Back to issues, thank goodness.
Chaka Fattah has issued his plan for a healthier Philadelphia. We read it thoroughly.
It's quite broad, though there is plenty it doesn't do, and if he's elected, he's probably already overcommitted his administration's time (between this and his lets-meet-a-lot ethics plan).
That said, this is a big statement. There are some very cool points. Our favorites:
*Fattah proposes covering all city workers, including unionized employees, through a single insurer -- which would be selected by a competitive bidding process. He points out that over the last five years, Philly has reduced its work force by seven percent, but its health insurance costs have increased by 60 percent -- and that Philadelphia’s health care cost per employee was higher than that of most other major cities. He also points out that joining one plan would save a lot of administrative grief for unions.
This contract would include performance criteria (I would hope so) and prefer insurers who would create Philly jobs, by being based here (woo-hoo for Cigna, Independence Blue Cross and United HealthCare!) or do back-office work here. The plan would also invite the School District of Philadelphia, the Community College of Philadelphia and other large employers in the region to join the purchasing pool as well -- another good idea.
*He has this neat idea to provide every uninsured Philadelphian with an annual check-up. How? Asking doctors and nurse practitioners -- starting with the Pennsylvania Medical Society -- to do them for free. He wants to pair this with screening to see if the patients are eligible for additional coverage. "The city’s hospitals already provide free emergency health care to those who cannot afford to pay," he said in his plan. "While this is valuable, it is also important to provide for the most basic medical assistance to residents as a preventive measure." At this point, we can start the countdown to hear from all those with reasons that this won't work. However, I can't help but think that this seems doable. If the city could pull it off, what a huge step forward.
*He wants to explore incentives to keep doctors in Philly. The malpractice rates here have cost us both doctors and medical options. (Please feel free to disagree with this point in the comments, where I will ask you how many maternity wards in this city are no longer delivering babies.) Fixing the reasons that malpractice rates are so high is unrealistic -- but maybe we can change the economics another way, through incentives of some kind. Teachers who serve in places that struggle to find teachers get breaks on their student loans (same for doctors, actually). How about something like that?
*"Appoint a strong permanent executive to head the Department of Public Health." 'Nuff said.
*Target diseases that affect Philadelphians, including HIV/AIDS and asthma.
*Build on and expand the work of the Nurse-Family Partnership. I promise this: If Chaka Fattah is elected, I will watch to see that he does at least this. If you need to know why, check out Philadelphia Safe and Sound's yearly report of the well-being of children and youth in our city. Out of every 1,000 live babies born in our city, 10.5 died in 2004 (the last year data was available) -- which is actually a small improvement. And the rate of low-birth-weight babies is GROWING in our city.
Fattah's report, like his ethics plan, is large and sometimes seems unworkable -- can we really ensure that the struggling city health care centers have night and weekend hours, much less lead a city-wide public health campaign targeting one disease per month?
And there is much that he doesn't do -- this wouldn't expand health insurance programs, for example, just make sure we get all eligible people into programs that exist now.
Still, a ambitious and thought-provoking plan.
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