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Healthy San Francisco a Finalist for Harvard Innovations Award

In a political era in which government is often blamed as a problem rather than a solution, Harvard University's Innovations in American Government Awards hopes to show the converse can be true. And one of its six finalists—out of 563 applicants from around the country—is Healthy San Francisco, a program a supported by the San Francisco Medical Society. The city's first-of-its-kind universal health care program is up against New York City's NYC Service, which connects volunteers with service opportunities; a separate New York City antipoverty program; Littleton, Colo.'s home-grown business program; a job creation program in Oregon; and an apprenticeship program for Boston teachers. Richard Scheffler, a professor of health economics at UC Berkeley, evaluated Healthy San Francisco this year for Harvard and said it's well coordinated, broadly supported by business and labor groups, culturally sensitive to its diverse population of patients, stresses primary care and prevention, and has grown to involve public and private health providers.

'Creative solution'

Created in 2007, the city's universal health care program now serves 55,000 patients who are treated at 33 locations. More than 85 percent of the city's uninsured residents now have a primary care doctor, and emergency room visits have dropped as a result. Any uninsured adult living in the city who doesn't qualify for Medicare or Medi-Cal is eligible. Patients' immigration status, pre-existing medical conditions and employment status aren't factors in qualifying for the program. Children and young adults up to age 24 are covered under a separate program. The program isn't considered insurance because it doesn't follow participants outside city limits; it wouldn't apply, say, to someone who has a heart attack while traveling. It cost $177 million last year - $100 million of which came from taxpayer funds. The rest was paid through a mix of participants' fees and mandatory employer contributions. Healthy San Francisco could change significantly if President Obama's health care program—and particularly its mandate that everybody purchase insurance—stands up at the Supreme Court. 60 percent of Healthy San Francisco patients would be expected to shift to regular health insurance, said Tangerine Brigham, director of Healthy San Francisco. She said millions around the country still won't be covered, though—because they get waivers for their religious convictions or because they prove they can't afford it, they're undocumented immigrants or they're incarcerated. "We'll still need Healthy San Francisco," she said, saying it could be a model for other counties that grapple with how to cover those who still don't get health insurance.

Great accomplishment

Scheffler said that just because millions of additional people stand to gain health insurance if Obama's plan stands up in court doesn't mean there will automatically be enough doctors and other medical staff to treat them. "San Francisco has done this already in a very cost-effective way, so I think the city will have an easier time implementing that, and other cities will look to what they've done to provide access," he said. Source: San Francisco Chronicle, November 28, 2011

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