Medallion Holders Association
Ken Jacobs on Health Care Financing
This memo was submitted to the Health Care Committee of the San Francisco Taxi Commission on December 19, 2006 by Ken Jacobs, who is a non-voting member of the committee
To: Taxi Drivers Health Care Committee From: Ken Jacobs, non-voting member representing private health care Re: Committee decisions on financing and "Voluntary vs. Involuntary" Date: December 18, 2006 I am unable to attend the meeting tomorrow. I did have several observations on the questions asked in the memo. (1) It is important to distinguish between how the funds will be collected and where the incidence falls. It is not difficult to imagine ways to pass a share of the incidence on to cab companies and/or medallion holders without triggering a requirement to go to the ballot. For example, if funds were collected from the drivers, but gate fees were lowered to cover some of the cost, the incidence would be born (sic) in part by the cab companies and medallion holders while it would clearly fall within the city's regulatory power. (If the color schemes are required to contribute towards the cost of health care, it is a reasonable assumption that part of those costs would be passed on to the medallion holders through lower lease fees.) Conversely, as noted in your memo, if funds were collected by the color scheme, part of the cost could be passed on in part to the drivers through higher gate fees. It might be helpful to separate out these questions in your decision making. (2) It strikes me as a mischaracterization to say that medallion holders would be "hit-twice" since they are also drivers. The medallion holders gain double income from the cab: as a driver and as a medallion holder. They would contribute to the plan in those two separate capacities. The medallion is a public good provided by the city, which comes with certain obligations and responsibilities. (It is hard to think of any public program in which people do not contribute in multiple capacities: as workers, taxpayers, consumers, employers, etc.) (3) If you want to require participation of cab drivers, the cleanest way to do that would be to make it a condition for drivers to receive their permit to drive a cab in San Francisco; you would want to allow drivers to opt out of the city's health plan with proof that they have coverage through another source. I look forward to hearing your results.