San Francisco launching universal health care plan

The city aims to provide basic care to 82,000 uninsured adults, but a restaurant association is fighting the plan's mandatory employer contributions.

By Doug Trapp, AMNews staff. Aug. 20, 2007.

Washington -- San Francisco last month began rolling out its plan to provide universal health care to residents through an expansion of its public health safety net and a new employer mandate.

The program, known as Healthy San Francisco, is essentially an upgrade of the city's century-old public health network, which today includes 20 health clinics and one hospital. Fourteen of those clinics and San Francisco General Hospital will provide care to the uninsured. The initiative's planners also anticipate that eight private nonprofit clinics and possibly private health plans and other hospitals will participate.

Keys to the reform effort are coordinating care within the network, using electronic referrals for specialists, giving patients medical homes and focusing on preventive care.

But Healthy San Francisco is not health insurance. Enrollees can only receive care in the program's network, located in the city. "In Oakland you have absolutely no coverage," said Edward A. Chow, MD, senior member of the San Francisco Health Commission, which oversees the city's health department, and past president of the San Francisco Medical Society.

The plan also requires employers in the city to contribute to the health care of employees who work in San Francisco, regardless of where they live. Companies must pay at least $1.17 an hour per employee for their health care starting, at the latest, in April 2008. Businesses with fewer than 20 employees are exempt from the mandate.