Brooklyn Supports a Public Option, and Beyondby Eleanor J. Bader
If you tuned in to pretty much any TV news program in August you undoubtedly saw an unprecedented array of people carping about President Obama’s health care reform proposal. Some compared BHO to Hitler; others ranted about alleged “death panels” and the euthanizing of Granny and Gramps. Still others groused about socialism, as if a public option alongside for-profit medicine would be a Yellow Brick Road straight to Stalingrad.
Sadly, there were no cameras fixed on Brooklyn, where a mid-August Town Hall meeting sponsored by the PICO National Network brought 60-some people to Bay Ridge’s Lutheran Church of the Good Shepherd. PICO—People Improving Communities Through Organizing—is a 37-year-old faith-based group active in 150 cities in 17 states. It prides itself on coalition building, and this meeting brought Christians, Jews, Muslims, atheists, and agnostics together for a rousing affirmation for the president’s plan that includes the public option. Rather than denouncing HR 3200, America’s Affordable Health Choices Act of 2009, the assembled speakers talked about the need for government sponsored healthcare and cited example after example of what happens when people lack access to health insurance and medical treatment. “According to the Institute of Medicine, 18,000 people in our nation die each year unnecessarily because they lack affordable health coverage,” one PICO leaflet informed. This statistic alone was enough to rile everyone in the room. But appalling statistics aside, this issue is both deeply personal and deeply felt.
Linda Sansour, Executive Director of the Arab American Association of New York, literally brought the topic home, reporting that a 2008 health needs assessment conducted by her organization found that 37 percent of the City’s Arab community are uninsured. According to Sansour, this means that many people seek health care only in emergencies, when it is too late to do much beyond the palliative. She cited several examples, including a recently deceased woman who had never had a mammogram. By the time the woman’s breast cancer was discovered, it had advanced to stage three. Similarly, a 41-year-old man known to Sansour did not go for recommended tests because he knew he could not pay for them on his $245 weekly salary. He, too, was subsequently diagnosed with late-stage cancer.
Worse, even when people have insurance, problems abound. According to Dr. Sharon Jaynes, a hospital psychiatrist, people on Medicaid are routinely shifted from one HMO to another—or are bumped off their plans completely—without either their consent or their knowledge. “I had one patient, a man in his 20s. He and his family keep up with his mail and try to stay on top of things, but when I called his HMO they told me he was no longer insured. He and his family had no idea about this. We had to ask the hospital’s finance department to look into it and most likely this extremely sick man will have to go to a hearing to get his coverage reinstated,” she says.
Jaynes also told the crowd about another patient—middle-aged, homeless, and acutely mentally ill with a severe substance abuse problem—who has been hospitalized three times in three months. “He needed in-patient aftercare, rehab for his substance abuse, after his second hospital discharge,” she continues. “But he was denied because his HMO said it was not medically necessary. They said he could go to outpatient treatment. We know that that usually does not work for people who are extremely disorganized, like this man.”
Nonetheless, the HMO denial stood, and the patient was released from in-patient psych care and advised to immediately go to outpatient substance abuse treatment. He didn’t. Instead, a few days later he was back in the psych ward and was seemingly more disturbed than ever. “He was suicidal, with psychotic symptoms, and physically assaulted and threatened members of the staff,” Jaynes says. On top of this, “the hospitalization occurred during the period when the man was supposed to re-up for his Medicaid coverage so he missed his appointment. “Next thing the hospital knew his claim for payment was denied because—you guessed it—“he was no longer enrolled in the program.”
“I went ballistic,” Jaynes admits, “and spent at least five percent of my time over the next few days trying to fix this monstrosity. Eventually, the Medicaid people said they’d made some errors and would work on re-opening the case. But even if his hospital stay is covered, the second this man gets out of our care he has nothing—his insurance coverage is gone because he missed his recertification appointment.”
Jonathan Yedin, Director of Congressman Michael McMahon’s Brooklyn office, attended this Town Hall meeting and agrees with Jaynes and Sansour that “the status quo is unsustainable.” Yedin quoted oft-repeated statistics to indicate why: 70 percent of all bankruptcies are health care related and each day, 15,000 more people lose their coverage.
At the same time, Yedin said that before McMahon will vote for HR 3200 he wants assurance that in addition to a public option, Disproportionate Share Hospital [DSH] funding will continue so that medical centers can be reimbursed by the federal government for treating undocumented residents and others who, for whatever reason, may lack insurance coverage at the time of hospitalization.
DSH, the public option, and other kinks notwithstanding, the people in this meeting were of one mind: Comprehensive health care reform is not negotiable. What’s more, they favor a national, single-payer system, essentially Medicare for all. Physicians for a National Health Program handed out postcards pushing this plan and urged everyone to learn more about it by going to www.pnhpnymetro.org.
PNHP’s position—that access to comprehensive healthcare is a human right that should be assured by government—has also been promoted by Congressman Anthony Weiner. Although neither the congressman nor his staff attended the PICO meeting, Weiner has been a tireless and outspoken advocate for single-payer, taking the issue from the House of Representatives to FOX, MSNBC, and to senior centers and food stores in Flatbush, Gravesend, and Sheepshead Bay.
“Medicare is good for 65-year-olds, so why not 55-year-olds, 45-year-olds, and everyone else?” he asked on FOX News. “The question is not whether we have to get costs under control. It’s how we do it.”
Of course, the seemingly never-ending spiral of health care costs is of concern to PICO members, but their interest extends beyond the pragmatic to encompass what they call a moral imperative. One participant raised the issue somewhat rhetorically: “Are we our brothers and sisters keepers? Do we care about our neighbors or do we care only about ourselves?” he asked.
Heads nodded in affirmation of communal responsibility as diverse spiritual leaders ended the meeting with scriptural references to caring for the poor, the downtrodden, and the weak. The mainstream media would likely have been shocked: No one uttered a word about Nazi medicine or health care rationing, but instead indicated clear support for publicly-funded health services.
“Our faith tells us that healthcare is about more than dollars and cents,” Dorothy Fyfe of the Local Organizing Committee of the Lutheran Church of the Good Shepherd concluded. “Healthcare is first and foremost a moral issue, a test of how we as a society treat people. We have a sense of duty to one another.”
One can only hope—and organize—to make this a reality.
Physicians for a National Health Program will sponsor a forum, “Single Payer and Healthcare Reform,” on Thursday, September 17 at 7:30, p.m., Beth Israel Medical Center, Phillips Ambulatory Care Center, 10 Union Square East, Second Floor, between 14 and 15th Streets.
ContributorEleanor J. Bader
Eleanor J. Bader is a teacher, writer, and activist. She writes the monthly Stoking Fire column on rhrealitycheck.org, and also contributes to feministreview.org, ontheissuesmagazine.com, The Progressive and other progressive, feminist publications and blogs.