Fight PA Medicaid Cuts
March 11, 2005
Call your state legislators today to oppose the proposed limits on Medicaid. For Phila area hospitals, the cuts will cost around $186 million and will force the closure of hospital floors and compromise emergency room services. CALL TODAY!
Health Care for Philadedelphia Town Meeting
September 28, 2004
Time: Thursday Oct. 7th 7pm
Location: Church of the Advocate, 18th & Diamond
You voted to have the Philadelphia Health Department develop a plan for Universal Health Care for Philadelphians. Now we need input in creating that plan. Please support the upcoming Town meeting. This could be the begining of Health Care for all in the US!
Justice Talking Taping
September 26, 2004
Instead of an October General Mtg at the Penn Newman Ctr. Some members of the PACDHC will attend the National Health Care taping & discussion at the National Constitution Center (525 Arch Street, Philadelphia, PA)
For more information and/or to get tickets go to
http://www.justicetalking.org/joinaudience.asp
Justice Talking is award-winning radio that engages listeners in timely, refreshingly honest debates on the current legal battles that capture our nation’s attention.
Each weekly program unapologetically tackles tough, provocative issues featuring reports from the field, polling analysis, and compelling debate between the nation’s leading advocates and political opposites.
Photo from The Rally & Demonstration in NYC
September 2, 2004
Jobs for Justice,PACDHC and others loaded onto two buses armed with Health Care for All signs and walking shoes to peacefully demonstrate during the Republican Convention in August.
Thank you to all those who lent their support!
Demonstration & Rally in NYC
July 30, 2004
Taking place during the Republican Convention.
The Philadelphia Area Committee to Defend Health Care and Philadelphia Jobs with Justice are working together to fill at least one bus to take Philadelphia-area healthcare activists to New York City for the demonstration called by United for Peace and Justice.
Reserve your seat on the bus now! Leaving from Center City Philadelphia 7:30am Sunday, August 29th
Campaign for National Health Care Site
July 20, 2004
We can provide coverage for healthcare, prescription drugs, mental health, dental, optical and long-term care. We can afford it NOW. We can’t afford not to have it. All of this has been written into House Resolution 676, the United States National Health Insurance Act, now before Congress.
Visit Campaign for a National Health Care Program’s Website for more information
Costs of Administration in the U.S. Healthcare System
January 20, 2004
Physicians for a National Health Program
Press Release
Study Shows National Health Insurance Could Save $286 Billion
on Health Care Paperwork:
Authors Say Medicare Drug Bill Will Increase Bureaucratic Costs, Reward Insurers and the AARP
A study by researchers at Harvard Medical School and Public Citizen in the International Journal of Health Services finds that health care bureaucracy in 2002 cost the United States $399.4 billion. The study estimates that national health insurance (NHI) could save at least $286 billion annually on paperwork, enough to cover all of the uninsured and to provide full prescription drug coverage for everyone in the United States.
The study was based on the most comprehensive analysis to date of health administration spending, including data on the administrative costs of health insurers, employers health benefit programs, hospitals, nursing homes, home care agencies, physicians and other practitioners in the United States and Canada. The authors found that bureaucracy accounts for at least 31 percent of total U.S. health spending compared to 16.7 percent in Canada. They also found that administration has grown far faster in the United States than in Canada.
The potential administrative savings of $286 billion annually under national health insurance could:
1- Offset the cost of covering the uninsured (estimated at $80 billion)
2- Cover all out-of-pocket prescription drugs costs for seniors as well as those under 65 (estimated at $53 billion in 2003)
3- Fund retraining and job placement programs for insurance workers and others who would lose their jobs under NHI (estimated at $20 billion)
4- Make substantial improvements in coverage and quality of care for U.S. consumers who already have insurance
Looked at another way, the potential administrative savings are equivalent to $6,940 for each of the 41.2 million people uninsured in 2001 (the most recent figure available for the uninsured at the time study was carried out), more than enough to pay for health coverage. The study found wide variation among states in the potential administrative savings available per uninsured resident.
Texas, with 4.96 million uninsured (nearly one in four Texans), could save a total of $19.5 billion a year on administration under NHI, which would make available $3,925 per uninsured resident per year. Massachusetts, which has very high per capita health administrative spending and a relatively low rate of un-insurance, could save a total of $8.6 billion a year, making available $16,453 per uninsured person. California, with 6.7 million uninsured, could save a total of $33.7 billion a year, which would make available $5,016 per uninsured person.
Last week, the government reported that health spending accounts for a record 15 percent of the nation’s economy and that health care spending shot up by 9.3 percent in 2002. Insurance overhead (one component of administrative costs) rose by a whopping 16.8% in 2002, after a 12.5% increase in 2001, making it the fastest growing component of health expenditure over the past three years. Hence the figures in the Harvard/Public Citizen Report (which was completed before release of these latest government figures) may understate true administrative costs.
The authors of the International Journal of Health Services study attributed the high U.S. administrative costs to three factors. First, private insurers have high overhead in both nations but play a much bigger role in the United States. Second, The United States’ fragmented payment system drives up administrative costs for doctors and hospitals, who must deal with hundreds of different insurance plans (for example, at least 755 in Seattle alone), each with different coverage and payment rules, referral networks, etc. In Canada, doctors bill a single insurance plan, using a single simple form, and hospitals receive a lump sum budget, much as a fire department is paid in the United States. Finally, the increasing business orientation of U.S. hospitals and insurers has expanded bureaucracy.
The Medicare drug bill that Congress passed last month will only increase bureaucratic spending because it will funnel large amounts of public money through private insurance plans with high overhead.
The recent Medicare bill means a huge increase in administrative waste and a big payoff for the AARP, said study author Dr. David Himmelstein, an associate professor of medicine at Harvard and former staff physician at Public Citizen’s Health Research Group. “At present, Medicare’s overhead is less than 4 percent. But all of the new Medicare money, $400 billion, will flow through private insurance plans whose overhead averages 12 percent. So insurance companies will gain $36 billion from this bill. And the AARP stands to make billions from the 4 percent cut it receives from the policies sold to its members.”
Dr. Steffie Woolhandler, a study author, associate professor of medicine at Harvard and a founder of Physicians for a National Health Program, said that “Hundreds of billions are squandered each year on health care bureaucracy, more than enough to cover all of the uninsured, pay for full drug coverage for seniors and upgrade coverage for the tens of millions who are underinsured. U.S. consumers spend almost twice as much per capita on health care as Canadians who have universal coverage and live two years longer. The administrative savings of national health insurance make universal coverage affordable.”
Dr. Sidney Wolfe, director of Public Citizen’s Health Research Group added: “This study, documents the state-by-state potential administrative savings achievable with national health insurance. These enormous sums could be used to provide health care for the more than 43 million uninsured people in the United States and drug coverage for seniors. These data should awaken governors and legislators to a fiscally sound and humane way to deal with ballooning budget deficits. Instead of cutting Medicaid and other vital services, officials could expand services by freeing up the $286 billion a year wasted on administrative expenses. In the current economic climate, with unemployment rising, we can ill afford massive waste in health care. Radical surgery to cure our failing health insurance system is sorely needed.”
Dr. Himmelstein described the real-world meaning of the difference in administration between the United States and Canada by comparing hospitals in the two nations. Several years ago, he visited Toronto General Hospital, a 900-bed tertiary care center that offered an extensive array of high-tech procedures, and searched for the billing office. It was hard to find, though; it consisted of a handful of people in the basement whose main job was to send bills to U.S. patients who had come across the border. Canadian hospitals do not bill individual patients for their care and so have no need to keep track of who receives each Band-Aid or an aspirin.
A Canadian hospital negotiates its annual budget with the provincial health plan and receives a single check each month to cover virtually all of its expenses, Himmelstein said. It need not fight with hundreds of insurance plans about whether each day in the hospital was necessary, and each pill justified. The result is massive savings on hospital billing and bureaucracy.
Doctors in Canada face a similarly simple billing system. Every patient has the same insurance. There is one simple billing form with a few boxes on it. Doctors check the box indicating what kind of visit they provided to the patient (i.e., how long and whether any special procedures were performed) and send all bills to one agency.
Himmelstein returned to Boston and visited Massachusetts General Hospital, which was similar to Toronto General in size and in the range of services provided. Himmelstein was told that Massachusetts General’s billing department employed 352 full-time personnel, not because the hospital was inefficient, but because this department needed to document in detail every item used for each patient and fight with hundreds of insurance plans about payment.
U.S. doctors face a similar billing nightmare, Himmelstein said. They deal with hundreds of plans, each with different rules and regulations, each allowing physicians to prescribe a different group of medications, each dictating that doctors refer patients to different specialists.
The U.S. system is a paperwork nightmare for doctors and patients, and wastes hundreds of billions of dollars.
###
Dr. Woolhandler and Dr. Himmelstein are co-founders of Physicians for a National Health Program, an organization with over 12,000 members advocating for single-payer national health insurance in the United States. PNHP was founded in 1987 and has physician spokespeople across the country. For a local spokesperson, call the national headquarters at 312-782-6006. Visit us online at www.pnhp.org.
Public Citizen is a non-profit, member-supported, consumer advocacy organization founded by Ralph Nader in 1971. Public Citizen fights for safe foods, drugs and medical devices; for greater consumer control over personal health decisions; and for universal access to quality health care.
Copies of the articles appearing in the January issue of the International Journal of Heath Services (listed below) will be available in .pdf format at www.pnhp.org starting on Wednesday, January 14, 2004 at 3pm. Advance copies for the press can be obtained by calling Joseph Shin at 312-782-6006.
1. Health Care Administration in the United States and Canada: Micromanagement, Macro Costs. Woolhandler, Campbell, and Himmelstein, IJHS Vol 34, No 1, 65-78, 2004.
2. Administrative Waste in the U.S. Health Care System in 2003: The Cost to the Nation, the States, and the District of Columbia, with State-Specific Estimates of Potential Savings. Himmelstein, Woolhandler, and Wolfe, IJHS, Vol 34, No 1, 79-86, 2004.
Legislative Issues
November 5, 2003
PACDHC led the creation of the Philadelphia city charter change for a plan for universal health care . This charter change placed the following words on the November 2003 ballot:
PROPOSED CHARTER CHANGE QUESTION #5
Shall Section 5-300 of the Philadelphia Home Rule Charter be amended to declare that because health care is an essential safeguard of human life and dignity, the City of Philadelphia Health Department shall prepare a plan for universal health care that permits everyone in the City of Philadelphia to obtain decent health care?
Our committee gathered 10,000 signatures and lobbied City Council in order to place this city charter change on the November 2003 ballot. Over 50 organizations endorsed the question, and on November 4th, 2003, it passed with a resounding 146,834 (75%) votes vs. 48,961 (25%)!
Current Status
After passage by the voters, the Philadelphia Department of Public Health asked Princeton University’s Woodrow Wilson School of International and Public Affairs to conduct a workshop of graduate students who would research the city’s health statistics and asset assessment, conduct key informant interviews, hold community wide focus groups, and put together a community advisory board to guide the formation of this plan.
The students held several seminars over 4 months and crafted a plan which was reshaped by the community advisory board. Led by Dr. David Grande, the other students were Rebekah Cook- Mack, Joshua Dubois, Jessica Goldberg, Adrienne Corpuz-Joyce, and Alexia Smokler. Faculty for the workshop was Dr. Walter Tsou.
Health Commissioner John Domzalski released the plan on Wed, May 11, 2005 in City Hall. The plan is available at http://www.phila.gov/health.
It calls for the initiation of a Health Leadership Partnership to bring together key stakeholders in resolving how we can best coordinate services for the uninsured in Philadelphia and ensure funding for safety net providers.
Jobs with Justice Health Care Action Day
May 11, 2003
Health Care Action Day
A march is planned from City Hall at 3:30 pm to International Blue Cross demanding
HEALTH CARE FOR ALL!
Come out and show your support for the millions of working people living without healthcare and raise your voice for justice!
For any additional information contact Fabricio or Reena at 215-735-3615.
About Us
December 31, 1999
The Philadelphia Area Committee to Defend Health Care is a group of doctors, nurses, health care workers, union members, activists, and others who are working together to build a health care system that guarantees accessible, quality health care for all Americans.
The Ad Hoc Committee to Defend Health Care is a national organization of health professionals who agree on five principles first set forth in a 1997 article in the Journal of the American Medical Association entitled “For Our Patients, Not for Profit: A Call to Action.” Those principles are:
1. The healing professions must not be diverted from their primary purpose: the relief of suffering, the prevention and treatment of illness, and the promotion of health.
2. Pursuit of corporate profit and personal fortune have no place in care giving.
3. Potent financial incentives that reward overcare or undercare weaken professional bonds, and should be prohibited.
4. A patient’s right to a health professional of choice must not be curtailed.
5. Access to health care must be the right of all.
The Philadelphia chapter has been working to promote these goals in the Delaware Valley since 1998.
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