Although local Republican and Democratic parties usually look to national parties to set positions on issues, it’s local leaders who get to pick and choose which ones they like and which ones to toss. KPBS spoke with Corey Gustafson and Kyle Krahel-Frolander of the San Diego Republican and Democratic parties respectively to get their take on President Trump’s first four months in office.

Corey, the San Diego Chamber of Commerce says the Trump administration’s tariffs on foreign goods and the promise of more have created uncertainty and could potentially devastate the local economy, creating empty shelves, supply chain issues, layoffs. How do you view these tariffs?

Gustafson: Well, look, I think, number one, tariffs from the perspective of the Trump administration are about national security. We have a tremendous inflow of fentanyl coming in over our southern border. And what we’ve seen under the Trump administration already is a 97% reduction in illegal immigration. We’ve seen him take the first narco terrorism charges against drug cartels that was just issued in the San Diego courts last week because President Trump made the cartels into terrorist organizations.

Kyle, the administration says the goal of these tariffs is to return manufacturing to the United States, a process that some economists say could take up to 15 years. What are the realities of the Trump administration’s tariffs?

Krahel-Frolander: These tariffs are only going to be a tax on the American people, increase prices yet again and squeeze us out even more. We have a bi-national economy here in San Diego, Tijuana and San Diego, and of course Mexico and the United States are two of the closest trading partners. And if you increase tariffs, you’re only going to drive down business and reduce investment on both sides of the border and hurt working people.

Kyle, I want to pivot very, very quickly to the local San Diego County Board of Supervisors. This is a race between Chula Vista Mayor John McCann and Imperial Beach Mayor Paloma Aguirre. This is to fill the District 1 seat. How do you think what’s happening in Washington D.C. right now affects this local race?

Krahel-Frolander: We have an amazing candidate in Paloma Aguirre. She has been fighting very hard to address the most pressing issue in South Bay, which is the terrible cross border pollution crisis. She’s been fighting for this for many years. This is not something new to her and that makes her unique in this. And I bring that up as part of the federal government because this solution that needs to take the federal government’s role into account, it’s not just going to be done locally, though we do need local work from the County Board and all other jurisdictions. We need the administration to work with Mexico, make sure that they fulfill their part of the bargain and also make sure that we continue our side to fix the problem on our end as well.

Corey, if McCann wins, Republicans will once again have a majority on the San Diego County Board of Supervisors after a multiple year hiatus. What would be the priorities of a Republican-dominated Board of Supervisors in 2025?

Gustafson: Well, number one, I would say homelessness. We have to get the problem under control. And Republicans around San Diego County, people like John Franklin, the mayor of Vista, Republican politicians and mayors are putting forward solutions on cutting homelessness and getting people off of the streets while providing them shelter. I think a Republican Board of Supervisors will really be able to attack the homelessness crisis and fix what we see going on. When you go to a Padres game, do you see homeless people everywhere? This is Democratic failed policies.

Okay, back to what’s going on in Washington, D.C. and the potential repercussions for San Diegans. Kyle, close to 1 million people are on Medicaid in San Diego County. The House GOP is proposing sweeping cuts to the program. Without Medicaid, what options do people here have for health care?

Krahel-Frolander: Well, you know, we need Medicaid. It is foundational to our health care system, both in California and across the country. And it’s a guarantee that people will not be left out without having health insurance, which is vital for the health of our economy, not just for those individuals. But it’s also lost in this that these cuts, these terrible, extremist cuts, are meant to just be able to fund a tax bill that would be a huge giveaway to billionaires. We would see the shutdown of many, many of our local hospitals if these drastic, draconian, extremist cuts to Medicaid go into effect.

Corey, Republican Senator Josh Hawley has said these cuts to Medicaid, if they go through, are morally wrong and politically suicidal. Do you agree?

Gustafson: I don’t agree with the question. These are not cuts. These are making sure that the folks who are eligible for Medicaid are eligible. These are just standards that Republicans are putting. And they’re making sure there’s not any waste, fraud and abuse, making sure that the people who are actually on the program are eligible. So I think this is fantastic. It’s something that the Obama administration tried to do in 2008–2016, but they failed. Republicans are saving taxpayers money.

Funding for scientific research has taken a real beating under the Trump administration. At UC San Diego, clinical trials have been halted at the Scripps Institution of Oceanography. Money for the study of the ocean, considered vital for weather forecasts and climate change study, is under threat. How do you view cuts or potential cuts to scientific research?

Gustafson: Innovation doesn’t only come from government. Innovation comes from the private sector. And what you see with the new proposal from Republicans on Capitol Hill is a massive amount of money going back to the American people, small businesses, corporations, because these are the folks who are innovating in our society. They grow the economy, they discover new possibilities, just like Apple Computer. Look at the things that Apple’s done for society because of the fact that they have an interest in profit.

I’ve spoken to government officials and university officials who say that there is no way that private industry could possibly fill the void of what government funding has been to scientific research in this country. These people have also told me that they’re looking to the state of California, which now has the world’s fourth largest economy, to use its economic leverage with Washington to stave off some of these cuts. What does that leverage look like?

Krahel-Frolander: We need to fight back and that’s what we’re going to do as California, as Democrats, because this is important to our economy, but it’s also important to the people who rely on clinical trials to save their lives. And I also think it’s important to point out that these cuts are not coming through the standard budget process. It’s not coming through Congress. These are being done unilaterally by the executive branch, illegally, in my opinion. And I think it’s part of an attack on our institutions like universities, like independent science, in order to advance a frankly authoritarian vision that doesn’t have any opposition power to this president.

The U.S. attorney’s office here in San Diego files dozens of border-related cases each week. President Trump has said in an interview this month that he didn’t know whether he has to uphold the Constitution by giving immigrants the right to due process before deporting them. What are your thoughts on this statement?

Gustafson: My thoughts are that President Trump is going to do what it takes to secure our southern border. He has done it. The idea that there should be any criticism against President Trump—his number one priority was saying we need to know who’s coming into this country. We need to stop and halt illegal immigration coming from our southern border. And he’s done it. He did it within a week. This is incredible.

Meanwhile, Trump’s aide Stephen Miller has said the administration is exploring suspending habeas corpus for migrants. Do you think it will happen? And if so, what recourse do opponents of this move have?

Krahel-Frolander: I think we need to rely on our checks and balances. The Supreme Court is our backstop here. I know it’s not a Supreme Court that I necessarily completely agree with, but I do believe that there are enough justices on that Supreme Court to strike down any unconstitutional power grabs that would invade the rights of Americans. And I say Americans not just because this is not just the migrants and other folks that they talk about coming through the southern border. These are attacks that are happening to people who are actually here legally.

A San Diego man is in the process of launching what he calls the Big Middle. It’s an online platform to assemble people of all political persuasions to find common ground. Is the time, is the moment ripe for this?

Gustafson: It’s already been done. President Trump just did it in November 2024. He just got 76 million people to vote for him. He just created an electoral landslide against the failed policies of the Biden administration and Kamala Harris. So if you want to talk about creating a huge movement amongst the American people, President Trump’s done it.

Do you agree? Is there representation of this so-called Big Middle, people from across political persuasions who may feel the same way about the big issues? Do they have representation in the Trump administration?

Krahel-Frolander: I can’t say that this administration has lived up to the promises that it said it would do to the American people that were supposed to attract the middle. All it’s doing is kowtowing to the richest in our country, to the billionaires and their friends, and that is not what the middle wants. The middle wants their prices to go down. That’s not happening. The middle wants good jobs. Those jobs are disappearing right now as we speak. They want their 401k so that they can retire with dignity, and those are being disappeared by this administration’s policies.

Students and residents made impassioned pleas at a meeting of the San Diego City Council on Monday, hoping to keep the city from reducing recreation center hours and closing libraries on Sundays and Mondays.

“Here we are begging for crumbs in your budget,” one student yelled at councilmembers.

“A lot of us learned to dance at El Toyo Park,” said another woman. “And I learned how to play tennis at MLK Park.”

The proposed cuts are part of Mayor Todd Gloria’s budget plan to make up a nearly $260 million budget deficit. He presented his final budget proposal to councilmembers on Monday.

Community advocate Francine Maxwell urged councilmembers not to rubber-stamp the budget. She urged council to cut people and not programs.

“At a minimum, you should be cutting deputy-level salaries,” Maxwell said. “Be bold leaders and cut them. We need our services. The middle management bloat is wrong.”

With the budget now in the council’s court to start making amendments, Councilmembers Sean Elo Rivera and Henry Foster said they’re looking to prioritize rec centers and libraries, especially after protests against plans to merge the Carmel Valley police station resulted in that proposal being scrapped, with nearly $800,000 restored to the police department.

“Keeping folks safe is our top priority, but that requires more than just, you know, putting cops on the street or firefighters on engines,” Elo-Rivera said. “That’s important. And if young people don’t have a place to go, a safe place to go after school, that makes us less safe.”

Elo-Rivera suggested keeping libraries and rec centers open full-time with the $11 million expected to roll in next year from paid parking at Balboa Park. He’d also like to see out-of-towners pay for parking at the zoo, new revenue that could help students focus on their future full-time at San Diego area libraries.

“I live in a house with five other people,” said high school senior Jaime Lopez Gill. “It’s always chaotic. There’s  no personal space. Going to these study rooms, I can focus on myself and put the best I can out there toward my education.”

The council will meet over the next three weeks to make amendments to the mayor’s proposed budget. Councilmembers will vote on the final budget on June 10.

In its first two weeks of operation, the new neuroscience center at Sharp Grossmont Hospital has averaged an 80% occupancy rate. That number is not terribly surprising, given that the La Mesa medical facility treated the 10th-most acute strokes in the state and handled the largest volume in San Diego County in 2023, according to state data.

Retired New York firefighter Thomas Daniels, 88, was among the first to occupy one of the 50 beds at what is officially called the Sharp Grossmont Hospital for Neuroscience. Admitted to Grossmont’s emergency department after having a stroke on April 29, he was transferred to the new center one day after it opened on May 1.

Thirteen days later, he was still there, feeling significant pain in his face, but able to chuckle over the enthusiastic welcome that occurred when the center’s first patients arrived.

“They were cheering for me and I said, ‘vote for me’ like I was running for governor,” he said. “That’s my way, just having fun.”

His ability to recall those memories made such a short amount of time after suffering a major neurological emergency is the entire point of building this new hospital within a hospital in the first place.

By dedicating space for neurological maladies, and filling that space with nurses, technicians and physicians all specificallytrained to handle brain-related care, the idea is to make it more likely that patients will receive medical interventions they need as quickly as possible.

Especially with stroke, the phrase “time is brain” has been the mantra in neurological care since the 1990s.

The speed and precision with which clot-busting drugs can be administered and surgery performed is literally the difference between full recovery and living the rest of one’s life with severely impaired movement. Or not surviving at all.

California hospitals are graded on their overall stroke mortality rates, a calculation of how many patients diagnosed with strokes die during treatment that is adjusted to account for overall underlying health conditions and other factors. In 2023, the most recent year for which data are available, Grossmont’s state-issued stroke rating was “as expected,” though results have been mixed, with some “below expected” ratings in previous years.

The goal of all hospitals is to consistently achieve a “better” rating, indicating that their risk-adjusted mortality rates are lower than would be expected when compared to similarly sized peers.

While not explicitly referencing state ratings, Dr. Gregory Apel, an emergency medicine specialist and Grossmont’s chief medical officer, said that breaking off neurological care into its own hospital on the larger medical campus, one with its own entrance and its own specially trained staff, will allow care to reach new heights.

Having dedicated space, he said, allows the recruitment of physicians who specialize more deeply. Already, for example, Grossmont has recruited several endovascular neurosurgeons who are able to conduct both minimally invasive brain surgeries and larger “open” procedures that often require larger openings in the skull for access.

“We have specialists here that are coming from the highest institutions and fellowship programs to really provide that level of care that doesn’t exist outside of a neuroscience center,” Apel said.

The physical structure of the new hospital also enables deeper subspecialization. Several rooms in their own set-aside section of the larger facility are designated as an Epilepsy Monitoring Unit and are equipped with special seizure-monitoring equipment. This new feature justifies bringing in a whole new category of subspecialists.

“There is actually a fellowship program for epileptologists who are neurologists who do nothing but seizure-related care,” Apel said. “We are in the process of recruiting to get specifically that specialty for that unit to be able to deal with the most complex seizures.”

It includes its own 16-bed neurological intensive care unit, as well as another 16-bed “progressive” care unit for those whose conditions are not severe enough to need intensive care. And there are 18 additional beds dedicated to rehabilitation, a major function of any neurology program. Those with strokes and other conditions often must spend many hours with physical therapists relearning once routine movements affected by the temporary loss of blood flow in the brain.

Rehabilitation beds are just a short walk from the neuroscience center’s beating heart, a cavernous physical therapy gymnasium filled with specialized exercise equipment designed for the kind of tasks that, with proper guidance, can help re-activate damaged nerve pathways and rebuild atrophied muscle tissue.

It’s an exponential upgrade over Grossmont’s former gym, which filled a single hospital hallway.

Scott Evans, chief strategy officer and market CEO for Sharp HealthCare, pointed out a special “studio apartment” room just off the main gym floor. This space is configured with all of the equipment a person would need to use when they return home after a serious neurological incident, such as a stroke.

“This is where we can simulate the activities of daily living,” Evans said. “They can start practicing doing their own clothes again, washing the dishes, making meals, getting in and out of the bathtub.”

The center treats far more than strokes. Brain and spine tumors, complex spine surgeries, movement disorders such as Parkinson’s disease, and vision problems related to neurological conditions are also services allocated to the neuroscience hospital, which does not have its own dedicated operating rooms. Surgeries will be performed in Grossmont’s Burr Heart and Vascular Center that opened in 2019.

Many who use the new physical therapy gym will be staying in the hospital’s rehabilitation unit, working daily to regain function before they can be discharged home. But the facility is also open to outpatients, those who are already home, but who require ongoing specialized workouts to help them handle neurological conditions.

By 9 a.m. on a recent morning, a dozen people were already using the gym, including AJ Fiume, 27, a La Mesa resident with cerebral palsy. He spent time using a hand bike, then went through a specialized muscle-building session with a physical therapist.

“That was probably the second or third time I’ve been able to get on the bike like that in my life,” he said. “You know, it’s not like you can do this stuff at 24 Hour Fitness.”

There is more to come. An upstairs doctor’s office will be staffed by a full complement of neurological specialists.

The point, stressed Apel, is to put as many neurological services as possible in one centralized location, decreasing the amount of travel necessary to make appointments.

“You will be able to walk in there and see your neurosurgeon, stroke neurologist, rehabilitation physician … I mean, it’s almost a revolving door of what specialties will be available to patients in one location,” Apel said.

For now, stroke patients and others with emergency neurological problems must be pushed through long hospital corridors to get from the ER to the neuroscience hospital, which is on the opposite side of the sprawling medical campus.

But Evans said that there are plans for a much straighter and subterranean path in the future.

“We’re going to dig a tunnel right under there to connect directly with the emergency department,” the executive said, gesturing south toward Grossmont’s emergency entrance closer to Grossmont Center Drive. “That will make it even faster to get over here.

“We want to make it as fast as possible.”