Friday, May 28, 2021

Another Way to Provide Bus Rapid Transit to Cal State Northridge

Metro Los Angeles is currently studying a bus rapid transit (BRT) line for the North San Fernando Valley.  Here is what the current alternatives look like.


However, all is not well with this project.  Acccording to Numble on Twitter, Metro is considering caving into NIMBYs on this project.


This would be disastrous for transit riders in this area.  In particular, this would leave California State University, Northridge (CSUN) out of our growing mass transit system.  If this terrible-case scenario occurs, I've been thinking about how else to serve CSUN.

One idea that has long been discussed is to have branch services from the "Orange" Line (now the "G" Line) on other busy north-south corridors in the San Fernando Valley.  One of these proposed busy corridors is Reseda Blvd.  

My proposal would be to have a branch service of the G-Line going north-south on Reseda, east-west on Nordhoff, and CSUN along White Oak as seen below.  We'd have G1 service between North Hollywood Metrorail station and Chatsworth Metrolink/Amtrak Station, and G2 service between North Hollywood Metrorail station and CSUN.


But we can see from this map even though we would still serve CSUN, what a large east-west gap in mass transit we are leaving out of our system in the North San Fernando Valley.  I really hope NIMBYs do not prevail here.  We need BOTH the proposed North San Fernando Valley BRT and a Reseda Blvd. BRT.


Also, coming to the San Fernando Valley will be a "Sepulveda" Line (hopefully as heavy rail and not monorail) between the Valley and the Westside, as well as a planned BRT route connecting North Hollywood to Burbank, Glendale, and Pasadena.

A note for the future.  Eventually, the G-Line may be upgraded to light-rail.  A further enhancement I would support for this new Reseda Blvd. BRT is to run it between Universal City station and CSUN via Ventura Blvd.  Somehow Ventura Blvd. keeps getting left out of our San Fernando Valley mass transit conversation, when we should already be installing bus lanes on it.


And, of course, we should be doubletracking and upgrading the Metrolink/Amtrak rail corridors as well.

What do you think?

Thursday, May 27, 2021

The Next Steps Toward Universal Health Care in America

Much was discussed about health care in this past election, but with narrow Congressional majorities coming in 2021, it remains to be seen what will actually change federally.  The Affordable Care Act ("ACA") was meant to be a first important step in health care reform -- a step to be built upon over time until we achieve universal access to health care.  

If the whole topic of health insurance and health care is a mystery to you, I highly recommend watching  Knowing Better's excellent and entertaining video explaining America's health care system, Healthcare | The Complete Moderate's Guide.  He will clearly explain premiums, deductibles, co-pays, Medicare, Medicaid, and the V.A. System.


I am going to assume from this point forward that you know what a premium is, what a deductible is, and what a co-pay is.  If you don't, then please watch the above video.


New York Times columnist and Nobel Prize Winner Paul Krugman has written about universal health care as requiring three basic components:

  1. Everybody In (either through taxation or a mandate to buy comprehensive health insurance);
  2. Nobody left out (no one can be denied health care or coverage due to pre-existing medical conditions or medical history);
  3. Government Subsidies (to help make health care accessible to all.)


The United States could learn a lot from what is already working around the world.  Universal health care is provided and financed by a variety of methods around the globe, some of which Healthcare Triage has done brief video descriptions:

  • In Switzerland, people are required to buy private health insurance on tightly regulated markets -- much more regulated than the ACA is currently. People buy voluntary supplementary insurance to cover co-pays.
     
  • The world's top rated system is in France,  Everyone must pay for mandatory health insurance.  Voluntary health insurance provides supplemental policies.  Providers are both public and private. Co-pays are lower in France and quality is high.

  • It wouldn't take much for the ACA to evolve into a system similar to Germany's.  Health insurance is mandatory, tightly-regulated, and non-profit.  Long-term care insurance is mandatory too.  Hospitals are both public and private.

  • Australia's public "Medicare" system operates alongside a private system. About half the people have private insurance.

  • Singapore has an interesting model.  Great outcomes with low percentage of GDP spent on healthcare.  Singapore has a mixture of public and private health care spending and public and private health care delivery systems.  There are also five tiers of service you can pay for.  What makes it unique is its reliance on mandatory Health Savings Accounts.  Workers are required to put aside 20% of their income into savings for various usages, including for health care expenses such as insurance. There is also an additional inexpensive catastrophic illness program that 90% of the population participates in.

  • In Canada they have "single-payer health care" which they call "Medicare", which is similar to our Medicare program for senior citizens.  Interestingly, single-payer started in one Canadian province and spread nationwide province by province.  If the Federal government gave statutory permission for states to use Federal Medicaid money to help create single-payer systems in their states the same thing could happen here.

  • In the United Kingdom, taxpayers pay for a publicly-owned and operated health care system that directly provides service through the National Heath Service.  The closest equivalent to this in America is our Veterans Affairs system.

  • Taiwan has proven that you make a major leap from a system of private insurance to a single-payer model in one swoop. 

President-Elect Biden ran on a platform with a credible health care plan that included adding a robust public health insurance option open to everyone, as well as overcoming red-state, holdout resistance to the ACA's Medicaid expansion, and strengthening Medicare.

Unfortunately for my fellow progressives, a direct Taiwan-esqe leap from what we have now to Medicare-for-All is likely not on the cards.  It couldn't pass the Senate.  Even getting any kind of federal public option or Medicare-Buy-In through a narrowly divided Senate with a legislative filibuster will be extremely tough.

As a backup plan, I would encourage Congress to pass a law that gives states statutory ability to use their Medicaid funding to establish public options open to all and/or single-payer systems within their states.  A few blue states could start a nationwide trend similar to what happened in Canada in how their "Medicare-for-all" system started in one province and went national.

One of the ways I would improve the existing ACA is to add adult dental, vision, and hearing benefits to the available plans for purchase on the exchanges.  Currently, those benefits are available those benefits are available to children on ACA "Bronze", "Silver", "Gold", and "Platinum" plans.  Let's add "Diamond- level plans which also include adult dental, vision, and hearing benefits too.  Yes, people could go purchase those benefits separately if they want them, but we want to make peoples' lives simpler and easier, not more complicated.  One-stop shopping would be helpful and worth it to many people.

There are also public option proposals currently floating in Congress, including ones that would call for a Medicare-administered public health insurance option.  One would hope that Democrats would use the Senate filibuster-bypassing, budget-reconciliation process to make it happen.

Social Security and Medicare were first established as limited programs and then gradually built upon over time into the universal programs as we know them today.  Let's keep moving forward in health care until we have universal access to insurance and care.  Let's not get stuck though on assuming that only one specific model of universal health care is acceptable.  The world offers us lots of examples of he we could move forward, and all of them are an improvement.  If we remain flexible in approach, we will get there sooner rather than later.  The ACA offers federal and state flexibility to compromise and do just that if we will allow it.

Link the coming Sunset and La Cienega Bus Rapid Transit Corridors

 Here is a Metro Los Angeles map of potential transit corridors for possible upgrade to Bus Rapid Transit.   



Metro  recently released it's top five priorities for Bus Rapid Transit corridors.



The La Cienega BRT Line would run from Slauson to Santa Monica Blvd.  Why not link this BRT Line  to the new proposed Sunset - Cesar Chavez BRT Line via Santa Monica Blvd. and/or Sunset Blvd.?



That map may off on scale, but a BRT Line between the ocean - Venice - La Cienega - San Vicente - Santa Monica - Sunset - Cesar Chavez - Union Station sounds pretty cool, doesn't it?  Actually that alignment works really well as a streetcar/tram too.

(As a side note, La Brea is also targeted for future BRT.  Well, if La Brea is already getting BRT, then surely the Crenshaw Metrorail Northern Extension project should flow at least as westerly as Fairfax.  La Brea doesn't need both, especially when we compare a potential stop to serve The Grove / Television City at Beverly & Fairfax, versus the two gas stations and a car rental at Beverly & La Brea.)