CALIFORNIA: SAN FRANCISCO PLANS FOR UNIVERSAL COVERAGE
San Francisco Mayor Willie Brown (D) announced plans toThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
offer "cradle-to-grave" health care to San Franciscans at a
city health summit on Tuesday. Brown plans to offer coverage to
all residents, "regardless of age, illness or employment," SAN
FRANCISCO EXAMINER reports. The goal is to provide a
"government-run system of coverage with three major elements:
access for every resident, comprehensive coverage and a choice
for consumers." He will name a "blue-ribbon task force" composed
of insurers, health care advocates, city officials and hospital
employees to outline the plan. Brown said, "In the end, I hope
we will chart a course in San Francisco that will provide a
national model" (Krieger/Gordon, 8/14).
A SKETCH: The plan would be financed by pooling funds from
Medicaid, Medi-Cal, the city, voluntary participating employers
and patients into a large trust fund. Patients would buy one of
a number of benefit packages offered by potential providers such
as Kaiser, Blue Cross-Blue Shield or a more economical public
clinic package (SACRAMENTO BEE, 8/15). Providers would be for
reimbursed for primary and specialty care, catastrophic care,
mental health services, and long-term nursing from the trust
fund. The plan aims to insure the roughly 15% uninsured San
Franciscans who drive up total costs by receiving tax-funded
emergency care at public hospitals. Eligibility requirements
would be established to prevent the city "from becoming a magnet
for the uninsured." The city is setting a standard of
competitive health insurance with guaranteed basic benefits, in
hopes of "forc[ing]" other insurers to follow suit.
WHY SHOULD IT WORK? The plan resembles California's failed
Proposition 186, a single-payer ballot initiative, and President
Clinton's ill-fated universal health care plan. However, Brown's
model does not require employers to contribute. The city will
offer tax incentives as "a driving force behind getting
businesses -- particularly cash-strapped small businesses -- to
sign on." No time line has been announced for drafting or
implementing the plan. Dr. Sandra Hernandez, director of the San
Francisco Health Department, said that they would "like to get a
long-term care strategy sketched out by year's end." EXAMINER
notes that city leaders anticipate receiving the necessary
federal waivers to implement the plan (8/14).