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The best money spent in the Affordable Care Act was the $11 billion dollars put toward expanding and maintaining community health centers across the country. That money will get poured directly into universal care programs for the poor, and possibly lead to some innovations in how we treat people, not just one illness or injury at a time but a comprehensive approach to wellness. The best model for this in the country is San Francisco’s universal care program, Healthy SF, which provides for care for everyone in the city limits, regardless of health, employment or immigration status. It’s not single-payer health care, it’s socialized medicine, and it’s led to significant reductions in the uninsured and a healthier city. Over 53,000 San Franciscans are covered under the program, which offers a full range of care in community health centers on a sliding scale (everyone up to 500% of the poverty level is eligible). I’ve written about it here.
Healthy SF always had one obstacle: getting past the ERISA law. The program has an employer mandate, forcing employers to either provide health care to their workers or pay into a citywide fund. The Golden Gate Restaurant Owners association filed suit over this, arguing that under ERISA, they are not required to provide health care for their workers. Yesterday, the Supreme Court declined to hear the case, meaning Healthy SF will survive.
The U.S. Supreme Court has declined to review San Francisco’s Health Access Law that forces most employers to contribute to a health care plan for their workers. The decision ends a four-year battle to uphold the law’s legality.
When Healthy San Francisco was enacted it was considered groundbreaking; the city offered local health plans to the uninsured with funding through employer contributions.
Now the US Supreme Court has refused to consider a lawsuit filed by the Golden Gate Restaurant Association when the law went in effect. Deputy City Attorney Vince Chabria says this is great news for 53,000 beneficiaries of the program.
It’s great news for lots of Americans. Because the San Francisco program was always viewed as a model for community health centers across the nation. You will probably see other cities adopt their approach. And now, there’s nothing legally standing in the way. As Anthony Wright, executive director of Health Access California, said, “This action by the Supreme Court not only upholds the Healthy San Francisco program that provides care for tens of thousands of California, but it keeps the door open for additional health reforms at the state and local level.”
Healthy SF was the brainchild of then-San Francisco Supervisor Tom Ammiano (now a member of the state Assembly), and he felt vindicated by yesterday’s ruling. “Today’s Supreme Court decision is an affirmation of San Francisco’s landmark efforts to provide affordable health care to the uninsured. With over 50,000 people receiving health care services and prescription drugs, Healthy San Francisco is a national model for what can be accomplished when the public and private sector work in partnership towards a common goal.”
With any luck, universal care programs like Healthy SF will be put together all over the country.
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This is progress, for sure.
However, health insurance should not be tied to employment. As a small biz owner, the cost of insuring my family through the company devours so much capital that there is not enough left for hiring employees–even without providing health insurance for them.
o/t
SCOTUS Vacates Siegelman Conviction
link
Damn those activist, liberal Supremes, upholding San Francisco Values!
Community Health Centers and other like organizations are tremendous assets to their communities and citizens who cannot afford even basic care. Many hospitals, physicians, nurses and other healthcare personnel donate resources and time to make them possible.
Anything that strengthens them is good news.
Good!I am so glad to hear this about Siegelman.
And good for S.F.
Per Siegelman @ Raw Story:
Editor’s note: Because of a legal misinterpretation, the original version of this story asserted that the Supreme Court had vacated Siegelman’s conviction entirely. In fact, they vacated a narrower part of the case, a recent ruling by the Eleventh Circuit denying Siegelman the right to a new trial. This version has been updated to correct those misinterpretations.
Correction: Ted Olson represents Paul Minor, not Don Siegelman. An earlier version of this story has been corrected to reflect the change.
DEVELOPING….
When are the billions slated to be spent on the community health centers?
Wow! There is justice in this world, if we work for it.
This reminds me of the most effective part of the stimulus package: Cash for Clunkers and Cash for Caulkers. They both returned something like three to five dollars into the economy for every dollar they cost.
Likewise, this may be the best part of the HCR bill, especially if it serves as an end run around ERISA.
What about specialty care?
Community health centers in particular, and, in general, making primary care universally available, are good ideas. I’ve been a primary care provider for 20 years, and I volunteer in a community health center, so I’m biased.
The problem my community health center has is that we can’t easily access the whole gamut of specialty care for our patients when that is necessary. Sure, primary care can and should do much itself. But a big part of what we do is surveillance for disorders that, once we identify them, absolutely need surgical, or specialist medical, intervention. These interventions are where the big money is spent, and would still have to be spent no matter how good the primary care coverage.
What does Healthy SF have to offer beyond primary care? You’re not really covered, at all, medically, until and unless you have access to the full gamut of medical interventions, not just primary care. Universal availability of primary care is just the first step in universal care, not its endpoint.
Hmmmmm. Was that the $11 billion dollars for which Bernie Sanders caved on the public option and some folks here (possibly, myself included) suggested he should be primaried? Just askin’.
But the Rove “victory” over Dem Gov Siegelman has not been tossed.
Thank goodness the Our activist judges – the corporate 5 – on the USSC were looking to protect CEO rights and thought to toss in a toss out of “honest services fraud” in 2006 conviction so as to protect a CEO in another case, leaving only bribery – a bribe he never received and his campaign never recieved (it was support for a political objective – and don’t corps/rich now have the right to do all things political with their money? Richard Scrushy (health ins co CEO) was accused of arranging $500,000 in donations to Siegelman’s campaign for a state lottery fund for universal education in exchange for a seat on a state hospital regulatory board – that was the “bribe”. No evidence really that it was quid pro quo. Scrushy had been on the board of the state hospital regulatory board during several preceding governorships and hard to see that his contribution towards the state lottery fund for universal education was related.
Healthy SF is not a great program for the working well. They would rather you get sick than assist with known, tested prevention. They make you wait three or four months to see a specialist, who might call in sick that day, vacating the entire day’s schedule. They like testing for STDs and TB, and giving flu shots. In fact, they’ll test you for STDs and TB whether you have risk factors or not. They’ll give you flu shots whether you’ve already had them or not.
The waiting room time, once your appointment day arrives, is between two and three hours, since the clinics seem unable to manage their caseload. They simply give out times to patients, who show up and sit in the waiting room together, sharing their commmunicable diseases.
The best doctors are not in the program, since we don’t pay primary physicians and community health practitioners what society deems suitable for Beverly Hills plastic surgeons. Until America rectifies its physician payscale, the best doctors won’t be seeing patients in these clinics.
It’s better than going to the emergency room for urgent care, but only just. If you need managed care, or a specialist, or followup visits with a doctor who understands your case, forget it.
One thing Gavin Newsom is really, really good at is putting a pretty wrapper on programs he co-opts from other people (Tom Ammiano) and then implements slapdash. See also, Care Not Cash, which was supposed to eliminate SF homelessness.
the $11 billion dollars for which Bernie Sanders caved on the public option
?? could be read that way – but the community health centers were a cause for many of us alongside the public option. Besides the public option died because Obama wanted it to die so he could keep his promises to the health insurance companies – not sure an Obama lie to us means we should primary the one socialist in Congress.
Healthy SF means basic care for all rather than having 20 to 50% of the population avoiding medical care no matter how sick and is therefore a good thing. If we ever get single payer it will most likely be for a basic care level of care because of cost – but it will still be a major move toward getting back a major part if not most of the 3 years that we all die earlier than those in other nations.
I would still love to have it. I am an insulin-dependent diabetic without health insurance. I should see a doctor about diabetes every three months but have only seen one once in the past three years, which also makes it tough to get prescriptions renewed for insulin. LOL, speaking of the STD clinic, it is free here in Orlando if you are below a certain income level and I have found that the only way for me to afford to see a doctor is to coax one of them into diagnosing something non-STD related.
Well, this seems a much better solution to the problem than Pelosi’s monster of baloney known as Health Care Reform.
You’re right, but this has to be viewed as a first step. Once people saw how it worked, they’d want more (specialist) care as well.
If this clears the way for states to set up single payer/socialized/public option health care (and I think it does), this is a big deal.
Now I’d like to see Bernie Sanders put his money where is mouth is and push for a state-wide single payer system with drug reimportation!
i’m a supporter of HealthySF, but i’d like to see people stop referring to it as “universal care” or “basic care for all”, because it’s not. it provides a certain amount and kind of basic care to people who have no other resources or places to turn (except emergency rooms). that’s a really important thing to be doing.
but a truly universal health care program would be just that: universal. if you meet the civic requirements – you live here, or you’re a citizen, or such – you can get care.
i know why there’s an income limit, it’s because the money’s not there. but that’s a catch-22 of sorts. i think that popular support for taxes to pay for a program would be much higher if everyone knew they could make use of that program. the trick is how to get there…
related anecdote: at a business lunch at some fancy ass restaurant in North Beach with $12 cheese toast and don’t-ask entrees. the only item on the bill they complained about? “What’s this 4% Health Care tax?” “I thought they couldn’t do that anymore now that Obama passed universal health care.”