San Francisco plan to cover everyone

Physicians support the principles of extending access to care but wonder how the funding will shake out.

By Beth Wilson, AMNews correspondent. Aug. 21, 2006.

As San Francisco prepares to become the first city to offer universal health care to its residents, local physicians applaud the plan, although many key provisions must be ironed out before implementation.

Mayor Gavin Newsom Aug. 7 signed an ordinance providing health care access to some 82,000 uninsured San Francisco residents. The program is aimed at people who earn too much to qualify for Medicaid but not enough to afford private insurance.

Under the groundbreaking measure, estimated to cost about $200,000 million during its first year, eligible residents could enroll as individuals or as a group through an employer to receive care at select city clinics and hospitals, beginning as early as July 2007.

Services, which include Pap smears, prescriptions, x-rays, routine office visits and surgery, would be covered and paid for through a combination of $104 million in city money, individual fees and potential co-pays, and employer contributions.

The plan, however, is not an insurance program. Services are available only to city residents while they are inside San Francisco County.

Participating physicians would receive some form of reimbursement but the exact amount is unclear, said Gordon Fung, MD, MPH, who serves as the San Francisco Medical Society president and sat on the Universal Healthcare Council, a group of medical professionals, insurers and business owners assembled by the mayor to study the issue.

"The funding aspects are still a bit murky," he said. "The medical society wants to get some firm answers."