Sunday, October 27, 2013

Demanding A Fair Shake From Integrated Delivery Networks

Yesterday morning I had the pleasure of working again with nurses from the SEIU on some grassroots community political action.  This past spring Altoona community members were forced to accept that the Altoona Regional Hospital would be subsumed into the UPMC network, and indeed it has been.  Our local hospital is now officially UPMC Altoona.  Today our group was working on educating people about some newly introduced legislation in the Pennsylvania General Assembly.
Me canvassing with Sue Delozier, registered
nurse at UPMC Altoona

The legislation I'm talking about are two bills that are going to be important for all of Pennsylvania and certainly right now Altoona especially.  The Altoona area is faced with a situation that's bound to become increasingly common around Pennsylvania given the trend of what's referred to as an "integrated delivery network".  Simply, an integrated delivery network is a hospital network that is also an insurance provider like UPMC or Geisinger or Highmark with its Allegheny Health Network.  The problem is the whereas once upon a time you'd have a hospital that wasn't affiliated with a particular insurance provider and so it contracted with multiple providers, now you've got hospitals whose parent networks are doing the negotiating and they're negotiating with their competitors.

Negotiation between competitors is bad enough, but what happens when negotiations break down?  Clearly hospitals have to treat you if you come to the emergency room, but you can certainly get charged out-of-network costs.  The legislation that has been introduced, HB1622 and HB1621 will require integrated delivery networks and hospital-owned physician practices to contract with any willing insurer.  I'm a supporter of this legislation and here's something to share with your Republican friends - so are Republicans.  The primary sponsors are Dan Frankel (D-23) and Jim Christiana (R-15) and John McGinnis (R-79) has already signed on to co-sponsor.  So yes, I now agree with Rep. McGinnis on something.

These bills are really important.  If we're not going to have single-payer universal health insurance then we need laws that mandate that hospitals - and most especially these integrated delivery networks - contract with all insurers because having insurance is pretty useless if your local hospital won't take it.

As a sidenote, this has nothing to do with the Affordable Care Act.  Nothing.  If you here people associating this in any way with the ACA set them straight, because the second you here "Obamacare" this or "Obamacare" that, the conversation has ceased to be worthwhile.  It is a red herring.

Besides talking about HB1622 and HB1621, our group was letting people know that nurses are coming up on their first negotiation with UPMC.  What you're going to hear about in the paper is that the nurses just want community support for their contract as though that's a horrible thing.  Our community should be supporting nurses in their contract negotiations because do you know what they're fighting for?  Safe patient-staff ratios.  Does it benefit nurses if the hospital needs to have a lower patient to nurse ratio?  Sure it does, then they need more nurses.  That ratio, however, also benefits patients.  If you've ever spent time in a hospital you know that having nurse coverage is incredibly important.  Do you want frazzled over-worked nurses that don't have time to learn one patient from the next?  I don't.  Supporting nurses makes sense for our community.
Nurses, community members, and family members who walked the
We should support our nurses because they support us.  When you need support most, you need nurses.  When you're in the hospital the doctors may make the big decisions, but the people taking care of you will be nurses.  When you read in the Altoona Mirror that the nurses are trying to negotiate for a better contract, remember the thing that the Mirror is probably not going to tell you: union nurses are negotiating for more than themselves, union nurses are negotiating for you and your health.