San Francisco’s recent health care initiative, Healthy San Francisco, is good as far as it goes, and the first-of-its-kind plan is garnering some national attention. Ultimately it guarantees the 82,000 uninsured San Franciscans free or subsidized health care, and even purportedly succeeds without new costs—the city plans on funding the plan by savings from diminished treatments in the ER, a $24 thousand 3-year federal grant, and sliding-scale co-pays from participants. The plan does face legal challenges from employers, especially in the restaurant industry, who are required by the plan to financially contribute to health care in the city. The success of the plan depends in part on the city winning these cases in court. But there’s a wider problem here and it’s one that Newsom can’t fix. The problem is that the SF initiative operates at a purely local level, only within San Francisco. It does not offer *insurance*—those that qualify for the plan get health care in SF, but they are completely uncovered out of town. The localism of the plan shows the limits of the city level when it comes to solving the healthcare problem, and why it’s so important for the federal government to get its act together and offer real insurance for all of the uninsured. Without a coordinated plan at the federal level, there will likely be substantial divergence in health care policy indifferent cities, further complicating an already complex issue. We should applaud the city for picking up the fed’s slack, but let’s also hope that the plan motivates federal legislators to get their act together and insure those who desperately need it.
–Benjamin Boudreaux

Wednesday, September 26th, 2007 \ 1:23 am \ Uncategorized
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