BUILDING AN ACCESSIBLE, AFFORDABLE, HIGH-QUALITY HEALTH SYSTEM IN AMERICA

WHEREAS, the problems of the American healthcare system continue to intensify and have created a significant crisis in our society; and

WHEREAS, costs continue to rise while access to quality care becomes more difficult for most Americans; and

WHEREAS, healthcare costs are growing considerably faster than inflation, the leading causes of that growth include high costs of pharmaceuticals, hospital care and new technologies. This leads to rising health insurance premiums with projected increases of 15 percent or more in 2002 and similar increases expected in the next few years; and

WHEREAS, the interrelated problems of cost, access and quality will be solved only by systemwide reform that provides universal access to healthcare for all Americans, controls costs and mandates standards that ensure quality care for patients; and

WHEREAS, the quality of care patients receive and the working conditions of healthcare professionals are negatively affected when managed care, insurance companies and government programs reimburse providers below the cost of providing care; and

WHEREAS, this pressure to cut costs on hospitals, nursing homes and home care agencies results in layoffs, unfilled vacancies, short staffing, deteriorating working conditions and an exodus of workers from the health professions; and

WHEREAS, the shortage of nurses and health professionals is leading to a serious crisis in the U.S. healthcare system; and

WHEREAS, the number of uninsured Americans is expected to surpass 45 million by the end of 2002 and is a concern to our members not only for humanitarian reasons but because they and the other insured pay for the care that is provided to the uninsured through higher insurance premiums and other costs; and

WHEREAS, the quality of medical care is a source of grave concern. In a recent report, the Institute of Medicine reported that as many as 100,000 Americans die in hospitals each year as a result of preventable medical errors; the fifth-leading cause of death in America; and

WHEREAS, cuts in staffing and the institution of such practices as mandatory overtime and excessive use of temporary personnel have further eroded patient safety, leading to even more serious concerns about quality; and

WHEREAS, the same problems with quality of care also exist in nursing homes, home care agencies and other places where care is provided; and

WHEREAS, we recognize that the employer-sponsored health insurance system is under attack from those who seek to replace it with defined-contribution plans or tax incentives that shift the burden of health insurance costs to workers and their families; and

WHEREAS, the challenge faced by AFT's local, state and national leaders is to ensure that our members and their families have access to high-quality care at a reasonable cost, and our responsibility is to provide tools that enable them to meet that challenge:

RESOLVED, that the AFT reaffirm its support for the goal of a comprehensive healthcare system that provides universal medical coverage and access to quality healthcare at a reasonable cost. AFT will support and advance programs that move toward that goal and discourage the implementation of programs that move away from that goal; and

RESOLVED, that the AFT call for measures to control the rapidly rising costs of healthcare for families, individuals and employers such as:

• the inclusion of a prescription drug benefit in Medicare, a change that would not only ensure seniors get the pharmaceuticals they require without impoverishing themselves but also would provide the federal government with sufficient leverage in negotiations with pharmaceutical manufacturers to provide lower drug prices for all Americans;

• limiting the extensions of patent protection for drugs in order to encourage market competition and lower costs; and

• encouraging employers and unions to form and/or join regional and statewide healthcare purchasing coalitions or state employee programs, with those plans remaining subject to state and federal regulations; and

RESOLVED, that the AFT call for programs to increase access to quality health-care for all Americans, while pledging to fight programs that would decrease such access. For example, the AFT calls for:

• the expansion of existing public programs, such as Medicare, Medicaid and State-Children's Health Insurance Program (S-CHIP), so that additional population groups can be covered. These programs have well-established claims-processing procedures, low administrative costs and are the key to long-term comprehensive reform to benefit all Americans;

• the transformation of Medicaid "a shared state and federal program that is intended to guarantee care for the poor" into an entirely federal program so that eligibility standards and benefit packages will be consistent and uniform throughout the country;

• conversion of the S-CHIP from a block grant to an entitlement program so that all children can be guaranteed access to needed healthcare;

• the rejection of proposals such as individual medical savings accounts as the primary health insurance as opposed to supplemental flexible spending accounts, defined-contribution health plans and individual tax credit schemes that undermine the principle of shared risk in health insurance systems. These approaches often create higher costs by leaving only the very sick in group plans and threaten the dissolution of employer-sponsored health insurance in America; and

• the AFT will fight efforts to privatize, "voucherize" or otherwise undermine the current Medicare program and will oppose proposals to turn Medicaid into a system of block grants to states, which could lead to such funds being used for purposes other than healthcare; and

RESOLVED, that the AFT call for measures to ensure that its members and their families receive safe, costeffective quality healthcare such as:

• the development and publishing of national practice guidelines by the federal government on effective treatments, particularly for common chronic conditions such as heart disease, diabetes and asthma and that these guidelines be disseminated to purchasers, providers and consumers;

• the expanded use of information technology, including computerized physician order-entry systems to eliminate errors in prescribing and dosage of pharmaceuticals and to enhance coordination of care;

• the development and implementation by federal or state governments of staffing standards and/or workload limitations for healthcare workers to ensure quality healthcare and safe working conditions. Such standards would reduce the exodus of healthcare workers who are leaving because of difficult and unsafe working conditions;

• the passage of federal or state bans on mandatory overtime to improve quality, patient safety, alleviate stressful working conditions and promote retention and recruitment of healthcare workers; and

• the development and funding of education and training programs to ensure a sufficient number of healthcare workers; and

RESOLVED, that the AFT assist its leaders and members in confronting the challenges of the healthcare system by:

• providing educational materials, guidebooks, data and programs on healthcare issues;

• assisting leaders in evaluating their health plans for quality, access and affordability;

• considering the convening of regional and state meetings to share "best practices" and innovative ideas, particularly in the areas of cost containment and collective bargaining;

• working with national coalitions such as the Quality Forum, the Leapfrog Group and others to pursue our mutual goals of improving quality, access and affordability;

• lobbying in support of measures to advance its goals for systemwide healthcare reform and against measures that would undermine quality, access and affordability; and

• considering the establishment of an ongoing AFT national task force on healthcare policy.