California IN BRIEF : SAN FRANCISCO : Uninsured Patients Face Loss of Services

City health officials are considering turning uninsured patients away from routine appointments if they have big overdue bills. “The assumption is there are some folks who use the services and really could pay but do not,” said acting Health Director Florence Stroud. “Medical care is an expensive service. . . . You can’t just provide it for everybody and still be able to provide it for those who need it most.” An internal memo to some of the city’s district clinics suggests that patients who have owed more than $100 for at least 150 days be evaluated to learn if the appointments are “medically necessary,” the San Francisco Examiner reported. If the visits aren’t essential, patients should be told to come back after they have paid their bills, the memo said. San Francisco’s Health Department, which spends more per capita than any other in California, has never had a policy of turning away patients who fail to pay their bills.