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By Heather Knight
SF Chronicle
San Francisco’s unique foray into universal health care has proved more popular than anticipated, enrolling its 1,000th participant last week - weeks before public health officials expected to hit the milestone.
Coping with the overwhelming number of people wanting to learn more about the program - called Healthy San Francisco - has been the only major hurdle for the health department since the program started July 2, according to Dr. Mitch Katz, the city’s public health chief.
"That’s the kind of problem we want to have," he said Tuesday.
The program, the first of its kind in the country, intends to provide health care to the 82,000 city residents without medical insurance. It started small and is currently available at just two locations: the Chinatown Public Health Center and the nonprofit North East Medical Services, on the border of Chinatown and North Beach.
It will take 18 months to two years to fully cover all targeted residents, but city officials said Tuesday that they’re pleasantly surprised by its initial success. Twenty more clinics will start enrolling participants on Sept. 17.
"One thousand human beings now have a medical home," said Mayor Gavin Newsom at a press conference at the Chinatown Public Health Center on Tuesday. "One thousand people no longer have the stress associated with day-to-day concerns about how and where to access medical care."
One of those is 29-year-old Xiuqun Lin. She lives on Washington Street with her husband and two young children, and the family is living on her salary from working part time at a restaurant. Her husband is looking for work but hasn’t found anything so far.
She called Chinatown Public Health Center to schedule a checkup and learned she qualified for the new program.
"I’m very, very happy," she said through a Cantonese interpreter. "I can’t believe there is such a great program in place - I didn’t realize."
The program was crafted last year by Newsom and Supervisor Tom Ammiano and was passed unanimously by the Board of Supervisors. It isn’t health insurance, because it doesn’t cover participants beyond city limits. Katz said he wasn’t aware of any complaints or confusion so far about this component.
Participants in Healthy San Francisco are assigned a primary care facility that stresses preventive care. They also have access to emergency care, mental health care, substance abuse services, radiology, pharmaceuticals and other medical services. Surgeries will be available to them at San Francisco General Hospital.
Adults qualify for Healthy San Francisco if they are uninsured, live in the city and are ineligible for Medicare or Medi-Cal. Employment status, immigration status and pre-existing medical conditions aren’t factors in coverage. Children and young adults up to age 24 have health insurance through a separate city program.
City officials had estimated that 600 to 1,000 people would enroll in Healthy San Francisco by the end of August, but as of Monday night, they had taken in 1,047 people - the most up-to-date figure available Tuesday. Between 30 and 40 people are added every day.
It hasn’t been easy for those workers in charge of enrolling people into the program and providing them with medical care. Judy Leung, who enrolls people at North East Medical Services, said people form long lines wanting to participate and drop in all the time with questions.
"I almost cry sometimes, it’s so stressful," she admitted, before quickly adding that she thinks the stress is worth it. "Even though it’s so busy, I can tell people are so happy. It’s so important for them to have a sense of security."
Katz said the public health department has added more workers to handle the crush, but it’s just going to get busier next month when the program expands.
The current phase, as well as the one starting next month, only includes people who earn 100 percent of the federal poverty level or less. For a single person, that’s $10,000 a year, and for a family of four, it’s $21,000. It will expand to people of all income levels on Jan. 2.
Hundreds of people have had to be turned away because they don’t yet qualify - either because they make too much money or because they’re not a patient at the two Chinatown health centers. Explaining that has been tough, Katz said.
"The message isn’t, ‘No, this isn’t for you.’ It’s, ‘Not yet,’ " Katz said. "We can’t enroll 82,000 people today - it’s not possible."
If the program’s popularity has been a challenge, another potential stumbling block looms even larger: the lawsuit filed by the Golden Gate Restaurant Association to block the city from requiring businesses who don’t offer employee health insurance to help pay for Healthy San Francisco.
The $200 million-a-year program was designed to be paid for through a mix of city and state money, participants’ co-payments and quarterly fees figured on a sliding scale, and contributions from employers with more than 50 employees. The restaurant association says the requirement would cause businesses to shut down. Both sides are due in court Aug. 31.
Newsom said the lawsuit represents "the final treacherous water" the city is navigating as it begins its health care experiment. But he said the program will somehow survive no matter what happens in court.
"We’re moving forward despite this cloud," he said. "I assure you whatever happens with that lawsuit, we’re going to work around it."
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