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Friday, October 17, 2008

Crisis in Health Care

Reader Jim Araby has written a fine piece of journalism on the health care crisis in our country. “As any Sonoma county employee can tell you, the volatility in health care is not good for the average American. And just like the problem we are facing in seeking resolution to our financial crisis, we have political leaders grasping at straws to come up with a solution.-J.A.

Being self-employed, I fall into the category of one payer, one plan, but have recently been rescued by an insurance adviser who is enrolling me in a group plan that will save me $200 a month. Whether you are an employee with an employer provided plan or an individual, if you own a home you have to have health insurance or risk losing everything you've worked so hard to obtain. Rock and a hard place. Thank you Jim for writing on this increasingly important topic.

The Crisis in Health Care
By Jim Araby

Before last week’s meltdown of the financial markets, the crisis in health care was likely the top priority for many voters. We had begun to hear about each of the presidential candidate’s health care plans and the differences amongst them. Whether it was Obama’s plan to cover 30 million uninsured and the costs associated with it or McCain’s plan to cover 5 million uninsured and create incentives that would shift more responsibility to the individual, the debate was heating up. Then the public dialogue around the crisis in health care melted away along with the dividends of the high flying stock trader as the financial market crashed.

But let’s not fool ourselves; this crisis has not gone away. It may have temporarily faded to the back pages of most newspapers and blogs, but the fundamental problems still exist. And if our health care system is to avoid the same fate as the banks that were peddling mortgage backed securities, we need to act now. As any Sonoma county employee can tell you, the volatility in health care is not good for the average American. And just like the problem we are facing in seeking resolution to our financial crisis, we have political leaders grasping at straws to come up with a solution. The only solution that they can see is to absolve themselves from the
responsibility of fixing this crisis.

An example is what the Sonoma County Board of Supervisors did last month. They decided that they were going to reduce their obligation to their employees. They did this by cutting the amount of money they were going to pay to insure the workers and retirees of the county and give them a stipend. They did this, in spite of the fact that they were contractually bound to do the opposite. They now wait with bated breadth that the federal government will come in and save them. Well, now that we are going to commit $700 billion to bailout the Wall Street brokers and banks, in addition to the billions committed to the Iraq war, somehow I do not see that happening anytime soon.

The numbers are familiar; there are over 48 million people in the US who are uninsured, 6.5 million in California, and over 50,000 in Sonoma County. Add in the amount of underinsured and the above numbers almost double. As less people every year have access to healthcare, costs continue to increase by double digits. The California Healthcare Foundation estimates by 2016 that healthcare will make up 17% of our Gross Domestic Product. The preceding numbers are dramatic, but what’s even more dramatic is the amount of profits that are being made in spite of this crisis around access to healthcare. In 2006 the combined total of profits made by the California healthcare industry was $3.6 billion. Digest that for a moment, $3.6 Billion! At the same time that patients are losing access to healthcare, hospital and nursing home corporations are making money hand over fist.

And despite these incredible profit margins (some as high as 8%!), turnover rates in nursing homes average 60%! In California’s health care industry we have RN vacancy rates at 16.1% and Respiratory Therapist vacancy rate at 20%. High turnover rates and use of temporary staff by nursing homes and hospitals lead to higher likelihood of severe health violations that result in bad care which then increase the cost of giving that care. In addition to the effect on patient care the industry spends billions of dollars ($4.1 billion in 2006) on recruitment and retraining new staff because of high turnover rates. Do you think that hospital executive takes a cut in his pay? No, they pass that cost to us, the patient/consumer.

So what can we do? The problem we face is not lack of money in the system; it is the way the system is organized. Many people, especially health care workers across the state are already doing something. Health care workers are forming unions and creating alliances with patient advocacy groups and other community leaders to create structures that allow them to work with progressive minded employers. And if the employers do not want to play, they negotiate and struggle until they do.

When hospitals and nursing homes invest in their workforce they reduce their long-term costs and that savings is passed off to us. The top 100 hospitals pay their employees about $3,000 more a year. They use 35% less temporary labor and use 14% less OT. It is no coincidence that most of these hospitals have workers that are part of a union that gives them the ability to have a voice and advocate not only for themselves but their patients. They are not waiting for the government to act, but are forcing their employers to act with them. They are forcing the industry to realign its priorities from making immense amounts of profit to redirecting the additional resources back to where it matters most, with the caregivers and patients.

This year over 75,000 caregivers across California are negotiating with their employers as a part of United Healthcare Workers West to raise the standards of hospitals, nursing homes and clinics. Healthcare workers are doing this so that we can have a more functional health care system. Kaiser is a good example of how employers work with their patients and unionized workers to create a contained functional system. But the fact of the matter is Kaiser and other like systems can’t do it alone. They need your help, so we can create mutual accountability and action to reorganize our health care system, because we know the federal government is not going to do it and our local elected leaders are not either.

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