The city's bold move last month toward universal healthcare is worth supporting. All city residents should have access to medical services, and the plans proposed by Mayor Gavin Newsom and Supervisor Tom Ammiano provide a mechanism to make that happen.
The business community, however, would have you believe that one plan must be selected over the other. This is not correct; the two plans actually complement one another. Ammiano has worked on the mayor's Health Access Plan, which provides an affordable alternative to health insurance, and was right beside Newsom at the news conference a couple weeks ago. The problem with HAP is that it doesn't require contributions from business to help fund it, a necessary element that Newsom has acknowledged. With an estimated 82,000 adults in San Francisco who are uninsured, HAP would cost about $200 million annually. Funding is proposed to come from the city, along with $38 million from voluntary contributions from businesses, and the rest from premiums paid by plan participants.
In an effort to make healthcare access a reality for all, Ammiano stepped forward with the San Francisco Health Care Security Ordinance, which was introduced Wednesday, July 5. This would require medium-size and large employers in the city to spend a minimum amount per hour on healthcare for their employees. (Large companies, 100 or more workers, would be required to spend a minimum of $1.60 per hour, per employee; medium-sized businesses, 20-99 workers, would be required to spend a minimum of $1.06 per hour, per employee.) Employers could contribute the money to existing access or insurance they provide (as the majority already do) or opt to contribute to HAP. HAP would replace the city's current system of caring for the uninsured. Participants would receive medical care through the Department of Public Health, nonprofit clinics, and nonprofit hospitals.
Ammiano is absolutely correct when he states that without requiring medium- and large-size businesses to pay their fair share of health costs, HAP will fail. Many businesses that currently provide health coverage might stop paying for that benefit, thus forcing their employees onto the public healthcare system, defeating the very purpose of HAP. Conversely, without HAP, medium-size businesses would have few affordable options for meeting the health spending requirement.
But to hear the business community tell it, the issue boils down to a choice between HAP and Ammiano's ordinance. In a misleading ad last week, the business community presented the argument as an either-or proposition. And the ad's central premise that Newsom's plan provides access to all uninsured San Franciscans is misleading because it neglects to mention the lack of funding.
Newsom's plan was devised by his Universal Healthcare Council, comprised of representatives of the healthcare, business, labor, philanthropy, and research communities. It is a groundbreaking way to provide access to healthcare for all at a time when the federal government lacks the initiative to develop a national plan.
The LGBT and HIV/AIDS communities have many members who don't have affordable healthcare. The combination of HAP and Ammiano's ordinance would ensure that Newsom's goal of providing universal access to healthcare would be fulfilled. We urge the Board of Supervisors to adopt the San Francisco Health Care Security Ordinance so that this plan can become a reality.