Taking a Bite Out of Health Care Costs

As Congress debates how to pay for national health care reform, here in California we are showing there are ways to make coverage both universal and affordable.

In San Francisco, we are finding that one of the most effective reforms, and the most affordable by far, is simply using the purchasing and persuasive power of our city to promote the kind of healthy habits that keep residents away from costly medical interventions and prevent chronic diseases.

Many readers already know that the only existing "public option" in America is the Healthy San Francisco program that has already covered 72% of the previously uninsured residents at a dramatically lower cost than private insurance. The data is in -- and the results show that a public option like Healthy San Francisco is more affordable than private insurance.

But in San Francisco we are going far beyond the notion of health care as just a way of treating sickness. We are saving money, and ultimately improving lives, by focusing as much of our attention on how to keep people well as we do on how to treat their illness.

We are implementing cost-effective reforms that will lower the cost of health care, while raising the level of good health, through a series of common sense programs like easier access to fresh and nutritious foods, preventative health care counseling, immunizations and promoting basic exercise. Study after study reach the same conclusion: keeping people healthy saves billions and billions in health care costs. No city in America is doing more to address that simple truth by investing in wellness, from the foods we eat to the simple steps we can take like walking a little more each day.

Last week we took a big step forward when we announced the first-ever comprehensive municipal food policy that encourages San Franciscans to eat healthy, local food. It's a simple goal that can have profound consequences on public health for our city and can bring about dramatic cost savings that are associated with healthier diets.

There was a certain amount of nay saying about our efforts to promote healthy foods. But there was resistance as well when we were the first city in America to ban smoking in the workplace two decades ago and during the numerous other health "firsts" that have made San Francisco a leader in American health policy.

Our Urban-Rural Roundtable just released its final recommendations (PDF) on how San Francisco can create a vibrant regional food production system that supports local growers, promotes local health and as an important added benefit, creates local jobs.

A separate study released last week quantifies a disturbing trend: unhealthy diets cost California upwards of $41 billion a year in health care expenses and loss of productivity. If we don't take proactive steps to reduce this trend, the costs of preventable diseases like Diabetes will skyrocket to almost $53 billion a year by 2011 in this state alone.

In San Francisco, we are trying to prevent this terrible drain on our economy by focusing on healthy lifestyles. In 2006, we launched Shape Up San Francisco, to encourage city residents to be physically active within the constructs of their daily lives. We have built a partnership with Kaiser Permanente, the San Francisco Chamber of Commerce, and other important stakeholders to develop policy, programs, and research efforts to promote active living. Just 30 minutes of moderate physical activity three days a week reduces the chances of developing Type 2 Diabetes, alleviates stress, and helps prevent heart disease. And the participation of local business underlies the important lesson that healthier residents help promote a stronger economy, because businesses lose fewer days to sick time and employees are more productive.

Beyond incorporating exercise into their daily lives, San Franciscans have a demonstrated desire to eat healthier as well. To this end, we installed salad bars full of locally grown produce in more than two-dozen public schools around the City. I've seen it with my own eyes -- elementary schoolers excited about eating broccoli! We are working to promote more farmers' markets beyond our internationally famous Ferry Building. And we're requiring that city departments and agencies leverage our municipal purchasing power to encourage the consumption of fresh produce and nutritious alternatives whenever possible.

San Francisco is both a city and a county, with a municipal budget larger than many states. We are using our tremendous purchasing power to build up the market for healthy foods, to make them just as affordable as unhealthy options. We hope other local and state governments follow our lead, just as they have adopted our bold policies on banning plastic bags, or reducing the use of bottled water, or promoting local solar use.

Eating food grown within a 200-mile food shed makes our environment healthier by minimizing the carbon footprint of the meals we eat and makes us healthier because residents are more likely to consume better tasting, fresher options. It also keeps food dollars in the regional economy, a major boon to local farmers. It's a win for everyone involved.

California can no longer afford billions and billions of dollars in health care for Type 2 Diabetes, heart disease, and other medical ailments associated with unhealthy diets and inactive lifestyles. Particularly not when there's a way to transition towards a food policy that encourages locally grown, sustainable, nutritious alternatives at no greater cost. We have an abiding belief in my city in the value of preventative health care, as demonstrated by our landmark Healthy San Francisco program. Healthy eating is a critical component of all-around well being, and I'm proud we're taking the first important steps on this critical public health challenge.

Follow Gavin Newsom on Twitter: www.twitter.com/GavinNewsom

Comments

[cosmicmom]

My son has two jobs, both teaching gymnastics in San Francisco, and no health insurance. As a mom I've worried about his physically risky occupation and urged him to sign up for Healthy San Francisco a year ago after doing research into healthcare options for him. It's been a G.O.D.send for him this year when he seriously injured both of his ankles at the same time while doing gymnastics. He never could have gotten the medical attention he needed, affordably, without Healthy San Francisco. Let's do it for the country now.

[Bladernr1001]

I am self employed and so carry individual insurance for about $200/month. Not necessarily cheap but not a bank breaker either. Co-pay is $25 for an office visit. This insurance covers everything that would wipe me out financially.

So great your son made his own choice of occupation so someone else in SF essentially paid for his injury. Sounds like his premium is priced at a below market level. In a government system someone is going to get a free ride and someone is going to get the shaft...that is socialism.....a system of social organization that has ultimately failed every time it has been tried.

I don't believe any individual insurance would have failed to cover this injury.

[Trittydi]

Health care is a basic right and should be free or cost VERY little.
*

[berre]

Brilliant. To paraphrase Thoreau "strike at the root of the problem, rather than the branches". SF approach is brilliant. Next step for SF: put a cap of 15 - 20% on the mark up. Currently between leaving the lab and getting into the hands of the patient, via the pharmacy and Dr's office, medication is marked up by 100 - 250%. We should no longer tolerate that business model.

[Bladernr1001]

You know most of that markup (if your numbers are even accurate) is to recoup the cost of the FDA approval cycle which I think is riddled with inefficiency and waste. However, this is typical of government run entities. I think we would be better off with a private institution that would put their seal of approval on drugs. A good model would be the UL Laboratories. Government based entities like this are just too prone to political manipulation and bad management oversight.

[Tim303]

Oh, that's why you can get the same drugs quicker and cheaper in the UK. Thanks for enlightening me madam. Now scuse me while I pray to Goldmanm Sachs.

[austinboy]

"Whole Paycheck" or not, Gavin rocks! At least he's a modern guy, which is more than you can say about the competition! First Sacramento, then DC; include me in!

[Brettster]

SF is the best city in the country. Gavin Newsome is Bruce Wayne. I'll vote for him for Governor.

[JayeSF]

Looky ! Another gavin newsom commercial ! Nice-sounding stuff...un­fortunatel­y, like all of Mr. Mayor's claims...there aren't facts to back it up. newsom was against Healthy SF program until it became obvious to him he didn't have the votes on the Board of Supervisors to stop it. Then he spun it as his own.

EVERY budget newsom has put forth (although even that is a misstatement, because undoubtedly his policies were drafted by his handlers, not himself) has DRASTICALLY SLASHED funding for public health programs in the city. 6 years of records there...not hard to confirm. Just look.

Healthy SF. Mandates that employers pay some sort of healthcare for their workers. Not a great program, but something. Intent was to make employers use some of their profit (SF businesses are thriving, even in recession) to pay into a pool for a local healthcare program.
What happens ? They pass along the costs directly to customers by adding an additional surcharge to their bills.
Consumers pay about 2% extra on their tabs to pay for this program. You can do this here because (despite newsom) there still exists a majority of residents who understand what 'common good' means.

To claim a victory/authorship for a revolutionary new way of thinking about health care....is a joke. newsom seems to think that his achievements are...whatever he claims them to be. At this point, much of the media seems to be perfectly willing to accept his baseless claims, too.,

[dclintn648]

Vippy, you're showing your own stupidity if you think that people get colds from walking through the freezer section. Cold are caused by viruses, not temperature!

[RightWingMarine]

Mayor Newsom is watching you!

Perhaps, in the interest of a healthy SF and a reduction in diabetes we could have mandatory excercise monitored by telescreens in our homes.

Pass the Victory Gin.

[austinboy]

Here in San Francisco, locals endlessly complain about "Whole Paycheck" (as they call it) and paying organic farmers a decent price for their product! Apparently, it cuts into their donut and booze consumption and why walk three blocks when you can hail a taxi! When did they drop the fat bomb on San Francisco anyway! Those munitions engineers at Berkeley never cease to amaze!

[vippy]

Healthy food purchases are expensive. Looked at the price of fresh fruit? You can easily pay $ 20 for a bag of cherries. True, in order for people to adapt healthy eating habits (you are what you eat), the
government (FDA) needs to clean up its act and leave out hormones from the meat (is greed).
The process of e-coli proving all vegetables and fruits. Ever noticed that the USA is the only country
where e-coli happens in veggies? Prevention is a healthy nation. I watch mothers going grocery shopping with their baby in only diapers thru the freezer section and then clog up the doctor's office
because baby has a cold. Can't fix stupid I guess. Childen waiting for the school bus who have not been fed and dressed wrong for the climate, because of no supervision of their parents, who watch
TV too late and then can't get up when the child gets up to wait for the school bus.

[Bladernr1001]

So we need government supervision of parents now?

[Tim303]

As a parent I would gave to agree. Yes we do. And we already do.

[sheilaofmiami]

Get a grip. Colds are not caused by being cold, it is a virus that is passed by touching things that are covered in virus. But if we don't expose ourselves to what is out there, we are more vulnerable by our bodies having no immunity to anything. Colds will happen, but if you take care of yourself and eat a healthy diet, you either won't notice that you battled a cold, or you won't be sick, or maybe not as sick, as someone who lives out of McDonald's.

And no, you can't fix stupid, good luck to you.

[Leo]

That is, to me, a seldom spoken advantage of implementing a public health care plan (if not single payer): finally placing incentives in place to curb the consumption of unhealthy foods and prescription drug abuse. When the impact on the Treasury of unhealthy habits is measurable, there will be a strong argument to deter, either by taxation, legal limits on advertising, or strong educational campaigns, the consumption of products that lead to early onset of diabetes, obesity and heart disease.

[urweatherman]

So where will all the employees of McDonalds & Taco Bell etc. find another job? It seems to me a good idea to use the stimulus money to build more walking and bike trails and provide low cost fitness centers to communities.....

[clueless JD]

Have you called Sen. Ensign to convey your very personal understanding of his situation?

[FreedomBeforeDemocracy]

I'll be honest. I don't really like the nanny state tone of this piece, but let's assume that the Mr. Newsom is on to something. That what San Francisco is doing can really help a lot as far as healthcare goes. Does Mr. Newsom prefer that he and his local constituents use their resources to address the healthcare crisis or would he prefer to send those resources to Washington D.C. and take his chances that our federal government comes to the same "brilliant" conclusions he has?

[Bladernr1001]

Sounds like Orwell's 1984 to me.

[FreedomBeforeDemocracy]

True. But at this point I'd be happy if we could just a few scattered "big brothers" rather than one large one. I think my pessimism is showing.

[TheFriendlyAtheist]

Pretty good idea Mayor; but if you really want to save a hunk of change then let's put all gov. employees into a single payer system and save about $100 billion a year.

[Chironomid]

What a great concept. Here in Charleston, SC, reddest of the red states, local food movements are catching on. It started with local seafood promotions simply to save a longstanding local industry, and has fanned out to produce, beef, eggs, etc. This growing interest gives new purpose to farm properties that normally get swallowed up in urban development. These farms are now producing fruits and vegetables and selling thru local community and individual contracts. The success of local produce has now inspired a set of local beef, fowl and egg producers using free range techniques, grass feeding, and other low-impact, lower cruelty methods.

Local food can improve health and reduce impacts, and you don't have to be liberal to see the value. A little care about the health of your local neighborhood is the key. Simple.