San Francisco First City to Roll out Universal Health Care

By Anastacia Mott Austin

After two months of testing a new program to provide health care to all of its city residents, San Francisco is ready to expand it city-wide.

Known as Healthy San Francisco, the program was drafted by mayor Gavin Newsome and city supervisor Tom Ammiano, after San Francisco voters overwhelmingly supported a city referendum to provide health care to all city residents.

After struggling and failing to find ways of providing universal health insurance, the focus shifted to health care. "We asked a different question," said mayor Newsome to reporters at The New York Times. "We asked, how do we provide universal health care to all uninsured San Franciscans? And that one modest distinction allowed us to answer the question we hadn’t been able to answer in a decade."

The program will offer residents a primary health care facility that offers preventive as well as diagnostic care. It will include emergency services, prescription drugs, substance abuse and mental health services, and surgical referrals.

The program will continue to grow from its current structure. Through November of this year, it will cover only those who are currently uninsured and earning below the federal poverty line, and will involve 14 city medical clinics and 8 community health clinics affiliated with the program.

After November, the plan will include all uninsured San Franciscans. From there the hope is to later involve private clinics and continue to expand.

The director of Healthy San Francisco, Tangerine Brigham, estimates that the cost of running the program will be approximately $200 million in the first year. However, the expectation is that city funds currently being used to address the uninsured health issue will be redirected into Healthy San Francisco.

In addition, the program will receive $24 million per year for three years through a federal grant.

The city hopes that employers will adhere to a provision in the program that will require local businesses with 20 or more employees to contribute to a health care program, which will prevent companies from simply dropping their private employee health insurance.

The local Golden Gate Restaurant Association has already filed suit to prevent the requirement, set to begin next January, from being implemented. A hearing on the issue will happen in November.

Would San Francisco’s plan to provide health care to all city residents work in other cities? Many are waiting and watching.

Several factors help provide a positive environment for such a program in San Francisco, which may not work in other cities. The city and county governments are unified, the geographic location of San Francisco is dense with superbly accessible public transportation, there are a great number of community clinics already in place, and most people in the city are already insured through private insurance.

But other cities are taking notice. For now, San Francisco is optimistic and hopeful that the program can work for its residents.

One of them, Xiuqun Lin, 29, whose entire family relies on her part-time restaurant salary, was thrilled to find out that she qualifies for Healthy San Francisco. "I’m very, very happy," she told reporters at The San Francisco Chronicle, through a Cantonese interpreter. "I can’t believe there is such a great program in place. I didn’t realize."

Agreed mayor Newsom, who visited a participating clinic and showed reporters a membership card for the program. "What this card entitles you to is the ability to go to the emergency room without risk of financial ruin," he told the press. "The psychological impact of that is so important. It’s profound."