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.
Related Organizations
December 31, 1999
Philadelphia
Philadelphia Jobs with Justice
Philadelphia Unemployment Project
Philadelphia Citizens for Children and Youth
Philadelphia Health Information College of Physicians
Action Alliance of Senior Citizens of Greater Philadelphia
Pennsylvania
Health Care For All Pennsylvania
National
Everybody In, Nobody Out
Families USA
National Coalition of Mental Health Professionals and Consumers, Inc.
Physicians for a National Health Program
Healthcare Now
Universal Health Care Action Network
Other
Other States
Massachusetts Ad Hoc Committee to Defend Health Care
North Carolina Committee to Defend Health Care
Coalition for Wisconsin Health
Connecticut Coalition for Universal Health Care
Health Care For All (Maryland)
Health Care For All – California
Health Care For All Oregon
Massachusetts Campaign for Single Payer Health Care
Minnesota Health Care For All/Citizens Organizing Acting Together
Other Countries
Canadian Health Coalition
Share Your Personal Story
December 31, 1999
The Philadelphia Area Committee to Defend Health Care is a listed organization with the Health Care Problems Archive. By recording your story in the archive, both our group and similar groups will have access to request to use your statement.
The Health Care Problems Archive is dedicated to gathering information for the same purpose the orthopedic surgeon gathers information: to make possible diagnosis and treatment of a problem. Unlike the doctor, however, The Health Care Problems Archive does not attempt diagnosis or prescription. That’s left to the reader. The Health Care Problems Archive does the first part of the surgeon’s job. It collects information and assembles it for study.
You can participate in two ways. First, you can share your experiences of shortcomings with the current health care system. Your writing will be identified only by your state and your profession. No other identifying information will be displayed. Second, you can use the information collected on the site to explore how and where the existing health care system fails. Armed with that knowledge, you can more accurately determine ways to fix or rebuild the current system (remember, in a democracy we are all responsible for diagnosing and fixing systems that don’t work).
How To Join
December 31, 1999
1. Attend the next general membership meeting. The general meeting will be at Community College in the Bonell Building, Room BG16. The Bonell Building is just south of Spring Garden on the east side of 17th street. There is a plaza in front of it that is reached by going down a broad set of stairs (a ramp is available to the left for wheelchairs). A security guard just inside the front door should be able to direct attendees to room BG16. A campus map can be found at http://www.ccp.edu/site/about/campus_map.php#. General membership meetings are held the 2nd Tuesday of each month from 7:00 p.m to 9:00 p.m.
2. Join our Yahoo group (phillyhealth-subscribe@yahoogroups.com) on-line and select if you would like to receive individual emails, a daily digest of emails, or individual emails. Optionally, if you would like to receive individual emails (be aware that this is a high volume list), and don’t want to sign up for a Yahoo ID, you can subscribe to the group via email.
3. Contact us or call for more information on how to volunteer (see address below). Please include your name, address, phone and especially e-mail.
4. Make a donation to support our efforts. No contribution is too small. Please make checks payable to: “HCAP c/o Phila PSR” and mail the checks to:
HCAP c/o Phila PSR
704 North 23rd Street
Philadelphia, PA 19130
Phone: (215) 280-3776
email: macman2@aol.com
Contact Us
December 31, 1999
Healthcare For All Philadelphia c/o Phila PSR
704 North 23rd Street
Philadelphia, PA 19130
(215)-280-3776
Sign Up
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