In the present economic downturn, many states have decreased their spending, particularly in the area of public health. That's why it's gratifying to see City Council, the Department of Public Welfare and the General Assembly working together to bring more dollars into the state so we can actually improve care for the Uninsured and Medicaid eligible population in Philadelphia.

Quick Fact! Just because a person has Medical Assistance Health Coverage, that doesn't mean they can find a doctor! Most doctors around here refuse to accept Medical Assistance, that's why the Federally Qualified Health Centers and the City's Health Centers are so important.

Council took the first step yesterday to move a plan that will move millions more dollars into our hospitals and health centers. PUP is especially excited because the Department of Health believes that these new funds should enable them to bring wait times at City Health Centers down to less than 30 days and improve health care by implementing electronic records throughout all city facilities (including jails and youth centers).

More details in the jump!

From the Philadelphia Unemployment Project

An Open Letter

April 10, 2008

Dear Senator Clinton and Senator Obama:

Healthcare has been central to each of your campaigns. As you work here in advance of the April 22nd primary, we wanted to alert you that healthcare is the number one opportunity we have to improve the lives of working Pennsylvanians right now. We, the undersigned, believe your campaigns could advance the cause of Pennsylvania’s reforms, should you choose to make them an issue.

Early last year, Governor Rendell unveiled an ambitious package of reforms known as The Prescription for Pennsylvania (Rx4PA, www.rxforpa.com). Rx4PA would expand access to health insurance with a high quality healthcare plan. With revisions from the House Democrats, that plan is now known as “Access to Basic Care,” and it passed the House this month in Senate Bill 1137.

Rx4PA would also rein in the forces that have driven up the price of insurance in the small group market, reward employers already providing coverage and insure that no one with a pre-existing condition is denied coverage.These also passed the House of Representatives in House Bill 2098 and House Bill 2005.

If these reforms succeed in the Commonwealth, it will make the arguments for either of your national plans much stronger. Rx4PA’s success should also galvanize your allies in Washington while chastening your opponents.

A coalition of Democrats and Republicans who really support small businesses is forming to make certain that you can get health insurance at every phase of your life. They should soon send a bill to the Senate that will make our health insurance market make sense.

Can you think of an industry that makes its money by avoiding customers? Doesn't that seem like a really weird concept? Well, there is one: the health insurance industry. Private insurers, like Aetna, carefully screen their customers to keep the ones most likely to have health problems out, a.k.a., "cherry picking." They look for small companies filled with healthy, young workers and offer them great plans. Then, they just rake in premiums, because even at reasonable rates they are making money because the young turks don't get sick.

They can do this because Pennsylvania permits insurers to set rates based for an employer based on the health status of its employees. So, Blue Cross & Blue Shield have to insure everyone. All the middle-aged and older workers end up with the Blues, while Aetna and others steal the healthier workers. By "steal," I mean they rob these larger pools of the healthy workers who bring costs down. That's the same trade-off we've always had with insurance. I pay in now while I'm healthy so that, in exchange, I won't have to pay in so much when I'm older.

That's not how it works anymore. Click "Read More" to find out what legislators are trying to do about it.

HB 2005 came out of the House Insurance Committee this week. It's a bill that Rep. Deluca (D-Pittsburgh) wrote that finally gives us some control of the health insurance industry. Imagine: up to this point, car insurance was better regulated than health insurance. That's like telling a kid not to run with scissors but letting him play with your guns. That could end. Word on the street is that they'll get HB2005 to the floor by the end of the year. That would be good.

Of course, lobbying and politics made it all more complicated than the had been initially planned. I'm not going to put the text of the bill in here, but here's the deal: small employers get nailed on their premiums all the time. Let's say we've got a plumbing company, right? We'll call it Dan & Ray's Plumbing. You've got this great plumber named Jen, and Jen's been working with you for years. Great gal. Works hard. She's in her late 40's. The doctor tells her that she needs a double-bypass. Big bill to your insurance carrier. Suddenly, we're paying a lot more money for all our plumbers, all our shop assistants and all our administrative staff. Premiums can spike like crazy because one of your crew had the audacity to get sick. The nerve.

Sickness is no good for insurance company profits.