By Jeff Adachi and Jim Illig
Editors note: Last week we ran an op-ed by Assemblymember Tom Ammiano opposing Proposition B. Public Defender Jeff Adachi asked for space to respond. His position follows.
OPINION San Francisco prides itself on the excellent health care services it provides to its residents. Per capita, San Francisco provides better quality healthcare to its poorest and most vulnerable residents than any other city in our state. Our city’s Healthy San Francisco program, which provides low- cost access to healthcare for all uninsured residents, has been heralded as a model program nationwide.
But the healthcare system that serves the city’s employees is teetering on the brink of insolvency. This year, the city will spend $456 million for healthcare costs for 26,000 city employees, and 28,000 retirees and their 47,000 dependents. According to the Controller’s Office, the city’s health system has an unfunded liability of $4 billion — meaning that it has made $4 billion in promised coverage to city employees and their dependents that it doesn’t have the money to pay for.
That’s a major reason why two city departments that serve the poorest residents, the Public Defender and Public Health, must cut millions of dollars of essential services each year, to save the city’s General Fund for growing employee healthcare and pension costs.
Currently most city employees contribute nothing for their own healthcare. Taxpayers subsidize the entire cost, which runs between $2,890 and $5,560 per year for each employee. Proposition B would change this by requiring that an employee insured under the basic health plan pay just $96 a year ($8 a month) for their healthcare. Under Prop. B, city employees would still pay 22 times less than private sector employees, who pay an average of $2,185 per year for their health insurance.
City employees with dependents currently pay $8 a month. Under Prop. B, they would pay $2,988 per year. Private sector employees with dependents pay an average of $7,026 a year. And this doesn’t include the 31 percent of San Franciscans who do not receive employer-paid health care costs and pay the entire cost themselves.
Opponents of Prop. B claim that city workers cannot afford to pay the health benefits if Prop B. passes. Their argument ignores the fact that the average San Francisco city employee earns $93,000 a year in salary alone, excluding benefits, while the average private sector salary is $46,000.
They also argue that “a single mother will be forced to pay up to $5,600 per year for her child’s health care — in addition to the $8,154 she already pays.”
First, this is not true. A city employee with two dependents only pays a total of $448 a month for full health coverage. Only if the city employee chooses the most expensive health plan, which costs $31,645, would the employee have to pay $19,561 a year under Prop. B instead of the $16,922, which he or she now pays.
Even with contributions required by Prop. B, city employees will receive a benefit package that is unparalleled in the private sector. Even more important, the city’s healthcare fund will be made more sustainable by ensuring that the funding for the city’s healthcare program doesn’t run dry when the city can no longer afford to pay these costs.
According to the Controller’s ballot statement, Prop. B would save the city $121 million annually. Some of these funds could be used to prevent the devastating cuts to the city’s mental health, substance abuse, and other community health programs for poverty-stricken adults and children who do not have healthcare coverage.
Voting yes on Prop. B is an antidote to continuing cuts to healthcare for the poorest San Franciscans. *
Jeff Adachi is a proponent of Proposition B and the city’s public defender. Jim Illig is the president of the San Francisco Health Commission.