Healthy San Francisco
Healthcare in the United States |
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Healthy San Francisco is a health access program launched in 2007 to
History
Prior to the implementation of Healthy San Francisco, the city's
Golden Gate Restaurant Association v. City and County of San Francisco
Healthy San Francisco mandated large businesses to provide health insurance for their employees, or instead either pay into a citywide healthcare fund or contribute to employees' health savings accounts.
Impact of the Affordable Care Act
The
Although the ACA led to many people becoming insured, there were still millions who were left without health coverage. Today in San Francisco, these patients are still eligible for Healthy San Francisco. These remaining patients include undocumented immigrants, prisoners, people who have lived in the city for less than 5 years and are thus ineligible for Covered California, and people whose incomes are too high above the Federal Poverty Line to qualify for Medi-Cal but not enough to afford private health insurance.[19]
Funding
Healthy San Francisco is funded by the city, the federal government, patient co-payments, and fees imposed on San Francisco businesses whose owners do not follow the mandate to provide health coverage for their employees.[1] The Health Care Security Ordinance included a requirement that employers with more than 20 workers spend at least a minimum amount towards employee health coverage. The minimum payment for 2014 ranges from $1.63 to $2.44 per hour, depending on firm size; for-profit employers with fewer than 20 workers and non-profits with fewer than 50 workers are exempt.[20] Employers can elect to satisfy this requirement by paying into Healthy San Francisco, in which case their workers may apply for the program.[8] As of early May 2008, over 700 employers had decided to participate in the program.[21][22] Early evidence suggest that employers are spending more on health benefits, but some are raising prices and cutting back on hiring.[22][23]
Healthy San Francisco reportedly costs about $140 million per year, which is expected to go down as the 2013-2014 health exchanges start.[19]
Results and reception
94% of surveyed Healthy San Francisco enrollees reported that they were somewhat or mostly satisfied with the health access program.[24] More than 90% would recommend it to a friend, but only 40% of participants said their care was considerably better since joining the program.[25] Usage of primary and specialty care services among Healthy San Francisco enrollees was similar to that of the uninsured across the state of California.[9]
Much of Healthy San Francisco's positive reception stems from the city's uniquely structured health care safety-net network, consisting of a conglomerate of both public and private hospitals, clinics, and health centers.[9] This collaborative system allows for greater communication between providers and enables patients to access facilities that are equipped to offer the type of care they need, whether that be primary, specialty, or urgent care.[9] The creation of a more coordinated system also led to more efficiency and less redundancy. As more patients became established in primary care medical homes, duplicative services waned.[9]
San Francisco residents who have benefitted from Healthy San Francisco have noted how the program has made them less wary of accessing health care, as previously many of the beneficiaries of Healthy San Francisco did not see a provider regularly due to cost.[6] Healthy San Francisco significantly affected access to ongoing care and chronic disease management for the uninsured, particularly because the Emergency Medical Treatment and Active Labor Act (EMTALA) had previously made emergency care available.[9]
Although Healthy San Francisco does not directly impact those with private or public insurance, studies have found that increasing the proportion of people insured in a community can lead to higher quality of care even for those who are insured, particularly in terms of access to and availability of specialty care.[26]
See also
- Health care reform in the United States
Notes
- ^ a b c "Reform Law Could Curb Healthy San Francisco's Enrollment by Up to 60%". California Healthline. April 19, 2011.
- ^ "San Francisco's Latest Innovation: Universal Health Care", by Laura A. Locke, Time, June 23, 2006
- ^ "What is Healthy San Francisco". Archived from the original on 2007-10-31.
- ^ a b c d Sankin, Aaron (2011-11-29). "Healthy San Francisco, The City's Universal Health Care Plan, Finalist For Harvard Prize". Huffington Post. Retrieved 2017-12-08.
- ^ "Visitors". Healthy San Francisco.
- ^ ISSN 0362-4331. Retrieved 2017-10-19.
- ^ a b "Are You Eligible?". Healthy San Francisco.
- ^ a b "Key Facts: Healthy San Francisco" (PDF). Kaiser Commission on Medicaid and the Uninsured. March 2008. Retrieved 2017-06-21.
- ^ PMID 21289344.
- ^ John Ritter (2006-07-07). "San Francisco may get universal health care". USA Today. Retrieved 2008-03-10.
- ^ Laura A. Locke (2006-06-23). "San Francisco's Latest Innovation: Universal Health Care". Time. Archived from the original on July 3, 2006. Retrieved 2008-03-10.
- ^ Doug Trapp (2007-08-20). "San Francisco launching universal health care plan". amednews.com. Retrieved 2008-03-10.
- ^ Christopher Heredia (2006-06-26). "Dellums considering health care option". San Francisco Chronicle. Retrieved 2008-03-10.
- ^ Michelle Durand. "County to study universal health care". San Mateo Daily Journal. Archived from the original on 2007-09-28. Retrieved 2008-03-10.
- ^ "Golden Gate Restaurant Association v. City and County of San Francisco: 546 F.3d 639 (9th Cir. 2008) | Berkeley Law". Berkeley Law. Retrieved 2017-10-05.
- ^ "Golden Gate Restaurant Ass'n v. City an County of San Francisco" (PDF). United States Court of Appeals for the Ninth Circuit. March 9, 2009.
- ^ John Wildermuth (June 29, 2010). "Healthy San Francisco clears last legal hurdle". San Francisco Chronicle.
- ^ ISBN 1421402971.
- ^ a b c d Knight, Heather (2013-10-26). "Healthy S.F. might sicken Tea Partiers". San Francisco Chronicle.
- ^ "Health Care Security Ordinance (HCSO)". San Francisco Office of Labor Standards Enforcement.
- ^ Wyatt Buchanan, "734 businesses sign up for S.F. health program", San Francisco Chronicle, May 2, 2008
- ^ a b "Coverage & Access | Healthy San Francisco Program Prompts Some Companies To Shift Costs to Consumers but Appears Effective"[permanent dead link], Kaiser Daily Health Policy Report, Kaiser Family Foundation, May 5, 2008
- ^ Phred Dvorak, "Firms Adjust to Health-Care Law", The Wall Street Journal, May 5, 2008
- ^ "Survey of Healthy San Francisco Participants". The Henry J. Kaiser Family Foundation. 2009-08-02. Retrieved 2017-12-08.
- ^ "Healthy San Francisco rates high in satisfaction"[permanent dead link], by Heather Knight, San Francisco Chronicle, August 26, 2009
- PMID 17848441.