ShareThisBy HEATHER KNIGHT
San Francisco Chronicle
As the national debate rages over how to fix the country's broken health care system -- with 2008 presidential candidates offering up their solutions and Michael Moore's documentary "Sicko" opening -- San Francisco will become the first city in the country to actually try to solve the problem itself.
Starting Monday, the city will roll out Healthy San Francisco, designed to eventually provide local medical care for all 82,000 city residents who lack health insurance. Recently renamed, the initiative received unanimous Board of Supervisors approval last summer.
It will start with just a few hundred patients in Chinatown but is designed to ramp up to full citywide coverage within 18 months.
City officials know their first-of-its-kind attempt is being closely watched by other cities, counties, states and even national leaders. Mayor Gavin Newsom said he has briefed New York Sen. Hillary Rodham Clinton, a Democratic presidential contender who famously tried and failed to get congressional approval for her own health care reforms in 1994.
"We're not overstating this," Newsom said at a press conference, flanked by Supervisor Tom Ammiano, Department of Public Health officials and the directors of two Chinatown health care centers that are part of the initial rollout. "This is unprecedented."
Under the program, crafted by Newsom and Ammiano, the city intends to begin with its existing network of public and nonprofit medical clinics and hospitals and the low-income people they already serve. Then it will be gradually opened up to all uninsured residents who don't qualify for government health care coverage programs.
Officials are starting small, however.
Dr. Mitch Katz, the city's public health director, said Chinatown was chosen in part because city officials want to make sure they can competently deal with language and cultural challenges before going citywide.
Healthy San Francisco is scheduled to start expanding in September, bringing in users of public health and nonprofit clinics citywide at a clip of about 4,000 per month.
In January, the city intends to throw open the program to all uninsured city residents. That's also when the city will require employers who don't already offer health insurance to their employees to start contributing to the program.
City officials say the program, estimated to cost $200 million a year, cannot work without that component -- but it is being challenged in court. The Golden Gate Restaurant Association has filed a lawsuit in federal court to block implementation of the employer mandate. Both sides are due before a judge Aug. 31.
Kevin Westlye, executive director of the association, said Wednesday the program can work without the contributions from employers and that many small-business owners simply cannot afford them. His group is proposing a quarter-cent sales tax increase as an alternative, which he said would add $40 million annually to the system.
The lawsuit aside, Healthy San Francisco is designed to work like this: Every participant will be assigned to a primary care facility at a health care center or clinic that will stress preventive care, and they also will have access to urgent care, emergency care, mental health care, substance abuse services, radiology, pharmaceuticals and other medical services.
More high-level medical care -- such as surgery -- will be offered at San Francisco General Hospital, though public health officials hope to bring on private hospitals around the city to participate.
To qualify, an individual must be an adult (children are already covered in San Francisco through another program), uninsured, live in the city and be ineligible for Medicaid or Medi-Cal. It is not being called an insurance program because medical care is only available within the city limits.
Employment status, immigration status and pre-existing medical conditions won't be factors in coverage. For example, someone who is unemployed, in the country illegally and suffering from cancer would have the same rights for coverage as anybody else.
"(People) are shocked by that," Newsom said. "We're taking care of all residents of San Francisco."
(Distributed by Scripps Howard News Service, www.shns.com.)
