By Marty Hittelman, CFT Senior Vice President
The CFT and other education labor groups have joined with administrative and school board organizations in the Education Coalition for Health Care Reform to find a way to stabilize costs while increasing quality. The group is determined to address the systemic reasons for high cost and low-quality health care.
We are committed to shifting from just paying higher prices to joint action against industry price gouging and poor-quality health care. CFT Field Representative Greg Eddy and I have been representing the CFT at these joint labor-management meetings.
The joint labor-management committee began meeting in December of 2004 to educate ourselves on the causes of the problems, possible ways to address them, and what best practices are elsewhere. We discovered that the United States has the most costly healthcare system in the world but only ranks 37th in the world with regard to healthcare quality. In 2002 the United States spent $5,267 per capita on healthcare. The next highest country was Switzerland at $3,445. This is, in part, due to the lack of a civilized approach to healthcare (a quality single payer system) in the United States.
We learned from an Institute of Medicine study that from 44,000 to 98,000 Americans die each year as a result of medical errors — equivalent to one jumbo jet crash each day. We learned of great discrepancies in the cost, success, and frequency of medical procedures from one location in the state to another and from one hospital to another. We found that high prices do not correlate with high quality. We learned of the increased consolidation in the healthcare industry that has led to more clout on the part of providers to demand and get higher prices.
We also now understand how poor quality care leads to higher costs in the long run. For instance, the group found that patients get treated according to clinical guidelines only about 50 percent of the time. According to the studies and reports we examined, there are significant differences in infection, complication, and mortality rates across hospitals and areas of California. Treatments and types of surgeries often depend more on how many specialists work in a hospital than on the condition that brought in the patient. There are three times as many heart surgeries in some hospitals than there are in others, all other factors remaining the same. In one county they say that if you’re a woman over 20 and haven’t had a hysterectomy you’re a tourist. When time and money have to be spent to correct misdiagnosis, mistreatment, and mis-prescription, the costs obviously go up.
We are now at a point where we can begin to educate both labor and management as to the real causes of increased costs and how they can be addressed through joint efforts. One explicit goal of the working group is to gain efficiency and cost savings by rating the hospitals and bringing people to the good ones. Another shared goal is to stop shifting costs to members of our bargaining units. We are after systemic change, rather than blaming the patient.
The CFT has already scheduled several presentations including a workshop at our convention in March. The joint committee will attempt to create a consistent message in collective bargaining about healthcare coverage and unite labor and management to demand better prices. We need to build our collective might so that we can, together, achieve substantial healthcare industry reform and transparency.
In the short run, it will be about insisting on data from hospitals concerning whether they are following quality procedures and how they are performing in providing quality care. It will be about building regional and state purchasing coalitions.
In the long run, it will be the enactment of a single payer health care system. We are determined to be in this for the long haul.