San Francisco Chronicle, July 11, 2008
San Francisco’s ambitious universal health care program took a step forward Thursday, when private hospitals agreed to begin treating participants rather than leaving their care entirely up to the city’s strained public health system.
The 25,000 people who have enrolled in Healthy San Francisco since it began a year ago have been treated at 27 community clinics for their primary care needs and at San Francisco General Hospital for inpatient services.
But some of those patients now will be sent to private, nonprofit hospitals in the city, easing some of the stress on San Francisco General, officials said.
Executives of the hospitals, which include California Pacific Medical Center and St. Francis and St. Mary’s hospitals, said they agreed to participate in the program because it’s morally correct, will curb expensive emergency-room visits and will boost the charity care they provide in exchange for big tax breaks.
Under the agreement, patients will pay between nothing and $250 per hospital admission, with all the fees going into the city’s universal health care fund. The nonprofit hospitals will receive nothing.
“It’s incredible,” Mayor Gavin Newsom said of the new partnership. “Lives are being changed, and our health care delivery system is being strengthened.”
Healthy San Francisco intends to provide health care to all of the city’s 73,000 uninsured people, and the city is rolling it out gradually, depending on people’s incomes. Projected to cost $200 million a year when fully operational, the program is designed to be paid for with a state grant, employer contributions and participants’ fees charged on a sliding scale.
At least one health care expert questioned the agreement for private hospitals to treat members of the city program without compensation.
“Hospitals do not treat people for free,” said John Graham, director of health care studies at the Pacific Research Institute, a free-market think tank in San Francisco. “What this looks like is that they are trying to keep Gavin Newsom and the San Francisco (Board of Supervisors) happy by giving them some political support.”
But Mitch Katz, director of the Department of Public Health, said it makes financial sense for the hospitals in the long run. They are required by law to treat anyone who shows up at their emergency room doors, even if such patients are uninsured and can’t pay for treatment.
“Ultimately, if everyone who’s uninsured is part of Healthy San Francisco, then there is no group of unaffiliated, uninsured people anymore walking into emergency rooms,” Katz said.
Hospitals get tax breaks for charity care, and some San Francisco hospitals came under fire earlier this year when a report by the city’s Department of Public Health showed San Francisco’s private hospitals were receiving $79 million annually in tax breaks but spending only $16 million on charity care.
Lloyd Dean, president and CEO of Catholic Healthcare West, which includes St. Francis Hospital on Nob Hill and St. Mary’s Hospital on the eastern edge of Golden Gate Park, said the hospital’s participation in the city program “will certainly contribute” to their charity care.
St. Francis will provide inpatient services to the 540 Healthy San Francisco patients who get their primary care at Glide Health Services. St. Mary’s will take patients from Sister Mary Philippa Clinic in the Tenderloin.
California Pacific Medical Center will take the more than 6,000 patients whose primary care home is North East Medical Services. California Pacific was the worst offender in getting more in tax breaks than it spent on charity care, according to the report.
UCSF Medical Center will provide diagnostic-imaging services to all Healthy San Francisco patients.
The Chinese Community Health Care Association, a group of doctors that treats mostly Chinese patients, has also agreed to take Healthy San Francisco patients. Their patients will be sent to Chinese Hospital for inpatient services.
Katz said he is in negotiations with executives at Kaiser Permanente to bring the health maintenance organization into the city’s program.
E-mail Heather Knight at hknight@sfchronicle.com.
This article appeared on page B – 1 of the San Francisco Chronicle
