Eating out in San Francisco

Quick. What special interest is the most active opponent against comprehensive health reform?

While many compete for that distinction (insurers, doctors, drug companies, etc.), there’s a strong argument that it is… the restaurants.

As the industry perhaps most likely not to provide health coverage to their workers, they have consistently opposed efforts that would require them to contribute a fair share to health care.

* Many have been actively opposed to single-payer at least since the 1994 ballot measure–with some even subjecting patrons to anti-Prop 186 table cards.

* Fast food and chain restaurants were the single largest opponents of SB2 and Prop 72, which would have required large employers to pay for their worker’s health care. In fact, fast food and chain restaurants–from McDonald’s and KFC to Applebee’s and Cheescake Factory–made up over 70% of the opposition fundraising to Prop 72–most of the rest of the employer community stayed on the sidelines. Without the California Restaurant Association, Prop 72-which lost by less than a percetnage point–would have been enacted.

* Despite Governor Schwarzenegger’s urging, they ultimately opposed AB x1 1. In opposing an minimum contribution for employers to health care, they graciously offered to support a sales tax–a tax they don’t pay, but that their customers and other businesses do.

* In San Francisco, the Golden Gate Restaurant Association–rather than the Chamber of Commerce or broader business interests–has led a lawsuit to overturn Healthy San Francisco. The lawsuit is still pending, although there have been encouraging signs from the Ninth Circuit Court of Appeals and even the Supreme Court (in the most underplayed story of the year).

Marc Lifsher’s new Los Angeles Times story places the spotlight on the restaurant’s opposition to Healthy San Francisco–an innovative and groundbreaking effort to ensure universal access to care. (See a new one-sheet summary of Healthy San Francisco by the Kaiser Family Foundation.)

The article indicates that dozens of SF restaurants are now placing notices on menus, announcing additional costs–from $1 to $2 dollar flat fees to 1-4% surcharges–to help pay for the new health care requirements.

But the tactic, clearly designed to stoke public opposition to the law, may backfire:

* Of all the things that your dollars, it would seem that San Franciscans might think that a few extra dollars to go to the effort for universal health care is a good thing.

* The beneficiaries of the health care law are not faceless. They are the waiters and waitresses that diners interact with. And even for the kitchen staff–wouldn’t you want the people handling your food to have health insurance? Especially since there is a correlation between being insured and health status?

* It’s clear that some of the traditional arguments against employer requirements don’t apply to San Francisco restaurants–people aren’t going to go across the Bay Bridge to get a burger, or a fine dinner, simply to avoid a small surcharge. Rather, the minimum requirement helps level of the playing field between a coffee place that does provide health benefits, and one down the street that doesn’t.

* The article quotes at least one patron that didn’t mind the surcharge. So, if the surcharge is truly passed on to consumers, this undermines the restaurant’s argument that the requirement will put cuts into their profits or put them out of business. They can’t have it both ways.

Any health coverage expansions–from employer mandates to single-payer to hybrid “shared responsibility” plans–are going to ask employers who don’t cover their workers to contribute more than they do now. It’s an issue not just of financing, but of fairness–to the many employers who cover all their workers. It’s also a practical issue: without a minimum contribution, policymakers fear “crowd-out,” where those employers currently offering coverage drop it so their workers take advantage of a public program expansion.

Fast food and chain restaurants will eventually have to be share in the solution, rather than spending their time raising money against reform, pursuing legal attacks, and even trying to make political points on menus. But it looks like that may be a longer wait than what’s at the trendiest San Francisco restaurant.

Health Access California promotes quality, affordable health care for all Californians.

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