Healthy San Francisco is attempting what no other US city has: To provide universal health coverage for residents.
The Healthy San Francisco program, funded by the city, employer contributions and participant fees, offers medical services to San Franciscans regardless of their income, employment or immigration status or pre-existing medical conditions. It’s been lauded by President Barack Obama, who supports a government-funded plan as part of reforming America’s disastrous health care system. San Francisco mayor Gavin Newsom has name-dropped the program every chance he gets.
Besides being speech fodder and reinforcing the city’s liberal credentials, the program is reaching people who need it. But, like other universal health care plans, it has critics.
Healthy San Francisco: The Beginnings
An estimated 65,000 San Franciscans—about 15% of the total population--have no health insurance. Former San Francisco Supervisor Tom Ammiano, the lead advocate of universal health coverage, contended that if uninsured people had regular access to a primary care facility, they’d get more preventive and routine treatment, the overstretched emergency room at San Francisco General Hospital would get some relief, and overall health costs would decline. Healthy San Francisco began in July 2007.
Who’s Covered Under Healthy San Francisco
Uninsured San Franciscans with incomes up to 500% of the Federal Poverty Level(amounting to $54,150 for a person living alone and $119,250 for a family of four) are covered. As of late July 2009, 44,540 people were enrolled in the program.
What’s Covered
Various medical services, including inpatient visits, at 30 public and private clinics and hospitals.
What It Costs
Healthy San Francisco’s total cost for the 2008-09 fiscal year is about $113 million, or an average of $280 per month per participant.
Who Pays
- San Francisco covers about 70% of the cost.
- Participants pay quarterly fees and charges for treatment and prescriptions on a sliding scale.
- Employers with 20 or more employees must spend a minimum amount of money on health care for their staff—to buy them health insurance, set up health care savings accounts or pay into the city’s HSF fund.
- Restaurant diners may find a “health care tax” surcharge on their tab. Some of the restaurants passing their health care costs onto customers are adding as much as 6% to the bills, which the patrons are not always swallowing quietly.
Is It Working?
San Francisco is healthier. More San Franciscans are getting medical services. About 27% of the participants had not received health care before joining HSF.
HSF is cheaper. The public program costs less than private insurance plans in California.
