For those of us graduating in June, we are eagerly in search of
the optimal job that includes health benefits ““ frankly
because it costs so much for an individual to purchase private
insurance as compared to an employer, who can get a group
discount.
In reality, many of us will not be so lucky as to obtain such a
glamorous job, which will force us to either join the 45 million
Americans already uninsured, according to a statistic for 2003 from
the National Coalition on Health Care, or pay for it ourselves.
Most of us will opt for a catastrophic insurance plan, which
typically only covers major hospital and medical expenses such as
surgery and intensive care, because it costs the least amount each
month. But this route denies coverage for routine medical visits,
which further limits our access to quality care.
San Francisco Supervisor Tom Ammiano has amended his proposed
legislation, which was introduced November 2005 and mandates that
all businesses with 20 or more employees provide benefits.
Businesses that do not offer health benefits to their employees
would be required to pay into a city-managed health savings account
used to provide coverage to the uninsured.
The proposed amendment would create a two-tiered system, with
the fees based on what San Francisco pays in health benefits for
its municipal workers.
Businesses with 100 or more employees would be required to pay
as much as $272 monthly per employee, whereas businesses with
20-100 employees would pay as much as $182 per employee, according
to a San Francisco Chronicle article. Another amendment to the
proposed bill would adjust the health benefits payments based on
the number of hours the employee works.
The reason for this mandate is the problem of caring for
uninsured workers in San Francisco. The city has an estimated
40,000 uninsured workers, which in turn has led it to spend $25
million a year for uninsured patients seeking care at San Francisco
General Hospital and public health clinics.
This problem is reflective of those of other cities across the
nation. The money spent on uninsured patients could have been used
to improve the infrastructure of medical and public health
institutions, but instead we have been plagued with emergency room
and public health clinic closures across the nation because they
have had the burden of the cost of uninsured patients.
The worrisome thing for San Francisco small business owners is
how they will pay the fees. Many of these employers may find
themselves cutting employees or closing altogether, so something
must be done to remedy the problem employers have providing
benefits. The city could propose some sort of incentive, such as a
tax deduction or write-off. Because what good is an insurance plan
for employees if you suddenly have an unemployment problem?
What are we soon-to-be graduates to do? If you find yourself
uninsured after donning cap and gown, at least buy catastrophic
insurance because although we’re generally young and healthy,
you never know when that appendix may rupture or that mass accident
may occur. There are many uncertainties in life, but at least with
catastrophic insurance you’ll avoid going bankrupt at 22.
Students interested in similar actions in their cities can lobby
and write to their local governments about this issue. This is a
step toward addressing the insurance crisis across the United
States.
The San Francisco Board of Supervisors Budget and Finance
Committee may vote on the amendments in March.
Fisher is a second-year student in the School of Public
Health.