In Opinion: “We need to be able to ask the question, ‘Are these public-sector programs achieving their stated purpose?’” mdweinberg tells owenthomas.
San Francisco’s great at innovation. It’s less skilled at sweeping up the bureaucratic detritus of once-useful programs left to fester on the books.
Healthy San Francisco is a health access program, not health insurance, designed to provide uninsured residents with an affordable form of managed care. The truth is The City was already spending money to care for most of these people when they showed up at city clinics or San Francisco General. Treating people at the ER inevitably costs more and delivers worse results.
The problem was that Healthy San Francisco was a component of a broader plan under the 2006 Health Care Security Ordinance, which included employer mandates to spend a certain amount per employee on health care, a requirement that many small business owners hated. A lawsuit by restaurateurs failed, so some resorted to a more passive-aggressive form of protest: tacking on a “Healthy SF” surcharge on bills.
Cruise ships are back in SF along with much needed tourism money In 2019, cruise passengers contributed $27 million to the San Francisco economy. Those dollars are coming back, offsetting billions in lost tourism revenue “At a time when small businesses are under a lot of pressure, you probably need to look pretty critically at a program that has a significant cost burden and administrative burden,” Micah Weinberg, CEO of California Forward, a nonprofit organization advocating for sound economic policies for the state. “The Health Care Security Ordinance has been anachronistic for coming up on a decade,” he added, given the passage of the Affordable Care Act.
One reason why some still opt for Healthy San Francisco over Covered California, according to the Department of Public Health, is that they don’t find the state program's premiums and copayments affordable: It seems like a better way to do that might be to adjust the subsidies in the health insurance exchange, rather than maintain a parallel system of paying for health care.
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