If you want to see the temperature rise on a political debate, mention health care. Just feel the heat of speeches and debates as candidates tour the country and meet many people who cannot afford health care insurance and /or medical costs.

In response to the growing crisis, NYSUT has adopted a series of principles for affordable health care. Last month, union Executive Vice President Alan Lubin presented these to the union's Health Care Professionals Council for feedback.

Lubin co-chairs the Business and Labor Coalition of New York — BALCONY — which formulated the "Seven Principles for Affordable Health Care."

Council members urged Lubin to add a provision for "well care" programs as part of the principles.

"Part of reducing health care costs is providing a wellness program," said Renee Setteducato, a nurse at Lutheran Hospital in New York City and member of the United Federation of Teachers.

Exercise and nutrition need to be part of those programs, members told Lubin.

"It's a vision VNS (Visiting Nurse Service) has already seen," said council member Cora Shillingford, a New York City-based visiting nurse and member of the UFT.

She noted that nurses are keeping many patients "out of the hospital" with education, wellness, pain management and nutrition information.

The principles are a foundation for NYSUT members and other groups to develop proposals for New York state to address the health care crisis. Although federal action is also needed, states can still can take action.

Core components

"These principles are all core components of what we would look for in a universal health care system," said NYSUT Vice President Kathleen Donahue, who oversees health care issues for the union.

Uninsured and unable to pay, many people don't get treatment early enough, said Setteducato. "We're seeing more and more acutely sick people coming into the hospital."

With more efficient use of health care capability, administration and improvements in quality of health care, NYSUT believes significant savings can be achieved.

The principles are:

(1) Universality: All New Yorkers should be covered through a health access program with insurance of some kind.

People with pre-existing conditions must not be denied coverage or discriminated against. Coverage should be considered a right.

(2) Affordability: The insurance/access system must be affordable for all public sector employers, unions, individual and families.

This means premiums, co-pays and deductibles should be reasonable and based on ability to pay.

(3) Administrative simplicity and transparency: The system is plagued by costly and confusing barriers to enrollment, payment and basic care. These barriers hurt patients, employers and providers. The system must be made easier to work with for all who need care.

(4) Adequacy: Coverage must be adequate to care for people's needs, including primary and preventive care, as well as quality chronic and acute care coverage.

(5) Efficiency: Savings must be achieved through more efficient use of resources, such as adoption of a system of electronic medical records, bulk drug purchasing and reduction of waste.

(6) Quality: Ensure and improve the quality of care at all levels of health care and for all patients.

(7) Eliminate disparities: Achieve fairness in health care services and counter discriminatory health care practices.

— Liza Frenette