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| San Francisco Supervisors Vote To Bankrupt City |
| 2006-07-19 |
| The San Francisco Board of Supervisors voted unanimously Tuesday to make the city the nation's first to provide all residents with health care, approving a plan that would give adults access to medical services regardless of their immigration or employment status. Financed by local government, mandatory contributions from employers and income-adjusted premiums, the universal care plan would cover the cost of everything from checkups, prescription drugs and X-rays to ambulance rides, blood tests and operations. Unlike health insurance, however, it would not pay for any services participants seek outside San Francisco. Instead, residents would receive care at existing clinics and public hospitals and from doctors who already participate in an HMO for low- and middle-income clients. With backing from both Mayor Gavin Newsom and all 11 supervisors, the so-called Health Access Plan proved to be a politically popular concept in liberal San Francisco despite unmitigated opposition from the business community. "What feels very good is the full board and the mayor getting on board," said Supervisor Tom Ammiano, who first championed the idea of making employers pay for some part of their workers' medical costs. "That says the political will is there to make it happen." To offset the estimated annual price tag of $200 million, firms with 20 or more workers would be required to spend $1.06 for each hour worked by an employee, and those with more than 100 workers would have to pay $1.60 per hour up to a monthly maximum of $180 per worker. Companies that already offer health coverage would still have to pay if their insurance contributions did not meet the city's funding levels. The Board of Supervisors still needs to vote on the plan once more for it to become final. The ordinance adopted Tuesday calls for businesses with more than 50 employees to start participating starting next July, while it would take effect for enterprises with 20 or more workers in April 2008. Michael O'Connor, a nightclub owner who serves on the San Francisco Small Business Commission, predicted that the "noble burden" of the mandate would keep businesses from locating in the city and make goods and services here more expensive as employers pass on the costs to customers. O'Connor said many business owners were disappointed by Newsom's backing of the plan since the mayor got his start in business as the owner of a wine shop and several restaurants. "One would think that someone who has owned and opened restaurants would be pretty clear on what the profit margin is, and how hard it is to get them open. A $5,000 licensing fee is difficult. A new $60,000 (health care) fee is disabling," he said. Before the board vote, Newsom defended the proposal as a creative solution to the problem of securing decent health care for uninsured residents, noting that businesses would not be alone in defraying the costs. Of the $200 million, the city would provide $104 million and participants would contribute about $56 million. "This is a moral debate as much as a political debate," Newsom said. The initiative adopted Tuesday developed as a compromise between Newsom and Ammiano, who last year introduced legislation that would have required businesses to create health savings accounts for uninsured workers. In a nod to concerns from business, the final plan requires employees to work at least 12 hours a week to be eligible and has an opt-out provision for workers who are insured through their spouses. Because fees would be adjusted on a sliding scale, city officials did not expect to see a rush of residents canceling their existing health insurance to take part in the city program. |
| Posted by:Anonymoose |
| #25 Companies that already offer health coverage would still have to pay if their insurance contributions did not meet the city's funding levels. That would seem to mandate gold-plating of corporate benefits wouldn't it? Pay enough for your employees benefits and you don't pay the city. |
| Posted by: AzCat 2006-07-19 23:54 |
| #24 Companies that already offer health coverage would still have to pay if their insurance contributions did not meet the city's funding levels. hee hee ha ha ha Hee! |
| Posted by: 6 2006-07-19 17:34 |
| #23 Why do the poor and illegals "deserve" health care at my expense, a man who is not illegal, and worked his ASS off to not be poor? I ask merely for information. |
| Posted by: mcsegeek1 2006-07-19 16:30 |
| #22 ed, what I meant about refining the numbers was mainly what portion of the 15 - 20k patients will be wracking up a half mil in costs. What you bring up is important too. How will this effect medicare / medicare payments? Will it be like private insurance? And, why would anyone in SF buy private insurance? As far as immigrants, is there going to be a residency requirement (hee, hee,) will someone showing up at a hospital or clinic have to prove that they live in SF?? I bet there will be a lot of 2 hour immigrants that immigrate over and over. |
| Posted by: AlanC 2006-07-19 15:10 |
| #21 Who wrote this? Financed by local government... And their money comes from... what exactly? |
| Posted by: eLarson 2006-07-19 15:01 |
| #20 Can you refine the numbers a bit? Not sure what you mean. Do you mean how many of those are w/o insurance? I don't know, but at the terminal stage, almost all of them will be w/o. At that point Medicaid takes over. I don't know how SF splits costs w/ Medicaid (e.g. 20/80%). What is more worrying is legal and illegal aliens moving to SF for the free treatment. Then the full burden is on SF taxpayers. If I was HIV positive and poor, my goal would be get to SF so I could live another 20+ years. |
| Posted by: ed 2006-07-19 14:54 |
| #19 Hmmm, United Airlines was considering SF as a possible new location for its HQ, but they chose Chicago instead...... I really thought UA was outta here, but they surprised me. Maybe this is a piece of the puzzle. |
| Posted by: anonymous2u 2006-07-19 14:19 |
| #18 --"What feels very good is the full board and the mayor getting on board," -- Well, that IS the most important thing, their "feeling good." |
| Posted by: anonymous2u 2006-07-19 14:16 |
| #17 --approving a plan that would give adults access to medical services regardless of their immigration or employment status.-- SF is so backward they don't already have this???? I thought they were "progressive?" |
| Posted by: anonymous2u 2006-07-19 14:14 |
| #16 DoDo you're not reading too well here. See "...regardless of their immigration or employment status." means that all those po' folk over in Oakland only have to get across the bridge and they're immediately eligible, likewise, Richmond, South San Fran, Detroit, etc. RE HIV: Ed...I just did a back of the envelope calculation and find that using the conservative end of your numbers, HIV ALONE will account for almost $250,000,000 (yes million) / year for SF. Can you refine the numbers a bit? 400K total / 25 yr = 16,000 /yr / patient, times 15K patients = 240,000,000. Now, how much did they say this would cost? |
| Posted by: AlanC 2006-07-19 13:46 |
| #15 And that is the real agenda behind this... |
| Posted by: Thurong Ebbatle2223 2006-07-19 12:21 |
| #14 If I had HIV, no matter where in the world I am from, I would pack my bags and head to SF. |
| Posted by: ed 2006-07-19 12:18 |
| #13 Decrease in new HIV infections smaller than expected Based on nine surveys, the health department estimates that the number of gay men living in San Francisco is 58,000, a 25 percent increase from 47,000 in 2001. ... The city's epidemiological portrait estimates that 18,735 residents are infected with HIV, including 14,000 gay men -- 1 in 4 of those living in the city today. Since AIDS was first detected in 1981, it has taken the lives of 17,917 San Franciscans. Lifetime cost of anti-HIV treatment estimated at more than $400,000 the researchers predict that adults who begin antiretroviral treatment when their CD4-cell counts drop below 350 cells can be expected to live 24.1 years and will run up a medical tab of between $405,000 with drug discounts to as high as $648,000 without them. Adults starting anti-HIV drugs with a CD4-cell count below 200—the AIDS-defining threshold—were predicted to live an average of 22.4 years and to spend from $370,000 to $589,000 for their care. |
| Posted by: ed 2006-07-19 12:16 |
| #12 It felt good to Tom. |
| Posted by: Nimble Spemble 2006-07-19 12:12 |
| #11 "What feels very good is the full board and the mayor getting on board," said Supervisor Tom Ammiano, See, it's all about feeling good. |
| Posted by: Deacon Blues 2006-07-19 12:09 |
| #10 Big organized crime presence in SF. And organized crime has their fingers in that big pot of money for health care. I remember back in the mid 90's in San Diego, that one of the big health care players was doing mergers and it was between the lines that the mob was getting involved. It's like construction, it's lots of money, difficult prove actual worth of services and products offered and now it will be easy pickings with less oversight. |
| Posted by: 2b 2006-07-19 12:07 |
| #9 SF just moved to the top of my retirement community list. Now to find a VW bus and |
| Posted by: wxjames 2006-07-19 12:03 |
| #8 Its not as brave or as costly as it sounds. San Francisco is an extraordinarily wealthy city. It consists of just the tip of the penninsula, and with just under 800,000 residents it is only the third largest city in the Bay Area. Poor people cannot afford to live in the City. They live in Richmond and Oakland, across the bay, and in South San Francisco. Most of the people living in the city are employed and there are very few children. The vast majority of people are already covered by health insurance. The City is home to much of the area's high income financial and legal businesses, which generates lots of tax dollars. Further, many of those apparently required to contribute are commuters who do not live in the city. The mayor is obviously of the opinion that San Francisco is such a great location that businesses will continue to maintain operations in the city. Its not apparent that the additional cost is so great that companies will be willing to accept an Oakland address. |
| Posted by: DoDo 2006-07-19 11:38 |
| #7 Hey maybe their onto something... After all its working so well for North Korea and Cuba! |
| Posted by: CrazyFool 2006-07-19 11:38 |
| #6 Unlike health insurance, however, it would not pay for any services participants seek outside San Francisco. Instead, residents would receive care at existing clinics and public hospitals and from doctors who already participate in an HMO for low- and middle-income clients. My office door just slammed. I think it was a gust of wind caused by that sigh of relief by non-San Francisco healthcare providers. |
| Posted by: Besoeker 2006-07-19 11:21 |
| #5 Class action against the Bd of Supes for fiscal irresponsability in 3,2,1... |
| Posted by: mojo 2006-07-19 11:18 |
| #4 ...businesses would not be alone in defraying the costs. Of the $200 million, the city would provide $104 million and participants would contribute about $56 million. And where did the city get the money it contributes? Pixies in the garden? It got that from taxing businesses in the city. Is there some idiot gas coming out of the sewers in that city? |
| Posted by: Oldcat 2006-07-19 11:18 |
| #3 This won't cause people to move, only employers. San Francisco is really an amusement park for adults, esciting cable car rides & all. But even with all its natural assets it is going to price itself out of the market. |
| Posted by: Nimble Spemble 2006-07-19 11:06 |
| #2 It will certainly open up the housing market as people move away. Help lower those pesky housing costs. |
| Posted by: BrerRabbit 2006-07-19 11:03 |
| #1 Well we know where all the illegals will end up. :) |
| Posted by: djohn66 2006-07-19 10:59 |