Notes on a Barter Process for Philadelphia Medical Centers

Many Philadelphians are walking around with untreated hernias, broken teeth, grinding knees, aching backs, pinched nerves, leaking valves, frightening bumps, and other untreated afflictions because they have neither insurance nor cash.

Nor are they poor enough, old enough, or young enough to qualify for public aid.

These people, the un-insured and poorly insured, whose billings are often uncollectable, can be brought into a mutually beneficial relationship with Philadelphia medical centers through an orderly barter process. Most of these people would prefer to pay, in some form, were they able to.

By offering them barter options, Philadelphia hospitals will obtain needed goods and services that it would otherwise purchase, and will recoup value otherwise uncollected. They will also strengthen community loyalty by presenting themselves as creative, flexible and working hard to make sure all medical needs are met. The program thus has both practical and promotional value.

By establishing clear guidelines, this program will be:
• perceived as fair-- first come first serve for basic skills-- without favoritism,
• offering distinct benefits responsibilities, so not to disappoint expectations,
• acceptable to both staff and Auxiliary volunteers,
• easy to administer (perhaps by an Auxiliary volunteer).

HOW TO BEGIN:
• Create/adapt a database of needed goods and services by category, schedule/frequency of need, job desciption, compensation.
• Opportunities for basic labor, like cleaning, providing rides to outpatients, etc. could be available both on your website and on user-friendly computer terminals in lobbies.
• For professional RFPs, invite hospital credit to be one component of bidding. Local people have an advantage in such bidding, and would be likelier to accept hospital credit as part payment if the credit they gain is transferable to family, friends, associates, etc.
• Area medical centers could in fact sell/pay their own promissory note-- Philadelphia <a href=”http://www.healthdemocracy.org/medicash.html”>MediCash</a>-- in small denominations: $5, $10, $20, $50, $100. These artistic notes, redeemable by anyone for anything medical, could circulate as money locally. The smaller notes would be retained as collectors' items not redeemed.
• Another very dynamic link to the communty would be participation in a Time Dollar system. <a href=”http://www.timebanks.org”>Time Dollars</a> are a computer credit system which matches seniors to help one another (home visits, companionship, cooking, chores, errands, letter writing, etc) and to receive one Time Dollar per hour of such help. Each Time Dollar is redeemable for one hour of help in return. The system has been credited with increasing by 50% the rate at which seniors are able to stay in their homes and out of nursing homes. It can be used as well to link seniors with children of single mothers (as surrogate grandparents), and any number of other social needs. Medical centers could boost this process and win community affection by crediting each Time Dollar earned as $1.00 of CMC services, upon presentation of authorized/signed receipts. Regard this as part of your promotional budget, an inspiring type of advertising.

Here are examples of two medical barter programs:
Artists and performers in Brooklyn <a href=”http://www.divinecaroline.com/article/22354/24104-artists-barter-health-care?CMP=ILC-RltdArtclWdgt “>barter for expenses</a> at Woodhull Hospital. Franklin Memorial Hospital in Maine barters with patients via <a href=”http://www.time.com/time/magazine/article/0,9171,988834,00.html”>“Contract for Care”</a>

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