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Thursday, March 12, 2009

Nurses, Public Health Advocates: What Good Is Universal Health Care if You Have to Sit All Day in the Waiting Room?

Posted By on Thu, Mar 12, 2009 at 4:20 PM

click to enlarge The doctor will be seeing you ... sometime
  • The doctor will be seeing you ... sometime
To many, the city's aggressive adoption of the Healthy San Francisco universal health care plan while simultaneously applying draconian cuts to the Department of Public Health's workforce and budget feels a bit like giving everyone a free pass to the amusement park -- and shutting down all the rides.

Dave Fleming, a 20-year nurse at General Hospital, feared that, even as Mayor Gavin Newsom and DPH Director Dr. Mitch Katz speak boldly of San Francisco's steps toward a Healthy Tomorrow, San Francisco would slide back into the bad old days of the early 1990s.

"As we cut programs, especially programs for our neediest, they'll end up on the street or in the emergency room -- and I don't think that's a cheaper solution. In the early '90s, we saw people waiting 72 hours in the emergency rooms, and not being assigned beds right away," says Fleming, who attributes the burgeoning of managed care programs and local clinics over the past 15-odd years for alleviating those problems.

Those programs, however, are the ones on the block. And it isn't as if folks heading to community clinics out of necessity have been living the good life up to this point. Alysabeth Alexander, an organizer for the Coalition to Save Public Health, notes that even before the mid-year cuts, "The women's clinic, the Castro-Mission clinic were turning away 50 Healthy San Francisco users a day. There wasn't room. ... Massive amounts of people are entering into the system with Healthy San Francisco and are unable to get access."

Alexander -- who describes Healthy San Francisco as "a really great platform to run for governor" -- adds that waits of five or six hours past scheduled appointment times are already routine at overburdened community clinics. "Some women are choosing between pre-natal care and work. If you show up for a 10 a.m. appointment and you have to be to work by 3 p.m., when 2:30 rolls around, it's decision time." How will things look when clinics are consolidated and funding is cut? Worse

Cheerfully, Alexander goes on to note that in addition to clogging the emergency rooms, Healthy San Francisco users with mental illness problems may well strain the police to boot -- the cops are already the de-facto front line in mental health cases. Exacerbating this will result in "mental health issues becoming criminal issues."

In an intriguing article in today's San Francisco Chronicle, Katz noted that "We want to provide care for everybody. We can't provide a Cadillac for a small number of people."

The folks SF Weekly spoke with are inclined to agree in principle -- but they also wonder which costs more: A Cadillac or an ambulance to the emergency room?

Photo   |   ManUnderStress

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About The Author

Joe Eskenazi

Joe Eskenazi

Joe Eskenazi was born in San Francisco, raised in the Bay Area, and attended U.C. Berkeley. He never left. "Your humble narrator" was a staff writer and columnist for SF Weekly from 2007 to 2015. He resides in the Excelsior with his wife, 4.3 miles from his birthplace and 5,474 from hers.


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