In a recently distributed flyer, PASNAP makes gutsy claims against TUHS.
Amid heated contract negotiations between Temple University Health System and the union representing the Temple nurses and professional staff, the Pennsylvania Association of Staff Nurses and Allied Professionals is claiming Temple has distorted priorities.
“Support Temple’s dedicated caregivers,” read a flyer recently distributed by PASNAP, accusing TUHS of overcharging patients.
According to recent reports filed by the Pennsylvania Health Care Cost Containment Council, the average charge per medical procedure for the Temple University Hospital is considerably higher than other area hospitals.
“If you look at [the Pennsylvania Health Care Cost Containment Council’s Web site], it has a page by page list of diagnoses, and it has the average charge. On the page that says abnormal heartbeat, the average charges on this at the different hospitals range from a low of [around $10,000] to a high of [$98,328] which is Jeanes, closely followed by Temple at [$96,222].
“And Hahnemann comes in at [$83,593],” Jerry Silberman, staff representative for Temple nurses, said. “And they are the highest on them. The average statewide charge is [$32,586]. So Temple’s charge is 300 percent of the average charge for the state. And they are out of [about 54] hospitals that are listed here, the two that charge the most are Temple and Jeanes, which is Temple.”
Interim CEO of TUH Sandy Gomberg said the accusation is wrong.
“It speaks once again to their uninformed position about health care finances in general,” she said.
Gomberg said the charges that appear in the reports are “like the sticker price when you buy from a car dealer. Nobody really pays the sticker price.”
Contracts for the various services and procedures, Gomberg said, are negotiated with the individual’s insurer, and the price paid is the result of that contract.
“The most important thing I want to reinforce is about uninsured patients. So first, anybody who comes here who needs any kind of care gets that care, regardless of their ability to pay,” she said.
“We have financial counselors who work privately with those patients [without the ability to pay] to help enroll them in medical assistance or other programs in order to help them get the coverage they need,” Gomberg said. “Now, not everybody is eligible for that medical assistance coverage, so for people without insurance, what we [ask them to pay] is based on a sliding scale, the cost of their care and of their ability to pay based on the federal poverty guidelines. They are not based on charges.”
The only other area hospital whose charges were comparable to TUH’s was the for-profit Hahnemann University Hospital.
“We’re a not-for-profit hospital,” Gomberg said. “So at the end of the year, any surplus that we have on the bottom line gets reinvested back into the organization so we can recruit new physicians, buy new equipment, upgrade or maintain the building of the hospital. All the things we need to do to keep improving patient care.”
PASNAP’s flyer, however, addressed Temple’s “distorted priorities.”
“Well, basically, the hospital was preparing for a strike, which did not happen. Temple spent, in our best estimate, based on our experience, Temple probably spent $6 [million] to $10 million preparing for a strike, hiring scabs, hiring replacements in all the categories, having approximately 1,000 people here in town,” Silberman said. “Now, all our demands would not have cost $10 million. If they met every single proposal that we [had] on the table, at that time, it wouldn’t have cost them $10 million.”
Gomberg said strike preparedness and negotiation terms were not financially related.
“From a preparedness standpoint, we are obligated and feel very strongly about our responsibility to provide uninterrupted patient care if the union decides to walk out and go on a strike,” she said. “We will do what ever it takes to provide the right staff to take care of the patients. Right now, because we don’t have a contract, there remains a strike risk. We’ll be ready if the union gives us another strike notice.”
Silberman emphasized that the heart of PASNAP’s concerns remain non-economic. The language in the contract that Temple currently has on the bargaining table, she said, limits the nurses’ ability to advocate for their patients and fails to address poor working conditions.
“They tell us across the table, ‘You don’t have anything to say about the quality of care we provide, it’s not your place to address those issues.’ Well, I’m sorry but it’s not only a nurse’s place and responsibility as a professional, but it’s our responsibility as a union to fight for our members’ better working conditions, which means better patient care,” Silberman said. “You can’t divide those two things. The working conditions of the nurse is the quality of care that the patient receives.”
Silberman pointed to money wasted on corporate management, explaining that several of the hospitals in TUHS have closed since creating the existing management structure.
“Do you need a separate tier of million-dollar executives to manage two hospitals? It doesn’t make any sense to us,” he added. “That’s what we think are distorted priorities.”
But Gomberg said TUH’s priorities revolve around providing quality patient care and a quality education to medical students.
“Our top priority is the delivery of quality and safe patient care to all of those who come here seeking care, so obviously, the nurses and technical staff are very important to making sure our patients get the best care,” Gomberg said. “We also have a strong academic mission, because we’re training the next generation of physicians, so what we’re all about is patient care, and our mission begins and ends with patient care, and certainly our employees, specifically the nurses and the allied health professionals are very important to making sure we provide great care to those patients.”
“[There] are non-economic proposals,” Silberman said. “They don’t cost the hospital anything. They are issues which are really blocking us and keeping us from getting to the serious discussion of finance.”
Valerie Rubinsky can be reached at email@example.com.