The San Mateo City Council has indicated its openness to passing a resolution supporting single-payer health care, often commonly known as Medicare for All, citing a local burden in covering gaps in the current system.

“I believe this is the right thing for us to do as a community, is to state our values. And I believe the resolution as it is currently written very clearly reflects our values supporting universal health care for all,” Councilmember Amourence Lee said.

Single-payer national health insurance would have a public government agency organizing health care financing, with care handled by the private sector health companies. All U.S. residents would be covered for medical services, which proponents say allows for an overall healthier population due to more preventative care. Opponents to the single-payer system, however, say it will require tax increases and higher government spending while causing higher patient wait times and a reduction in services.

Lee first proposed discussing the issue in November, with South San Francisco passing a similar resolution in 2021. She noted health care costs are often passed down to cities, with San Mateo affected by the current system in employee health care costs.

“It’s burdened by everyone. Our city is also limited in the ways we can make up for these escalating costs through taxes and fee recovery,” Lee said, who first proposed the resolution.

City Manager Drew Corbett said health care premiums for the city are up 5.3% this year and generally see a 4% to 7% increase each year, with a potential 7.25% increase in 2023.

“For the fiscal year 2021, the city paid $6.9 million in medical costs and then another $700,000 in dental costs. So, it’s definitely a considerable part of the city’s operating budget, and as those costs continue to escalate, does put a pinch on our ability to provide core services,” Finance Director Rich Lee said.

Councilmember Joe Goethals agreed everyone should have health care coverage, access to local hospitals and doctors, and eliminate disparities. However, he was hesitant about the lack of details and proposals at the state and federal levels. He supported finding a solution to a critical issue for people in San Mateo and across the country, suggesting the resolution have revised language echoing value statements to end inequity in health care.

“It couldn’t be any more important, and so there are unique times when we have to speak up. This is one of those times,” Goethals said.

Deputy Mayor Diane Papan noted her brother dealt with a medical condition that resulted in extreme health care costs and health insurance carriers that tried to drop their coverage because of the costs. Based on her families’ experiences, she championed helping other people with similar health care experiences.

“For me, I am equally as passionate about this idea of affordable and accessible health care. It’s important to all of us and especially our most vulnerable,” Papan said.

Mayor Rick Bonilla supported the resolution, asking the state and federal government to take legislative action.

“We have medical bankruptcies in the country. We have people who can least afford health care, who because of that lack of health care, have worse health outcomes because they haven’t been able to have health care maintenance,” Bonilla said.

However, Councilmember Eric Rodriguez said he would not vote for it. He said it was a national issue that did not relate to local issues among residents and was concerned about how the state or federal government would pay for it. He noted it could cost up to $400 billion a year for a state solution.

“I don’t feel right looking at only the benefits without closely examining the practicality or the potential cost and consequences side of it, and I don’t feel right guessing on how San Mateans feel about an issue so outside of the purview of the City Council,” Rodriguez said.

The council will bring back a resolution at its Jan. 18 meeting with revised language.

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