AFT Resolution


WHEREAS, there is a need to reclaim the promise of quality healthcare to fulfill our collective moral responsibility to provide access to all; and

WHEREAS, the U.S. healthcare system is the most costly in the world and yet produces no better care than countries which spend half of what we do or less; and

WHEREAS, reclaiming the promise is about creating a healthcare system that puts patient care and safety above corporate profits—a promise that is under attack by those who demand and pursue profitization, privatization and deprofessionalization of health services; and

WHEREAS, compensation for hospital executives increases at double-digit rates while nurses and other healthcare workers are being laid off. The CEO of the large for-profit hospital system HCA received $46 million in compensation in 2013. The nonprofit sector also rewards its administrators well. In 2013, the average annual compensation of a hospital CEO at a nonprofit hospital was $600,000, with many nonprofit administrators receiving more than $ 1 million; and

WHEREAS, the 2013 data showed that CEO compensation was not tied to higher quality, better outcomes or other factors that would benefit patients and communities. Instead, CEO compensation is linked to the purchase of new technology as well as, in some cases, increases in revenue and in hospital admissions—exactly the opposite of what our system needs and what the Patient Protection and Affordable Care Act is trying to achieve; and

WHEREAS, others are also extracting exorbitant sums, often at taxpayer expense, from the healthcare system. The 2014 release of data on Medicare payments to physicians included examples such as three Florida ophthalmologists who tried to bill the government more than $22 million in a single year and seven doctors who each received more than $10 million in payments from the government; and

WHEREAS, it has been estimated that a third of the nearly $3 trillion the U.S. spends on healthcare each year—or more than $700 billion—is spent on unnecessary and/or wasteful procedures as well as simple fraud; and

WHEREAS, the true cost and price of hospital procedures are often unobtainable and frequently unknowable. It is impossible to “comparison shop” for hospital procedures because most hospitals will not or cannot provide an average price for their services; and

WHEREAS, in 2013, data were released that showed wild and inexplicable variation in charges for the same procedures. One hospital in Virginia charged more than $117,000 for a lower-limb replacement while another charged $25,600 for the same procedure. One hospital outside Dallas billed $160,832 for lower-joint replacements while another, five miles away, charged $42,632. One New York City hospital charged an average of $34,310 to treat complex cases of bronchitis or asthma while another, 63 blocks away, charged $8,159 on average; and

WHEREAS, too often monies are allocated to flashy new technologies, profitable specialty services and costly marketing strategies instead of what the communities really need; and

WHEREAS, our healthcare system has gradually shifted to a culture in which, far too often, the needs of patients and communities may be subordinated to the pursuit of profit; and

WHEREAS, we believe there are many nurses, physicians, administrators, healthcare workers and other professionals who remain committed to the ideal of service and to the vision of a healthcare system in which the patient is at the center; and

WHEREAS, the time has come to address the skewed incentives and distorted values that have led to a system in which healthcare is viewed as a commodity and patients are seen as profit centers:

RESOLVED, that the American Federation of Teachers will join with patient advocates, community groups and other providers to create a national education and advocacy campaign that will focus on reshaping the U.S. healthcare system to serve the needs of our communities and to truly put patients first; and

RESOLVED, that the AFT will seek to reclaim the promise of quality healthcare by advocating for resources and policies that will ensure frontline caregivers and staff are well-prepared and supported to provide safe, efficient and high-quality patient care; and

RESOLVED, that the AFT will advocate for transparency in the healthcare industry. On the theory that sunshine is the best disinfectant, we are calling for all financial information and quality indicators to be publicly available, including staffing levels and the results of investigations by industry groups responsible for quality oversight, such as the Joint Commission; and

RESOLVED, that the AFT will work with patient advocacy and community groups to demand an end to wasteful, out-of-control spending on new technologies and specialty services as well as a new emphasis on patient safety and quality care; and

RESOLVED, that the AFT will advocate for structures to be created that ensure a strong voice for communities and healthcare workers in determining what services the community actually needs; and

RESOLVED, that the AFT will work to unite the voices of caregivers, patients, families and the community to reclaim the promise of quality healthcare; and

RESOLVED, that the AFT will call for regulatory agencies to do their jobs. In addition, there should be better coordination among agencies and departments charged with monitoring criminal and/or inappropriate behavior as well as quality of care. Penalties should be real and substantial for those who cross the line.