PA: Gov Rendell Unveils Historic 'Prescription for Pennsylvania'; expansion of NP's

  1. governor's second term speach:

    governor rendell unveils historic 'prescription for pennsylvania' to provide access to affordable, quality health care for all pennsylvanians


    cover all pennsylvanians
    creation of cover all pennsylvanians (cap), a program offering affordable basic health coverage to small businesses and the uninsured through the private insurance market

    uninsured adults who earn less than 300 percent of the federal poverty level and employees of small businesses whose average wages are lower than the pennsylvania average will get help paying cap premiums through discounts and subsidies. for example, a family of four who earns up to $60,000 a year will be eligible for assistance.

    every uninsured adult who earns more than 300 percent of the federal poverty level can participate in cap by paying the full cost of the premium, which will be approximately $280 per month.

    impose a "fair share" tax on employers who do not provide health insurance equal to 3 percent of their payroll

    smokers and businesses that do not provide employee health insurance would pay higher taxes


    to further enhance access to health care, the prescription for pennsylvania will enable nurses, advanced nurse practitioners, midwives, physician assistants, pharmacists, dental hygienists and other licensed health care providers to practice to the fullest extent of their training and skills.

    promotes incentives for health care providers who offer services in the evenings and on weekends, which will help to discourage consumers from seeking emergency room treatment for routine medical concerns.

    significant reforms that will increase the accountability of everyone in the health care system: consumers, hospitals and other care providers. the initiative will focus on improving patient safety by eliminating hospital-acquired infections and targeting avoidable medical errors...

    ...plan also updates decades-old hospital regulations to require state-of-the-art patient safety and electronic health records, initiatives that will improve the quality of care patients receive and, in turn, drive down costs.

    for more information on governor rendell's prescription for pennsylvania and the proposed cover all pennsylvanians program, visit

    tv stations in philly focused on health coverage of all pa citizens + increased use and expansion of np's practice in pa.
    see video: [color=#11327f]rendell details health care reform plan

    he's meeting at univ. of penn's school of nursing today to discuss plan in depth.
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  3. by   Jolie
    I hate to sound like a naysayer, but I anticipate a number of complaints about this plan that are common to all insurance coverage.

    First of all, most employers who don't offer insurance to their employees make that decision based on financial constraints, not greed, meaning that they WOULD provide insurance if they could afford to do so. Imposing a 3%"fair share" payroll tax, and then taxing them more heavily than their competitors who offer insurance benefits will likely harm these businesses financially, perhaps leading to lay-offs.

    Secondly, insurance that costs $280/mo per person will still be out of reach of many who wish to obtain it.

    It is simply not possible to bring insurance and health care costs under control by shifting the financial responsibility to others. Only when individuals take responsibility for spending their own healthcare dollars will costs be brought under control. Gov. Rendell would serve Pennsylvanians better by negotiating low cost catastrophic coverage and creating incentives for medical savings accounts.
  4. by   oramar
    No matter what plan the govenors come up with it will not be perfect. They are being forced into this because something has to be done. I have wondered if maybe a catatrophic plan that kicks in at a certain amount could be the solution. There could be several ways of covering that initial amount.
  5. by   oramar
    I read the link and watched the Gov. on PCN. I am impressed.
  6. by   NRSKarenRN
    the patriot news , sunday, february 04, 2007
    review and opinion

    nurses are ready for larger role

    gov. ed rendell's health care initiative is a landmark in the ongoing struggle to provide adequate health care for all pennsylvanians. nurse practitioners applaud his "prescription for pennsylvania." who can argue with his proposal to tackle what he termed "an inherently complex problem" to provide adequate health care to all residents of pennsylvania? it is unconscionable that more than 750,000 adult pennsylvanians lack the basic health care they need.
  7. by   HM2VikingRN
    Quote from Jolie
    It is simply not possible to bring insurance and health care costs under control by shifting the financial responsibility to others. Only when individuals take responsibility for spending their own healthcare dollars will costs be brought under control. Gov. Rendell would serve Pennsylvanians better by negotiating low cost catastrophic coverage and creating incentives for medical savings accounts.
    I don't think that anyone is going to go from one provider to another to save 50$ on a gallbladder surgery. When people are sick they just want to get well. I really think that we have reached the limit on costsharing as a means for controlling health care inflation. When you compare the cost of drugs purchased under Medicare part D with the exact same drugs bought by DOD; DOD is able to buy them for 50% less. What is the difference? DOD/VA negotiates bulk drug prices while Big PHRMA was able to insert a rider that forbade bulk purchase negotiation for Medicare. HSA/Medical saving accounts usually benefit the very well off while the middle class takes it in the shorts. See: for an example of how screwed up HSA's can make your life as a consumer.

    Under the program, Johnson would contribute $900 to this account and his employer, the county, would contribute the remaining $1,100. Johnson could use that money for medical expenses, and if he remained healthy and didn't use it up that year, it would carry over to the next year. He could even withdraw the money for any other use, although he would pay taxes on it (and if he was not yet 59, he would also pay a 10-percent penalty). Along with this he would have an insurance plan. The one catch: He would be responsible for the first $2,000 in costs should he become sick. But the idea was that the MSA would be there to cover this high deductible.
    "So I was thinking it's going to be great for me because at least I would have something to show for my good health at the end of the year," says Johnson. As a generally healthy person, he says, he felt that traditional insurance was a waste. "I just never got anything out of that benefit." But Johnson made a bad gamble. That year, he decided to go hang gliding. "I broke my ankle," he notes ruefully. "And that pretty much ate up the funds because I had to have two operations." Because the county paid into the savings account in installments, and had only put in $400 when Johnson sought medical care, not only did he have to pay the $900 deductible employees were responsible for, he also had to front the full $2,000 deductible "right off the bat." If he had stayed in his traditional insurance plan, he would have had a $100 deductible and 20-percent co-payments for doctor services, up to an $800 limit. While both plans may have cost him about the same amount in the end (it is unclear what the co-payments would have amounted to under the traditional plan), the MSA was definitely not the boon he had hoped for.
  8. by   Jolie
    We have had this type of insurance for a number of years now. We carry a $4000 deductible and have a Medical Savings Account to help meet our expenses until the deductible is met. We contribute approximately 75% of the funds in the MSA, my hubby's employer contributes about 25%.

    I don't claim that this arrangement is a "boon" or a cure-all for rising healthcare and insurance costs, but I do firmly believe that it is effective in controlling costs to a large extent. With our previous "cover-all" type of insurance, I was probably TOO quick to run to the doctor's office for minor problems, largely because it "didn't cost me anything". I will never take chances with my family's health by skipping necessary medical care, but I am now much more inclined to take a wait and see approach with minor ailments and injuries. Also, in the event that a family member requires a "big ticket" medical procedure, I will call the facility in advance to negotiate a lower price given that I am paying out of pocket. I have never had a facility refuse to work with me on this. My daughter's CT scan ended up costing $200 rather than the $600 originally quoted. My PT for a knee injury was likewise significantly discounted. Obviously this works best when medical care can be planned in advance, not in an emergency situation, but most facilities will discount after the fact, as well.

    It is interesting that you mention prescription drugs, as that is the ONLY area that I have been unable to negotiate significant discounts, and prescriptions account for a large portion of our healthcare expenses. I ask for samples when possible, but they don't go too far, unfortunately.

    Johnson, in the above example, theorizes that both the traditional insurance plan, and the MSA plan may have cost him about the same anount in the end. That is probably true, as it has been our experience. (We do a comparison at open-enrollment time each year, and have stayed with the MSA plan because it has offered us modest cost savings.) I understand his concern that the payments into his MSA were insufficient early in the year to cover his expenses. That was a problem we had also, and we were able to convince Hubby's employer to credit the full yearly amount as of January 1. That makes the full contribution available immediately, so that if an employee or family member has expenses early in the year, they can be covered from the MSA. If Hubby should terminate employment during the year, we would be obligated to re-pay that money on a pro-rated basis. So, some of the disadvantages of this type of plan can be easily overcome.