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San Francisco is now the first city in the United States implementing a universal health care plan. The program, Healthy San Francisco, opened in July with two clinics. We are now expanding the project to all 20 neighborhood health clinics. So far, 1,548 San Franciscans have enrolled for free or subsidized medical care and by the end of the year, we hope to cover an additional 17,000 residents - well on the way toward our ambitious goal of offering coverage to all 82,000 uninsured San Franciscans.
When fully implemented, Healthy San Francisco will be available to any resident 18-64 without health insurance, regardless of income or immigration status.
As the Bush administration continues to ignore millions of uninsured Americans — we are taking action. As our state government in Sacramento studies what to do — we are implementing a bold plan. And the country is watching. Read what the New York Times has to say about our unprecedented attempt "to patch a broken federal system." Check out the Healthy San Francisco website. And if you believe in universal health care — help us fully implement Healthy San Francisco by signing our petition.
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October 7th, 2007 at 1:12 pm
Dear Mayor Newsom:
I applaud your efforts to improve access to health care for everyone, regardless of their income. Unfortunately in the US many view health care as a privilege based on the size of your wallet-rather than a basic human right- which is the premise of the international treaties the US signs
As a nurse, who has worked in many hospitals in the US and has spent 15+ years designing, implementing and evaluating international health and development in over 30 countries I am very concerned about the crumbling US health care system. While it is horrible for people with no/little insurance, health care costs for people with insurance has become a increasing reason that individuals file for bankruptcy
While financial support/insurance is an important issue; it is not the only issue. Personally I am not sure how sustainable the insurance business model is since it selectively pays for preventive services but pay for treatment which is much more costly.
Health care is a system. In the US the health care system is decentralized and fragmented with unclear lines of accountability; often slow to adapt to changes, and has received limited investment over the pas few decades. This implies that to address the root causes of the current health care situation a systematic approach is required and insurance alone will fall over the overall aim
Key three factors that also limit access to quality services include: 1) personnel; 2) facilitates/infrastructure; 3) medical mindset. First, there needs to be adequate numbers and appropriate types of personnel. According to the workforce study, the nursing shortage in California is estimated to be 20,000-30,000 by 2015. This begs the question of who would take care of people, even if they have insurance. In addition, specialists (MDs) greatly outnumber general/family parishioners and most providers reside in urban areas living rural areas far from services.
Second, there also needs to be equtibale distribution of well-maintained facilities. Since many of the hospitals in the Bay are rebuilding to meet the seismic code this is a great opportunity to upgrade the facilities. However, many hospitals have closed limiting access and hospital beds. For example, Richmond only has one hospital that will have to manage growing numbers of chronic illnesses and an aging population. They often have to divert pts to Walnut creek and Fremont because they are full.
Third, there also needs to be a huge shift in medical and client thinking. As the former CEO of Pfizer said, we have a sick care system not a health care system. The high number of specialists, number of hospitals compared to clinics, and curative focus is what the US health care system has evolved into. The AMA has been lobbying against universal health care (socialized medicine) since the 1930s. One of there arguments is that they feel they won’t be on the cutting edge of research. From a consumer perspective, most Americans due not like to wait for services ( e.g., in Britain it may take 3 months to get elective knee surgery.
All these factors (financing, staff, and facilities) need to be addressed to ensure that the system can provide high quality services. I know that these issues are concerns for Mitch Katz and Tangerine. I also know that many of these issues are beyond the scope of SF and the lack of federal leadership is appalling.
I think that what you are doing is a great first step. I also know that many of these efforts have to be implemented at a larger scale to have any real impact, requiring complex partnerships among many stakeholders. It doesn’t seem that the press is covering these broader issues. I think that because SF is being looked at as a model you are uniquely positioned to raise some of these issues at the state and national.
Thanks for listening
susan