San Francisco Mayor Gavin Newsom wrote a column for the Huffington Post promoting his Healthy San Francisco plan as a model for the federal "public option" touted by President Obama. Healthy San Francisco could be a model, but not in the way Newsom imagines.

Under negotiation between congressional politicians and lobbyists, the "public option" refers to a new complex of bureaucracies that would provide health insurance to any American who prefers to have his health insurance paid by taxpayers rather than receive it as a benefit of employment or acquire it himself. Former Health and Human Services Secretary Michael Leavitt describes this as a "Trojan horse" that would crowd out health insurance chosen by employers or individuals and metastasize into a government monopoly.

The public option aims to tax privately purchased health benefits to subsidize these new bureaucracies, which, like Medi-Cal, will probably be scattered across federal, state and local governments. That is a key reason an estimated 119 million Americans will lose their private health benefits and become dependent on the "public option," according to economists at the Lewin Group, which analyzes health policy.

The Congressional Budget Office issued a report concluding that the costs of a national health plan will be much higher than the politicians suggest. To buck the tide, the White House has called upon Newsom to trumpet the success of Healthy San Francisco, which is the "public option" writ small.

Newsom insists that his Healthy San Francisco, which increases taxes on employers to pay for the city's public-health bureaucracy, has increased choice and competition while lowering costs. In recent interviews, the mayor claims that patients dependent on Healthy San Francisco enjoy access to a wide selection of private doctors and services through the plan's Care Network. That sounds good, but it isn't true.

Until June, the "network" was limited to branches of the Department of Public Health and the Community Clinic Consortium, alongside two private providers. But one private provider is the Sister Mary Philippa Health Center, the charity wing of St. Mary's Medical Center, a small part of the megasystem Catholic Healthcare West.

The second private provider is the Chinese Community Health Care Association. These two private providers served less than 3 percent of Healthy San Francisco's dependents, according to a January report. Noticeably absent from the Care Network were any mainstream hospitals or physician practices.

On June 3, after two years of operations, Healthy San Francisco finally added Kaiser Permanente to its network - but this move bears all the signs of political pressure.

The only part of Healthy San Francisco that's real are the taxes, of which $28 million were levied on San Francisco's small businesses in 2008. High taxes, high costs and limited choice under a "public option." Is this the future of health care in the United States?

John R. Graham is the director of health care studies at the Pacific Research Institute in San Francisco. E-mail him at forum@sfchronicle.com.

This article appeared on page A - 15 of the San Francisco Chronicle