Wilson School students develop health care plan for Philadelphia

Graduate students in Princeton's Woodrow Wilson School of Public and International Affairs have developed a plan to provide universal health care for Philadelphia's residents.

The efforts of students in the Wilson School's graduate policy workshop -- commissioned by Philadelphia's Department of Public Health to develop the plan -- are expected to influence issues related to access to health care on local, state and national levels.

The plan, which calls for the creation of a nonprofit organization to oversee efforts to improve health care for city residents, was announced at a news conference at Philadelphia City Hall on Wednesday, May 11, by the city's health commissioner, John Domzalski. It was developed by the Princeton students under the tutelage of Walter Tsou, a former Philadelphia health commissioner and a lecturer at the Wilson School.

Titled "Decent Health Care for All in Philadelphia: Local Leadership and Action," the plan recommends that the city create a Health Leadership Partnership, a nonprofit organization to better coordinate and integrate health services in Philadelphia to guarantee care for all city residents. The partnership would "increase access to decent health care for all Philadelphians by engaging all elements of the community, government and local health system for collaborative planning and action to develop coordinated and integrated systems of care," according to the plan's executive summary.

The report also highlights strategies such as improving financing of universal health care in the city by increasing Medicaid funds and offering incentives to businesses that offer health insurance.

In its executive summary, Domzalski wrote that the student-devised plan is "practical and visionary."

"The plan draws upon the varied experiences of other cities and counties that have developed strategies to address the issues of the uninsured. The plan also provides an illuminating history of Philadelphia's long-standing efforts to address health disparities and the consequences of a national health policy that does not ensure decent health care for all," he noted.

Uwe Reinhardt, a professor of economics and public affairs at the Wilson School and a renowned health care economist, wrote in the foreword to the report that "the United States stands alone as the only industrialized nation without some form of universal health coverage for its citizens. … Local initiatives thus have become the core of American health policy in the 21st century. Their result will be the 'outcomes' by which the nation as a whole will be judged."

In November 2003, Philadelphia voters approved a city charter change that required the Department of Public Health to prepare a universal health care plan. The department then commissioned the Wilson School to write the plan.

Tsou led the fall 2004 Wilson School graduate policy workshop "Philadelphia Health Care Reform," which enrolled six graduate students including David Grande, a medical doctor and former intern at the Philadelphia Department of Public Health.

Tsou and the students examined various components of the city's health care system, including hospital-based care, ambulatory care, specialty services and mental health care. Workshop participants interviewed local stakeholders, community groups and health officials, invited speakers to the Princeton campus to offer local expertise on various aspects of the system and joined a series of community roundtable discussions in Philadelphia led by Tsou.

Each fall, the Wilson School sponsors six to eight graduate policy workshops to investigate a policy issue for a real-world client. The Philadelphia health care reform workshop explored the strengths, weaknesses and opportunities for universal health care in Philadelphia and examined how other American cities address the issue of the uninsured -- especially cities such as Boston, Detroit, Milwaukee, San Diego and Tampa, Fla., that, like Philadelphia, do not have a public hospital.

Philadelphia 's Advisory Committee on Universal Health Care, which comprises key local stakeholders and community leaders, will meet next week to discuss implementing the plan's recommendations.