Healthy San Francisco

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Healthy San Francisco: Snapshot of Universal Care

Jack Snook expresses his appreciation for Healthy San Francisco in a panel discussion last night. (Photo: Kamal Menghrajani)

Jack Snook expresses his appreciation for Healthy San Francisco in a panel discussion last night. (Photo: Kamal Menghrajani)

It’s been almost five years since San Francisco launched its innovative, universal health plan–Healthy San Francisco–and last night a panel of public health experts and care providers gathered at the Tenderloin’s Glide Foundation to provide a snapshot of how the program is faring.

Glide has a long history of providing services to the poor and marginalized–and advocating on their behalf. Glide’s Freedom Hall was packed, with a smattering of people who indicated they were participants in Healthy San Francisco. Tangerine Brigham, director of the program, spoke first and described the program’s goals: to provide improved access to care through a network of community clinics and hospitals. Of primary importance is for people to have a relationship with a doctor or clinic so they don’t resort to the emergency room for what are essentially primary care problems.

Healthy San Francisco has enrolled 80 percent of San Francisco’s uninsured–about 55,000 adults.
Since its inception in 2007, Healthy San Francisco has enrolled 80 percent of San Francisco’s uninsured–about 55,000 adults. And people are using the primary care benefits. “Over 70 percent of the people in Healthy SF are getting a primary care visit at least once a year,” Brigham said. “Because they’re using primary care, we saw a reduction in emergency room utilization at San Francisco General Hospital. We compared that to other public hospitals in California and what that analysis showed was that San Francisco emergency utilization was declining while others’ was rising.” Continue reading

Healthy SF: Not So Healthy Financially

(Flickr:a.drian)

(Flickr:a.drian)

Four years ago, the City of San Francisco launched an ambitious attempt at health care coverage for all. Today, the San Francisco Public Press devotes its winter edition to an analysis of how well “Healthy San Francisco” is working. While tens of thousands of previously uninsured people have enrolled, and now have health care access they did not have before, the costs have been daunting.

In the Public Press report Stephen Shortell, Dean of the UC-Berkeley School of Public Health appropriately summarized the problem, “Healthy San Francisco is a model for health care delivery, but not for payment.”

“The program is very, very important, but I think we should recognize that it does not pay for the care of the population.”
Healthy SF is not insurance. Instead, it is access to community clinics and other safety net providers, but only those in San Francisco. Participants are not covered if they visit providers outside San Francisco. It is largely uninsured adults, people who earn too much money to qualify for Medi-Cal, who have signed up. In a state where more than 20 percent of people lack health insurance, only three percent of San Franciscans now are without health care. The Public Press reports that many people who had not seen a doctor in years are now receiving treatment.

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