San Insurance the Uninsured of San Francisco

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The Uninsured of San Francisco

San Francisco is the only major metropolis in the United States that provides some level of healthcare to all of its citizens, with services designed specifically for those who are uninsured or underinsured and mandated by city law (SFFC 2010; Romney 2006). The uninsured in San Francisco match the general demographics of uninsured people throughout California -- they are largely unemployed; often female; tending to be either young adults, the children of young adults, or individuals fifty years of age or older; many have a particular pre-existing medical condition or disability that greatly increases the cost of standard medical insurance if it is even possible for them to purchase any; and the vast majority live at or near the state-established poverty line for a family of their given size (SFFC 2010; Romney 2006). These are primarily the demographics served by the San Francisco Free Clinic, as well as other clinics operated by Healthy San Francisco (SFFC 2010).

The needs of the uninsured and underinsured individuals that are served by the San Francisco Free Clinic run the gamut of typical medical services needed by most individuals, but the clinic also commonly deals with pregnancies and with child and infant care to a disproportionate degree (SFFC 2010; Daley & Mallet 1998). Health practices of the uninsured tend to be poorer than the practices of those with insurance primarily in the regularity of their seeking out of treatment and their attitude towards the advice received from medical professionals (SFFC 2010). Immigrants without legal status in the country are especially prone to being uninsured and fearing seeking out treatment or consultation (Romney 2006).

The San Francisco Free Clinic is one of several organizations that serves those that are uninsured or underinsured, and is largely impacted by these populations (SFFC 2010). Operated as a part of the Healthy San Francisco program that was voted into law in 2006, the clinic has a mandate to serve those that cannot receive or afford treatment elsewhere, and though it makes it a policy to attempt to determine ability to pay and tries to get people to purchase insurance when they can afford it, the clinic also turns no one away (SFFC 2010). Though the clinic operates with a fair amount of success most of the time, it can also be faced with staffing shortages due to the level of demand that exists in a city with a population the size of San Francisco's, especially during harder economic times when many more people are out of work and out of the health insurance their jobs provided (SFFC 2010).

The stated mission of the San Francisco Free Clinic is to provide medical care to those that do not have insurance and to provide educational opportunities for medical professionals (SFFC 2010). The San Francisco Free Clinic actually predates the Health San Francisco program, and though it now operates with funding from this program it has been a mainstay in the community for nearly twenty years, with many community members receiving their primary care at the clinic and also receiving certain specialized care as it has been made available (SFFC 2010). The history and track record of the San Francisco Free Clinic has made the organization into a trusted resource for medical care and knowledge, and has helped to strengthen the city of San Francisco and made its inhabitants healthier (SFFC 2010).

In 2000, the clinic was able to move to a larger building, enabling it to serve more patients and thus attract more donor dollars that in turn led to the provision of more services in an upward cycle that continues to this day, to some degree (SFFC 2010). The passage of the Healthy San Francisco law and the beginning of this program in 2006 has also had a major impact on the organization, providing some funding and relieving much of the burden that existed on the San Francisco Free Clinic when it was the only organization of its type operating within the city of San Francisco (SFFC 2010; Romney 2006). These are the most major singular events that have impacted the organization over the past ten years, and it remains to be seen how the healthcare reform package recently passed (and perhaps to be imminently gutted or simply retracted) will actually affect the levels of insurance carriage in the entire nation, let alone in the city of San Francisco specifically.