STOP INSTALLING GLOBAL HEALTH CARE SYSTEMS TIED TO WALL STREET AND PROFIT.
'At the moment, over one hundred of Chase Brexton’s employees: nurses, social workers, physicians, therapists and pharmacists, are in the process of organizing to join 1199SEIU United Healthcare Workers East. The SEIU is a national labor union for service employees with a membership of about two million people'.
The issue surrounding Brexton Chase is the misappropriation of yet MORE Federal, state, and local taxes PRETENDING to be addressing low-income or public health. Baltimore has had this problem forever and it is getting worse as almost ALL citizens are going to fail to have access to ordinary health care. When I saw this location identified as a Medical Enterprise Zone I immediately knew this was a scam. So did our Baltimore Public Health Commissioner DR WEN. It is our health commissioner's duty to guard the public health of all citizens and as usual this appointed position is tied to global health corporations and Johns Hopkins writes our health policy. Hopkins wants that beautiful building in wealthy Mt Royal renovated using low-income health revenue and VOILA----we have BREXTON CHASE rebuilt as a temporary community clinic.
REPUBLICAN AND CONSERVATIVE VOTERS MUST WAKE UP TO THIS COMPLETE PRIVATIZATION---WE NEED A PUBLIC HEALTH SECTOR FOR ALL.
If Baltimore City center is slated to be the global 1% and their 2% and the surrounding communities global corporate campuses---where is the public structures FOR WE THE PEOPLE? The answer is---they do not see those structures. This is why we must stop this MASTER PLAN of Baltimore City center being that global rich only.
THAT IS WHAT GROUPS COMING OUT TO PROTEST FOR LABOR AND JUSTICE WOULD BE SAYING---THEY WOULD OUT THIS HEALTH PROJECT AS POSING PROGRESSIVE AND DEMAND REAL SOLUTIONS FOR OUR PUBLIC HEALTH.
'through innovative public health strategies including tax incentives, financial awards and capital improvement funding for physicians and health care organizations'.
The first clue was having Anthony Brown----O'Malley farm team -----promoting these policies. We know Clinton/Obama Wall Street global corporate neo-liberals send all money to the top. Second, we knew the areas targeted for these HEZ were right inside International Economic Zones slated for global corporate campus development.
Health Enterprise Zones: "I Believe We Can Eliminate Health Disparities"
Dec 12, 2012, 12:25 PM
Maryland Lt. Governor Anthony Brown (photo courtesy of State of Maryland Office of the Lt. Governor)
The state of Maryland recently passes legislation to address health disparity issues through “health enterprise zones.” The legislation allows local non-profits, health agencies, and local health providers to work together to address this critical issue through innovative public health strategies including tax incentives, financial awards and capital improvement funding for physicians and health care organizations.
Lt. Governor Anthony Brown of Maryland played a key role in establishing the zones, and spoke about them in session at yesterday’s GOVERNING Summit on Healthy Living. Lt. Governor Brown gave some important background on his personal push to establish the health enterprise zones, explaining that his father was a doctor who “taught a lesson of service.” For decades, he said his father saw and cared for patients in some of the poorest neighborhoods in New York. “I saw the file cabinets of unpaid invoices. My father taught me we have a responsibility to serve and care for our neighbors.”
Brown told the audience that, “as we look at health reform, there are real opportunities to address disparities in health. As we expand access, we need to increase quality and equity. I believe we can eliminate health disparities.” NewPublicHealth had the opportunity to speak with Lt. Governor Brown about health enterprise zones.
NewPublicHealth: Is this the first time that a health enterprise zone has been implemented?
Lt. Governor Brown: Yes. Maryland has introduced and now established the health enterprise zone program. As far as we know, and we have searched the literature and looked at practices around the United States to address health disparities, there is no other state that has a program similar ours.
OH REALLY? THESE SAME HEZ ARE BEING BUILT IN INTERNATIONAL ECONOMIC ZONES AROUND THE GLOBE.
The health enterprise zone is an innovative approach to add incentives to the delivery of primary care in targeted communities that are underserved and are experiencing higher rates of chronic diseases, which lead to health disparities. The thinking is that if we can incentivize providers to deliver more resources into the communities that need it most, we can reduce health disparities.
NPH: How did it come about that you chose health enterprise zone as a vehicle to address disparities?
Lt. Governor Brown: The concept is not new, only new in the area of health care and health disparities, but it has been tried and tested already. For example, in economic development, we have economic enterprise zones. In some communities in the U.S. facing economic distress and a high unemployment rate, jurisdictions have offered a package of incentives to companies to provide jobs in those areas and they call them economic enterprise zones. The Harlem Children’s Zone is located in an area of New York City where you have underperforming schools in distressed communities. The community was targeted with resources to improve performance in school. So that is the same concept for addressing disparities that we are looking at for improving health disparities in Maryland. If it works in school and works in economic development then it will work with health disparities.
NPH: What was effective in persuading policymakers to adopt this program in Maryland?
Lt. Governor Brown: In my discussions with them, I started by saying that eliminating health disparities is a moral imperative. There is no reason why an African American girl should be two and a half times more likely to die before her first birthday than a white girl. There is no reason why Maryland should have, and we do, the second highest number of primary care providers per capita compared to any other state yet when it comes to geographic health disparities we rank 35. We are better than that. But then what I did was go to a second step.
If you aren’t convinced about the moral imperative, there certainly is a business case to be made. We have excess admissions of African American patients in our hospitals. What I mean by excess admission is this: African Americans make up a certain percentage of the population in Maryland yet if you look at the admissions in our hospitals, the percentage of admissions for African American patients is a higher percentage than they represent in the population. That additional percentage cost us 820 million dollars in 2010. And in Maryland, because of our all-payer system of reimbursing hospitals, everyone pays for that additional care—particularly when the patient is on Medicaid or if they don’t have insurance at all. So if you don’t think there is a moral imperative there is certainly a financial case to be made that we can save dollars by addressing health disparities.
NPH: How will you measure success?
Lt. Governor Brown: Some of it will be quantitative. In the zones that are created, we will look at hospitals and admissions and readmissions for those conditions that are being addressed. So, for example, if an applicant for a health enterprise zone says my strategy and my focus is reducing asthma or diabetes or hypertension in this zone, we will look at the number of admissions and readmissions for those conditions. We will measure them and we believe we will see a reduction in hospital admittance. Another example could be emergency department visits for preventable conditions where prevention services would reduce the number of emergency department visits.
But some intangible ways in which we will measure the success is the extent to which we bring additional resources including primary care and community resources into targeted communities; create partnerships; create better outreach to the communities that are being served. Because the best way to administer a program is to assure that the community is involved in the program.
Regarding specific metrics, each applicant in a health enterprise zone is also responsible for setting forth what their proposed metrics and criteria are for success. So this is not the state dictating but working collaboratively with applicants to agree on what a set of metrics ought to look like.
NPH: What are some of the other thing you are doing in Maryland to eliminate health disparities?
Lt. Governor Brown: When developing our health enterprise zone, we also established a mandate in other areas. We are requiring our health plans to deliver culturally appropriate educational materials regarding healthcare to their members. Number two is we are developing criteria and eventually curriculum for continuing education for health providers in the area of multicultural healthcare. Number three, we are going to require all state-funded institutions of higher education that teach health professionals, whether it is doctors, nurses, dentists or pharmacists, to take action. We want to see in their curriculum and in their program, effort to reduce health disparities. And finally, we are developing a standard of measurement to measure racial and ethnic variations in health outcomes that will be measured in our hospitals. That information will be available to our health insurance companies so that we can use the data to learn better about what better health disparities. For example, we know things like what percent of African American patients have asthma or have diabetes. We understand and have some data on the disparities, but we need better data in terms of how we deliver care and who we deliver it to.
We know that in our hospitals there are over 50 complications that we believe are preventable. And they are preventable if we adopt certain protocols that, if followed, statistically you are going to eliminate a particular complication—such as changing IV lines and bed pans on a regular basis, and asking certain questions of every patient that comes in. We don’t currently measure that by race or ethnicity, so we don’t know if we asking the same questions of African American patients that we do of other patients. Are we changing bedpans regularly for every patient regardless of race or ethnicity? And since most of these protocols are billable codes that we send to insurance companies, if we could put a racial or ethnic identifier on it, we will be able to better track how we are delivering care in our hospitals. And it will give us more data to determine whether or not there are changes in protocols or practices that need to occur.
We have a significant problem here that has gone unaddressed and that is reducing health disparities. We have to look beyond what we have been doing traditionally.
'And since most of these protocols are billable codes that we send to insurance companies, if we could put a racial or ethnic identifier on it, we will be able to better track how we are delivering care in our hospitals. And it will give us more data to determine whether or not there are changes in protocols or practices that need to occur'.
Billions of dollars earmarked for these HEZ-----HEALTH ENTERPRISE ZONES in the heart of what will be the global rich communities is just the start. Above we see the progressive posing regarding the funding for what is a massive technology infrastructure needed for global health tourism and look---they are concerned with disparities tied to race and class---that is why they are collecting all that health data.
It was the billing codes behind much of these few decades of trillions of dollars from our Medicare, Social Security, and Medicaid Trusts all easily stopped by simply having oversight and accountability in an already computerized Federal health system. CLINTON/BUSH/OBAMA simply didn't look for that fraud so what are these same pols going to do with this new billing system? Again, the Federal programs of Medicare and Medicaid when first created were monitored for oversight-----it was when global Wall Street pols dismantled that oversight the health industry fraud soared. We don't need a new system-----
They are retooling our national or Federal health technology system to be global. A global insurance corporation for example needs to know whether a global health system is operating in India, China, Africa, or the US. What does all this do for the American people?
'The law aims to “improve quality” and “increase value” by supposedly promoting greater coordination between doctors, hospitals, and insurance companies by merging them into one entity; relying on healthcare information technology to limit care options by ensuring adherence to “evidence-based care;” and encouraging institutions to give care in settings outside of the hospital (cheaper settings) with lesser-trained and skilled providers (cheaper labor).
Guess what? These are all goals that the healthcare industry had anyway. The ACA codified some of these aspirations, turning them into the law of the land'.
ABSOLUTELY NOTHING----IT IS NOT BEING BUILT FOR WE THE PEOPLE.
This is one of the great drivers to our discussion on environment and soaring energy and technology needs killing our environment. Global health tourism is VERY, VERY, VERY, VERY, VERY BAD POLICY.
The first thing citizens need to do is stop the misappropriation of funds designated for public health. Even if a family is middle-class today we will see those families not accessing health care soon enough. Then the same will happen to the upper-middle-class.
WE KNOW A CLINTON/OBAMA FARM TEAM CANDIDATE BECAUSE THEY ALWAYS USE THESE SAME TALKING POINTS IN HEALTH CARE.
The reason this is coming from nurses more than American Medical Association of physicians ----these policies will make a 1% and their 2% of doctors extremely wealthy but many US doctors are protesting as well.
TROUBLE ON THE HORIZON: Top five things nurses must know about where healthcare is heading
National Nurse Magazine, 3/21/14
It’s 2014, which means the bulk of the Affordable Care Act is now in effect. While most of the mainstream media has focused on whether patients will finally be able to find affordable health insurance through the programs it creates (or not), very little attention has been paid to discussing how the wide-ranging law is being capitalized upon by healthcare corporations, and how some of its other incentives and provisions change the registered nurse’s scope of practice, speed up the computerization of healthcare, and encourage fundamental changes to healthcare delivery and systems. In fact, these changes are redefining the meaning of “care” that healthcare providers, like you, are expected to provide.
Registered nurses do not need to know every minute aspect of the Affordable Care Act, but they should understand in general what goals the legislation claims to set and the kinds of problems it claims to solve.
U.S. healthcare policymakers often can’t agree on much, but the one thing almost all agree on is that the United States spends way too much money per capita per year on healthcare, about $8,508 according to the Organization for Economic Cooperation and Development. It’s the highest of all countries in the world. But for that price tag, we get less-than-stellar results. Our infant mortality and longevity rates are far behind all other Western, developed nations.
National Nurses United has long argued that to lower our expenditure on healthcare and promote a single, high standard of good care, we need to remove the profit motive from healthcare and run it like the public utility that it really should be. All people need things like clean water, electricity, police and fire rescue. These services are critical to sustaining human life. Accordingly, we often operate the systems that provide these services as a public entity, for the public good and not for profit.
It should be the same with healthcare. All people have bodies. We all fall sick, have babies, grow old, get into accidents, sustain injuries, die. For this reason, NNU has long advocated for, at the very least, a single-payer health insurance system that covers everybody from birth to death and is funded by everyone’s tax dollars. That’s how most other industrialized countries have set up their healthcare financing systems. They don’t run healthcare as a business or view healthcare as an appropriate arena in which to make profit.
The United States, on the other hand, continues to let healthcare corporations call all the shots. That’s why, when we examine the Affordable Care Act, which was crafted with the help of companies such as Kaiser Permanente and Pfizer, we see a law that does not at all challenge the dominance of healthcare corporations and actually facilitates their ability to make money by enabling the least, cheapest, and fastest care possible.
The law aims to “improve quality” and “increase value” by supposedly promoting greater coordination between doctors, hospitals, and insurance companies by merging them into one entity; relying on healthcare information technology to limit care options by ensuring adherence to “evidence-based care;” and encouraging institutions to give care in settings outside of the hospital (cheaper settings) with lesser-trained and skilled providers (cheaper labor).
Guess what? These are all goals that the healthcare industry had anyway. The ACA codified some of these aspirations, turning them into the law of the land.
Now that the dust has settled around healthcare reform, corporations are redoubling their efforts and accelerating the race to the bottom. Almost all hospitals across the country are adapting and attempting to transform themselves in a way that takes full financial advantage of the current system. Sometimes it means merging with bigger, corporate chains and sometimes it means buying up those smaller community hospitals. But, increasingly, it also means that registered nurses are noticing their employers venturing into activities like opening up urgent care clinics around town and setting up their own insurance plans – on top of continuing to make the relentless cuts to services, staffing, equipment, and supplies that they always have. Here at National Nurses United, we often refer to all of these changes as healthcare “restructuring.”
In this article, we will list the top five trends RNs must know about this restructuring. Since the bottom line of all this reorganization is always to make more money, a goal that is typically in conflict with our role as patient advocates, registered nurses must work together at the unit level, facility level, and organizational level to fight any changes that would harm our patients or our practice. But, as always, the first step is education, so read up.
1. Hospitals will use the Affordable Care Act as an excuse for anything and everything horrible they want to do
It’s like the 2014 hospital version of “The dog ate my homework.” Want to cut benefits for part-time RNs? It’s because of the ACA. Want to make layoffs? Blame the ACA. Want to reduce the hours for per diem nurses? The ACA made us do it. As soon as it was signed into law in 2010, hospitals started using the law and the “uncertainty” and “ambiguity” it supposedly created to justify all types of changes, mainly cuts to services and staffing. The ACA has been invoked at multiple bargaining tables, including Sutter Health and Kaiser Permanente, usually as the basis for some type of argument that the hospital will collect less revenue through drops in reimbursement. Hospitals never seem to anticipate that their revenue will rise due to the increased number of people eligible for Medicaid and who will now carry health insurance.
2. Hospitals are trying to shift patients who need to be in the hospital out of the hospital
Yes, hospital care can be expensive, but that’s largely because hospitals charge so much (See page 6 for report on excessive hospital charges), plus money gets siphoned away to fund million-dollar executive pay packages, advertising and marketing campaigns, and profits to shareholders. To rein in spending, the ACA encourages care to be provided in non-hospital settings. This means several things, including figuring out ways to move patients through the hospital faster, discharge patients early, or never admitting them into the hospital in the first place. In the Kaiser Permanente system, nurses are seeing patients held under “observation” status without formal admission for up to 24 hours before being sent home, and also changes in treatment protocols that shift care to outpatient settings or the patient’s home. There, the burden of care is put on sometimes very ill patients themselves or on their family members. For example, a Kaiser facility in California’s Central Valley used to admit patients with deep vein thrombosis so that providers could administer blood thinners and monitor patients to make sure their clots did not cause more problems, but Kaiser protocols have changed in the past couple of years so that RNs are told to teach patients or their relatives how to inject themselves and to return every day for testing of clotting levels.
Clinic care does have its role in the healthcare system, agree RNs, but patients who legitimately require the type of round-the-clock observation and care RNs can provide in a hospital should not be shunted into a 15-minute clinic visit.
Not surprisingly, some hospitals are rapidly building new clinics. Kaiser is apparently experimenting in constructing clinics with prefabricated walls, with the first such building in Kona, Hawaii. According to a June 2013 West Hawaii Today article, a team manager for Kaiser’s National Facilities Services described the Kona clinic as a “pilot project” and that “national Kaiser officials wanted to find a way to make building clinics ‘faster, better (and) cheaper.’”
RNs point out that clinics are often staffed by lesser-skilled and nonunion workers and more loosely regulated. For example, the mandatory RN-to-patients ratios law that sets a maximum number of patients per nurse does not yet apply to clinic settings.
3. Everyone wants to violate your RN scope of practice
You, my dear RN, are a highly educated, trained, and skilled healthcare provider. Your labor does not, and rightly should not, come cheap. But the healthcare industry, anticipating many millions more people accessing healthcare, wants that care to be provided most “efficiently” (read: at the lowest cost possible). At the same time, industry-connected policy wonks complain about a lack of RNs and general practitioners to provide the primary and preventive care people need. Instead of investing in the education of more registered nurses, nurse practitioners, and medical doctors (many countries provide a free or heavily subsidized medical school education), they argue that healthcare should be delivered “in new ways.”
That’s why, across the country, there is a huge push for all kinds of lower-skilled, unlicensed staff to assume registered nursing duties and practice, and to dissect and break down the complex work that RNs do into discrete tasks to be parceled out to ancillary staff.
In California, Minnesota, Michigan, as well as other states, hospitals and other healthcare policy organizations are lobbying for medical assistants, paramedics, emergency medical technicians (EMTs), and licensed vocational or practical nurses to take on expanded roles. For example, in a July 2013 white paper, the UC Davis Institute for Population Health Improvement recommended that California launch pilot programs in which paramedics who received additional training get to assess whether patients need to be transported to an emergency department or should be treated by the paramedic as needed; to essentially serve as home health RNs to follow up on patients who had been discharged from the hospital; and to provide care for patients with chronic conditions.
In one “Challenges” section of the paper, the authors write that “patients may perceive there are tiers of care or lower levels of care being provided by the [community paramedic] if the patient is accustomed to receiving care from doctors or nurses.” They’re right to worry, because it’s true; this program does create inferior levels of care.
In Michigan last November, Sparrow Health System replaced all the registered nurses at its urgent care clinics with unlicensed medical assistants, though nurses warned that this move was bad for patients. “Patients who walk into an urgent care should be assessed by a highly trained RN who can detect serious problems that may go unnoticed to an untrained eye,” said Jeff Breslin, RN and president of the nurses union at Sparrow. “Registered nurses have the skills and experience to tell immediately whether patients need more advanced care.”
At San Joaquin General Hospital in French Camp, Calif., nurses objected last year when the hospital wanted medical assistants in its ambulatory care clinics to provide services such as diabetic foot screens. Management expected medical assistants, who in California are not licensed nor even certified by any medical board or body, to fill out a sheet that asked them to answer questions such as, “Has there been a change in the foot since last evaluation?” and “Is there a foot ulcer now or history of foot ulcer?” and “Does the foot have an abnormal shape?” The nurses had also obtained a copy of a separate “skills academy” form that supposedly recorded which in a long list of “skills” the outpatient clinic assistant (medical assistant) had received training in. These “skills” ranged from the diabetic foot exam just mentioned to staple and suture removal and “anticipating needs” for patients who complained of chest or abdominal pain. The RNs believe that these evaluations constitute nursing assessment and should be performed by a registered nurse, not a medical assistant, and are currently working on correcting this problem.
These are all examples of how care by registered nurses is being split into simpler tasks that can then be parceled out to unlicensed personnel to complete. What’s missing in this new model of medical care is a fundamental appreciation of how registered nurses are not educated, trained, and experienced to only just perform medical tasks, but to contextualize and synthesize all the information they collect to provide an individualized assessment of any particular patient. Nurses use that assessment to make ongoing judgments or decisions about the best course of therapy or treatment for that patient.
Healthcare corporations who are attempting to break down nursing care into its constituent parts fail to understand that the sum of the parts does not equal the whole – or perhaps they do know but do not care. For the sake of their patients and their own profession, registered nurses must fight to protect their scope of practice and force them to care.
“Hospitals continue to shop around for a cheaper way of delivering care to patients, but it doesn’t work,” said Karen Higgins, RN and a member of the NNU Council of Presidents. “They’ve tried it before. It’s never worked, and it puts patients at risk. You need to have a good, educated, experienced registered nurse.”
4. Hospitals will be accelerating rollouts of dangerous electronic health records systems
Any RN who has experience with electronic health records systems (EHRs), whether they be electronic charting, electronic medication administration, pharmacy programs, or computerized physician order entry, knows that they do not support or complement nursing care. It’s obvious to RNs that there is little nursing value in being forced to stand in front of a screen and click a bunch of little check-off boxes or select from pages and pages of drop-down menus.
Instead, EHRs exist to help the hospital make more money by maximizing billing for every item or service the patient uses unless, like Kaiser, the hospital is paid a flat fee for treatment. In that case, the hospital may use EHRs to limit the amount of care provided. Under any business model, EHRs also maximize earnings by limiting healthcare providers’ use of independent judgment in treatment options.
Built into these electronic health records systems is what’s called clinical decision support software, which is just a fancy name for software code that prompts the user to adopt whatever treatment plan the computer thinks is appropriate based on a fictitious, “average” patient in its database. This is the software programming that, for example, limits the choices you can check off when you are trying to chart or makes a pop-up warning window appear on your screen that you have to override if you want to continue. If this sounds like the computer is taking over your independent nursing judgment and maybe ultimately your job, that’s because it is.
Electronic health records systems seek to routinize and standardize care. Not only is this cheaper, but it’s simpler and easier and can be done by non-registered nurses in non-hospital settings. There’s less variation, everyone gets the same thing, care is not individualized. Again, there’s less and less independent judgment involved, which is exactly what registered nurses excel at: applying their knowledge and experience to make decisions in unexpected situations. Human bodies are not inanimate widgets; they are complex systems and some may behave and respond differently than others to the same drugs, treatments, or procedures. Patients need registered nurses to help figure out and advocate for the type of care that particular patient needs, not what the computer thinks is best.
Additionally, EHRs are a critical foundation upon which all types of remote care can be implemented, whether it’s electronic intensive care units where doctors and RNs are watching patients 100 miles away via video cameras, video conference medical examinations, or virtual diabetes management clinics where patients use home sensor devices to transmit data and vitals to the computer system. EHRs not only enable healthcare corporations to shift care out of the hospital, but ultimately remove people – face-to-face contact – from healthcare.
“Care tools will be on site in many people’s homes,” reads a 2012 slideshow presentation titled “Kaiser Permanente’s Healthcare IT Journey” by the company’s then-CEO, George Halvorson.
“Some...technology for in-home care two years from now will be as good or better than actual hospital inpatient technology was five years ago. In-home monitoring, EKGs, ultrasounds, video conferences, blood and fluid diagnostic and testing tools will be increasingly sophisticated, effective, and cheap.”
What’s missing from this picture? That’s right, you.
And, by the way, the federal stimulus package passed in 2009 incentivizes the adoption of electronic health record systems – what is often termed “meaningful use” – through subsidies and penalties. It included massive incentive payments, about $30 billion, for hospitals that can demonstrate that their electronic health record systems work with computerized physician order entry (CPOE) and clinical decision support systems. Beginning in 2015, some hospitals may face reduced Medicare reimbursements for failure to adopt EHRs.
5. Hospitals are turning into insurance companies AND doctors’ groups
Instead of eliminating the root cause of our outrageous healthcare costs, the profit motive, the Affordable Care Act operates from the assumption that costs can be brought down if only hospitals, doctors, and insurance companies better coordinated and cooperated with one another over care and reimbursements. The ACA promotes the creation of accountable care organizations, which are essentially “integrated” healthcare systems like Kaiser Permanente, where the hospital not only owns and runs the hospital, but acts as the insurance company as well as hires and pays the doctors. If an accountable care organization meets certain so-called quality standards such as patient satisfaction and saves money at the same time, it is allowed to keep a share of those savings.
RNs are concerned that this type of power dynamic incentivizes these ACOs to deny care, since they will be able to pocket more of the insurance premiums as well as control what physicians and nurses can and cannot provide as treatment. “Absolutely there’s a conflict of interest,” said Jean Ross, RN and a member of the NNU Council of Presidents. “Independent judgment, I think, is quashed.”
If Kaiser is the model, we should all be very, very worried, say RNs. Kaiser has advanced further in all of the trends than most employers. Currently, nurses who work for Kaiser are fighting what they see as a deliberate push by the healthcare giant to keep patients who need hospital care out of the hospital by discharging patients early or sending patients to clinics staffed mostly with medical assistants or simply just home. It then claims that because of reduced hospital census, it needs to lay off registered nurses and cuts remaining staff to the bone. According to a January 2013 Los Angeles Times article, Kaiser has captured 40 percent of California’s health insurance market, and nearly one out of every five Californians is a Kaiser member, according to Kaiser membership and state population figures.
“Currently, the Kaiser model of care is becoming one of denying care,” said Katy Roemer, an RN nurse rep leader in the Kaiser system. “That way they can pocket more of the premiums. When you subject healthcare to the business model, this is where you’re going to end up. As nurses, we’re here to take care of patients. Anything that gets in the way of us being able to take care of our patients, we are going to fight.”
Below we see our local SEIU health division doing a good job advocating. The problems with our public University of Maryland Medical System is that QUASI-GOVERNMENTAL designation basically making it a corporation. Tons of public funding for health care tied to what will become the global health tourism structure with Johns Hopkins. I have asked local labor lawyers to take these quasi-designations to court----we cannot support candidates or pols running as Democrats allowing these privatized status for our governmental agencies. It is killing labor and any ability of citizens to have a voice in health care policies. Private institutions like Hopkins have more power to operate independently but they receive hundreds of billions of Federal funding that says PUBLIC TRANSPARENCY AND ABIDE BY FEDERAL LAWS.
'Currently, UMMC is a quasi-private and quasi-public institution and is not subject to rules of either the National Labor Relations Board or the Maryland Labor Relations Act. The board of the statewide hospital system is appointed by the governor, and the system receives 58 percent of its funding from public sources.
This health care union is letting the citizens of Baltimore and Maryland know about the subpriming of our UMMS. This institution is expanding well beyond its means creating TONS OF DEBT, lots tied to bond deals, even as everyone knows an economic crash and bond market collapse will take the national economy into a great depression/recession.
UMMS IS DELIBERATELY SETTING ITSELF UP TO DEFAULT AND FALL INTO THE HANDS OF GLOBAL INVESTMENT FIRMS AND ENFOLDED INTO PRIVATE HANDS.
These union leaders know this-----they know the Baltimore politicians MOVING FORWARD with these policies and they come out to support them EVERY ELECTION.
University of Maryland Med System's Credit Rating Is Downgraded
Feb 10, 2014
The ratings agency Moody’s is continuing to assign a “negative” credit outlook to the University of Maryland Medical System and is warning that rapid expansion and increased debt is further damaging the system’s credit rating.
After UMMS purchased St. Joseph Medical Center in December 2012, the hospital was unable to receive Medicare certification and lost $14.8 million. The resulting loss of operating revenue was a factor that led to Moody’s placing the system’s debt rating on a “negative” credit outlook in February of 2013. On December 16, 2013, Moody’s continued their negative outlook of UMMS due to problems caused by the St. Joseph purchase and due to losses in operating, debt and balance sheet measures.
In the latest report, Moody’s also identified that there is risk of “management distraction” due to the integration of so many new facilities. UMMS has added seven hospitals to the system in the last 10 years. In addition to these acquisitions, UMMS has planned significant capital improvements and, in some cases, entire hospitals are planned to replace existing facilities that UMMS has acquired.
Moody’s indicated that unless UMMS improves its FY 2014 financial performance that it would face a downgrade. Notably, Moody’s also warned that an increase in debt could also lead to a downgrade. At the October meeting of the Maryland Health and Higher Educational Facilities Authority, UMMS executives sought approval to apply for $155 million in additional debt to fund the acquisition of the remaining 51 percent of the Upper Chesapeake Health System. UMMS currently owns 49 percent of Upper Chesapeake. UMMS sought this approval even as the system’s debts mounted from the purchase of St. Joseph Hospital and even as it had failed to build a promised hospital on the Eastern Shore. This additional debt was requested also as UMMS executives granted themselves pay raises and bonuses while laying off employees throughout the state.
We understand our labor unions are fighting to hold on to collective bargaining and other union rights but these problems are killing our US labor. This is why I shout WE MUST REBUILD OUR LABOR UNIONS FROM GRASSROOTS. Baltimore already has a strong health care labor force all killed by repressive labor enforcement/laws so we could have micro-unions moving away from those international labor unions like SEIU.
INTERNATIONAL LABOR UNIONS ARE PARTNERED WITH WALL STREET AND GLOBAL CORPORATIONS----
When we see nurses, doctors, and technicians outside of Brexton Chase wanting to join SEIU we see citizens trying to change and protect patients and health care but staying with the same political structure.
Issued November 17, 2015
SEIU endorses Hillary Clinton for president
Members: Clinton supports our movement to build a better future for working families
WE CANNOT GET WALL STREET POLS OUT IF OUR LABOR UNIONS KEEP PUSHING FOR THEM.
Below you see Baltimore/Maryland/DC SEIU coming out for Hillary, Van Hollen, PUGH for Mayor of Baltimore and all these pols are the Wall Street Clinton global corporate neo-liberals killing our public health, our SS Trust, Medicare and Medicaid and behind building a global health system that will exclude over 80% of Americans. These labor union leaders know the goals of Brexton Chase----they know health care workers are going to be 100% global labor pool with the wages attached to third world nations.
I understand in a state with captured and crony elections labor and justice finds it hard to take a stand. Not supporting any candidate is better than a bad candidate. I am saying this not because labor unions did not endorse Cindy Walsh for Mayor of Baltimore---I'm saying this because we need to reform our national labor union structures across the US to downsize and be those grassroots labor unions we started with a century ago.
I don't support GREEN PARTY as a Democrat but MARGARET FLOWERS would have been the health industry candidate against Van Hollen.
Maryland Members Celebrate Electoral Victories
Jun 15, 2016
Published: April 26, 2016
1199ers helped Maryland Congressman Chris Van Hollen win the April 26 primary for U.S. Senate.
1199SEIU members in Maryland are celebrating victories in races for Baltimore City Council and in Maryland’s open Senate seat during April 26 primary elections.
Baltimore City candidates endorsed by 1199SEIU won big in primary elections, supporting a slate of insurgent and incumbent candidates for Baltimore City Council. In heavily Democratic Baltimore City, the outcome of the primary election generally determines the results of the general election in November.
“City Hall is stale. We canvassed with the new candidates and they have a lot of energy. They’re ready to make change,” said Renee Neal, an 1199 member who lives in East Baltimore and is an oxygen therapy tech at Johns Hopkins Hospital. “It’s a good look for Baltimore City.”
When 1199SEIU endorsed U.S. Congressman Chris Van Hollen, he went on to win the Democratic primary to become Maryland’s next U.S. Senator. 1199 committed a significant number of member volunteers and other campaign support for Van Hollen in the April 2016 primary.
“I know Chris Van Hollen will be a great Senator because he listens and feels our fights and issues,” said Natina Newsome, an 1199 member and Baltimore City resident who is an environmental care worker at Johns Hopkins Hospital. “We marched with him at a Freddie Gray memorial event and he was chanting right along with us. He was taking note of everything he was going to do once he’s in office. I know he’s going to be the people’s senator.”
Members and volunteers knocked more tens of thousands of doors and sent several mail pieces to members in support of endorsed candidates.
Unions endorse Catherine Pugh for Baltimore mayor, City Council candidates
State Sen. Catherine Pugh (center) puts her arm around a young girl on Tuesday afternoon near intersection of Pennsylvania and West North avenues. A police commander at the scene said officers tried to arrest an armed man when his weapon fell and went off.
(Luke Broadwater/Baltimore Sun)
Luke BroadwaterContact ReporterThe Baltimore Sun
SEIU Local 500 and DC State Council have endorsed State Sen. Catherine E. Pugh for mayor.The Service Employees International Union's Maryland and DC State Council has endorsed State Sen. Catherine E. Pugh for mayor of Baltimore.
The umbrella organization represents several SEIU local unions of workers in the fields of education, early learning and human service to developmentally disabled Baltimoreans.
"Catherine's work on behalf of Baltimore families and working people across Maryland made her the obvious choice," Merle Cuttitta, president of SEIU Local 500, said in a statement. "As a member of the Senate Finance Committee, she has been a leader in the fight to expand collective bargaining rights to all employees at Maryland's community colleges - from adjunct faculty to groundskeepers."
Pugh is among 13 Democrats running to become Baltimore's next mayor. She has been polling second to former Mayor Sheila Dixon. Incumbent Mayor Stephanie Rawlings-Blake is not seeking re-election.
In Baltimore's City Council races, union members from two politically active SEIU locals --1199 and 32BJ -- have endorsed an initial slate of candidates. The unions represent about 5,000 Baltimore workers. They did not endorse for mayor.
A big-money, two-party race for City Council heats up in Southeast Baltimore The unions endorsed:
* Councilman Brandon Scott (District 2)
* Jermaine Jones, who is running for the seat now occupied by retiring Councilman Robert W. Curran (District 3)
* Councilwoman Sharon Green Middleton (District 6)
* Kris Burnett, who is running for the seat now occupied by retiring Councilwoman Helen Holton (District 8)
* John Bullock, who is challenging incumbent Councilman William "Pete" Welch (District 9)
* Councilman Edward Reisinger (District 10)
* Shannon Sneed, who is challenging incumbent Councilman Warren Branch (District 13)
* Councilwoman Mary Pat Clarke (District 14)
"It is time to clean house. We will work hard to elect advocates who will represent Baltimore City's working families," Lisa Brown, executive vice president of 1199SEIU United Healthcare Workers East, MD/DC Division, said in a statement. "What we heard from our members and Baltimore residents during the Uprising in the aftermath of Freddie Gray's murder was the need for change in our city and a demand for our elected officials to be our voice and act in our interest."
I wanted to stay with these few news items to bring all public policy we discuss together. If we search national media on this story we see almost nothing but a repeat of the Baltimore Sun story. We are glad SEIU is fighting these union-busting policies but everyone knows far-right Wall Street Clinton neo-liberals are UNION-BUSTERS so why support these candidates? The answer is ---the national labor union decides on a candidate and our state and local unions are supposed to do the same.
The SEIU will come out against unfair development----yet it does not make an easy calculation on Chase Brexton--knowing it will not remain low-income. It will wait until the clinic is removed then protest. It is our SEIU labor union members in BAltimore not even getting good health care plans because of the candidates they support. What happens in a global health tourism market? Jobs are eliminated by technology-----jobs are outsourced to the global labor pool -----wages will become third world. So, why does a labor union support all the candidates determined to MOVE FORWARD?
Chase Brexton simply represents yet another tiering to public health access and as groups are tiered away from the main hospital system they disappear. This is only a small group ---our Veteran's Administration is tied to University of Maryland Medical System and we already hear these VA locations are going to close.
You can see where this transitions Medicaid patents out of the main system..............
'While it is known for catering to the lesbian, gay, bisexual and transgender community, Chase Brexton has been trying to position itself as a clinic that serves everyone. It served nearly 10,000 Medicaid recipients last year, according to the state health department'.
Chase Brexton files complaint against labor union
The board of directors at Chase Brexton Health Care has asked the National Labor Relations Board to postpone an upcoming vote by employees seeking to join a union.The move is the latest volley in an increasingly acrimonious labor dispute between the leadership...
The board of directors at Chase Brexton Health Care has asked the National Labor Relations Board to postpone an upcoming vote by employees seeking to join a union.
The move is the latest volley in an increasingly acrimonious labor dispute between the leadership of the chain of community healthcare centers and its employees and even its own supervisors. It came as part of a larger complaint by Chase Brexton's board alleging unfair labor practices and illegal interference in the election process by some of the nonprofit's supervisors, who it said were illegally encouraging formation of the union with the help of union leaders.
The Chase Brexton board is seeking an investigation of the actions of the supervisors and the union that it says violate the the National Labor Relations Act. The unionization vote is scheduled to take place Thursday.
In an email sent to staff Monday, the board said it believes some of its managers and supervisors are encouraging employees to join the 1199 SEIU United Healthcare Workers East labor union. The board also accused the union of illegally encouraging the push for support.
"Chase Brexton believes that all of our employees eligible to vote in NLRB elections have the right to make an informed choice free from illegal coercion or interference…," the email said. "In order to protect the rights of our employees, we have filed unfair labor practice charges with the local office of the NLRB seeking an investigation into the unauthorized acts of these supervisors, as well as the conduct of the union."
Union members said that Chase Brexton was trying to stall the vote and that as of now, the election would go on as planned Thursday.
"Management will have to present evidence to have it postponed," said Brian Owens, a lead organizer with SEIU. "They just can't ask for it to be postponed."
The National Labor Relations Board could not be reached for comment late Monday.
Some Chase Brexton employees argue that being part of the union will give them more more sway with management and more say in the decision-making that affects their workplace. They have said they have seen a rapid increase in the number of patients they treat and a resulting decline in the quality of care patients are receiving because employees have been ordered to spend less time with patients.
More than 100 people rallied outside the Mount Vernon headquarters of Chase Brexton Health Care Friday to protest the recent firings of five employees and draw attention to what they say has been a decline in the quality of care provided.
If we look at what a US city deemed International Economic Zone will look like we will see that huge expanse of global corporate campuses, a global port needing lots of CIA/Homeland Security and global militarized security forces, and as in all overseas International Economic Zones there are pesky SOVEREIGN CITIZENS always seeming to be fighting for their rights. Authoritarian, far-right, militaristic global corporate campuses create lots of civil unrest. This is why all have development making global security central. All Maryland pols---Congress, Maryland Assembly, Baltimore City Hall----MOVING FORWARD Larry Hogan and Catherine Pugh---just as with O'Malley and Erhlich see Baltimore or Prince George's County International Economic Zone as an independent global city state needing its own security structures. I think it is easy to see all of Baltimore City Center becoming ONE BIG JOHNS HOPKINS GLOBAL CAMPUS with all of today's institutions folding into this umbrella. Rather than see a Johns Hopkins Medical campus----a University of Maryland Medical campus (UMMS), a Chase Brexton Medical Building, a Maryland State Hospital now under UMMS----let's look at all of these operating as one medical unit with different specialties. Hopkins campus has its specialties and UMMS has seen tons of revenue spent making it a GLOBAL TRAUMA CENTER. One can easily see Hopkins closing its Emergency Room and having UMMS as the place for this specialty. If they sound like military evacs that would not be a coincidence.
'They contain the latest in avionics and equipment, including terrain awareness warning systems, night vision compatibility, cockpit voice and video recorders, radar altimeters and advanced instrument flight rating capabilities. The new helicopters also have more space in the patient and cargo areas to give medics better access to patients and to carry rescue equipment on board all the time'.
If UMMS is part of a global health structure specializing in trauma we can see the global 1% and their 2% flying emergency cases in from around the world---we can see trauma helicopters bringing emergencies from around the nation. Meanwhile, for Baltimore citizens not having the funds to pay for ambulances---those benefits will soon disappear.
Everyone wondered why O'Malley created this huge debt with so many air rescue vehicles and the answer is ONE WORLD GLOBAL SECURITY FOR INTERNATIONAL ECONOMIC ZONES.
'Despite the expense during tough economic times, O'Malley said the investment was crucial to preserve an important public safety initiative
The Maryland Board of Public Works - which includes Gov. Martin O'Malley, Treasurer Nancy Kopp and Comptroller Peter Franchot - voted 3-0 to approve the contract with Agusta Aerospace Corp'.
Maryland Purchases Six New Medical HelicoptersContract includes an option to buy up to six additional helicopters between July 2011 and July 2013.
Thu, Sep 30, 2010
ANNAPOLIS, Md. - Maryland officials approved a $72 million contract Wednesday to buy six medevac helicopters to replace an aging fleet for the state's renowned emergency response program, a need highlighted by a helicopter crash two years ago that killed four people.
The Maryland Board of Public Works - which includes Gov. Martin O'Malley, Treasurer Nancy Kopp and Comptroller Peter Franchot - voted 3-0 to approve the contract with Agusta Aerospace Corp. The contract includes an option to buy up to six additional helicopters between July 2011 and July 2013.
Despite the expense during tough economic times, O'Malley said the investment was crucial to preserve an important public safety initiative, which was established in 1970 as the first civilian agency to transport critically injured trauma patients.
News & Events
University of Maryland Medical Center Celebrates Opening of New Shock Trauma Critical Care Tower
Friday, November 08, 2013
R Adams Cowley Shock Trauma Center
The University of Maryland Medical Center (UMMC) today dedicated its new Shock Trauma Critical Care Tower, marking the near-completion of 140,000 square feet of new space designed to care for the region’s most critically ill and injured patients. Home to the world-renowned R Adams Cowley Shock Trauma Center, the new construction represents much-needed increased capacity. The original trauma space was designed to serve 3,500 patients a year, and has been operating at more than twice that capacity, serving more than 8,000 patients annually the last several years. The new space is nearly fully occupied with patients, with construction having been completed in stages to enable staff to expand into the new areas as soon as work was completed on a given floor or unit.
The new tower, with a public entrance on Lombard Street, houses nine floors of patient care space including 64 new patient rooms, and 10 new operating rooms. The new space also enabled expansion of the adult and pediatric emergency departments at UMMC, and new laboratory and pharmacy space. A new family and visitor lounge designed to serve the special needs of families dealing with the sudden traumatic injury of a loved one has also been added to the space.
On the roof of the new building is an additional helicopter landing pad, increasing the center’s capacity to accept air medical transport patients to four. The new landing pad has been specifically designed to accommodate larger and heavier helicopters such as Marine One in the event of a necessary landing.
“Time sensitive critical care medicine is a hallmark of this Medical Center’s service to our community, state and region. This new tower -- and the incredible people who work within it -- will enable us to remain at the forefront of trauma and critical care medicine for decades to come,” said Jeffrey A. Rivest, president and chief executive officer of UMMC.
Special guests joining today’s event included Maryland Gov. Martin O’Malley; Sen. Ben Cardin; Baltimore Mayor Stephanie Rawlings-Blake; Rep. C.A. “Dutch” Ruppersberger; Major General Mark Ediger, Deputy Surgeon General of the U.S. Air Force; and The Honorable Francis X. Kelly, Jr., chairman of the Shock Trauma Board of Visitors.
U.S. Air Force surgeons, nurses and technicians come to Shock Trauma for training through the Center for Sustainment of Trauma and Readiness Skills (C-STARS) program. The new Shock Trauma Critical Care Tower will house a technologically advanced simulation facility, where teams can replicate conditions in the hospital and on the battlefield to enhance the skills of both civilian and military health care professionals.
“This new building represents the culmination of our team’s collective vision to give each and every patient the best possible opportunity for survival and recovery,” said Thomas M. Scalea, M.D., FACS, Physician-in-Chief, R Adams Cowley Shock Trauma Center, and the Honorable Francis X. Kelly Distinguished Professor of Trauma Surgery at the University of Maryland School of Medicine. Scalea added, “We remind the citizens of Maryland that when life is on the line, we are here for them, and we need their continued support as we advance this one-of-a-kind critical care facility for the future.”
The total project cost was $160 million. $35 million is being raised through private philanthropic donations; $50 million has been provided for the project over the last 5 years from the State of Maryland, with an additional $2 million from the federal government. The University of Maryland Medical System is the largest contributor to the project.
“As a resource for all of the people of Maryland, we are grateful to the State for their support of our vision to expand and enhance this facility, and to our private donors, who have given generously so we can continue our mission,” said Scalea. “We are still actively fundraising to fully complete several key projects related to the expansion, and appreciate the generosity of those who have and will give.”
Donors who have invested $1 million or more in the tower project include: Alexandra and the late Tom Clancy; Willard Hackerman/Whiting-Turner; Edward St. John/St. John Properties; George Doetsch, Jr./Apple Ford; and Frank and Janet Kelly. $500,000 donors include: Carl Julio; John Paterakis; France-Merrick Foundation; and M&T Bank Foundation.
Additionally, leadership teams of the University of Maryland Medical System/Center and the University of Maryland School of Medicine each have contributed $1 million to the new tower. “We could not ask for the financial commitment of others without first asking ourselves,” said Rivest. “This gift and the leadership these individuals exemplify embody the spirit of our mission and is a legacy we are proud to support.”
No-bid contract with Agusta Helicopter sees Maryland's Department of Public Works operating just as Baltimore's Board of Estimates. Specializing in military helicopters sold to International Economic Zones globally.
'The Maryland Board of Public Works - which includes Gov. Martin O'Malley, Treasurer Nancy Kopp and Comptroller Peter Franchot - voted 3-0 to approve the contract with Agusta Aerospace Corp'.
This is what looking at the big picture tells us-----we cannot have Wall Street Baltimore Development 'labor and justice' organizations shouting only about individual local issues when we have gorillas in the room.
Changhe Aircraft Industries Corporation
From Wikipedia, the free encyclopedia
Changhe Aircraft Industries CorporationTypeState-owned
HeadquartersJingdezhen, Jiangxi, China
Key peopleYu Feng (Chairman)
ProductsMilitary aircraft, helicopters
Total assetsCN￥4.3 billion
Number of employees4300
ParentAviation Industry Corporation of China
Websitewww.changhe.comChanghe Aircraft Industries Corporation (CAIC) (Chinese: 昌河飞机工业(集团)有限责任公司) is a Chinese helicopter manufacturer and supplier to the People's Liberation Army of China. It is a member of the Aviation Industry Corporation of China (AVIC). The company is based in the city of Jingdezhen in Jiangxi province.
Changhe employs 4300 employees in two production facilities with 1.29 million sq. metres and 0.22 million sq. metres of construction area. It has a joint venture with Agusta Helicopter (Jiangxi Changhe-Agusta Helicopter Co., Ltd) and relationship with Sikorsky Aircraft Corporation. Its subsidiary, Changhe Machinery Factory, is a major automobile company in China.