What If They Gave a Health Care Plan and Nobody Came?

This is an interesting turn of events: San Francisco has been abuzz about a new health care plan designed to cover everyone in the city. A court ruling has (for now) prevented City Commissars from taxing businesses to pay for it, and so for now the plan is temporarily scaled back to cover people who are at 300% of poverty level or less if they do not otherwise qualify for Medicaid. But on the first day of the big program, breathlessly promoted by media and politicians—nobody came to sign up. From the story:

Blame it on confusion over a federal judge’s recent ruling. Blame it on a postholiday slump. Whatever the case, San Francisco’s expansion on Wednesday of its landmark plan to provide health care to its 73,000 uninsured city residents had all the excitement of an annual physical.

The program, dubbed Healthy San Francisco, previously had been available only to uninsured city residents whose earnings didn’t exceed the federal poverty level – about $10,200 a year. On Wednesday, it expanded to include those making up to about $32,000 a year, meaning roughly 47,000 people now qualify.

But few seemed to be taking advantage of it. At the program’s new eligibility office near San Francisco General Hospital—designed for people to drop in or call to see if they qualify for the program—just one person had phoned by noon and all the chairs in the waiting room were empty. “Usually our chairs are all filled—it’s unbelievable,” said Vanda Baptista, who manages the eligibility office. “I was anticipating patients out the door.”

Or maybe the intended beneficiaries are not as excited about receiving those services as the politicians and media are in providing them. Maybe health care isn’t the huge 800 pound political gorilla some think it to be. We’ll have to keep an eye on this, but if the program remains a benefit that nobody wants, it may have a more profound meaning than may at first meet the eye.

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