WHEREAS:

AFSCME represents approximately 100,000 workers in public general hospitals around the country; and

WHEREAS:

Public hospitals play an invaluable role in our health care delivery system as the only place where everyone is guaranteed care regardless of ability to pay, with uncompensated care accounting for 29% of public hospitals' inpatient care and 46% of public hospitals' outpatient/emergency room care; and

WHEREAS:

Public hospitals provide specialized services, too costly for most private hospitals to maintain, to the entire community. These include burn units, trauma centers, emergency alcoholism, drug abuse and child abuse centers, neonatal intensive care and poison control units; and

WHEREAS:

The policies of the Reagan Administration have had a disastrous impact on public hospitals and public hospital workers. Medicare, Medicaid and the health block grants have all been cut back, leaving public hospitals to care for the increasing numbers who are refused care elsewhere. The Administration has consistently refused to provide special relief for public hospitals even though allowed by Medicare and Medicaid legislation. The increased numbers of the unemployed, who are also uninsured, are straining the resources of public hospitals, with one survey showing 44% of unemployed patients responding that they had not used the public hospital as a regular source of care before becoming unemployed. These trends subject public hospital workers to unbearable pressures - more work and fewer resources; and

WHEREAS:

State and local governments, also reeling from Reaganomics, have been in no position to substantially increase their support of public hospitals. Since 1981 state and local governments have lost $42 billion, or approximately one-fifth, of their federal aid. Unemployment has reduced local revenues to the point where 39 states project fund balances below 5%; and

WHEREAS:

Many public hospitals occupy outdated physical plants that are especially costly to maintain or that need to be replaced. Reliable estimates put the capital needs of public general hospitals at a minimum of $30 billion for the 1980s. This situation makes public officials especially receptive to takeover bids by for-profit chains; and

WHEREAS:

Public hospitals have kept their inflation rate well below that of the hospital industry as a whole and public hospitals have managed their resources efficiently. Public hospitals have experienced the largest decrease in length of stay, and the only increase in occupancy rates among all classes of hospitals in the nation's 52 largest cities; and

WHEREAS:

Public hospitals are major employers of women and minorities and provide jobs in communities which offer few opportunities for other employment.

THEREFORE BE IT RESOLVED:

That AFSCME continue to lead the fight against Federal and state cutbacks in health care programs and that AFSCME continue to work with the National Association of Public Hospitals and others to get special relief from the Federal government for public hospitals; and

BE IT FURTHER RESOLVED:

That AFSCME continue to work actively for new programs targeted to those without other health insurance, such as health insurance for the unemployed and child health assurance programs; and

BE IT FURTHER RESOLVED:

That at the Federal and state level, AFSCME promote all-payor hospital rate-setting systems which include a mechanism for funding indigent care; and

BE IT FURTHER RESOLVED:

That AFSCME work to influence additional changes in healthcare financing, including controls over capital expenditures, so that they are most advantageous to public hospitals; and

BE IT FURTHER RESOLVED:

That AFSCME seek to eliminate the legal advantages that for-profit health care facilities enjoy over publicly-owned facilities including the return on equity, depreciation allowances and tax breaks, allowances and tax breaks for interest expenses and for other acquisition costs.

SUBMITTED BY:

Virginia Diogo, Delegate, Local 257
Council 57
Oakland, California