When you visit our dental offices, your care is our top priority. Dr. Geoffrey Berg and his entire team are dedicated to providing you with the personalized, professional care you expect.

http://mid-valleydental.com/

Hmmmmm. I am not “assigned” a provider. I can pick any from the limited PPO network. I cannot see a specialist unless referred by a gatekeeper (my primary physician). That's Anthem, Blue Cross. A corporate bureaucrat decides if I need anything more than a routine office visit. There's only one hospital in my town. There's nowhere else to go for ER care. The “horrors” of the SF plan are my reality anyway, under private insurance.

However, that's not how Medicare works. Under Medicare I could go to any hospital (if there were any others) and see any doctor who accepts new medicare patients (97% do accept some, same number accepting privately insured patients). So there are several “models” of how government could run a health care system.

Bottom line, you get dumped into the County System for just about everything but primary care, a system that is legally obligated to provide indigent care in the first place. While county facilities can provide good care, it is usually accompanied by long waits for appointments.

Extrapolating this to a government run health care program (i.e. the public option) is tantamount to ridiculous. It is not an insurance program but a primary care gatekeeper system designed to reduce utilization and bring an additional source of revenue for indigent care into play from businesses.

It's also not clear how valid the claims of job preservation are. It would be very difficult to determine this one way or another without a major study of the cities businesses. If that's been done, it wasn't in anything I have read.

In short, the idea that this addresses any of the issues of health insurance is comparing apples to watermelons — not even close.

I just happened to pick restaurants and waiters as an illustration. But, as you know, the SF “experiment” applies to many other small businesses, and thus many other employees benefit from the health care delivery system.

But, regardless, your point is well taken.

Dorian..

Good thing there are not too many “commenters,” on this thread ..would have caught my math error (and I am supposed to be a Math major—).

Of course $4 is 5 percent of $80.

So, instead of giving a 20 percemt tip, make it 15 percent. Still a pretty good tip, plus hopefully one is contributing towards the waiters' health care

You might not realize this but in doing a “good deed” you would have just hurt the waiters financial situation. Let me explain:

You tip the waiter less to make up the difference, the surcharge that you pay goes to the business which then uses it to provide for all employees covered, dishwashers, cooks, prep staff, cashiers, all the other waiters who may or may not work as much, etc. So the waiter is getting less for the same work. Maybe 50 cents of that surcharge actually goes to your waiter's healthcare.

More than 25 percent of restaurants, for example, have instituted a “surcharge” — about 4 percent of the bill for most establishments — to pay for the additional costs.

Whether or not less affluent economies could absorb such mechanisms as easily as San Francisco is highly questionable.

But your approach only covers those restaurants that are truly sit-down, serve-the-meal establishments. Surely even SF has less labor-intensive servicers (think… take-out). Those folks would be in a different boat altogether.

Of course $4 is 5 percent of $80.

So, instead of giving a 20 percemt tip, make it 15 percent. Still a pretty good tip, plus hopefully one is contributing towards the waiters' health care

It seems that most agree that the SF “experiment,” thus far, is too limited, too “tailored,” too “localized,” and hasn't been in effect long enought to draw nation-wide. long term conclusions.

As to the $4 surcharge by restaurants, I look at it this way: $4 on a, say, $80 dinner for two is 2% of the tab. We pay up to 20% on a tip. Make the tip 18% and voila, there you have your original 20 %…and for a good cause (18% is still a pretty good tip)

While I see where Leonidas' objections are coming from, they don't apply to all areas of commerce. Thus, if *all* restaurants are adding 4% surcharges, the net effect is an increase to everyone who eats out. It doesn't affect global competitiveness if the particular service industry doesn't compete globally.

However, the article says ~25% of the restaurants took this approach — meaning the majority of them went another direction. Freezing wages (another solution by some) would ultimately have some real consequences, on both income levels (haven't we been talking about disparities?) and public coffers (via flat income taxes).

HSF is very specific in scope:
* Living on a combined family income at or below 500% of the Federal Poverty Level. See if you meet the income requirements
* A San Francisco resident who can provide proof of San Francisco residency;
* Uninsured for at least 90 days;
* Not eligible for public insurance programs such as Medi-Cal, Healthy Families, or Healthy Kids™;
* Between the ages of 18 and 64

The income requirements go up to 500% of current federal poverty guidelines — a number that makes sense in an expensive place like SF, but looks pretty generous in rural Arkansas (for example).

It's lack of portability is a problem for people who can only receive care via HSF, of course, but the logic of such a limitation when they're working in a vacuum and self-funding only makes sense.

Myself, I think it hasn't been running nearly long enough to draw real conclusions — and that's really part of the overall problem with the hc reform discussions in generall. Every plan on the table for consideration, from any corner of the spectrum, will have a rippling impact — and I suspect that long-term effects are not fully understood, by either their proponents or detractors.