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PUP Rallies For Health Centers To Increase Coverage
By: Jenny DeHuff , The Bulletin
Philadelphia - Members of the Philadelphia Unemployment Project (PUP), For Our Common Good, LLC (FOCG) and local union members picketed at Philadelphia Health Care Center No. 2 at Broad and Morris streets yesterday in an effort to inform the public and city of what they believe to be inadequate health-care coverage for the city's working poor.
"If we want to be a working city again, if we want more people to have jobs and stay on those jobs, we need them to be healthy. The simple truth is that fewer and fewer jobs come with benefits anymore, and most of the uninsured are employed," Irma Sumler, PUP member and health center user said.
PUP began in 1975, and is a membership organization of unemployed and low-wage workers who advocate fairness and economic justice for the jobless. They recently released a report called "Waiting: 3 to 5 Months for First Appointments at District Health Centers," which addressed issues of low-wage workers' inability to get a timely doctor appointment. It compiled the results of several experiments PUP members conducted by making appointments at various clinics two different times throughout the year, once in the summer and again in the fall. The study showed that an uninsured Philadelphia resident would typically have to wait as many as five months before an initial doctor visit. Exactly two-thirds of the appointments made fell under this category.
"This problem is not getting any better, and we all know that employers are moving away from providing benefits and providing less adequate benefits when they do," Andre Butler of PUP said.
He added that insurance programs for the uninsured in the state, such as adultBasic and Blue Cross Special Care, fail to provide prescription coverage. Here is where district health centers aim to fill this gap in public health care needs.
Sumler said that the "Waiting" report maintained goals of keeping district health centers open every night until 9 p.m., and having regular hours on Saturdays.
While there are 10 public health centers in the city, many Philadelphians are forced to wait as many as five or six months for an appointment with a doctor. Walk-ins are welcomed, but services are not always available at the time of arrival.
According to the Community Health Database, there are approximately 140,000 uninsured people in Philadelphia. National statistics show that 82 percent of the uninsured live in families headed by an employed person and 59 percent of those persons work full-time. FOCG representatives said the city is at a loss because it has not developed a universal health care model.
Sue Rosenthal, chair of the Board of Citizens for District Health Center No. 10, spoke on behalf of the board members of all city health centers.
"We believe this increased waiting period is due not only to the increase in patients seeking health care, but to a failure on the part of the city's personnel department to fill the staff positions agreed to in the new budget. Additional funding was available as of July 1, but little or nothing was done to test, create lists or hire the needed persons."
Currently, each district health center has one day of the week with hours of operation later than 4:30 p.m. These nights vary according to the district. Only Health Care Center No. 2 has Saturday hours, from 8 a.m. to noon.
Dave Mora, vice president of Local 2187 of the American Federation of State, County and Municipal Employees (AFSCME) said:
"Despite the drop in population in the city of Philadelphia, the number of working poor has dramatically increased. The number of jobs that provide adequate health insurance for the citizens of Philadelphia has decreased."
Mora said many city residents rely heavily on public health centers for basic coverage, but over the years, increased pressure to cut the city budget and lower taxes caused the center to be inadequately staffed.
Carl Grant, a PUP board member donned an orange shirt reading "First Things First: Jobs" and said he, too, would like to see more health coverage for the working poor.
"Let's spend some of that surplus on the health centers instead of waiting three to five months for an appointment. I would rather see the city in debt and providing these services than the city having a surplus with people not being helped."
No one from the district health centers were available for comment at press time.
Posted on Mon, Jan. 15, 2007
Urban Warrior | Patients put on hold at city health clinics
MARGOT MENEZES was feeling pretty good about herself.
She found a job in November, running a cash register in a retail shop, after being unemployed for four years.
The job doesn't provide health care benefits and her state-provided insurance ended when she stopped taking welfare. So Menezes called one of the city's nine Neighborhood Health Centers to set up a routine check-up.
No problem, they said. We can fit you in sometime in April.
You read that right - a six-month wait to see a doctor in a city health center.
Should Menezes be forced to look back with fond nostalgia for health care from welfare?
"This is very upsetting to me. On one hand, I want the health coverage" of welfare, she said. "On the other hand, I want the independence" of having a job.
This is the spot where I usually suggest that the city should seriously consider doing a better job of caring for its residents, even if it means spending more money.
The city agrees.
To be more precise, City Council and Mayor Street agreed last May to spend $1.8 million to add staff to the Neighborhood Health Centers in an effort to cut down on the wait time for patients.
Council wanted the staffing. Street wanted Council to approve his proposed city budget. So he gave in on the demand.
That was eight months ago.
The process here is not complicated. The city's Personnel Office, which reports to Street, works with the Department of Public Health, which also reports to Street, to develop a list of people who can be tested and then hired for health center jobs.
Last Tuesday, I asked Street's staff and the Department of Public Health to explain the wait for more staffing to end the waiting at the Health Centers. Then, naturally, I waited for answers.
While I waited for Street's people to get their stories straight, I perused a report released last week by the Philadelphia Unemployment Project. A group of PUP volunteers and staffers made 44 calls to Health Centers in July and October, seeking first-time appointments to see how long the wait would be.
Six callers were told the wait for an appointment was a month. Eight were told two months. Twelve were told three months. Eleven were told four months. Four were told five months. Three were told six months.
PUP is calling for more staffing and extended hours for evenings and weekends so that people working without health benefits don't have to skip a day on the job to see a doctor.
Instead of adding staff at the Health Center, PUP officials point out, the city has left posts vacant as employees leave.
City Councilwoman Marian Tasco, who helped push for the added money for Health Center staffing last year, wants to know why that is.
"It really is unfortunate," Tasco said. "We fought for many years to have the health centers open in the evening and have adequate staffing so the clients wouldn't have to wait so long."
Back to Mayor Street's people - after asking on Tuesday morning and Wednesday afternoon for information about staffing at the health centers, Street spokesman Joe Grace promised on Thursday that Health Commissioner Carmen Paris would call that day to answer my questions.
I'm still waiting.
So Street's staff can't or won't explain why they can't or won't spend the money to boost staffing at the Health Centers.
What are we to make of that?
Here is my best guess: An administration that so often speaks of caring for the most vulnerable in our city has grown fat and lazy in the lame duck days of the mayor's second term and is now coasting listlessly toward the end.
Posted January 25, 2007
Attention to health benefits is welcome
Analysts doubt Bush's plan will get far, but all agree that something must be done.
By Jane Von Bergen
Inquirer Staff Writer
Robert Basile employs 45 people at his real estate development company in a rural corner of Berks County, not far from the Montgomery County line.
John Dodds works with low-wage earners and the unemployed in Philadelphia.
Different worlds, but the two men agree that it's important for the president to pay more attention to health care.
In President Bush's State of the Union address Tuesday evening, he talked about providing more health-insurance coverage using tax credits to help finance affordable plans through private insurers. Also, employees whose health benefits exceed a federal limit would be taxed on the difference.
Some analysts doubt that the plan will get anywhere - partly because it would help only three million to five million of the 46 million uninsured Americans and partly because the Democratic majority in Congress has different ideas about how to handle the problem.
But everyone agrees that something needs to be done.
"It's the most out-of-control expense category in our overall operating budget," said Basile, a principal in the Basile Corp., of Douglassville. Also, it is a distraction. "We have to spend a lot of time on it," he said.
"It's interesting that he is finally beginning to pay attention to the issue of the uninsured," wrote Dodds, director of the Philadelphia Unemployment Project, referring to the president. Dodds participated in an Inquirer online chat yesterday.
"The question is, will giving less coverage to the high end of the insured reduce health-care costs?" Dodds wrote.
Medical economist Mark Pauly, a Wharton School professor, another participant in the chat, said: "The most interesting part is the proposal to change the tax treatment of health insurance by the well-off insured that is intended to reduce their levels of medical insurance and therefore medical-care spending.
"This addresses what economists think is the easiest distorted incentive to correct," he wrote. Employees, he wrote, tend to choose the most expensive insurance plans when they are not taxed on them. Health benefits now are not taxed.
Tax breaks are not the point for the unemployed and uninsured low-wage workers, Dodds said.
"They can't afford the monthly premiums, and they tend to be in low tax brackets already," he said. The working poor who are uninsured "are living paycheck to paycheck. Individual policies can be denied due to pre-existing conditions."
Glenn Alvarez, a benefits analyst at Lincoln Financial Group in Philadelphia, said he thought that whatever the president proposed would be dead on arrival in Congress.
Alvarez attended a breakfast conference yesterday at the Four Seasons hotel held by Mercer Human Resource Consulting L.L.C. on how to reduce health-care costs by improving employees' health.
"The benefits package is part of our tool to recruit and keep employees," he said. "We have to be competitive with everyone in the market. But, at the same time, we have to watch the costs, so we're walking a tightrope."
Paul Fronstein, director of health research and education at the Employee Benefit Research Institute, a private nonprofit research group in Washington, said he doubted whether Bush's proposals would come to fruition.
But if they did, he said, "it would be the end of employment-based benefits as we know them."
Employers would rather give employees the money and let them shop on their own, he said. The result would be that the healthiest employees would get the best plans and the sickest ones, whose costs are now covered when their health risks are spread over a larger group, would find it difficult to obtain affordable insurance.
Still, he said, employers would be glad to have it be someone else's problem. "Employers have been struggling with health-care costs for years," he said. "They are tired of the headache."
Posted January 21, 2007
Like a good neighbor
A woman shows a personal way to insure the needy.
By Monica Yant Kinney
Inquirer Columnist
Susan Martel and Ed Rendell don't know each other, but they're soul mates on health care. Both think it's criminal that Pennsylvania is home to 767,000 uninsured people.
The governor wants to use his political mandate and muscle to slap an insurance card into the hand of every one of them. Martel, a Germantown therapist, is spending her own money to do the same for one man.
Martel calls it paying her "civic rent." And in a society as economically and socially splintered as this one, it's long overdue.
The politician and the part-time philanthropist couldn't be more serious about their promises.
Rendell - the state's most famous junk-food junkie, with a Wawa hoagie named after him - even pledged to lose 25 pounds. So while he's infuriating smokers and hospitals with his bans and plans, at least they'll know he's feeling the pain, too.
Martel, meanwhile, is warning friends and family not to expect anything from her for the next two years. That's how long she and her partner, Cathy Barlow, have pledged to pay the health insurance of Whittier "Butch" Dow, a 56-year-old Philadelphia man with cerebral palsy who can no longer work.
"Anybody can do it," Martel says of the $270 monthly commitment.
"We're far from wealthy. I don't buy gifts. I don't even buy Hallmark cards. I don't write big checks. This is it."
Strange as it seems, Martel is not the first person to ring up the Philadelphia Unemployment Project wanting to sponsor a stranger.
Usually, it's help with housing. But in a city where 140,000 lack health insurance - more than half of them being the hardworking poor - the notion of sharing the wealth to aid someone's health is a ripe one.
"She's hoping to inspire others to take on this terrible problem one person at a time," PUP director John Dodds says. "We look at it as trying to change the system."
To start, PUP wants City Hall to catch a clue, beef up staffing at public health centers, and keep them open nights and weekends, when working people could see a doctor without fear of being fired. Now it can take up to six months to get an appointment, if they can swing the day off to go.
Dodds is encouraged by Rendell's push to leave an insurance-for-all legacy, especially his offer to help small businesses buy low-cost plans for their employees, sharing the burden with workers.
That makes a lot more sense than forcing the poor to rely on the most expensive care in emergency rooms and telling a guy like Dow - who was insured at work for decades, until his body gave out on him - he has to wait two years for coverage now that he's officially disabled.
"That's absurd," Dodds rants. "What's the goal? That maybe he'll die before he qualifies?"
I met Martel 10 years ago when I was assigned to write a feature on her. She was a Main Line divorcee developing an ultra-personal approach to philanthropy - give what you have, when you have it, to someone who needs it.
First, she lent a home she owned to a family of Vietnamese refugees. Then she saved for a year, bought a $4,500 rowhouse in North Philly, and handed the keys to a single mother living in a tent. Later she went without, using her mad money to fix people's roofs.
"We're all poor," Martel told me back then. "Does my neighbor know my needs? I have a bathroom, a hot shower and a job, but I'm isolated. I have poverty of spirit."
Butch Dow only recently felt that. He has a master's degree and had a long resume before his body fired him.
Growing increasingly dependent on a motorized scooter, Dow reluctantly applied for disability. He gets a monthly check, but no insurance.
Dow knew Dodds, and Dodds knew about Martel and Barlow's offer, and that was that.
"They really did humble me," Dow says, "and I'm not easily humbled."
Now it's up to Rendell to work his magic for the masses. Dow's longtime sweetie is a certified nurse's aid, earning $8 an hour for backbreaking work. She could do better at Starbucks. And there she'd get insurance.
Posted January 22, 2007
Urban Warrior | Street's health-center tune off-key
By Chris Brennen
WAS STARTING to wonder what takes longer - getting an appointment at one of the city's overcrowded and understaffed Neighborhood Health Centers or getting Mayor Street's administration to explain the long wait.
But then Carmen Paris, interim commissioner of the Department of Public Health, called, nine days after I left messages asking about a new report from the Philadelphia Unemployment Project.
The project's report shows that first-time patients are waiting four, five and sometimes six months to get an appointment at one of the city's nine health centers.
I'm guessing Paris finally got on the phone because I asked her boss, the mayor, last week to explain why his administration was sitting on $1.8 million set aside in the city budget last May to add staff to the health centers.
City Council, in a budget deal with Street, demanded the added staff to reduce the wait time for health-center appointments.
Street responded last week with his standard lecture on how Council has to find ways to pay for the things it wants.
That's a bogus argument.
The mayor agreed to spend the money because he needed Council to approve his budget.
Street also complained that it takes several months for the city to hire employees. "We're not the private sector," he said. "We can't just bring people on and put them on the payroll in an instant."
Another bogus argument.
Guess what would happen if hiring health-center staff was a priority for Street? The jobs would be filled by now.
Finally, the mayor said he would keep his promise.
"Any budget deal we make, we intend to keep," Street insisted.
Time will soon tell if that too is a bogus argument.
The Department of Public Health, like all city agencies, must make requests for new positions, even if the money is set aside in the budget to pay for them.
Paris said her department requested about 70 new health-center jobs, half in July when the city's fiscal year started and half in October.
If the new health-center workers aren't on the job by the end of June, when the city's fiscal year ends, then the department has to restart the hiring process with new requests for the positions.
And the waiting continues.
"That is painfully correct," Paris told me last week. "That is exactly what happens."
So how goes the hiring?
Not so good. Of the 70 new positions, about 70 are unfilled.
Paris said her department has managed to fill about 25 existing jobs that had been vacant since staffers left.
So that's a start.
And Paris points out that she's shopping around for health-care positions in high demand - nurses, dentists and pharmacists.
"It is very challenging for us in the Health Department to recruit staff," Paris explained.
The patients at the health centers are often people known as the "working poor," holding low-paying jobs that don't provide health insurance. More staff at the health centers, along with cutting down on the wait time, would extend hours in the evenings and on weekends so patients would not have to miss work to see a doctor or dentist.
"Our uninsured patients have so few options for care," Paris said. "It is very, very hard to meet the need."
Which brings me back to the mayor, now winding down the end of his second term with the same rhetoric as the opening days of his administration.
You know his song and dance - we should care for the most vulnerable in our city, the children, the elderly, the poor, the people desperately trying to make it who need a helping hand.
It's a nice tune. Too bad his moves don't match the
lyrics.
Posted February 19, 2007
Urban Warrior | Health centers are getting the staff help they need
PUP Health Committee wins Increase in City Health Center Staffing
WHEN YOU'RE STUCK in a quagmire - like waiting six months for a doctor's appointment - a little progress goes a long way.
So patients and employees at Philadelphia's nine overworked and understaffed Neighborhood Health Centers can find some solace now that the city is, at long last, getting serious about hiring more employees.
The Department of Public Health and the city's Personnel Department asked about 30 people who had been pre-approved for hiring to perform clerical work to come to the Municipal Services Building Saturday for job interviews. The goal is to hire about a dozen clerks for the health centers and have them on the job in about two weeks.
Health Commissioner Carmen Paris recently met with the city's personnel director to speed up hiring for the health centers, her spokesman, Jeff Moran, said on Friday. "The personnel director recognized the critical needs at the centers and agreed to expedite the process," he added.
If this goes as planned, there will be more people around to help schedule appointments for people to see doctors and dentists at the health centers, which serve the working poor with jobs but no health insurance.
Now all we need is more doctors, nurses, dentists and other skilled health center staff.
Here is why that is important: The Philadelphia Unemployment Project last month released a report showing that first-time patients were waiting four, five and even six months for a health-center appointment.
City Council knew about the problem and struck a deal last May with Mayor Street to try to solve it. Street wanted Council to approve his budget. Council wanted Street to spend $1.8 million to hire 70 health center staffers. Both sides got what they wanted.
Except not really.
The Department of Public Health didn't start filling those jobs when the money became available on July 1. Half the city's fiscal year, which ends on June 30, flew by with the new staff still not hired. That's a problem because approved jobs not filled during the fiscal year have to be created all over again in the city budget for the following year.
A larger, more looming problem is that the Street administration told most city agencies in December to start the budget process for the 2007-08 fiscal year by finding 2.5 percent in spending to trim.
Street's staff suggested the Department of Public Health could accomplish that by cutting the 70 unfilled jobs.
A month later, the mayor told me he had every intention of keeping his budget deal with Council.
Do the math and see if Street's claim adds up for you.
As of last week, about 16 people were in the process of finally being hired for health-center jobs - five nurses, a dentist and a dental technician, a clerk and some custodial workers.
The Department of Public Health put a rush on the nursing jobs, approving them as "provisional appointments," which means they can start working and then pass city tests to prove they have the skills for the jobs.
With those 16 jobs and the 12 that were hopefully filled on Saturday, the Department of Public Health still hasn't met half of Street's obligation.
The quickened pace on hiring didn't happen until the PUP report came out and this column suggested it might be time to look past Street's time in office to the next mayor to solve the problem.
Still, the health centers hiring could signal a positive change.
"Certainly I think that's a step in the right direction," said City Councilwoman Marian Tasco, who chairs the committee overseeing the Department of Public Health.
"You have the clerks to make the appointments but do you have the professional staff to handle the appointments?"
Posted March 2, 2007
Most Support U.S. Guarantee of Health Care
By ROBIN TONER and JANET ELDER
A majority of Americans say the federal government should guarantee health insurance to every American, especially children, and are willing to pay higher taxes to do it, according to the latest New York Times/CBS News poll.
While the war in Iraq remains the overarching issue in the early stages of the 2008 campaign, access to affordable health care is at the top of the public’s domestic agenda, ranked far more important than immigration, cutting taxes or promoting traditional values.
Only 24 percent said they were satisfied with President Bush’s handling of the health insurance issue, despite his recent initiatives, and 62 percent said the Democrats were more likely to improve the health care system.
Americans showed a striking willingness in the poll to make tradeoffs to guarantee health insurance for all, including paying as much as $500 more in taxes a year and forgoing future tax cuts.
But the same divisions that doomed the last effort at creating universal health insurance, under the Clinton administration, are still apparent. Americans remain divided, largely along party lines, over whether the government should require everyone to participate in a national health care plan, and over whether the government would do a better job than the private insurance industry in providing coverage.
Looking ahead to the presidential campaign, 36 percent of Americans polled said they had confidence in the ability of Senator Hillary Rodham Clinton, Democrat of New York, to “make the right decisions on health care,” while 49 percent said they were uneasy about her.
But Mrs. Clinton retained the confidence of nearly 6 in 10 Democrats on the issue, despite the politically devastating collapse 13 years ago of the national health initiative she helped develop early in her husband’s presidency.
The poll helps explain why health care already looms large in the presidential campaign, and in statehouses from California — where Gov. Arnold Schwarzenegger, a Republican, has proposed a sweeping coverage plan — to Massachusetts, now instituting a program passed under Mitt Romney, the former governor and current Republican presidential candidate.
John Edwards, the Democratic presidential candidate and former senator from North Carolina, recently unveiled his own attempt at a consensus plan, one that would require everyone to have insurance and require employers to provide it or pay into a fund that would do so. Nearly 4 in 10 said that was a good idea; nearly half said they were unsure.
While Democrats are traditionally strong supporters of expanding health coverage, this survey found many Republicans and independents in agreement.
“I think everybody should have some kind of health care available to them,” said Diane Manning, 66, of Vancouver, Wash., who described herself as an independent.
“I don’t necessarily think that socialized medicine is the answer, but I think everyone should have that right,” said Mrs. Manning, who participated in the poll and agreed to a follow-up interview. “And there are so many people that don’t.”
Nearly 47 million people in the United States, or more than 15 percent of the population, now go without health insurance, up 6.8 million since 2000.
The poll also found overwhelming support behind the Children’s Health Insurance Program, which covers many low- and moderate-income children and is up for renewal in Congress this year. Eighty-four percent of those polled said they supported expanding the current program to cover all uninsured children, now estimated at more than eight million. A similar majority said they thought the lack of health insurance for many children was a “very serious” problem for the country.
The nationwide telephone poll of 1,281 adults was conducted Feb. 23- 27, and has a margin of sampling error of plus or minus three percentage points.
The poll found Americans across party lines willing to make some sacrifice to ensure that every American has access to health insurance. Sixty percent, including 62 percent of independents and 46 percent of Republicans, said they would be willing to pay more in taxes. Half said they would be willing to pay as much as $500 a year more.
Nearly 8 in 10 said they thought it was more important to provide universal access to health insurance than to extend the tax cuts of recent years; 18 percent said the tax cuts were more important.
“I wouldn’t want to pay a lot of taxes, but if it was spread out and everyone paid their fair share, it would be fine,” said Don Galvan, 50, a computer programmer from Ringwood, N.J., who considers himself an independent. “Everybody should have some kind of medical coverage, in case they or their children get sick. Especially children.”
Most participants said they were satisfied with the quality of their health care, but there was widespread concern about costs. Nearly half of those with insurance said an employer had cut back on benefits or required them to pay more for their benefits in recent years.
A quarter of those with insurance said someone in their household had gone without a medical test or treatment because insurance would not cover it. Six in 10 of those without insurance said someone in their household had gone without care because of the cost.
More people now see guaranteeing health insurance as important than did so at the end of the Clinton efforts in 1996. At that time, 56 percent polled said it was the government’s responsibility to do so, and 38 percent said it was not. In the current poll, 64 percent said the government should guarantee health insurance for all; 27 percent said it should not.
Moreover, an overwhelming majority in the current poll said the health care system needed fundamental change or total reorganization, just as they did in the early 1990s, when a deep recession and soaring health care costs galvanized the public and spurred the Clinton drive.
But now, as then, this concern did not translate into a consensus on what should replace it.
One question offered a choice between the current system and a national health insurance program covering everyone, administered by the government and financed by taxpayers. Thirty-eight percent said they preferred the current system, 47 percent the government-run approach.
Robert Blendon, an expert at Harvard on public opinion and health, said politicians had to find some compromise between these philosophical divisions on the role of government, which are deep-seated in American culture, or “we’re going to have the same train wreck we did before.”
The Clinton plan, itself an attempt at a compromise, collapsed under attacks from an array of interests, including the insurance industry, which warned that the plan amounted to a big government takeover.
Mr. Blendon noted that many politicians were seeking a blend between the private market and the government in their health plans.
Megan Thee, Marina Stefan and Marjorie Connelly contributed reporting.