Newsom, Ammiano agree on universal health care
By Pat Murphy
January 31, 2006, 8:00 p.m.
Mayor Gavin Newsom and Supervisor Tom Ammiano today praised their
newly agreed approach to universal health care access in San Francisco.
Termed the Defined Benefit Program (DBP), early details came
on the eve of a preliminary vote on Ammiano's initial proposal
to mandate health insurance for San Francisco employees working
80 hours or less per month.
The issue will be heard Wednesday before the Budget and Finance
Committee of the Board of Supervisors at 1:00 p.m.
Businesses will still be mandated to participate, although under
DBP the cost and timing would be determined a Health Care Council
comprised of stakeholders.
Appointments to the council will be made jointly by Ammiano and
Newsom, Ammiano told the Sentinel tonight.
DBP cost is projected much lower than the estimated $345 per
employee proposal first advanced by Ammiano. Although Ammiano
would not say whether he would drop his immediate mandate requirement
at Wednesday's hearing, "I'm sure we can work that out,"
Ammiano told the Sentinel.
Essentially DBP is built on three pillars.
It draws on use of 26 city and non-profit health clinics throughout
the city, thus avoiding brick and mortar construction cost.
It also establishes a one-stop administrator, thereby removing
the burden of plan administration for every employee by business
And it shifts emphasis on health care delivery away from expensive
emergency care to preventive care.
The administration of city employee health plans is currently
provided by The San Francisco Plan, which would become the single
administrator for DBP.
Only San Francisco residents would be eligible for DBP, and its
benefits are not portable. Health care services would be provided
only in San Francisco.
Those who enroll would choose their primary care physician and
primary care clinic. Enrollment is good for six months, after
which it may be renewed.
Coverage includes routine health screening and physical exams,
prenatal care, primary care, specialty care (through San Francisco
General Hospital (SFGH) and back-up by private hospitals), pharmacy,
planned SFGH hospitalization with back-up by private hospitals,
and emergency services (only at SFGH with high co-pay fee if not
Co-pay by patients would be determined through implementation
tasking of the Health Care Council.
In separate press briefings, both Newsom and Ammiano noted they
individually had been out front on the issue.