manager’s goal is to help make the mayor’s vision a reality in a cost-effective way. Having a professional city manager to oversee and run the administrative operations may make local government more efficient and potentially help to make housing more affordable in San Diego. 

Mark Powell is a licensed California real estate broker and former vice-president of the San Diego County Board of Education.

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Opinion: Don’t Get Hammered — 10 Steps to Protect Yourself from Contractor Fraud https://timesofsandiego.com/opinion/2024/05/26/dont-get-hammered-10-steps-to-protect-yourself-from-contractor-fraud/ Mon, 27 May 2024 05:05:13 +0000 https://timesofsandiego.com/?p=273911 New home under constructionContractor fraud is a pervasive issue that not only undermines trust within communities but also inflicts significant financial and emotional harm on families across America. ]]> New home under construction
New home under construction
The frame of a new home under construction. Courtesy County News Center

Last year was a historic one for billion-dollar weather and climate disasters in the U.S., with 28 separate events costing at least $1 billion each. In the 1980s, the average time between billion-dollar disasters was 82 days. In 2023, it was just 12 days.

These catastrophic events leave millions of Americans struggling to recover and rebuild their lives, and when repairs or renovations are needed, the process can often feel overwhelming. Unfortunately, disreputable contractors often swoop in after these catastrophic events, preying on desperation with high-pressure tactics and promises of quick fixes, which can leave homeowners financially and emotionally drained.

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Contractor fraud is a pervasive issue that not only undermines trust within communities but also inflicts significant financial and emotional harm on families across America. With the promise of renovations, repairs, or construction projects, fraudulent contractors exploit the vulnerabilities of unsuspecting homeowners, leaving behind a trail of broken promises, shoddy workmanship, and depleted savings. 

This type of fraud not only affects individual homeowners, but also impacts insurance premiums throughout the industry and costs Americans billions of dollars every year.

To combat this growing problem, the National Insurance Crime Bureau partners with government agencies and its member insurance carriers to educate homeowners and businesses on how to avoid becoming a victim of deceptive contractors after a natural disaster as part of its annual Contractor Fraud Awareness Week, which just ended.

Contractor fraud is a crime that thrives in the shadows. By arming ourselves with knowledge, vigilance, and a healthy dose of skepticism, we can protect our homes and our hard-earned money. Luckily, there are important steps every homeowner can take to protect themselves from contractor fraud:

  • Be Wary of High-Pressure Sales: Legitimate contractors understand the value of informed decisions. A contractor demanding an immediate decision or offering a “limited-time” discount is likely using a scare tactic.
  • Do Your Research: Never hire the first contractor you meet. Seek referrals from friends, family, and neighbors. Verify licenses and insurance with the state licensing board. Tools like the Better Business Bureau can reveal a contractor’s complaint history.
  • Seek Multiple Bids: Don’t settle for a single estimate. Obtain bids from at least three qualified contractors with a detailed breakdown of costs and materials.
  • Get a Signed Contract: A verbal agreement is worthless in case disputes arise. Every detail — scope of work, materials list, payment schedule, completion timeline, and warranty information — should be outlined in a signed contract.
  • Beware of Upfront Payments: Being required to make a significant upfront payment by a contractor is a red flag. Consider a reasonable down payment, with progress payments tied to completed milestones. Never pay the full amount until the project is finished to your satisfaction.
  • Watch for Red Flags and Trust Gut Feelings: Unethical contractors often exhibit telltale signs. Be wary of contractors who lack a permanent address, offer unusually low bids, or pressure you to use their financing. Finally, trust your gut. If something feels off, it probably is.
  • Contact Your Insurance Carrier: Contact your insurance company before hiring a contractor, especially after a disaster. They may have a list of pre-approved vendors or offer guidance. Furthermore, understand your insurance coverage regarding repairs and replacements.
  • Educate Yourself on Projects: Educate yourself about the specific project you’re undertaking. This basic understanding allows you to ask informed questions and scrutinize proposed solutions. Resources like local building departments offer valuable information on permits and regulations.
  • When in Doubt, Walk Away: Don’t be pressured into signing a contract you’re uncomfortable with. A reputable contractor will respect your right to due diligence. Don’t hesitate to walk away and seek a more trustworthy professional.
  • Report Fraud: If you suspect contractor fraud, report it to your state licensing board, the BBB, and law enforcement. You can also contact NICB to report fraud by calling toll-free 800.835.642).

Homeownership is often viewed as a cornerstone of the American Dream. By taking steps to deter contractor fraud, we can ensure that it does not become the American nightmare.

David J. Glawe is the president and CEO of the National Insurance Crime Bureau, a not-for-profit organization dedicated to combatting and preventing insurance crime. He is a former U.S. Under Secretary of Homeland Security for Intelligence and Analysis.

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Opinion: California’s Broken Constitution and Powerful Lobbies Make a Balanced Budget Impossible https://timesofsandiego.com/opinion/2024/05/25/californias-broken-constitution-and-powerful-lobbies-make-a-balanced-budget-impossible/ Sun, 26 May 2024 05:05:00 +0000 https://timesofsandiego.com/?p=273807 Gov. Gavin NewsomPoliticians and lobbies know very well that the California constitution is broken. They have long had the power to give the state the new constitution it needs — without all the fiscal ratchets that drive up spending and limit revenues.]]> Gov. Gavin Newsom
Gov. Gavin Newsom
Gov. Gavin Newsom presents his budget plan in Sacramento. Courtesy of the governor’s office

You can tune out Gov. Newsom when he talks about the state’s big budget deficit. Ignore the Democrats who control the legislature, too. And turn the volume down when lobbies complain about proposed cuts.

California’s ballooning budget deficits are not a crisis. They are normal and predictable. 

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Because they are grounded in our state constitution, and in a reality so paradoxical it would make Kafka blush:

Our constitution requires the state to balance its budget. But balancing the state budget requires violating the state constitution.

How’s that? Because on fiscal matters, our constitution is a ratchet. The document is full of guarantees and formulas that ratchet up spending on favored programs — and limits on taxes and fees that ratchet down revenues in slower economic times. 

Californians may have forgotten about the ratchet. The past decade was an unusual one for the state budget, as stock market growth and federal pandemic relief created budget surpluses. 

But with those revenue sources gone or declining, California’s constitution is reasserting itself, and producing deficits projected recently to range anywhere from $27 billion to $70 billion.

That leaves Gov. Newsom stuck, and forced to do what all California governors must: 

Violate the constitution. 

First, he’s not offering a balanced budget. The spending delays, draw-downs on reserves, and cuts he’s proposing eliminate only about half of the deficit.

Second, he’s violating the state’s education funding guarantee, a voter-approved formula called Prop. 98.

Prop. 98 is, famously, so complicated that no one really understands it. (It involves three complex formulas to determine state funding, and it’s never clear really clear which formula will apply in which year.) The main effect of Prop. 98 is to keep pushing education spending up; it’s one of the biggest spending ratchets in our constitutional budget ratchet.

Newsom’s maneuver is a sneaky ploy to reduce Prop. 98’s ratchet effect by changing the inputs to the formula. Newsom’s budget proposes to travel back in time and reclassify certain moneys spent on education in previous years as non-education spending. 

This maneuver is intended to lower the funding base, which would make the budget look less out of balance. The problem is that the lower funding base would mean tens of billions less in school funding in future years

Yes, my fellow Californians, “screw the kids” remains the real, if unofficial, state motto.

The powerful education lobby is crying foul, as are some Democrats and local governments. Newsom defends himself by saying he’s required to balance the budget. 

The problem with this blame game — and demands that Newsom reverse the cuts — is that it defines the discussion as being about the budget. The real problem is California’s broken constitution.

Finding tens of billions of dollars in cuts for anything is hard. Health programs have all kinds of court-ordered, statutory, and, in some cases, constitutional protections. Cuts to prisons and state agencies require concessions from politically powerful labor unions. Tax increases run up against Prop. 13 and other state revenue limits. 

That doesn’t mean I’m trying to let Newsom, the Democratic supermajority in the legislature, and other powerful Sacramento interests off the hook for the state’s budget problems. It’s the exact opposite. The governor, Democrats, and interest groups are responsible for the budget mess — because they’ve had plenty of time to fix the constitution, and haven’t even tried.

Gavin Newsom has been in statewide office since 2011. California Democrats have had full control of Sacramento since that same year. And powerful unions and other lobbies have held sway for far longer than that.

All of these politicians and lobbies know very well that the California constitution is broken. They have long had the power to come together and give the state the new constitution it needs — without all the fiscal ratchets that drive up spending and limit revenues. 

But they haven’t been willing to lead and change the system. They have focused instead on building their own power within this broken system. Jerry Brown and other California leaders have spent the past decades dismissing calls for a constitutional rewrite (including my own, via the book California Crackup) as unrealistic.

But state leaders are the ones who have lost touch with reality. They claim they can fix the budget, but they can’t because the constitution won’t let them.  And they won’t fix the constitution because they say it’s politically impossible. How long can they keep saying this — and keep pretending they are doing their jobs?

When the governor and legislators say they are trying to solve the problem, they aren’t telling the truth. This miserable budget, full of cuts to education, is a product of the budget system, and the constitution, that they themselves have chosen.

Joe Mathews writes the Connecting California column for Zócalo Public Square,  an Arizona State University media enterprise.

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Opinion: Decades-Long Delta Tunnel Water Project May Finally Be Nearing a Historic Decision https://timesofsandiego.com/opinion/2024/05/24/decades-long-delta-tunnel-water-project-may-finally-be-nearing-a-historic-decision/ Sat, 25 May 2024 05:05:08 +0000 https://timesofsandiego.com/?p=273758 California aqueduct fills with storm waterThe tunnel’s $20 billion cost is already many billions of dollars over earlier estimates. As costs climb, the willingness of downstream water agencies to cover construction bonds is still uncertain, and environmental groups are still opposed.]]> California aqueduct fills with storm water
California aqueduct fills with storm water
A drone provides a view of water pumped into into the California Aqueduct. Courtesy DWR

It’s been almost a half-century since I first heard the term “peripheral canal” uttered by William Gianelli, who was then-Gov. Ronald Reagan’s top water official. The project, in one form or another, had already been kicking around for decades.

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The California Water Project became operative in the 1960s and was the most prominent legacy project of Pat Brown, whom Reagan had defeated in 1966.

The project dams the Feather River near Oroville and releases impounded water to flow down the Feather into the Sacramento River and eventually into the Sacramento-San Joaquin Delta. Pumps at the southern edge of the Delta suck the water into the California Aqueduct, which carries it down the San Joaquin Valley to more pumps over the Tehachapi Mountains into Southern California.

Pumping water out of the Delta changes the massive estuary’s natural flows and, as widely recognized, damages habitat for fish and other wildlife. The envisioned 44-mile-long peripheral canal would have carried water around the Delta to the head of the aqueduct thereby, it was said, improving water supply reliance and protecting fish.

However, there was widespread opposition, mostly from environmentalists who doubted the canal would have a beneficial impact. The project stalled until Pat Brown’s son, Jerry, became governor in 1975 and attempted to complete the last remaining link in his father’s landmark water plan.

Brown relentlessly pressed the Legislature to authorize the canal and finally succeeded, but the compromise version failed to mollify environmentalists and alienated San Joaquin Valley farmers. The two disparate groups formed an odd-bedfellows alliance that defeated the project in a 1982 referendum, the same year Brown’s bid for a U.S. Senate seat failed.

Voter rejection put the project in political limbo for two-plus decades, until Arnold Schwarzeneger became governor and proposed twin tunnels, instead of a canal, to bypass the Delta. Jerry Brown returned to the governorship in 2011 and once again sought to get it done.

It was still just an idea when Gavin Newsom succeeded Brown in 2019. Almost immediately he downgraded it to one tunnel and ordered the Department of Water Resources to get it going. The much-revised project barely survived a 2016 ballot measure that probably would have killed it, and with Newsom’s governorship down to its last couple of years, it is nearing the decisive moment.

The project has undergone several name changes over the decades but is now dubbed the Delta Conveyance Project. Recently, the water agency released an updated report on the tunnel, raising its cost to $20 billion but insisting that it still pencils out in a cost-benefit analysis.

“For every $1 spent, $2.20 in benefits would be generated,” Department of Water Resources officials declared. “The report also shows the very real cost of doing nothing, posing significant future challenges to supplying water to California communities.”

Cost-benefit claims of big public works projects are notoriously subjective because they rely on notoriously unreliable cost estimates and equally squishy definitions of benefits.

The tunnel’s $20 billion cost is already many billions of dollars over earlier estimates. As costs climb, the willingness of downstream water agencies to cover construction bonds is still uncertain, and environmental groups are still as opposed as they were in 1982.

By its nature, a bypass tunnel would reduce water flows through the Delta. As Newsom’s administration tries to clear financial and environmental issues, it is also trying to get San Joaquin Valley farmers to take less water from its rivers so that more can flow through the Delta.

The interplay between those two somewhat contradictory efforts is one of the project’s most intriguing aspects. 

CalMatters is a public interest journalism venture committed to explaining how California’s state Capitol works and why it matters.

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Opinion: Amid Threats to Reproductive Rights, It’s Time Strengthen San Diego’s ‘Buffer Zone’ Law https://timesofsandiego.com/opinion/2024/05/23/amid-threats-to-reproductive-rights-its-time-strengthen-san-diegos-buffer-zone-laws/ Fri, 24 May 2024 05:05:16 +0000 https://timesofsandiego.com/?p=273595 Abortion rights rallyTo protect access and privacy at healthcare facilities, the City Attorney’s Office is proposing amendments to San Diego’s Municipal Code that aim to reduce the hostile interactions that too many women face when making some of the most personal decisions of their lives.]]> Abortion rights rally
Abortion rights rally
An abortion rights rally in San Diego in May. Photo by Salvatore Giametta

In 1997, the city of San Diego adopted a buffer zone law to address demonstrations and access to health care facilities, places of worship, and schools. This law was adopted before smartphones, before social media, and in an era where Roe v. Wade was the law of the land.

In 1997, I was signing up for an AOL Instant Message account and my little sister was desperately trying to keep her Tamagotchi digital pet alive. A lot has changed since 1997 and legal changes at City Hall are needed now to better protect San Diegans, especially women, against harassment and threats they’re facing in today’s divisive, toxic political environment.

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I believe the vast majority of San Diegans agree that anyone accessing a healthcare facility has a legal right to privacy and a right not to be harassed. Entrances and exits should never be blocked.

Patients making deeply personal medical decisions shouldn’t have to suffer through group intimidation or public humiliation by those who disagree with their choices. The same is true for parishioners attending church, a mosque, or a synagogue, and parents and students entering a school.

Most of us also firmly support the First Amendment and the fundamental right of Americans to speak their mind. But, increasingly, the activity happening outside healthcare facilities isn’t a legitimate form of protest at all. Planned Parenthood has reported multiple examples of abuse outside its clinics, including people blocking driveways and doors, throwing papers at patients or into open car windows, and providers being photographed and followed. That’s not protected free speech, that’s harassment.

To protect access and privacy, the City Attorney’s Office is proposing amendments to San Diego’s Municipal Code that aim to reduce hostile interactions too many face when making some of the most personal decisions of their lives. These are simple, straightforward legal changes to protect privacy, ensure access to vital services, and enforce the law fairly and justly.

Currently, San Diego’s buffer zone law allows demonstrators to approach someone trying to enter a healthcare facility until they are explicitly told to back off. When that happens, the law requires the demonstrator to move at least 15 feet away. The burden is entirely on the patient entering the clinic to advocate for their privacy. 

The proposed amendments, spearheaded by City Attorney Mara Elliott, shift this dynamic by requiring demonstrators get permission from people they seek to engage with and to respect those who would rather not. By requiring permission before engagement, people seeking health care (and anyone trying to access education or practice religion) control their interactions in spaces where safety comes first. 

And we’re striking a fair balance with an 8-foot buffer zone that ensures free speech at a reasonable distance is always protected. More than anything, the law is clear and enforceable: it’s a right to assemble peaceably, to speak, and to protest — not a right to harass, obstruct, or otherwise try to force an unwilling participant to listen.

These proposed buffer zone law changes aren’t just about reproductive rights. No one should be screamed at for getting vaccinated. Parents should be able to attend parent-teacher conferences or school board meetings without schoolhouse doors being blocked by protesters. No San Diegan of any faith should be targeted on their way to pray.

In today’s polarized world, demonstrations occur frequently, without warning and at a higher pitch than ever before. The law must keep pace — and keep San Diegans’ access to fundamental services protected.

It’s time for the city to update its buffer zone law to better protect people who access services under increasing threat: places of worship, public schools, and yes, women’s health clinics that provide abortion care.

Heather Ferbert is the Chief Deputy City Attorney of San Diego and a candidate for City Attorney in November.

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Opinion: Copay Accumulators Continue to Harm Patients, But California Can Help Them https://timesofsandiego.com/opinion/2024/05/22/opinion-copay-accumulators-continue-to-harm-patients-but-california-can-help-them/ Thu, 23 May 2024 05:05:07 +0000 https://timesofsandiego.com/?p=273522 MedicationsAssembly Bill 2180 by San Diego Assemblymember Akilah Weber will ensure that health insurance plans count the value of copay assistance toward a patient’s deductible. This will safeguard vulnerable patients from unnecessary costs]]> Medications
Medications
Image by Steve Buissinne from Pixabay

Have you ever experienced the frustration of going to the pharmacy to collect a prescription, only to be faced with the harsh reality that you cannot afford your copay? Sadly, this scenario is all too common and underscores the systemic challenges many patients face when accessing essential medications.

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Reflecting on personal experience, my late father was born with hemophilia B, a hereditary disorder that requires regular infusions to control bleeding episodes. Without these infusions, he experienced severe pain, joint damage, and life-threatening complications. The treatments Californians living with bleeding disorders and other chronic conditions take aren’t a luxury, but a matter of survival, yet the associated costs can be out of reach for most patients.

Research shows that when faced with a copay as high as $250, more than 70% of patients find themselves unable to cover the cost of their medication. To help ease out-of-pocket costs, many rely on patient assistance programs. These assistance programs enable pharmaceutical manufacturers and nonprofits to help alleviate high copay costs for patients, which in turn helps them afford and adhere to their medications. A 2021 survey found that 69% of those who depend on patient assistance programs make less than $40,000 a year.

Unfortunately, health insurers and Pharmacy Benefit Managers are effectively blocking this assistance with the use of copay accumulator adjustment policies (CAAPs), which are prevalent in 83% of commercial health plans. The detrimental impact of CAAPs on those living with chronic and rare diseases cannot be overstated. These policies exclude any copay assistance from counting toward a patient’s deductible or out-of-pocket maximum, which makes it difficult or nearly impossible for them to get the medications they need. 

Since many of these policies are hidden within health insurance coverage documents, most patients are caught off-guard several months into the plan year when their financial assistance has run out, and they learn that they have not met their annual deductible. When they attempt to refill a prescription or get other health care, they may be faced with a bill for thousands of dollars. 

When patients are unable to adhere to their treatment, they risk worsening their health — in some cases, irreversibly. These practices undermine coverage for pre-existing conditions, hurt patient access to medicines, decrease drug adherence, and cost our health care system more money.

California has an opportunity to join 20 other states, plus Washington, DC, and Puerto Rico, in eliminating CAAPs by passing Assembly Bill 2180. Introduced by San Diego Assemblymember Akilah Weber, AB 2180 will ensure that health insurance plans and pharmacy benefit managers count the value of copay assistance toward a patient’s deductible. The goal of this bill is to safeguard vulnerable patients from unnecessary costs and ensure they can access the necessary treatments and medications their doctors prescribe. 

We cannot expect to help improve care for Californians living with chronic and rare diseases without cutting barriers like CAAPs out of the picture. If it’s still hard to understand, imagine you or a loved one not only living with a persistent chronic disease, but also having to experience the choice between going into debt or surviving.

AB 2180 is the exact legislation we need to address these issues and to ensure fair, accessible, and affordable lifesaving care for patients. It’s time patients receive the full benefits of copay assistance without facing any roadblocks from insurers or pharmacy benefit managers. Their lives depend on it.

Lynne Kinst is the executive director of the Hemophilia Council of California and a steering committee member of the California Rare Disease Access Coalition.

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Opinion: Concerned Coronado Residents Confront the Danger of Christian Nationalism https://timesofsandiego.com/opinion/2024/05/21/concerned-coronado-residents-confront-the-danger-of-christian-nationalism/ Wed, 22 May 2024 05:05:46 +0000 https://timesofsandiego.com/?p=273424 Awaken Church and its Christian nationalism are a threat to Coronado -- and to religious tolerance and democracy in America.]]>
The crowd at the art center watching “Good & Country” in Coronado. Photo by Brad Willis

It was a full house of more than 500 concerned citizens last Sunday at the screening of the God & Country documentary at the Coronado Performing Arts Center. That’s because people in our community truly care.

We are concerned about the Christian nationalist political movement, and we don’t want the radical political hate group, Awaken Church, whose founder calls us unholy, unclean demons and threatens to run us out of town, coming here trying to take over our school board, exploit our military, attack our library, preach a false gospel and seek to, in his own words, “take the crown of our Crown City.”

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The film had numerous voices, most of them Christian leaders, including conservative evangelical pastors, expressing their deep concerns about the Christian nationalism movement, the role it played in the Jan. 6 insurrection, and the threat it poses to our democratic republic.

The event was hosted by World Religion Professor Bolland, who led a panel discussion afterward with three local pastors, J.T. Greenleaf of St. Paul’s United Methodist Church, Steve Mather of the Coronado Council of Churches, and Reverend David Rodriguez of Graham Memorial Presbyterian Church. The discussion lasted more than an hour, and covered a lot of important territory.

As some opponents have noted, we all have the right to freedom of religion. I could not agree more. But when an organization falsely cloaks itself in religion to conceal ulterior political motives, concerned citizens have the right, and duty, to speak up and inform the public. The Bible warns of “wolves in sheep’s clothing,” and that’s what we have with Awaken. 

As one attendee noted in response to the threats Awaken’s founder has made to run us out of town, “I took that as a personal threat from what I saw come from the man’s mouth. It wasn’t secondhand. It wasn’t a rumor. I saw it. I’m not going to stand for it. I live here, I grew up here, and I’m staying here.”

As a former war correspondent who was inside Afghanistan during the Soviet occupation in the 1980s, and spent time in Iraq and the wider Middle East during the Gulf War, I’ve seen what radical religious theocracies do when they are in power. Believe me, it’s not something we want here in the United States of America.

Brad Willis is a former NBC Network News foreign correspondent whose numerous awards include the Columbia duPont Award for his work in Afghanistan, which is considered the Pulitzer Prize for broadcast journalism. For more on Awaken and the threat to Coronado, please see Willis’ columns on Substack.

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Opinion: California’s Lagging Economy Hinders Efforts to Close State Budget Deficit https://timesofsandiego.com/opinion/2024/05/20/californias-lagging-economy-hinders-efforts-to-close-state-budget-deficit/ Tue, 21 May 2024 05:05:58 +0000 https://timesofsandiego.com/?p=273322 construction siteCalifornia’s recovery from the devastating economic impacts of the COVID-19 pandemic has been sluggish at best, trailing what’s happening in the nation as a whole and in the state’s archrivals, such as Texas and Florida.]]> construction site
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Workers pour cement at a construction site for an office tower in downtown San Diego. REUTERS/Mike Blake/File Photo

As Gov. Gavin Newsom and state legislators spend the next few weeks fashioning a state budget that’s plagued by a multibillion-dollar deficit, they can’t count on a booming economy to make their task easier.

California’s recovery from the devastating economic impacts of the COVID-19 pandemic has been sluggish at best, trailing what’s happening in the nation as a whole and in the state’s archrivals, such as Texas and Florida.

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According to Employment Development Department data, there are 200,000 fewer Californians in the labor force — those employed or seeking employment — than there were in February 2020, just before the pandemic exploded. There are 500,000 fewer employed, and 200,000 more unemployed.

While California’s unemployment rate of 5.3% in March was just a third of what it was at the height of the pandemic-induced recession, it was still the highest of any state, markedly higher than the national rate of 3.9% and nearly two percentage points higher than it was before the pandemic.

By the federal government’s more nuanced measure of employment called U-6, which counts not only the unemployed, but workers who are “marginally attached” to the labor force and those who are involuntarily working part time, the state’s 9.5% rate of underemployment is also the nation’s highest.

Those numbers imply an economy that’s not even operating at cruising speed, much less accelerating. Even the state’s technology sector, centered in the San Francisco Bay Area, has cooled off as its once high-flying corporations announce layoffs virtually every day.

“California’s civilian employment growth has been essentially flat since the second half of 2022 while the U.S. has remained relatively healthy, resulting in the state’s unemployment rate rising faster than the nation,” the revised budget Newsom unveiled last week acknowledges.

The pandemic erased about 3 million jobs in California as Newsom shut down large segments of the state’s economy. Countless employers, particularly small businesses, never reopened after the health crisis eased and those that did survive have had to contend with inflationary costs, tighter loan conditions and changed consumer habits.

The budget blames stubborn inflation and the high interest rates imposed by the Federal Reserve System to tame inflation for California’s slowdown, but economies of other states have experienced the same factors and prospered despite them.

However, they don’t contend with factors unique to California, such as extremely high costs for housing, utilities and labor that make job creation more difficult here. Until recently, California has been losing population, thanks to outward migration to other states. The state has also seen employment shifts, particularly in technology.

Those conditions underscore the sluggish recovery that sets California apart from other states. For instance, Texas’ unemployment rate, 3.9%, is identical to the national rate while Florida’s 3.2% is even lower.

So, one might ask, where is California’s once-booming economy headed?

Newsom’s Department of Finance says it “has not modeled a recession scenario. However, if inflation takes longer to cool and interest rates remain high for longer than projected in the May Revision baseline forecast, continued tight credit conditions could further discourage economic activity.”

A few days before he released his revised budget, Newsom stood at the top of a Golden Gate Bridge tower to record a video celebrating the tourism industry’s recovery.

Visitors to California spent $150.4 billion last year, he said, surpassing the previous record of $144.9 billion in 2019.

That’s good news, even though an adjustment for inflation would probably reduce the recovery’s relative impact. But while it’s a high-profile economic sector, tourism is scarcely 3% of the state’s overall economy. It’s the other 97% we should be nurturing.

CalMatters is a public interest journalism venture committed to explaining how California’s state Capitol works and why it matters.

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Opinion: New Taxes Won’t Solve San Diego’s Budget and Homelessness Problems https://timesofsandiego.com/opinion/2024/05/19/new-taxes-wont-solve-san-diegos-budget-and-homelessness-problems/ Mon, 20 May 2024 05:05:51 +0000 https://timesofsandiego.com/?p=273281 Entrance to City HallIt is unrealistic to keep asking the public for more money when the city makes poor financial decisions. The city needs to stop crying wolf.]]> Entrance to City Hall
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The entrance to San Diego City Hall. Photo by Chris Stone

The city budget for the 2025 fiscal year presents a pivotal moment for elected officials to prioritize San Diego’s welfare over special interest groups. However, calls by City Council President Sean Elo-Rivera and other lawmakers to impose new taxes have raised severe concerns about our local elected officials’ accountability.

Past leaders have made regrettable real estate decisions. Unfortunately, our current leaders have replicated these errors by deferring maintenance on critical infrastructure and making poor real estate decisions, as evidenced by the 101 Ash Street fiasco. The question on everyone’s mind is whether the 1,000-bed mega shelter will become another real estate scandal.  

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The details of this big homeless shelter remain opaque, and regrettably hark back to a time when San Diego was dubbed the “Enron by the sea.” San Diego’s current deficit of millions of dollars is partly due to past city leaders, but it is unfair to blame them solely. Our current city leaders share this responsibility.

As an example, it is disheartening to note a lack of significant efforts to address infrastructure issues during the past three-plus years. Infrastructure now looks like the buzzword, but only after the January storm revealed how our storm channels were poorly maintained.  

The neglect of critical infrastructure is not just an inconvenience. It has direct, tangible effects on our residents’ daily lives and safety. The lack of streetlights threatens our citizens’ security, and the poor condition of our roads leads to increased vehicle maintenance costs for families.

These are not just numbers on a budget sheet but real problems that our residents face every day. It’s urgent for us to address these issues, and it’s disheartening that these infrastructure injustices have not been handled responsibly.

The other buzzword circulating in the city is the need for additional tax revenue. San Diegans do not want to pay more taxes to receive “world-class” service. However, San Diegans expect dependable and affordable service. It is plausible for the people of our great city to question why they should approve additional taxes when the dity continues to spend carelessly.

It seems like a failure in fiduciary responsibility when the city keeps spending money it does not have. This highlights the need for accountability and responsible spending, which should be a priority for our city leaders. If the city cannot afford to fund all of the programs fully, we expect city officials to act responsibly and make realistic decisions.  

I see the hardship daily in the store, at a gas station, or just getting coffee. The people of our city are suffering, and with the price of everyday commodities rising, families are making tough decisions about what they can and cannot afford. Who will be hurt the most by these additional taxes? The burden of the additional proposed taxes will fall on the families with the least — the lower-income families will hurt the most.

A stormwater tax will be paid by all residents, homeowners and even renters, because landlords will potentially force the tax on their tenants. A one-cent sales tax will hit every San Diegan. However, the lower-income households may not have the means to shop outside the city limits, where the sales tax is lower in neighboring cities.

San Diego Gas & Electric is adding a line-maintenance charge every month. The city’s water and sewer rates are increasing, and in the future, garbage rates will increase for approximately half of San Diegans. Businesses are still recovering from COVID-19, and so are the families in San Diego.

The cost of housing is not the sole reason for homelessness, and this belief ignores the many root causes. The trauma our brothers and sisters have experienced, which has led them to an unsheltered life, cannot be cured by any amount of housing. It is empirical knowledge of those of us who have worked and interacted with the unsheltered for many years to understand this simple truth.

The public understands this truth, and expects our city officials to stop spending millions on unsuccessful programs. This is one of the basic tenets of government: public accountability. A report by the California State Auditor provided transparency into the lack of financial responsibility and accountability associated with our San Diego homelessness programs.

It is common knowledge to all San Diegans that more affordable housing is needed, but destroying the tapestry of our single-family neighborhoods to build mostly unaffordable housing is illogical. District 9 alone has numerous vacant lots along the east and west corridors of El Cajon Boulevard and University Avenue. These vacant lots are ideal for adding responsible density along main transit corridors. We should work to preserve our historic single-family neighborhoods and iconic landmarks.

If the city were genuinely interested in creating additional rapid and affordable housing, it would work to close the loopholes in its Short-Term Rental programs. If the city were genuinely interested in increasing revenue, it would stop waiving Development Impact Fees that are not mandated by the state and use those funds to improve services for the betterment of all of San Diego years ago.

We are beginning to hear repeated claims of a shortage of consistent revenue. Truthfully, these “cries of wolf” are not believable and are becoming tiresome to the public. It is unrealistic to keep asking the public for more money when the city makes poor financial decisions. The city needs to stop crying wolf.

Terry Hoskins, a former police community relations officer, will face City Council President Seal Elo-Rivera in the November general election to represent District 9.

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