Ammiano ordinance would require broader private sector health care coverage for employees

Supervisor Tom Ammiano
Photo(s) by Luke Thomas

By Pat Murphy

November 23, 2005

Supervisor Tom Ammiano yesterday introduced legislation requiring San Francisco businesses with 20 or more employees to provide health care coverage for employees.

He cited passage of city policy Proposition O in 1998, which declared San Francisco should move to universal health care, as popular mandate for the measure.

The ordinance exempts businesses which already provide health insurance, and businesses whose employees are represented by unions.

"I think we need to take the example of small businesses who now have health care, or who offer affordable health care, and increase the size of that universe," Ammiano said in a noon City Hall press conference.

However, the number of small businesses providing health care coverage is decreasing, added Ammiano.

"It's a shame, but I believe…Kaiser (Permanente) just came out with a study that showed that those small businesses providing health care have decreased in the past two or three years rather than increased," Ammiano recalled.

"We have 40,000 people who are working hard every day and who do not have health care.

"We are here today to announce this ordinance which will level that playing field.

"This legislation will require small businesses with 20 or more employees who work 80 hours (per month) or more to be covered.

The District 9 supervisor called for a December public hearing on the proposal. Under city legislative rules, 30 days must pass before new legislation can be acted upon.

The ordinance would establish a seven-person task force to determine implementation.

Supervisors Chris Daly, Sophie Maxwell and Ross Mirkarimi were at Ammiano's side to endorse the measure.

Supervisors Maxwell and Mirkarimi lend support to Ammiano's ordinance...

As does Supervisor Chris Daly

It was backed by a coalition of the San Francisco Peoples' Organization (SFPO), Senior Action Network, the San Francisco Labor Council, Young Workers United, ACORN, Gray Panthers, Health Care for All, the Tenderloin Housing Clinic, SEIU Local 790, UFCW Local 21, and Health Access California.

The coalition did not include a representative of small business.

"Frankly I was a little shocked about getting the legislation just in my hands this morning," said Agnes Briones, executive director of the Small Business Commission.

Agnes Briones

"I commend Supervisor Ammiano and the other supervisors for wanting to put this debate forward, but I think the debate needs to be open, transparent, and allow for small business owners to have a say around an ordinance that will impact their ability to do business in San Francisco.

"I would encourage Supervisor Ammiano to have a couple of small business owners on the task force," Briones stated.

Ammiano attempted to pre-empt criticism of the measure.

"Every time you make a move toward any kind of social justice issue, whether it would be universal health care or whether it would be paying people's housing…'businesses are always going to move,' said Ammiano.

"Well, I haven't seen them move, and they're not going to move.

"And you know why they're not going to move? Because those businesses that currently supply health care are thriving.

"They have better employee morale. They have less turnover, and they certainly have employee loyalty because they are being treated with dignity for the hard work that they do."

Mirkarimi praised Ammiano for bringing the legislation forth.

"Tom once again you make us very, very proud, and I'm proud to co-sponsor this ordinance today," Mirkarimi stated.

"Nationally the system of…employer-based health insurance combined with the delicate reach of managed care is completely in shambles," continued Mirkarimi.

"Expenses are out of control. The cost containment is impacting the wrong place altogether.

"Not-for-profit hospitals are shutting their doors, and for-profit hospitals are creeping in.

"Most people lack adequate pharmaceutical coverage, not to mention dental coverage.

"The actual paper chase for patients and the families of patients who are seeking to navigate around the health care bureaucracy are making those patients that much more sick.

"The non-profit managed health care vision of yesterday is under the threat of becoming a for-profit, pre-selective health provider today.

"This nation needs a complete overhaul in its ability to provide for universal health care, but until that happens we're obviously very fortunate to have Supervisors like Tom Ammiano.

"We believe that here locally in San Francisco we can actually do something about that. We cannot stand by and permit even the most minimal traditional system of employer based insurance to unravel.

"This is not a left or right proposal. This is a populist proposal. It's based on the decency of protecting Americans so…that while the health insurance system is collapsing ordinary people are no longer the victims," Mirkarimi insisted.

Daly described a broken social contract.

“About one in eight San Franciscans does not have health insurance, so it’s clear here in San Francisco – one of the wealthiest cities around – that the social contract where you work and their employees (are) not meeting the terms of the social contract (is broken)…which is basically you do your work and then the company takes care of you in terms of your salary and your benefits for you and your family,” stated the District 6 supervisor.

"That system is broken, and so government leaders like Tom Ammiano have to step in, and I'm proud to join Ross Mirkarimi and hopefully a unanimous Board of Supervisors…

"Health clearly is a human right. When these companies do not provide the health insurance to their hard working employees these San Franciscans end up relying on the city's public health system.

"…the burden of the responsibility of that health care moves from those corporations that are supposed to be providing the health coverage to taxpayers and the local government here in the City and County of San Francisco.

"And we spend a lot money on the public health system in the city, and we're proud of it, but we cannot keep continuing on the course we're going…without the private sector…making good on the social contract.

"This legislation is going to save the city a lot of money and…we can take that money and we can spend it on the unmet needs that still exist in this city," said Daly.

Supervisor Sophie Maxwell framed adequate health care as true homeland security.

"Healthy families, healthy children - that's true homeland security," Maxwell began.

"I think that every single one of these corporations that's making money in this country have a responsibility to this country and if not as far as I'm concerned it's Un-American.

"I do not think that health care should be market driven. Housing should not be market driven.

"Those are things that should be - because you are a human being and because you live in our country - we're going to make sure that you have those things.

"So when we talk about homeland security let's make clear what we are talking about: healthy families, healthy children, an educated populace," the District 10 supervisor stated.

The San Francisco Labor Council threw its support to the ordinance.

"Every time we go to the collective bargaining table what we end up negotiating is our health care benefits," reported Tim Paulson, Labor Council executive director.

Tim Paulson

"But the costs keep going up…we think it is important that we raise the bar for everybody in San Francisco because there are good contractors here in town that provide health care.

"Why shouldn't everybody else provide health care if you work hard?

"Part of the cost of health care is because of those corporations and those companies that do not provide health care…and we think that is a horrible injustice," said Paulson.

A spokesman for the Golden Gate Restaurant Association suggested the task force draw on national health care experts.

"I think the problem with the legislation, as I've initially read it, is that it doesn't have an element of cost containment," said Kevin Westlye, executive director of the Golden Gate Restaurant Association (GGRA).

Kevin Westlye

"The national health care crisis in this country is about expensive medical care. Both Supervisor Daly and Supervisor Mirkarimi both quoted the expensive health care as a national crisis," continued Westlye.

"I would hope San Francisco could be more creative as opposed to mandating health care by coming up with a more pro-active and long term solution to the problem by incorporating some level of cost containment.

"Everyone is for health care. And we'd like to see it work.

"There are some awfully bright people in the medical field that have been struggling with this problem on a national basis. I'd like to see the task force involve some of the brightest minds in the country…doctors specifically who deal with the problem everyday and come up with some creative solutions," Westlye stated.

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