Communities innovate to provide health insurance

The lack of leadership at the national level to provide health insurance to the over 45 million Americans that do not have it, has driven states like Maine, Massachussetts to create programs for the uninsured within their borders. As Kevin Sack writes in the New York Times, some cities are becoming local laboratories for health insurance innovation.

[...] Healthy San Francisco, is the first effort by a locality to guarantee care to all of its uninsured [82,000 resident], and it represents the latest attempt by state and local governments to patch a inadequate federal system.

It is financed mostly by the city, which is gambling that it can provide universal and sensibly managed care to the uninsured for about the amount being spent on their treatment now, often in emergency rooms.

After a two-month trial at two clinics in Chinatown, the program is scheduled to expand citywide to 20 more locations on Sept. 17.

Whether such a program might be replicated elsewhere is difficult to assess. In addition to its unique political culture, San Francisco, with a population of about 750,000, has the advantages of compact geography, a unified city-county government, an extensive network of public and community clinics and a relatively small number of uninsured adults. Virtually all the city’s children are covered by private insurance or government plans.

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