San Francisco's tax-hiking and opaque pay-or-play business tax to fund its public health bureaucracy claims to have finally overcome one of the major criticisms that I had made of it. Namely, that it did nothing to improve the quality or delivery of health care to (previously) uninsured San Franciscans, because it had no private doctors or hospitals in its "network". All it did was tax small business to fund an expansion of community clinics and San Francisco General Hospital, the county's safety-net hospital. Lo and behold, Mayor Gavin Newsom has now declared that this problem is rectified. Hospitals owned by Catholic Healthcare West, Sutter Health, and the University of California will treat patients enrolled in Healthy San Francisco. And get this:
"The hospitals are providing services to HSF participants without reimbursement."
Oh, really? And how long will that last? UCSF is owned by the University of California, so it can probably lose money without consequences, but the other two systems are private, non-profits.
I suppose that this is a PR stunt. HSF only had 25,000 patients in the first year, and probably only a small fraction of them needed expensive hospitalization. But it is still disturbing that these huge hospital chains are playing along with the mayor's charade that his program is "free" - another example of hospitals' bad public policies.
I have little doubt that the mayor of San Francisco (and prospective governor of California) exercised the significant moral suasion at his command, courtesy of a report last January, which concluded that these hospitals receive millions of dollars of tax breaks without providing adequate charity care in return.
So, I have two questions for these non-profit hospital chains that are collaborating with Mr. Newsom:
- Why does a poor San Franciscan have to be enrolled in the mayor's program before you'll give him "free" charity care, without question?
- If the mayor does become the governor, executing all the power the state has over hospitals, how do you know he won't demand the same freebies for the whole state?
