“If Only the Nation Were More Like San Francisco”

Posted by daprovocateur on Wednesday, January 6, 2010 at 11:19 pm

(Crossposted at CureThis)

The most recent edition of San Francisco Magazine (which I read only when I see it strewn across piles and piles of books, journals and mags at my in-laws’ place in Sonoma) features a run-down found here on Healthy San Francisco, a health care access system for SF residents to receive care at nearly all health care providers in the city (My long-time SF friend reminds me that it’s not a health insurance plan so what you do when you get alcohol poisoning in Napa or get shot in Oakland – or vice-versa – is beyond me). I am looking forward to actually reading the thing and learn about its inner-workings, but what I find most intriguing is this commentary by SF Mag’s Editor-in-Chief Bruce Kelley.

Kelley states:

When it comes to national healthcare reform, I think we should throw participatory democ­racy out the window. This one policy debate would go better if the American public were silent and disengaged, refusing to blog, carp, watch Fox News, or exercise its voice. It would also be helpful to suspend the constitution, strip all interest groups of power, and install a temporary dictatorship. One smart person would make the final decision how to address the healthcare disaster. She’d be advised by other smart people. She would wave a wand. Then Congress would return from a short hiatus, and the sausage-making would resume.

Kelley goes on to tell that that’s basically how Healthy SF came to be – without anyone actually noticing – and since it’s such a hit, we should replicate the process and fix US health care a la SF.

Even though it doesn’t really matter, I gave it some thought. Maybe he’s right. Let’s get the right person to just…DECIDE. Of course, remember the last “decider” we had in office…

What about Obama? Well, are we talking Candidate “If I could start it all over again, I’d do single-payer” Obama or President “Let’s cut a deal with Big Insurance and Big Pharma so they play nice” Obama?

I thought again…how participatory is our national democracy now anyhow? When I yell or email or fax or call the Hill, who is actually listening? The play by the Golden Rule – He with the gold, makes the rules.

Whatever happens in DC, we need to point our eyes and efforts locally and follow SF’s model. We can keep better eyes on the gold when it’s in our own neck of the woods. But, we should be careful what we wish for in hoping other parts of the US take SF’s lead and steamroll health care reform of their own.

Kelley dreams “If only the nation were more like San Francisco.”

Amen to that.

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