Universal Health Care in San Francisco

Thanks to Dan Mitchell (UCLA) for posting this interesting story about how the City of San Francisco is using existing structures to provide universal health care to its citizens.

From the LA Times:

Forget the driver's license and credit cards. The most important piece of plastic in Cheng Wang's wallet is his new medical identification card featuring a picture of a heart and this city's signature skyline.

Wang, who has diabetes and other ailments, says the Healthy San Francisco program saved his life.

When he immigrated here in May to be closer to his elderly mother, the 64-year-old Taiwan native brought enough pills to last seven months. When those ran out, he didn't know what to do. He had no medical insurance. And it scared him.

Then he learned about a groundbreaking city health plan that provides a network of care to residents regardless of their ability to pay, immigration status or existing medical conditions. Wang, a proud man with oversized glasses, said it's important to him that the program is not purely a handout. It's a bona fide medical plan offering care free of charge to those who can't pay and on a sliding scale to those who can afford to contribute to their care. When he finds work, he'll pay, he said . . . . .

Launched in July at two pilot clinics in Chinatown, Healthy San Francisco now has 14 city health clinics and eight affiliated community clinics. More than 82,000 San Franciscans are without healthcare of any kind. Program managers hope to have enrolled all of them over the next two years by advertising the service in three languages at clinics and social service agencies.

Officials stress that their universal healthcare plan is not insurance. The program does not travel with members, who are only covered for visits to participating clinics and the public hospital in San Francisco. It also does not cover dental or eye care. Those below the federal poverty level of $10,210 in annual income for a single person and $20,650 for a family of four pay no fees.

Starting next month, the plan will be open to individuals with incomes up to 500% of the poverty level. Quarterly fees on the sliding scale range from $60 to $675. Co-payments for those who don't qualify for free care range from $10 to $20 for clinic visits and $200 to $350 for a hospital stay.

Clearly, this is a gap-filling measure as the country struggles to pass meaningful health care reform, and it is not an insurance program, but I'm sure people like Mr. Wang could care less about its intricacies.

How is it funded?:

[T]he program should cost $200 million the first year, and officials expect to finance it without a tax increase. They will also receive a federal grant of $24 million a year. In addition to membership fees and co-payments, the city will also receive money for the program from employers with more than 20 employees, who, starting in 2008, will be required to contribute a set amount to healthcare.

Neat idea and a great way to spend health care money on preventative care rather than less minute, expensive emergency procedures.

PS