Washington kicking 40,000 off state health plan — while San Francisco enrolls 600 weekly

Health care “stakeholders” are meeting in Olympia to discuss how to take 40,000 people off the state’s health care plan, even while the numbers of uninsured grow. Drive half a day south and it’s a different story. San Francisco is enrolling 600 people a week in Healthy San Francisco, the city’s universal health-care program.

According to Mayor Gavin Newsom, Healthy San Francisco is cost-effective, simple to administer, preserves patient choice — and is ready to scale up:

I’ve been in our nation’s capital this week meeting with Obama Administration officials and Congressional leaders about national health care reform. Everywhere I go, from the White House to the Department of Labor to the U.S. Senate, I get the same question: can San Francisco’s universal health care program, Healthy San Francisco, be scaled?

The answer is yes.

The program got under way in 2007, and the results do look promising. It requires private companies with at least 20 employees and not-for-profit groups with at least 50 employees either to provide health care benefits to workers at a cost that meets minimum spending levels or help cover the cost of Healthy San Francisco. The program is not health insurance because it covers services only in San Francisco.

According to the Associated Press, elected leaders in Washington DC appear to be going in a different direction – but voices calling on Congress and the Obama administration to take a hard look at universal health care are growing louder:

…hundreds of nurses swarmed Capitol Hill on Wednesday to call for “single payer” — or government-run — health care, and demand “no” votes from liberal lawmakers on anything falling short. Congressional leaders on health care have taken single payer off the table as politically impractical.

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  1. Mike Perry says:

    San Francisco’s hardly a model that could scale well for the rest of the country or, indeed, to most major cities. Sociologically, San Francisco is very atypical.

    The median household income is high, at over $65,000 and that for families even higher at over $81,000. Earlier figures for Seattle are $46,000 and $40,000.

    The high cost of living there has driven out middle-class families, making the proportion of children, 14.5 percent, the lowest in the country. Children need a disproportionate amount of care for birthing and growing up, so getting rid of them saves money both for medical care and for education.

    I couldn’t find the figures, but I suspect few elderly and retired people who aren’t wealthy can afford to live there either, eliminating another major health care cost.

    Tourism, one of the city’s major industries, attracts mostly young adults as workers, people who have very low health care costs. Again that’s atypical. The city does have a serious problem with homelessness and poverty, but that is a group that simply suffers without good medical care. It’s easy to suspect that the city’s rich population cares little about that.

    In short, it’s silly to even ask if this program could be replicated elsewhere or scaled up for the rest of the country.

    In addition, no program administered by Obama is likely to be successful. In his one experience as an executive, he headed a program that spent $165 million on Chicago schools that produced no measurable effect on the schools. Imagine that! I could do far better myself and I would never have the hubris to undertake major reforms in education and health care.

    Washington is kicking 40,000 people off Basic Health because our politicians are incompetent. In flush times they built stadiums we are now paying for and neglected basic infrastructure. Even with the economy down, they still want to rebuild the Viaduct with a costly tunnel whose cost overruns are likely to rival that of the “Big Dig” in Boston. That shows all too clearly that politicians who run our state can’t even get simple stuff like roads and bridges right. It’s insane to put something as complex and critical as medical care in their hands and equally insane to take seriously any “expert” who’d consider that as an option.

    –Mike Perry, Seattle

    • Mike,

      I’d wager that it’s no cheaper for a small business to buy health insurance for its employees in San Francisco than it is in any other part of the country. The big costs in health care aren’t geographic in origin – they have to do with the massively inefficient way we administer our private health care system. San Francisco seems to have realized savings by cutting out the middlemen to reduce overhead, and by ensuring everyone gets access to preventative care, which reduces expensive trips to the emergency room.

      But it sounds like you don’t think those ideas will really work. So…given that America has the most expensive health care in the world among comparable nations – a system that still leaves millions of families without even basic health coverage – how do you propose we control those costs and ensure everyone who needs preventative or emergency care can get it?

      ~Aaron Keating, EOI

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