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PROMISES MADE, PROMISES BROKEN:
A Few
Reasons Not To Support Mayor Williams's Efforts To
Contract With Greater Southeast Community Hospital
Promise Made #1:
Expanded Access to Heath Care.
In his 2001-2001 Policy Agenda, Mayor Williams wrote, "I am committed
to ensuring access to quality health care to every man, woman and child in
the District -- no matter their ability to pay."
Promise Broken: Fewer
individuals will be covered under the proposed contract.
- According to the
latest data available, about one-third of all uninsured individuals
have incomes above 200 percent of the Federal Poverty Line, and the
contract does not provide coverage for such individuals (Exhibit A,
Clause 1).
- There are an
estimated 80,400 uninsured residents in the District. Therefore, at
least 24,000 DC residents who currently have access to the PBC Health
Care System (comprised of DC General Hospital and the six neighborhood
health clinics) will not have access to health care under Mayor
Williams's plan.
Promise Made #2:
Expanded Number of Services.
In a March 28 press release, Mayor Williams wrote, "I'm building a
better health care system."
Promise Broken: The
flawed contract allows Greater Southeast Hospital to provide fewer
services.
- The Contract's
estimates of how many residents will use its services and,
consequently, its cost estimates, are based on the present level
provided by PBC, guaranteeing than an increase will not occur within
the budget estimates.
- Clause 1.10.8
eliminates corrections health care once the money is gone: "The
Contractor shall not be required to provide Corrections Health Care
Services or Administrative Services in excess of the amounts set forth
in Exhibit G."
- Clause 3 to
Exhibit A states, "[T]he Contractor shall not be required to
provide any health care services that were not previously provided by
the PBC ...."
- Emergency room
care will be "consistent with the level and scope of emergency
room services provided by the PBC" (Clause 4.3.1).
- Ambulatory care
will be "consistent with the level and scope of services provided
by D.C. General Hospital ..." (Clause 4.4). Emergency dental
services will be "in the same scope as provided by the PBC."
(Clause 4.5).
- The Contract does
not guarantee its own pharmacy services: "In the event that the
Contractor determines that it is unable to provide the Pharmacy
Services for the amounts set forth herein, the parties shall attempt
to renegotiate such amounts in good faith. If the parties fail to
reach agreement on the amounts required to provide the Pharmacy
Services with thirty (30) days of the expiration of the Evaluation
Period, the Contractor shall discontinue the provision of Pharmacy
Services hereunder. Discontinuation of the provision of Pharmacy
Services pursuant to this Section 1.11 shall not be deemed to be a
default under this agreement" (Contract Clause 1.11.4).
Promise Made #3:
Access to a Greater Number of Health Care Providers.
On March 28, 2001, Mayor William issued a press release claiming that
"the centerpiece of our health services reform plan ... provide[s] a
network of more than 100 primary care locations."
Promise Broken: The contract does not protect the Community Health Centers
and does not guarantee that providers will be found.
- According to the Contract, "the Contractor shall initially
maintain and manage no more than the six neighborhood health centers
... [and] may recommend to the Authority the closure, consolidation or
relocation of neighborhood health centers" Exhibit A, Clause 4.2.
- The Williams Plan's Physician Services payments (Exhibit E) are so
far below industry standards that some experts believe it will be
almost impossible to find doctors to provide care. '
Promise Made #4: Less waste.
In a March 12, "Health Services Reform Update," Mayor William
wrote, "The current health care delivery system is not using millions
of dollars each year in available resources wisely."
Promise Broken: The Mayor's plan spend too much on administration and
too little on care.
- The contract allocates $7,604,730 for administrative fees (according
to the totals from Exhibits E, F and G) versus $6,139,233 allocated
for physicians' fees (according to the totals from Exhibits E and G).
- The contract's total estimate for all services is $83.3 million.
FY2001 allocation for PBC: $66.8 million.
- According to experts, the fee schedule in Exhibit E is incomplete
and thus encourages fraud. Key terms are left undefined, leaving a
table that lacks the necessary complexity to define key medical
procedures.
Promise Made #5: An Enhanced Safety Net for Uninsured Individuals
A health care flyer on the Mayor's website states, "The Mayor is
committed to health care as a right."
Promise Broken: The Mayor's plan does not provide guarantees to health
care.
Page 2 of the Contract notes that, "This Agreement does not create an
entitlement to health care in the recipients of health care
hereunder."
If you are concerned about access to health care service and an
expanded number of health care services, about fording doctors to care for
our needs, about the quantity of health care, and if you care about an
enhanced safety net for our most vulnerable neighbors, you must oppose
this flawed contract.
Keep the promise. |
