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 30% of public hospitals' inpatient 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 number of patients transferred from private hospitals to public hospitals because of the patients' lack of insurance increased 500% between 1980 and 1984 at Cook County Hospital in Chicago; 300% between 1983 and 1985 at Parkland Memorial Hospital in Dallas; and 500% at District of Columbia General Hospital. These trends subject public hospital workers to unbearable pressures — more patients and fewer resources; and

WHEREAS:

State and local governments, faced with losses from Gramm-Rudman cutbacks and the loss of general revenue sharing, are in no position to substantially increase their support of public hospitals. From 1982 through 1985 state and local governments lost $59 billion, approximately one-sixth, of their federal aid; and

WHEREAS:

Many public hospitals occupy outdated physical plants that are especially costly to maintain or that need to be replaced. At the same time, public hospitals must spend all available revenues to cover operating losses and thus cannot afford capital improvements. Operating losses at public hospitals give them poor credit ratings. 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:

The precarious financial condition of public hospitals tempts public officials to privatize these hospitals. For-profit hospitals provided only .1% of the charity care in the 100 largest U.S. metropolitan areas in 1980. For-profit hospitals use significantly fewer staff, and more part-time staff, than other hospitals. Non-profit hospitals in the 100 largest U.S. metropolitan areas provided almost half the charity care provided by public hospitals in the same cities in 1980; and

WHEREAS:

Public hospitals are major employers of women and minorities and provide jobs in communities that 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 and for other state and federal legislative initiatives that will fund uncompensated care; and

BE IT FURTHER RESOLVED:

That AFSCME work to influence additional changes in health care 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; and

BE IT FURTHER RESOLVED:

That AFSCME seek to increase regulation, especially by the states, of for-profit chains to ensure that such chains either meet a legal obligation to provide their fair share of uncompensated care and to treat all requiring emergency treatment regardless of ability to pay, or that such hospitals face substantial fines and loss of licensure; and

BE IT FURTHER RESOLVED:

That AFSCME oppose efforts to privatize public hospitals unless such efforts include guarantees that the hospital will continue to treat all regardless of ability to pay and that the hospital's workers will suffer no loss in wages, hours and working conditions, including union representation by AFSCME; and

BE IT FINALLY RESOLVED:

That AFSCME work with broad-based community coalitions to create and expand support for public hospitals.

SUBMITTED BY:

Richard Timmons, Delegate
Local 1550
Houston, Texas