San Francisco’s Healthy San Francisco plan is one of a few local government initiatives to help improve health access and quality for all citizens. The debate on whether government should intervene in health care delivery has raged on for decades in the United States. The Healthy San Francisco Plan was designed to protect and advance the interests of citizens by ensuring affordable and quality health care. The argument forwarded in this paper is that government has an active role to play in delivering affordable and high quality care. The argument that market is infallible and capable of ensuring affordable health care has been deemed porous due to the constant increase of individuals who use the emergence room because they have no health insurance.
Safeguarding the interests of citizens is one of the major roles of government and ensuring healthy communities is a critical component of this role. The Healthy San Francisco Plan provides care to more than 82, 000 residents of San Francisco through both private and public health care facilities. The cost of leaving the health of the city to the mercy of the market is relatively high. It does not include just monetary cost but also loss of life and reduced monitoring of unhealthy lifestyles. The bill of caring for the uninsured through emergency rooms is $104 million (Kaiser, 2009). Through other various mechanisms like business contributions the city is able to bank role the Healthy San Francisco Plan. There is a problem associated with business contributions which is the fact that they believe that the plan will eat into their profits. Businesses however have to consider the long term effects of healthy communities. They are bound to make larger contributions to the economy as compared to workers who rely on the emergency room.
Health care costs have traditionally increased at a pace that is higher than any positive income changes. Families are faced with a dilemma of whether to invest in health care and forget about other critical facets of life. The single way in which this dilemma can be solved is by government taking on a proactive role in health delivery.
In addition to the cost in monetary value, there is a moral case that can be made about health care delivery. Health care “comes freighted with a host of fundamental moral, ethical and emotional issues that simply don’t exist for other industries” (Benbrooks in Heskett, 2007. n. p.). The moral cost to society is high if fatalities are high due to the fact that they couldn’t afford to get adequate health care on the market. Government in as much as it is big and cumbersome provides protection to the most vulnerable. Eremia argues that despite occasional inadequacies, government oversight and regulation of the market is needed if meaningful improvements are to be made in better provision of care (2002). There is a moral obligation to take care of the disable who require more care and attention. The market is blind and incapable of taking the needs of those less fortunate into consideration (Tang, Eisenberg & Meyer, 2004). The residents of San Francisco benefit from the plan because they avoid the emergency room as well as the unnecessary loss of life.
The objection to government provision of health care is that it reduces the quality of care. It is argued that insurance companies and health care providers are forced to reduce to provide supplemental coverage and this affects those that had quality care from the beginning. This is related to the regulation of the health care market.
The Healthy San Francisco Plan falls into the debate about government and individual freedom. It is apparent that public health provision entails placing the health of the group as a higher priority at the expense of the individual’s interest. In cases were the government advances a public agenda, individuals perceive that their personal freedom has been violated. Marinker argues that a classic example of how sacrificing individual freedom for the benefit of all can be a good in itself is quarantining a person who suffers from a potentially fatal infection (2001). It is impossible for the health not to be coercive in some aspect of individual life but it provides the best balance between freedom and health. Without health individual freedom can become an empty shell and the cost on society is relatively higher morally and financially.
The Healthy San Francisco plan brings to the fore the question on whether a healthy balance is achieved between personal freedom and government responsibility. The plan does ensure balance. A report by the Kaiser Family Foundation reveals that participants in the Heathy San Francisco plan were satisfied with the amount of care they were getting. For these individuals in as much as government forces them into a program, it helps them in acquiring services that they would individually not be able to. Those who object to the program are the least affected by it. It was designed to help uninsured people regardless of immigrant status, employment status, and preexisting conditions. For this one group, the program enhances personal freedom rather than curtail it.
In conclusion, Health San Francisco provides a careful balance between individual freedom and health communities. It is intended for the highly vulnerable and poor. History has shown that the market is not infallible. It is subjected to all forms of manipulation and abuse and the government has an active role to play in ensuring community health.
References
Charlton, B. G. (2001). Public health and personal freedom. In Medicine and Humanity. Ed
Marshall Marinker. London: King’s Fund.
Eremia, A. D. (2002). When self-regulation, market forces, and private legal actions fail:
appropriate government regulation and oversight is necessary to ensure minimum
standards of quality in long-term health care. Ann Health Law 11, 93-124.
Heskett, J. (2007). What is the government’s role in US health care? Harvard Business School.
Retrieved from http://hbswk.hbs.edu/item/what-is-the-governments-role-in-u-s-healthcare
Kaiser Family Foundation.(2009). Survey of Healthy San Francisco Participants. Retrieved from
http://healthysanfrancisco.org/wp-content/uploads/Kaiser-Survey-of-HSF-Participants-Aug-2009.pdf
Tang, N., Eisenberg, J. M. & Meyer, G. S. (2004). The roles of government in improving health
care quality and safety. Jt. Comm. J Qual Saf. 30, 1, 47-55.
