Contra Costa Times
January 30, 2001

S.F. plan to insure all children
Kids' health would be a county priority
By Ilene Lelchuck
Chronicle Staff Writer

At Mission Neighborhood Center, serving poor and working-class residents in San Francisco's large Latino district, a whopping one-third of the patients are uninsured children.

Executive Director Gladys Sandlin is overwhelmed by stories she could tell about the clinic's 13,000 families struggling to keep their children healthy.

There are immigrants. And families who make too much money to qualify for state health insurance but too little to afford private insurance. And families who don't sign up for government help because the endless forms are too confusion.

"Oh, I have so many," Sandlin said, exasperated, when asked to share anecdotes.

That's why Sandlin, who runs one of the area's nine nonprofit health clinics, applauds a new proposal that would make San Francisco the second county in the country to provide medical coverage for uninsured children.

The city's proposal would follow Santa Clara County, which late last year became the first local government in the country to insure its needy children.

The San Francisco Public Health Department's blueprint for providing medical, dental and vision insurance to about 5,000 eligible children is scheduled to be revealed at today's San Francisco Health Commission meeting, which begins at 3 p.m.

The plan would insure children who don't qualify for other state and federal programs and whose family income is up to three times the national poverty level. A family of three would be eligible if their annual income is up to $45,450, said Tangerine Brigham, the health department's director of policy and planning.

The insurance would cost just $4 a month per child.

The price tag for San Francisco is about $5.7 million a year, Brigham said, and the funding could come from San Francisco's General Fund, tobacco settlement money, taxes or a combination of those pots of money.

The insurance plan would take San Francisco one step closer to meeting a 1998 voter mandate, Proposition J, to create universal health care coverage for an estimate 158,000 to 205,000 uninsured residents.

The Proposition J goal is the product of Mayor Willis Brown's Blue Ribbon Committee on Universal Health Care and includes creating a city purchasing pool for health care coverage.

Progress has been slow and piecemeal, however. The purchasing pool isn't in place, but San Francisco now provides health care coverage to in-home support services health care workers, requires health insurance as part of its living wage law for vendors who do business with the city, and is creating a pilot program to offer health insurance to child care providers.

Brown, who made universal health care one of his key campaign promises in 1995, said Monday he was not familiar with plans for the next step: children's coverage. When asked whether he was happy with current progress on Proposition J, the mayor said no.

"I'm not satisfied until everybody is covered," Brown said, refusing to answer further questions.

Universal health care, an ambitious goal that Hillary Clinton as First Lady never succeeded in selling the nation, now is sought on the local level by frustrated governments that bear the costs of uninsured patients who end up in county hospital emergency rooms.

Advocates in Santa Clara County, the first to insure children hope their model approved by the Board of Supervisors in late 2000 spreads.

"You hope you can get this groundswell of communities supporting kids, and then they can pressure the federal authorities," said Sylvia Gallegos, chief of staff for Santa Clara County Supervisor Blanca Alvarado.

At San Francisco General Hospital, the county hospital, pediatrics chief Dr. William Taeusch said he saw uninsured families who were so terrified by their first hospital bill that they avoided doctors and hospitals the next time they needed help - when a small problem has mushroomed into medical emergency.

"And these aren't the poorest of the poor, these are working moms and dads," said Taeusch, who supports the plan before the Health Commission today.

"I think it's time we stop being an underdeveloped country," he said.