DON GONYEA, host:
Two places on opposite ends of the country are going ahead with universal health insurance programs.
Yesterday, federal officials approved a Massachusetts plan that requires every resident there to be covered. Massachusetts is the first state in the nation to adopt such a program. It'll be launched this fall using a mix of federal and state money.
RENEE MONTAGNE, host:
Here on the West Coast, the city of San Francisco this week adopted its own universal health insurance plan. Some don't like the price tag. But as NPR's Richard Gonzales reports, the uninsured say it's long overdue.
RICHARD GONZALES reporting:
Meet 26-year-old receptionist and waitress, Patty Senical(ph). She's blonde, with an irrepressible smile and an equally sunny disposition. She's also $10,000 in debt.
Ms. PATTY SENICAL: And it's for something that wasn't what people associate young people being in debt for. I didn't go and spend credit cards on new clothes and trips and partying in college.
GONZALES: Five years ago, Senical was diagnosed with a lump on her thyroid gland. At the time, she had no medical insurance.
Believing she had cancer, Senical had surgery, which was only partially paid for by the state. The lump proved to be benign and today Senical is healthy, but the $10,000 bill still hangs over her head.
Ms. SENICAL: I'm now so far in debt that I can't really see myself getting out of it.
GONZALES: San Francisco's new Health Access Plan won't pay down Patty Senical's old bills, but it will cover her in the future, along with an estimated 82,000 other San Franciscans.
This week, officials gave final approval to what's being called the first citywide universal healthcare program. It excludes no one because of income, immigration status, or pre-existing medical condition. The price tag for this sweeping health coverage is about $200 million. About half of the money will come from taxes, the rest from individual premiums and mandatory contributions by employers.
San Francisco Mayor Gavin Newsom thinks the plan could become a national model.
Mayor GAVIN NEWSOM (San Francisco, California): San Francisco is not waiting around. San Francisco is moving forward to fulfill its moral obligation to insure the 82-or-so thousand San Franciscans that are currently uninsured.
GONZALES: The plan has unanimous support from local officials, but many critics in the business community.
Nathan Nayman, who leads a group called the Committee on Jobs, says employers shouldn't have to foot the bill.
Mr. NATHAN NAYMAN (Executive Director, Committee on Jobs): And until there is a conscious effort to determine how to control healthcare costs, any insurance package or any sort of program that requires employers and employees to pay into a fund without looking at the healthcare costs side I don't believe is sustainable.
GONZALES: Nevertheless, national healthcare experts say San Francisco is breaking new ground with a real-life experiment.
Stephen Shortell is a Dean of the School of Public Health at UC Berkeley.
Mr. STEPHEN SHORTELL (Dean of the School of Public Health, UC Berkeley): I think what we may see is what I'll call a contagion effect spreading across the United States where other cities will begin to look at these options as well. They'll do it in their own way - they're different from San Francisco - and will build into a major debate on what we're going to do in this country in the next presidential election.
GONZALES: The mayor is expected to sign the program into law next week, but it may take a year for it to become operational.
Richard Gonzales, NPR News, San Francisco.
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