Sick of Waiting

Where's the "decent health care" we voted for?

by Robert Sigmond

National studies suggest that only about half of all Philadelphians receive decent heath care, including many people covered by Medicare,Medicaid, Independence Blue Cross and commercial insurance. For those with little or no coverage or income, the likelihood of getting care that measures up to decent standards is much worse.

Throughout the nation, this scandalous situation results in much pain, suffering and unnecessary loss of life, but seems to be accepted as another unfortunate aspect of 21st-century life. What is really sickening is that all other developed countries in the world have national health systems that do so much better.

But public outrage is mounting, and is currently being whipped up by Michael Moore's very funny and powerful movie, Sicko.Academic purists and defenders of the status quo can find technical flaws to quibble about in this Moore movie, as in his others;they point to the absence of any examination of where the money is going to come from to pay for the changes required to avoid the tragic situations that heexposes so starkly, for instance. Showinghow Americans and others who live in foreign countries get much better health care, Sicko demonstrates that the issue is not really money.No other country comes close to spending as much moneyonhealth care as we do.Some countries, like England, spend half as much per capita, and rank much higher in the effectiveness of their health systems.

Fortunately, we can change things for the better.We know how.By 2013 � or even sooner � this country can have a national health system, based on better organization of health care, in every city and town. Already, the transformation of our health resources is beginning to take shape.Everyone has many opportunitiesto get involved right now in changing things for the betterhere in Philadelphia, in Harrisburg and in the nation's capital.Here are some things to do:

At the national level, urge your representatives in Congress to vote for expanding the program to provide coverage for the nation's children.Also, support only those candidates for president who are for universal health-care coverage, nothing less.

At the state level, join the struggle for the governor's endangered health-care reform program (See this week's cover story.)

In Philadelphia,learn about and join the effort to carry out the City Charter mandate for decent health care for all Philadelphians.Led by a tiny group of dedicated community activists, a ballot initiative was adopted overwhelmingly in 2003 mandating a plan for just that.With modest support from the mayor, progress has been steady but without the prominence and energy that it deserves.

In personal conversations with me, both mayoral candidates have pledged their active support for decent health care as the standard for all Philadelphians. Michael Nutter is on record that all Philadelphians should have a decent level of care "equal to what we want for our children and parents." During the primary campaign, Nutter said, "The next mayor can convene providers and advocate for a new system of coordination and cooperation that will improve the health care of vulnerable Philadelphians while actually reducing the cost now leaking out of the chaotic system we have." He pledged to do so if elected.

Whoever ends up being our new mayor needs your support now in preparing for the struggle beginning next year to make the necessary changes.Your support for assuring that Rendell's health reform is built on local initiatives and is enacted is also essential right now. Community health activists, including dedicated physicians, nurses, the National Union of Hospital and Health Care Employees and other union members, as well even some courageous executives, academicians and governing board members need your support and encouragement in promoting more humane and effective care of the sick.

Nothing less than decent health care for all Philadelphians must be our goal.

Robert Sigmond (www.sigmondpapers.org) is Walter J. McNerney Fellow of the Health Education Research Trust of the American Hospital Association. He is a former executive VP of Albert Einstein Medical Center and former senior adviser to the city health commissioner.