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Over the past several years in the administration of attorney general eric sniderman. During this administration, we have had 22 cases that we brought criminal charges in, including two cases announced just this morning. And they are in a wide range of industries. Prevailing wage contractors, tortilla factory, home health agencies, its been a pretty broad range of different types of employers. And having been in this field for awhile, i feel strongly about the importance of criminal enforcement because i think that it sends a very, very strong message about the seriousness of these laws and the importance of compliance and it is a very powerful deterrent. I think criminal prosecution is just qualityively different. Its a very different experience to be arrested than to be sued. And even without a jail sentence, i think that the aspect of public pressure and public shaming is very powerful, particularly for employers who have been the cases that we have handled are really outliars in te ....
Youll get into it more a lot about competitive nature and of course, everyone would agree a more competitive environment should produce lower costs. But how much do you think just generically speaking is we do live in San Francisco in the bay area and its an expensive place to live and its more of a cost for hospital not only to exist in terms of the land value, but its more expensive to build here. We saw from the building cost with the cpc hospitals are big. You have to pay higher wages and as a city we have a lot of values associated with San Francisco where were willing to pay higher wages to workers in our city because we believe in that. How do you think about the differences and maybe its part of a melting pot but i like to get your perspective. We could measure all those differences so we can do analysis that shows differences in prices, how much is due to the cost of l ....
Disadvantage me. Even if im four times more expensive, you cant charge your members more to go to my hospital than you do other hospitals. This is antitiering preventions in contracts and it prohibits fair competition. We have to do something about this. Could you repeat that for everyone, so if a provider or insurance carrier chargers us more, we cant charge our members more . Thats correct. Not every contract has this prevision, but many of the biggest Hospital Systems in the state have antitiering preventions. They say you cant disadvantage any of my hospitals that you contracted for. They have to be on the same Playing Field as everybody else. So it falls on us as a government to pick up those costs . The payers have to just pay. Our choices are really to pay or a shift cost to members through premium increases. Okay. The catalyst for payment reform and well have a speak ....
Purposes here, the cpi is not bad because basically you want to measure what are the input prices that providers have to pay to deliver the services and that includes wages and other things that they have to purchase as input. Now, what this slide doesnt show is improving in quality and the mix of patients thats being seen. Theres some evidence that the population is getting sick overtime. Im unable to control over that here. This is an issue that affects us as a station and as a state, and the people thats speaking in this room has a lot of that background and data that you look at. From my perspective im focused on San Francisco and the health of our city and the heath of our resident and the health of how economy here in the city and our budget as a city. We talk about you talk about maybe youll get into it more a lot about competitive nature and of course, everyone would agree a more competitive environment should produce lower ....
We have a lot of values associated with San Francisco where were willing to pay higher wages to workers in our city because we believe in that. How do you think about the differences and maybe its part of a melting pot but i like to get your perspective. We could measure all those differences so we can do analysis that shows differences in prices, how much is due to the cost of living and thats factor prices inputs, but the more general answer is a competitive market, you know, will protect consumers to insure that the services theyre getting are the most efficient and if they have the information, the ones that they want at the quality level they want at the Service Leave he will they want and folks move to San Francisco on live hee expect to pay more for things so were not talking about price level, but were talking about ....