Healthy San Francisco: One City's Attempt at Health Reform

With federal health care reform about to be center stage again in health reporting as the Supreme Court takes up the constitutionality of the Affordable Care Act, a few of us at San Francisco Public Press got a practice run on reporting the issues.

We produced a package of stories on Healthy San Francisco, this city's universal health care plan, and delved into many of the issues that surround federal health care reform, too.

Healthy San Francisco and the Health Care Security Ordinance that created it assure access to health care to all city residents. The plan does so by offering primary care as well as coverage of specialists and hospitalization to any adult who isn't covered by private health insurance, Medicaid or Medicare. The ordinance requires that most employers buy some kind of health coverage for employees, private or city-sponsored.

San Francisco's plan works slightly differently than President Obama's health care plan in that it is access rather than insurance and puts requirements on employers rather than individuals. Nonetheless, it has generated debate on the same kind of topics: how to pay for it, whether it is socialized medicine, whether the medical care is up to par, and who is ultimately responsible for assuring people have health care.

For our main story, "San Francisco's universal health plan reaches tens of thousands but rests on unstable funding," I interviewed medical directors of participating clinics, patients, doctors, the plan's top administrator, health care economists, businesses and politicians.  

Then my colleague, Kyung Jin Lee, interviewed dozens more patients to write about whether Healthy San Francisco works from patients' viewpoints. She also produced radio-quality audio snippets of those interviews. I joined her sitting in many clinic waiting rooms and pleading with patients to talk to us.  

Our third colleague, Angela Hart, took a deep look at how Healthy San Francisco's promise to adopt electronic records as a way to streamline costs and operations is working out. Electronic record keeping is a goal in the federal plan, as well, so the story was indeed good reporting practice for what's ahead on a national scale. She sifted through data and interviewed medical directors of many clinics, as well as HSF administrators.Lastly I did a second story on how some employers had tried a short-cut around the requirements of the city's Health Care Security Ordinance and, in the meantime, shortchanged employees. That's now the topic of an investigation by a county civil grand jury.

We learned what we've already seen on the national level: that there sure are a lot of stakeholders in health care reform and they all have slightly different agendas.

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Photo credit: kafka4prez via Flickr