for that to be drawn down to pay for help the san francisco are to pay for private insurance? then a series of other questions we would collect that data to really understand the scope of the problem. if it turns out that health access is not being provided, because these hra's are being restricted so that the funds are not used to buy insurance, then we will have that information. we will have a conclusion based on real data from the real world. we hear compelling examples from workers about how they're not able to access the benefits. we should bear out those examples and see how prevalent in widespread they are. if it turns out after the time of examination and study that this problem is very widespread, as you contend that is, the mayor would be supportive of a policy that does provide broader halifax's, something along the lines of permanent expenses. his only comfortable making a policy like that in opposing it on the business community of the data is there to support it or

refuted. getting the data from employers and employees is very important. supervisor campos: i certainly look forward to a more in-depth proposal and the mayor. but we need more data to understand what is going on. in fact, the data is here. the data has been collected. it is not that the city has been trying to figure out, on its own, with the numbers are, but it is data that came directly from the restaurant's come directly from the businesses that are covered. one thing is clear, we have two examples. we have the health reimbursement account example, which is the liberal we're trying to close. then we have the example of what is happening with health the san francisco, in terms of the same specific accounts that apply to the same population. in terms of mra's. the same account, the same population. you see the difference in terms of usage. in help the san francisco, the usages 55%.

with respect to the reimbursement accounts, the median is 50%. you know, just on the data we have available that when you have none of the restrictions that the business community is opposing on these accounts, the people are more than three times more likely to use the account. i do not understand why there is a need to wait when the evidence is clear that the problem is not that workers do not need these accounts, but that, simply, they do not have access to the accounts. and i am not prepared to, you know, pay for yet another study, and many are paid for here in city hall, and we know it usually happens to those studies. i am not prepared to pay tax their money on something when we already have the data. you can get it directly from lsc. if you have not gotten it, my office would be happy to give it to you. but the data is there. >> thank you. we have looked very carefully at

the data provided by the department of public health on the health care security ordinance more broadly. the question still remains on the mayor's mind, focusing back on health care access, is of those hra's, are they restricted so that employees cannot use that money to buy into private insurance or into healthy san francisco? that data, as far as i know, does not exist. and that is precisely the data we would like to collect. a corollary to that, the business community, we have been in close contact with over the past weeks in debating this policy, the business community itself has stated that they are willing to encourage, within their own community, a change to how these hra's are set up, to encourage the ability to draw down the funds to pay for health insurance and healthy san francisco.

supervisor campos: the problem with that, and i trust the vast majority of members of the committee will do the right thing, a close to 90% are doing the right thing, but we also know that would lead to their own devices, there are members of the community that do not do that. and we know that of the 13% of businesses that are impacted by the ordinance, 80% of that money, 80 cents on the dollar is not going to health care and is pocketed by those businesses. i take exception with the idea that somehow it is enough to simply let the industry regulate itself. we created this law. we drafted the law. that law led to this loophole. doesn't the mayor think we have an obligation to fix that? >> the mayor certainly believes it is an obligation to provide broad health care access. is the most sensible way to do that is to make these expenses irrevocable while we find out if

these hra's have a drawdown. and if we find out that they actually do, maybe not likely, but it is possible, the congress is also true. we might find out that most businesses are not allowing for the hra money to be drawn down to buy health access. if that is the case, the mayor would be supportive at that point of moving forward ricky solution we are debating today. supervisor campos: again, i just heard about your proposal today. i look forward to hearing about is the civics. but if you are saying that only six quarters can be accumulated, you're actually -- >> that is not actually had. for the purpose of collecting the data from both the employer side and the employee side, we just say time out for the next 18 months. nobody take money out for the next 18 months. supervisor campos: so to the extent that only a portion of that is guaranteed to actually be going to the employee, you actually have a situation where

the mayor seems to be saying that he is ok with consumers being asked to pay to cover health care without getting a complete guarantee that all of the money they paid for, in fact, will the health care? it than they are prepared to say that? because that is a significant policy statement. >> it is a bit of a separate issue. what businesses and restaurants predominately put on the bottom line of their jackets and the healthy san francisco fee. the proposal i brought to you earlier this afternoon is one that deals with once that money is deposited in hra's, a candid or cannot be accessed by low- income people for primary health care? what we decided a long time ago with the primary preventative care is the most humane thing to do in the most cost-effective thing to do. in your example of the pregnant women spending $16,000 to deliver her baby, first of all, if she is low-income, she

receives a discounted hospital bill. but taking for the moment that she is a middle income or upper- income person, we do not want her to pay $16,000. we do not want her to pay $8,000. we want her to be covered. i do not know the insurance rules around that. but my point is we want people to have insurance, so that when they do have that element or the problem, they're not paying rack rates for health care services, because prescription pills alone will drain four thousand dollars or $8,000 or $12,000 in an instant. >> bottom line, the proposal you described is not guaranteed to any consumer in san francisco that when they're being asked to pay for health care that, in fact, every penny of that amount will go to health care. you say that is a different issue. but quite frankly, i the most consumers would take exception to that. it is not a different issue. it is connected to this. this idea that somehow this is $50 million coming out of a

business's pockets, the money -- a lot of that money is coming from the consumers, who are the ones that are actually paying for that. and the idea that you're not guaranteeing that people's money go to that, which it is represented to go to, i do not understand how a major could say that. >> i think i have said what the mayor's proposal at this point is. as you pointed out, i am not here with legislation to be considered. that is not the point. my point is this is moving on an accelerated schedule, and the mayor's goal of sending me here to speak to you is to just let you know we're deeply engaged in the situation and looking for policy-based solution that will provide healthcare access. that is my purpose of being here today to represent the mayor. supervisor campos: president chiu. president chiu: thank you.

i appreciate you being here. we have wondered for many months exactly where the administration is on this. i appreciate that you have come with some more specifics on exactly where you're going. >> here i am. >> here you are. a couple of quick questions. i actually increase it the 18 month timeframe you're talking about. i am absolutely open to a timeframe that this summer between one year and be in deficit timespan we're talking about, 18 months could be reasonable. we should talk about that. when you talk about it being irrevocable, your idea is that for the next 18 months, money goes into an account, and that money is the employees for the rest of the time? >> yes. president chiu: that sounds very reasonable. >> the reason for that is to sort of be able to have clean data on how it is being utilized. if an employee prefers taking that money back, we will not really been able to gauge of the employees are using those funds.

president chiu: with the mayor's office at be willing to support olsc staffing to make sure we get the data we need? >> yes. president chiu: when will we have details? >> as soon as i leave here, i will go back to my desk and work on it. this is something we're working on now. president chiu: ok, because we have been debating this for many months. let me ask a different question. my sense s someone who has been trying to work with all the various stakeholders for months now is that the good coalition that has put forth supervisor campos' legislation that currently has six co-sponsors, there would like to move to a vote. my guess, just a guess, is that while i appreciate what you're offering, i am not sure that that is something that the coalition would want to see as an amendment. it turned out that the version that supervisor campos has been to a vote and put in front of

mayor lee's desk, what is your sense that he would sign it or veto it? >> appreciate that. my goal here is not to derail any kind of timeline that supervisor campos and the coalition have but this legislation on. we have stayed focused, and it has been our primary priority to find a solution that is based in policy that provides health access for low-income and all workers. the mayor is in favor of something that looks much more like the proposal that i just laid out to you than the proposal you are currently considering today. president chiu: that is not exactly an answer to my question. supervisor campos: what is the answer? >> the mayor is not going to move forward on this proposal, and we would like to see a coalition and the health department get involved in this to provide perspectives on health outcomes and how we can provide access and come to resolution. president chiu: in other words,

he would be to the current legislation? >> here is the thing, he has not said those words to me. i do not want to represent that here and the committee. but our goal and our target, and my working orders have been to find a solution. the staff at the mayor's office has been meeting with a number of small business representatives and with a broader array of people to create a solution that looks something like what we were presented yesterday and what we presented today. president chiu: i appreciate that. from my perspective, i have been working for months to try to find a solution here. i think it would be helpful before tuesday for us to understand what the mayor is on that. it would give us all some clarity and guidance. of course, we have been talking regularly on this. we look for reducing this language as soon as possible. >> thank you, supervisor. supervisor campos: i do want to have a better sense of how well thought out your proposal is.

if it is 18 months, right, that you're talking about, that is about $6,000, right? >> depending on how many hours the person works. supervisor campos: it would be a lot less. how much research have you done on this? to get to the 18 months that you're talking about? >> as president to mention, we have been discussing this and debating the issues for months now. supervisor campos: for months. so are you aware that if the 18- month time span when to and the fact that the following procedures would not be covered. mri's will not be covered because they're too expensive. chest pain, the average cost of that, $15,000, would not be covered because it is too expensive. we talked about the cost of normal delivery, $16,000. if you have ac section, $22,000, again, would not be covered. any treatment of pneumonia, $23,000 would not be covered by

what the mayors is saying. an appendectomy without the complications, if with complications from a more expensive, 35 of the dollars, would not be covered. kidney stones, any kind of urinary tract infection, $40,000. again, $6,000 would not be covered. so is the mayor aware that all these procedures that are procedures that people throughout san francisco need would not be covered by what you're proposing? >> the policy goal of the mayor in the proposal i just laid out is to not look at those absurdly high costs, and we cannot as a city solve the issue is spiraling out of control medical costs in this country. it is at of control. but his proposals not aiming to san appendectomy should not be $30,000. but it says that that low-wage workers or that person has a need for medical procedure, that person is covered by either healthy san francisco or by private insurance to be able to

pay for that procedure in the wake where they're only paying out of pocket for a co pay. and a reminder, depending on the patients in time, the procedure may not cost the full $36,000. >> did you look to the issue of health and cost before you put the proposal forward? >> broadly speaking? supervisor campos: diddley the procedures? >> this is actually motivated by the out of control costs of health care. the idea is not to let someone develop the diabetes and heart condition and to actually do preventative care. the best way to do primary and preventive care is to have someone enrolled with the primary care physician. the way to do that is they can use that hra money. supervisor campos: but you are aware that these procedures will not be covered by the $6,000 you're talking about? >> i personally do not the cost of an appendectomy. supervisor campos: i would say that before you put a proposal

forward, make sure that you have a better understanding of how it impacts the daily lives of people. make sure you put it in the context of how expensive it is to get these basic procedures. because unless you do that, you know, you're talking policy without really having a deep understanding of how it applies to real people. and that is what we're trying to do. so i would urge you, please go back, do your homework, make sure that you look at cost. because that is ultimately what is going to matter to that worker, whether or not they can go and have their kid's teeth fixed, whether or not there kid gets pneumonia, that they can cover that. that is what it comes down to. it is not weather looks good on paper. it is understanding how it impacts real life. irish the mayor to go back to the drawing board a look at those costs. do not justesen and without understanding the context in which it happens. anything else, colleagues?

let's not take it to public comment. there are a few names. you each have three minutes. john, shasaun, keyong, mike casey, steve, tim paulson, gus feldman. please come forward. >> thank you, supervisor campos. i am here today to speak in favor of your legislation, as a worker who has been effected by this loophole. specifically, as someone who really had to fight to get my health care money. i work early this year, for the first six months of the year, for a very well-known, established, made from scratch cafe in bakery in the city of san francisco. i needed a lot of dental work done and was in the position, like so many minimum-wage workers, of not having health care, or so i thought.

i found out through a friend about the health care ordinance. i asked my manager about it, and they told me they did not know what i was talking about. so i asked my manager's manager, and they also told me they did not know what i was talking about. so i asked the lady who was in charge of all of these bakeries in san francisco and she told me, no, that does not apply to you. so i ended up going back and forth with the city enforcement agent, and i did end up filing a complaint. and back to my people at work, and is getting two different messages. the city had all the reports on file that the company was in full compliance, and my bosses said, no, we do not know what you're talking about, you do not get health care benefits. eventually, i marched up to the health care -- to the human resources office, and his story was different. of course i am covered, and this money is available for all the employees. here are the forms. all the paperwork is in order.

of is getting two stories. long story short, i ended up being able to get some medical expenses reimbursed, but i needed to fight for it. even after i got these expenses approved from the third party hra administrator, they still would not give me the check. i still had to go to the city's enforcement agent, and eventually i had to contact the owner of the company. this is a $50 million a year company. and i had to contact the owner directly to say, hey, you denied this program existed. once i got you to admit it existed in your improved my clients, it is two months and still not have a check. eventually, i did get it. but i am the only one there who demanded answers from the vice- president of human-resources. that is to say i quit that job. i work for another well-known established catering big three in the city of san francisco now, and they tell me i do not have health care benefits. frankly, i am worried standing here today speaking.

i will not said the name of my employer, and i am and hoping they're not watching the closed circuit tv here. but again, or i am now, i am still kolbe's benefits do not exist. and none of my co-workers know, and they're scared to come forward. that is why it is so important to close this loophole, because people will eventually find out they have the benefit, but it might be too late. some of the employers do not want their employees to know, and it just is not fair to the companies who are paying this. [bell chimes] supervisor campos: thank you. [applause] and i have a few more names. you can please come forward. president chiu: i just want to say one thing. i want to thank the courage of that worker who just spoke. [applause] and i want to say, i think both my alternative and supervisor campos' legislation would deal with the situation.

if there is an employer who thinks of retaliating against an employee, that employer better be careful. i just want to state that. thank you for being here. supervisor campos: thank you again. next. >> also with the chinese progress of association and the progress of workers alliance. my organization, we work directly with hundreds of low- wage immigrant workers who suffer from low wages, poor working conditions, and therefore higher exposure for health risks. when we talk to our members about their needs, time and time again, it is jobs and health care at the top two issues that they face. we have seen examples in our community of workers who submitted it reimbursements for healthy san francisco -- for hra's and were refused without explanation. then there were worker's buying health care and switched over to hra because they could presumably get the money back at the end of the year, but they continue to be reduced

reimbursements. there was bribery saying they would get kickbacks at the end of every month that you do not use hra's. when workers are low wage, speaking about this issue, you know, coming forward with what is happening is extremely frightening, and they are very worried about retaliation. we have seen a very high level of fear of speaking out about what is happening. i feel like the first half an hour of this meeting really over complicated the issue. it is not that complicated an issue, ok. there is talk of this $50 million price tag. but that is exponentially said as the price tag on consumers and workers and the society as a whole. low-income workers do not have to pay that much because they get discounts was mentioned. someone is paying that bill, taxpayers, right? someone is paying that bill when people are not getting the health care that they need. thanks to each and everyone of

you here today, we were able to unanimously passed an ordinance, and we're very happy and appreciative of your support around that issue. but if you stand with us against wsip, you cannot turn your back on workers facing healthcare theft. to the same issue, this same problem. at a level playing field. if there is a minority of businesses, 13%, 87% are following their release and spending the money to buy health care insurance so workers can get access to the health care they need. i think the liberal has created an incentive that is upholding a certain part of our industries and our work force behind. if this loophole is closed, will incentivize employers to join the 87% better paying into healthy san francisco. people do not want hra's. no one says, give me an hra. they want health care. the one access to emergency

rooms and all kinds of preventive health care. 30 seconds, some people have said that is $50 million sitting around, and in these hard economic times we cannot have that money sitting in accounts unused. i think that is not true. i think what's this loophole is closed, this will go into our health care system. that is going to big -- to be good for workers, consumers, and our city. [applause] supervisor campos: thank you. next speaker. >> i am also with the chinese progress of the association of speaking on behalf of a worker was afraid to be here today because she is afraid of retaliation. she is a full-time worker and a mother. she said, when working people like me have medical emergencies -- [no audio]

my employer has hra's, of course, but they never told us about it. i have been held the come up recently at a serious medical condition, appendicitis, that requires surgery and a week of hospital stay. likely as qualify for charity care. otherwise i do not know what i would have done to pay the bills. the health care liberal has to be closed, and we support supervisor campos' amendment. the workers' money in the hra should not be drawn out at the end of the year. of course, i want to stay healthy and not have to use hra at all. but the workers funds should remain in the accounts in case they get sick. as a full-time worker, i would only be able to accumulate between $1,000 to $2,000 hra funds for year. that is enough -- not enough for a series medical emergency.

these funds should be cumulate -- should accumulate year after year [applause] ] supervisor campos: thank you. next bigger. >> good afternoon. my name is mike casey petraeus is speaking as president of local two and the san francisco labor council. first, i want to thank you for your initiative on closing this loophole, supervisor campos. during the darkest days of the bush administration, san francisco stood out as a beacon of light in terms of addressing real working families' needs. during that time, sick days for all working families in a san francisco was passed. we had worker retention ordinances passed. we had the right to organize legislation passed. we had living wage past. we had minimum-wage past, and

this legislation initiated by a the supervisor unprecedented anywhere in the country was passed. unfortunately over the past several years, we have seen a real erosion of working people's rights across this country, and likewise, an erosion of the responsibility of employers. responsibility that, in better times, was fully accepted, to provide for working families to be able to make ends meet. this groundbreaking concept of providing universal health care was one that created hope of real coverage of health care. this was, in many of our view, is here is compromised when that was hard fought for. we do not think it went far enough with the amount of money that was put in. however, we agree. but there is one fundamental understanding in those

negotiations with both the employers and with the city government at the time from labor's perspective. and that is that we were going to get everybody covered. we knew nothing about these health care reimbursement account is being loopholes. it was never imagined. there are three key reasons why this needs to be passed. one, to address the consumer fraud, which of quite adequately addressed and was highlighted in the "wall street journal." two, to level the playing field. 3, most important, provide real health care for working families. you already commented earlier about the cost of health care, supervisor campos. i just want to add a couple more things. a simple mri is average charged $8,000. that would be, for some of the working full-time, two years' work of health care reimbursement. we would have, in an average stay in the hospital in san

francisco, over $19,000. supervisor campos' legislation does the things we need to do. it addresses the frog, levels the playing field, and it restores the hope once and for of providing real health care for working families. thank you. [applause] supervisor campos: thank you for your comments. i do want to ask you a question. one of the things that i have found it disturbing is some of the things we have seen coming out of the chamber of commerce in terms of the impact of this effort on the other efforts. and i know that you and the labor community have really gone out of the way to try to work with the business community and have been, i am certainly disappointed by the way in which that has transpired. i am wondering if you have any thoughts about that? >>