Quinn tours a union health clinic that she hopes will be a model for freelancer care
As soon as this summer, the Freelancers Union plans to open a health clinic in Brooklyn which could eventually serve up to 100,000 self-employed New Yorkers. Yesterday, as part of an effort to bolster that plan, as well as pay homage to the union that inspired it, Council Speaker Christine Quinn toured a Hotel Trades Council-run health clinic.
A trail of staffers, union leaders and reporters followed Quinn through the hotel union’s Harlem clinic. The group wound past dental patients sitting in chairs, half-filled waiting rooms, the back of a pharmacy, and a room with a medical patient mid-injection. Finally the tour stopped in the ground-floor lobby.
“There is no greater form of compliment to pay to someone, in my opinion, than plagiarism,” Quinn said, standing next to Hotel Trades Council President Peter Ward. “And when Peter and I recently met, he was describing to me the really unbelievable soup-to-nuts health program that the hotel trades has. I was impressed.”
To aid the union with its plan, the City Council recently set aside $100,000 to go toward a flagship health center in Brooklyn. Freelancers Union founder Sara Horowitz said they’re still looking for space in Downtown Brooklyn, but they’ve already signed on Cambridge-based Iora Health to manage the facility. Iora is a for-profit company that has two clinics that serve restaurant workers in Las Vegas and another in New Hampshire for Dartmouth College employees.
Initially, the Freelancers’ Union, which has 93,000 members in the city, will support 3,000 people in the walk-in clinics. But according to the plan, it will eventually support as many as 100,000 patients enrolled in the Freelancers Insurance Company. Aside from having primary care and other specialized medical services, Horowitz said they’re also looking at alternative medicine and yoga.
Speaking to reporters, Quinn said one reason the Council highlighted freelancers is because of their growing numbers across the city.
“It was a growing part of our workforce before the recession, but even after recession that’s been up significantly,” she said.
Quinn also praised the hotel clinic's modern facilities, and said it differed from her mental image.
“If you described, ‘Oh, the hotel workers have a clinic,’ you have a picture in your mind,” she said. “This isn’t a clinic … They’ve really created a medical home here.”
Quinn went on to complain about typical medical waiting times and juggling between the doctor’s office, the pharmacy and insurance.
“None of that happens here, so I might have to get myself a side job to get better health care than I get from the city,” she said.
In a seperate initiative, the Freelancers Union last month got a $340 million federal grant to create Consumer Operated and Oriented Plans (CO-OPs) in New York, New Jersey and Oregon. Of that, $174 million will go to New York's plan. (The money comes from $3.8 billion in co-op funding set aside for in the 2010 national health care legislation.)
The freelancer co-ops would be independently run plans with their own leadership, but sponsored by the union. They would compete with private insurers and launch in 2014.
Horowitz pointed out that New York was the place where experiments in health, banks and insurance began.
“So it’s wonderful that the speaker is starting to realize that you have to go back and see the pilots that worked because our country is looking for leadership now on these kinds of issues and we have it here and we should be looking at these models,” Horowitz said. “You know, there’s the saying that future is now, it’s not just evenly distributed. The future is here.”
Horowitz said the union clinics could be made competitive by running more efficiently than existing facilities.
“There’s a lot of waste in this system and it doesn’t have to do with the quality of care, in fact ironically it’s the opposite,” Horowitz said. “Sometimes the most expensive is not the best.”
Ward invited people across the city to look at the hotel union’s model, which treats 80,000 workers and their families. (In fact, the union’s comparatively generous benefits have been widely looked at recently.)
“It’s not the only model that could be used to drive down costs and to increase efficiency and quality, but it’s a very good one,” Ward said, “We’re very proud of it.”
He added that while the national health care bill changed some rules and provided insurance to 40 to 60 million people, it wasn’t helping to lower costs.
“How much longer can citizens of New York or the citizens of U.S. continue to have health care? And the answer is we’re about to reach a saturation point. We’re about to reach a point when the cost of health care will be beyond any normal, everyday person’s ability to pay for it.”
The clinic is one of the four the union operates to keep costs down and consolidate its services. Its premise is that locating every medical service in one building streamlines communication between primary care doctors, specialists and insurance providers.
Robert Greenspan, who heads the union’s benefits fund said keeping all the staff on salary eliminates the need to "over-treat" and test. He said getting rid of duplicate services saved 66 percent of costs.
“I think the problem with health care in this country is that we pay for quality, not quantity,” said Greenspan. “Doctors in private practice are having to produce more and more order as fees get cut in order to maintain their standard of living.”
Victor Rodwin, a professor of Health Policy and Management at NYU Wagner, said the union's clinic idea is good, as long as it’s well-run and can effectively serve people with no insurance. While he was unfamiliar with the specifics of the Freelancers Union plan so far, he said experimental pilots like the one they're proposing can serve a valuable purpose, at least for the parties who are directly involved.
“I think they work for people who study and evaluate them, and they work for the small amount of people who get served in comparison to not getting solved at all, but they don’t solve the real problem,” he said over the phone. “But that’s what you do when you have limited resources.”