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There’s an old saying in politics: “You campaign in poetry. You govern in prose.”

Gavin Newsom’s approach to health care policy reflects this thinking. Newsom’s most ambitious campaign promise last year was to provide health care to all Californians through a government-run, single-payer system. But as the election drew closer, qualifiers like “inevitably” and “ultimately” began to creep into his conversation, suggesting a longer-term effort would be necessary.

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To put the CMS’ latest voluntary program promoting primary care in its proper perspective, one should think in biblical terms.

In the beginning, the 2006 Tax Relief and Health Care Act called on the CMS to set up “medical home” experiments at willing primary-care practices. In 2011, the newborn Center for Medicare and Medicaid Innovation begat the Federally Qualified Health Center Advanced Primary Care Practice demonstration and the Multi-Payer Advanced Primary Care Practice demonstration.

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In my mid-twenties, I was twice prescribed the common antihistamine Benadryl for allergies. However, my body’s reaction to the drug was anything but common. Instead of my hives fading, they erupted all over my body and my arms filled with extra fluid until they were almost twice normal size. I subsequently described my experience to a new allergist, who dismissed it as “coincidence.”

When I later became a nurse, I learned that seemingly “harmless” medications often cause harm, and older adults are particularly vulnerable. Every year, Americans over age 65 have preventable “adverse drug events” (ADEs) that lead to 280,000 hospital stays and nearly 5 million outpatient visits. The Lown Institute in Boston draws attention to this underrecognized problem in their recent report, Medication Overload: America’s Other Drug Problem. Policymakers, patients, and health professionals must act, because over the next decade, medication overload is predicted to cause 4.6 million hospitalizations of older Americans and 150,000 premature deaths.

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Jenny, a woman in her twenties with morbid obesity (not her real name), had already been through multiple visits with specialists, primary care physicians (PCPs), and the emergency department (ED) for unexplained abdominal pain. A plethora of tests could not explain her suffering. Monthly visits with a consistent primary care physician also had little impact on her ED visits or her pain.

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This month, UC Berkeley announced a change in insurance carriers for the Student Health Insurance Plan, or SHIP, effective fall 2019. In a press release, the campus told students to expect “a modest increase to premiums” and “minimal changes to specific copays.” But to the students that this change will impact, this is far from the truth.

University Health Services, or UHS, will break from Anthem Blue Cross and, instead, partner with Blue Shield of California, increasing costs and possibly limiting health care providers for students on campus.