Ammiano ordinance would require broader private sector health
care coverage for employees
Supervisor Tom Ammiano
By Pat Murphy
November 23, 2005
Supervisor Tom Ammiano yesterday introduced legislation requiring
San Francisco businesses with 20 or more employees to provide
health care coverage for employees.
He cited passage of city policy Proposition O in 1998, which
declared San Francisco should move to universal health care, as
popular mandate for the measure.
The ordinance exempts businesses which already provide health
insurance, and businesses whose employees are represented by unions.
"I think we need to take the example of small businesses
who now have health care, or who offer affordable health care,
and increase the size of that universe," Ammiano said in
a noon City Hall press conference.
However, the number of small businesses providing health care
coverage is decreasing, added Ammiano.
"It's a shame, but I believe
Kaiser (Permanente) just
came out with a study
that showed that those small businesses providing health care
have decreased in the past two or three years rather than increased,"
"We have 40,000 people who are working hard every day and
who do not have health care.
"We are here today to announce this ordinance which will
level that playing field.
"This legislation will require small businesses with 20
or more employees who work 80 hours (per month) or more to be
The District 9 supervisor called for a December public hearing
on the proposal. Under city legislative rules, 30 days must pass
before new legislation can be acted upon.
The ordinance would establish a seven-person task force to determine
Supervisors Chris Daly, Sophie Maxwell and Ross Mirkarimi were
at Ammiano's side to endorse the measure.
Supervisors Maxwell and Mirkarimi lend support to Ammiano's ordinance...
As does Supervisor Chris Daly
It was backed by a coalition of the San Francisco Peoples' Organization
(SFPO), Senior Action Network, the San Francisco Labor Council,
Young Workers United, ACORN, Gray Panthers, Health Care for All,
the Tenderloin Housing Clinic, SEIU Local 790, UFCW Local 21,
and Health Access California.
The coalition did not include a representative of small business.
"Frankly I was a little shocked about getting the legislation
just in my hands this morning," said Agnes Briones, executive
director of the Small Business Commission.
"I commend Supervisor Ammiano and the other supervisors
for wanting to put this debate forward, but I think the debate
needs to be open, transparent, and allow for small business owners
to have a say around an ordinance that will impact their ability
to do business in San Francisco.
"I would encourage Supervisor Ammiano to have a couple of
small business owners on the task force," Briones stated.
Ammiano attempted to pre-empt criticism of the measure.
"Every time you make a move toward any kind of social justice
issue, whether it would be universal health care or whether it
would be paying people's housing
'businesses are always going
to move,' said Ammiano.
"Well, I haven't seen them move, and they're not going to
"And you know why they're not going to move? Because those
businesses that currently supply health care are thriving.
"They have better employee morale. They have less turnover,
and they certainly have employee loyalty because they are being
treated with dignity for the hard work that they do."
Mirkarimi praised Ammiano for bringing the legislation forth.
"Tom once again you make us very, very proud, and I'm proud
to co-sponsor this ordinance today," Mirkarimi stated.
"Nationally the system of
employer-based health insurance
combined with the delicate reach of managed care is completely
in shambles," continued Mirkarimi.
"Expenses are out of control. The cost containment is impacting
the wrong place altogether.
"Not-for-profit hospitals are shutting their doors, and
for-profit hospitals are creeping in.
"Most people lack adequate pharmaceutical coverage, not
to mention dental coverage.
"The actual paper chase for patients and the families of
patients who are seeking to navigate around the health care bureaucracy
are making those patients that much more sick.
"The non-profit managed health care vision of yesterday
is under the threat of becoming a for-profit, pre-selective health
"This nation needs a complete overhaul in its ability to
provide for universal health care, but until that happens we're
obviously very fortunate to have Supervisors like Tom Ammiano.
"We believe that here locally in San Francisco we can actually
do something about that. We cannot stand by and permit even the
most minimal traditional system of employer based insurance to
"This is not a left or right proposal. This is a populist
proposal. It's based on the decency of protecting Americans so
while the health insurance system is collapsing ordinary people
are no longer the victims," Mirkarimi insisted.
Daly described a broken social contract.
About one in eight San Franciscans does not have health
insurance, so its clear here in San Francisco one
of the wealthiest cities around that the social contract
where you work and their employees (are) not meeting the terms
of the social contract (is broken)
which is basically you
do your work and then the company takes care of you in terms of
your salary and your benefits for you and your family, stated
the District 6 supervisor.
"That system is broken, and so government leaders like Tom
Ammiano have to step in, and I'm proud to join Ross Mirkarimi
and hopefully a unanimous Board of Supervisors
"Health clearly is a human right. When these companies do
not provide the health insurance to their hard working employees
these San Franciscans end up relying on the city's public health
the burden of the responsibility of that health care
moves from those corporations that are supposed to be providing
the health coverage to taxpayers and the local government here
in the City and County of San Francisco.
"And we spend a lot money on the public health system in
the city, and we're proud of it, but we cannot keep continuing
on the course we're going
without the private sector
good on the social contract.
"This legislation is going to save the city a lot of money
we can take that money and we can spend it on the unmet
needs that still exist in this city," said Daly.
Supervisor Sophie Maxwell framed adequate health care as true
"Healthy families, healthy children - that's true homeland
security," Maxwell began.
"I think that every single one of these corporations that's
making money in this country have a responsibility to this country
and if not as far as I'm concerned it's Un-American.
"I do not think that health care should be market driven.
Housing should not be market driven.
"Those are things that should be - because you are a human
being and because you live in our country - we're going to make
sure that you have those things.
"So when we talk about homeland security let's make clear
what we are talking about: healthy families, healthy children,
an educated populace," the District 10 supervisor stated.
The San Francisco Labor Council threw its support to the ordinance.
"Every time we go to the collective bargaining table what
we end up negotiating is our health care benefits," reported
Tim Paulson, Labor Council executive director.
"But the costs keep going up
we think it is important
that we raise the bar for everybody in San Francisco because there
are good contractors here in town that provide health care.
"Why shouldn't everybody else provide health care if you
"Part of the cost of health care is because of those corporations
and those companies that do not provide health care
think that is a horrible injustice," said Paulson.
A spokesman for the Golden Gate Restaurant Association suggested
the task force draw on national health care experts.
"I think the problem with the legislation, as I've initially
read it, is that it doesn't have an element of cost containment,"
said Kevin Westlye, executive director of the Golden Gate Restaurant
"The national health care crisis in this country is about
expensive medical care. Both Supervisor Daly and Supervisor Mirkarimi
both quoted the expensive health care as a national crisis,"
"I would hope San Francisco could be more creative as opposed
to mandating health care by coming up with a more pro-active and
long term solution to the problem by incorporating some level
of cost containment.
"Everyone is for health care. And we'd like to see it work.
"There are some awfully bright people in the medical field
that have been struggling with this problem on a national basis.
I'd like to see the task force involve some of the brightest minds
in the country
doctors specifically who deal with the problem
everyday and come up with some creative solutions," Westlye