Everybody In Newsletter - November 2014

H E A L T H C A R E - N O W !
Healthcare-NOW! - 215-732-2131 - info@healthcare-now.org - 1315 Spruce St., Philadelphia, PA 19107 - www.Healthcare-Now.org! 1
Everybody In
Healthcare-NOW!’s Quarterly Newsletter on the Single-Payer Healthcare Justice Movement
www.Healthcare-Now.org! Issue No. 6 - Fall 2014
Hobby
Lobby
&
Wal-‐Mart
2014's
Wake-‐Up
Call
on
Employer-‐Based
Health
Insurance
By
Benjamin
Day
2014
was
supposed
to
be
the
year
the

Affordable
Care
Act
finally
started
turning
its

wheels:
expanding
Medicaid
in
the
states

with
sane
leadership,
and
rolling
out

exchanges
(or
“insurance
marketplaces”)

everywhere.
We
all
know
how
the
story
of

bring-‐insurance-‐to-‐the-‐uninsured
has
gone,

but
the
surprise
plot
twist
for
2014
effects
a

much
larger
group
of
people:
those
who
rely

on
their
employer
for
health
insurance.
In
June
the
Supreme
Court
ruled
in
Burwell
v.

Hobby
Lobby
that
private
employers
have

the
right,
based
on
their
religious
beliefs,
to

eliminate
coverage
of
certain
forms
of

contraception
from
the
health
insurance
they

offer
to
their
employees.
In
October,
Wal-‐Mart
-‐
not
to
be
outdone
-‐

unilaterally
eliminated
health
insurance

coverage
for
all
of
its
employees
working
less

than
30
hours
per
week,
and
increased
the

insurance
premium
for
all
of
its
other

workers.
The
cut
for
part-‐timers
affected
only

30,000
of
Wal-‐Mart’s
more
than
2
million

employees,
because
so
few
of
their
part-‐time

workers
could
afford
the
company’s
health

plan
on
a
Wal-‐Mart
wage
in
the
first
place.
The
decisions
produced
a
national
wave
of

calls
to
end
a
system
of
health
insurance
that

subjects
workers’
life-‐saving
access
to
health

care
at
the
whims
of
their
employers.

Princeton
health
policy
expert
Uwe
Reinhardt

published
a
rebuttal
to
the
Hobby
Lobby

ruling
in
the
New
York
Times
that
concluded:

“The
Supreme
Court’s
ruling
may
prompt

Americans
to
re-‐examine
whether
the

traditional,
employment-‐based
health

insurance
that
they
have
become

accustomed
to
is
really
the
ideal
platform
for

health
insurance
coverage
in
the
21st

century.”
We
can’t
think
of
any
century
in
which

employer-‐sponsored
healthcare
would
be

moral
or
efficient,
but
we
plan
to
make
this

the
century
it
comes
to
an
end.
Healthcare-‐NOW!
hosted
its
tenth
annual

Strategy
Conference
in
Oakland,
CA
this
year,

where
over
300
activists
converged
for
our

first
joint
conference
with
the
Labor

Campaign
for
Single-‐Payer
Healthcare
and

the
One
Payer
States
network.
The
conference
offered
thirteen
plenaries

and
fourteen
workshops,
covering
the
history

and
prospects
of
state
single-‐payer
ballot

initiatives,
how
to
make
labor-‐community

collaborations
work,
developing
strategic

work
plans,
the
health
care
is
a
human
right

model,
organizing
around
HR676
to
build
the

national
movement,
and
more.
Healthcare-‐NOW!
created
a
Wiki
for
the

conference,
and
attendees
have
uploaded

their
notes,
photos,
and
video
of
every
single

speaker
and
workshop.
If
you
missed
the

Oakland
conference,
or
are
interested
in
the

workshops
that
you
missed,
visit
the
wiki

here:

http://singlepayer2014.wikidot.com
2014
National
Single-‐Payer
Strategy
Conference!

John
Lozier
Speaks
With
Us
About
Homelessness
and
Healthcare
John
N.
Lozier
has
been
executive
director
of
the
National
Health
Care

for
the
Homeless
Council
since
its
founding
in
January
1990.
The
Council

is
a
network
of
more
than
10,000
doctors,
nurses,
social
workers,

patients
and
advocates
who
share
the
mission
to
eliminate

homelessness.
John
lives
in
Nashville,
TN
with
his
wife
Joceline,
and
sits

on
the
Board
of
Healthcare-‐NOW!
Can
you
start
off
by
talking
about
how
people
come
to
experience

homelessness,
and
whether
the
healthcare

industry
plays
a
role
in
that?

Medical
debt,
deeply
rooted
in
the
current
system,

is
a
major
and
often
overlooked
contributor
to

homelessness.
PNHP
research
shows
that
over

60%
of
personal
bankruptcies
in
the
US
are
the

result
of
medical
debt.
From
bankruptcy
there
is
a

well-‐worn
path
through
eviction,
followed
by

temporary
stays
with
family
or
friends,
to
sleeping

in
a
car,
a
shelter
or
outdoors.

Beyond
that
driver
of
homelessness,
untreated

illnesses
play
a
huge
role
in
selecting
who
will

experience
homelessness
in
an
economy
that
is

sorely
lacking
in
affordable
housing.
Those
who
are

most
quickly
squeezed
out
onto
the
streets
tend
to
be

those
with
so-‐called
“behavioral
health”
problems
–
addictions
and

mental
illnesses.
Without
minimizing
the
difficulties
in
treating
these

diseases,
very
helpful
treatment
approaches
do
exist,
but
are
far

from
universally
available.
Uninsurance
and
underinsurance
play
a

central
role
in
excluding
people
who
need
and
want
treatment.
Even

when
one
has
a
payment
source,
system
insufficiencies
create
wait

lists
for
people
who
need
to
enter
treatment
at
the
point
when
they

are
ready.

Does
homelessness
and
housing
insecurity
create
particular

challenges
for
accessing
needed
healthcare?

Most
assuredly.

The
Institute
of
Medicine
of
the
National
Academy

of
Sciences
recognized
this
as
early
as
1988
in
its
seminal
publication,

Homelessness,
Health
and
Human
Needs.

Beyond
the
very
high

uninsurance
rates
in
the
homeless
population,
competing
survival

priorities
can
take
precedence
over
seeking
health
care.
Just
as

people
a
bit
higher
in
society’s
pecking
order
might
have
to
choose

between
paying
for
medicine
and
heating
the
house,
people

experiencing
homelessness
may
have
to
choose
between
standing
in

line
for
a
meal
or
a
chance
for
a
shelter
bed
and
standing
in
line
or

waiting
for
a
health
care
visit.
Think
about
Maslow’s
hierarchy
of

human
needs,
and
what
choice
you
would
make.
Transportation
is
another
problem.
While
public
transportation
and

safety-‐net
services
sometimes
help,
may
people
without
homes

must
walk
to
get
places,
and
services
are
not
always
located
close
to

areas
where
people
stay.
In
Health
Care
for
the
Homeless,
we
see

terrible
foot
problems,
a
result
of
all
that
walking,
of
sleeping
sitting

up
(fluids
pool
in
the
lower
extremities),
and
of
high
rates
of

diabetes.
Poor
provider
attitudes
toward
people
who
are
obviously
homeless

and
distressed
–
perhaps
with
poor
personal
hygiene
(hard
to
control

when
you’re
on
the
streets!),
bad
odors
and
strange
behaviors
–

create
new
barriers
to
care.
People
are
pushed
away

in
ways
ranging
from
subtle
to
brutal.
If
a
single-‐payer
healthcare
system
were

implemented
in
the
United
States,
how
would

that
effect
homelessness?

It
would
help
to
end
mass
homelessness
by

dramatically
improving
access
to
care.
It
would

reduce
immense
human
suffering.
Medical
debt
would
be
a
thing
of
the
past,
closing
a

front
door
into
homelessness.
At
the
primary
care

level,
the
barrier
of
co-‐pays
and
deductibles
(an

oddly
emerging
barrier
for
dispossessed
people
as

they
become
auto-‐enrolled
in
Medicaid
managed

care
programs
under
the
Affordable
Care
Act)
would

be
eliminated.
Specialty
care
and
non-‐emergency
procedures
would

become
available
–
no
longer
would
people
living
under
bridges
have

to
forego
oncology
services
or
cancer
surgery
for
lack
of
a
payer.
And

reasonable
health
planning
would
help
ensure
appropriate

geographical
distribution
of
services.

Adequate
housing
and
access
to
healthcare
are
both
fundamental

to
quality
of
life
and
human
dignity,
but
they
are
also
two
massive

industries
in
the
United
States.
Do
you
see
parallels
between
the

social
movements
to
recognize
healthcare
and
housing
as
rights?

Are
there
spaces
where
these
two
movements
could
work

together?
We
do
work
together.

We
share
the
theoretical
perspective
that

housing
and
health
care
are
both
human
rights,
and
as
such
are

interdependent
and
inseparable.
Moreover,
we
recognize
on
a
very

practical
level
that
housing
is
health
care:
one
cannot
expect
to
get

well
or
stay
well
when
living
without
housing,
exposed
to
all
sorts
of

infectious
agents,
the
harsh
elements,
parasites,
violence,
poor

nutrition,
and
poor
rest.

One
way
that
insight
takes
form
is
in
the
widely
accepted
“housing

first”
approach
to
homelessness
interventions.
Usually
focusing
on

people
whose
health
status
makes
them
particularly
vulnerable
to

homelessness,
“housing
first”
moves
homeless
people
into
housing

without
expecting
sobriety,
employment
or
other
indicators
of

John
Lozier

The
Living
Hope
Wheelchair
Association

“housing
readiness.”

Housing
becomes
the
foundation
upon
which
a

person
can
begin
to
become
healthy.

The
National
Health
Care
for
the
Homeless
Council
enthusiastically

participates
in
the
work
of
the
National
Low
Income
Housing

Coalition
for
a
National
Affordable
Housing
Trust
Fund
to
increase

the
actual
supply
of
housing.
The
Corporation
for
Supportive
Housing

helps
to
bring
our
expertise
in
health
care
delivery
into
housing
first

developments.

Of
course,
I
describe
a
relatively
narrow
focus
on
homelessness,
the

place
where
the
extremes
of
poor
housing
and
poor
health
intersect

and
offend
the
conscience.
The
collaborations
among
organizations

are
mostly
focused
on
services
and
housing
initiatives.
The
challenge

is
broadening
this
work
to
bring
the
human
rights
perspective
to
our

well-‐intentioned
colleagues
who
may
have
less
expansive
visions.

Ultimately
in
a
democracy,
the
strength
of
the
profiteers
in
industry

must
succumb
to
a
mobilized
constituency
insisting
on
basic
human

rights.

Where
can
we
learn
more?
At
our
website
(nhchc.org),
the
organizations
mentioned
above

(nlihc.org
and
csh.org),
and
the
National
Coalition
for
the
Homeless

(nationalhomeless.org)
are
great
places
to
start.
We
spoke
with
leaders
of
the
Living
Hope
Wheelchair
Association,

based
in
Harris
County
(which
includes
Houston),
Texas,
which
is
a

member
of
our
affiliate
Health
Care
for
All
Texas.
Raymundo
Mendoza

(board
secretary
and
Living
Hope
member),
Francisco
Cedillo
(board

treasurer
and
Living
Hope
member),
and
Francisco
Arguelles
(Executive

Director
of
Living
Hope
Wheelchair
Association)
answered
our

questions.
You
can
learn
more
about
Living
hope
at

LHWAssociation.org
or
by
calling
281-‐764-‐6251.
Why
was
the
Living
Hope
Wheelchair
Association
formed,
and
can

you
tell
us
a
bit
about
the

situation
faced
by
its

members?

Living
Hope
is
an
organization

formed
by
immigrants
with

spinal
cord
injuries
working
to

improve
our
quality
of
life

through
services,
advocacy,
and

community
organizing.
We

formed
in
2005
when
the
Harris

County
Hospital
District
decided

to
stop
providing
basic
medical

supplies
to
immigrants
who

were
not
eligible
for
Medicaid.

We
had
to
organize
to
find
ways

to
help
one
another
raise
funds

to
buy
catheters,
diapers,
and

other
supplies,
and
after
some

years
evolved
to
become
a
small
non–profit
organization
operated

by
us
with
the
help
of
some
volunteers.

Suffering
a
catastrophic
spinal
cord
injury
has
a
brutal
impact
on
a

person’s
life.
If
this
person
is
an
immigrant
or
a
low-‐wage
worker
in

the
United
States
then
he
or
she
is
in
an
extremely
vulnerable

situation.
During
our
existence
as
an
organization
we
have
been
able

to
help
each
other
first
to
survive
the
depression
that
comes
after
the

accident,
then
to
survive
the
problems
that
come
with
not
having

resources
to
buy
medical
supplies
and
equipment.
We
have
learned

to
improve
our
quality
of
life
through
hope
and
solidarity,
sharing

what
we
have
and
organizing
to
get
what
we
need.

What
does
the
experience
of
Living
Hope
members
tell
us
about

the
healthcare
system
in
the
United
States?
Our
experience
with
the
healthcare
system
in
the
United
States
is
a

mixed
one.
We
are
grateful
to
doctors
and
nurses
in
the
emergency

services
that
took
care
of
us
after
we
were
victims
of
a
crime
or

suffered
car
or
workplace

accidents.
We
are
grateful
to

therapists
and
rehabilitation

specialists
that
have
helped
us

along
the
years.
On
the
other

hand
it
is
very
frustrating
not

having
access
to
regular

healthcare.
It
is
very
painful
to

see
our
members
needing

attention
and
having
to
wait
until

they
are
in
very
bad
shape

because
they
can
only
be
treated

as
emergencies.
We
have
a

member
that
needed
dialysis

treatment
three
times
a
week

due
to
the
kidney
damage
he

suffered
when
he
was
shot
in
a

drive-‐by
shooting
and
he
could

only
receive
treatment
every
week

or
every
ten
days
when
his
potassium
reached
critical
levels;
even

though
we
were
able
to
get
him
more
regular
treatment
in
a
clinic,

the
damage
to
his
health
was
devastating.

More
recently
one
of
our
members,
who
is
also
our
board
treasurer,

had
to
wait
fourteen
hours
seated
in
his
wheelchair
in
the
waiting

room
at
the
county
hospital
before
a
doctor
saw
him.
They
didn’t

even
give
him
a
bed
during
those
fourteen
hours
so
he
could
lie
down

and
avoid
developing
a
bedsore
ulcer
that
can
be
very
dangerous

because
they
take
months
to
heal.
We
know

this
is
not
the
fault
of
doctors
and
nurses
but

a
consequence
of
terrible
public
health

policies
that
exclude
so
many
people
from

having
access
to
health
care.

We
believe
that
the
fact
that
we
are
not

included
is
a
great
injustice
because
we
have

contributed
to
the
economy
of
this
country

and
this
is
very
frustrating.
We
want
equality

for
all,
health
is
a
human
right,
and
we
don’t

go
to
the
emergency
room
because
we
enjoy

it!

The
situation
in
Texas
is
particularly
bad,
we

are
the
state
with
more
uninsured
people

and
recently
Governor
Perry
refused
to
take

advantage
of
available
resources
to
expand

Medicaid,
ignoring
the
negative
impact
this

has
on
the
whole
system;
we
believe
it
is

outrageous
that
he
and
other
politicians

don’t
see
that
while
they
count
the
votes

they
win
with
these
decisions,
we
have
to

count
the
hours
we
spend
waiting
in
the

emergency
room,
the
hours
we
spend
in

severe
pain
because
we
don’t
have
access
to

treatment
and
medicine,
and
we
count
those

who
die
and
could
have
lived
if
their
right
to

health
care
would
be
respected
before
the

profits
of
insurance
companies
or
the

electoral
interests
of
politicians
that
have

never
suffered
like
regular
people.

Advocates
for
a
single-‐payer
healthcare

system
will
often
hear
the
question:
“Will

this
cover
undocumented
immigrants?”

How
does
Living
Hope
make
the
case
that

access
to
health
services
and
goods
should

be
available
to
all,
regardless
of

documentation
status?
What
can

advocates
for
truly
universal
health
care

learn
from
Living
Hope’s
experience

speaking
with
the
broader
community
in

Texas?
For
us
this
is
very
simple:
We
are
human

beings,
we
have
human
rights,
just
like
the

rest
of
people
in
the
U.S.
Including

undocumented
immigrants
in
the
healthcare

system
makes
sense
from
a
public
health

point
of
view
and
also
from
an
economic

point
of
view,
it
has
been
demonstrated
by

many
different
well
respected
studies;
but

that
shouldn’t
be
the
main
reason
why
we
are

included:
human
dignity
should
be.

Texas
is
the
state
with
more
uninsured

people
and
so
many
groups
defending

human
rights
in
our
state
are
working
for
a

Medicaid
expansion
so
we
can
have
a
better

healthcare
system.
Ours
is
a
very
religious

state
and
we
think
that
those
who
want
to

deny
our
rights
and
humanity
need
to
ask

themselves:
If
we
are
not
their
brothers
and

sisters,
how
can
they
say
that
God
is
their

Father?
So
to
advocates
all
over
the
country
we
have

one
advice:
do
not
try
to
convince
your

opponents
only
with
cost-‐benefit
analysis,
or

seductive
talking
points;
it
is
better
to
share

stories
that
show
the
humanity,
suffering
and

dignity
of
our
communities
and
then
let
our

opponents
and
the
undecided
do
their

homework
with
their
consciences
and
beliefs,

most
people
will
do
the
right
thing
when
they

can
connect
with
their
own
humanity
and
not

just
with
ideological
noise.
If
a
national,
single-‐payer
system
was

implemented
that
included
all
residents,

how
would
that
affect
the
lives
of
Living

Hope
members?
Having
access
to
a
single-‐payer
system

would
have
a
great
positive
impact
in
our

lives,
it
would
mean
opening
the
possibility

of
regular
health
care
services
that
would

help
us
prevent
problems
instead
of
having

to
live
in
a
constant
state
of
emergency.
We

are
clear
that
a
single-‐payer
system
would

not
solve
all
of
our
problems,
we
will
still
be

in
our
wheelchairs,
we
will
still
have
to
face

the
discrimination
we
encounter
both
as

immigrants
and
as
persons
with
a
disability,

but
what
people
who
have
health
insurance

and
good
health
need
to
understand
is
that

for
us
this
is
not
an
issue,
this
is
a
battle
of
life

and
death,
and
having
access
to
health
care

will
reduce
the
amount
of
pain
we
have
to

live
with
every
day,
it
will
help
us
live
longer.

So,
paraphrasing
our
friend
Ken
Kenegos

from
the
Health
Care
for
All
coalition
here
in

Houston:
those
who
prevent
us
from

entering
hospitals
are
today’s
version
of

Alabama
Governor
George
Wallace
standing

in
the
door
of
the
University
of
Alabama
in

1962.
We
know
we
are
human
beings
and

have
rights
and
dignity;
the
question
is
if

many
of
our
current
politicians
in
Texas
are

ready
to
acknowledge
this
and
be
on
the

right
side
of
history.
New
York
Assembly

Sponsoring
Historic

Single-‐Payer
Hearings
The
Health
Committee
of
the
New
York

Assembly
has
announced
that
it
will
be

hosting
a
historic
series
of
six
public
hearings

across
New
York
state
to
receive
testimony

on
the
“New
York
Health,”
bill
which
would

establish
a
single-‐payer
healthcare
system

for
the
state.
Below
is
the
announcement

from
the
NY
Assembly
Health
Committee,

along
with
the
dates
of
the
hearings.
The

Campaign
for
New
York
Health
-‐
a
coalition
of

organizations
advocating
for
single-‐payer

legislation
in
the
state
-‐
is
spearheading
the

grassroots
campaign,
and
they’ve
set
up
a

new
web-‐site
here:
www.nyhcampaign.org.
"New
York
Health,"
a
universal
"single
payer"

health
coverage
bill,
would
replace
insurance

company
coverage,
premiums,
deductibles,
co-‐
pays,
limited
provider
networks
and
out-‐of-‐
network
charges.
Instead,
it
would
provide

comprehensive,
universal
health
coverage
for

every
New
Yorker,
with
a
benefit
package
more

comprehensive
than
commercial
or
other

health
plans,
with
full
choices
of
doctors
and

other
providers.
The
program
would
be
funded

by
broad-‐based
taxes
based
on
ability
to
pay.
It

would
eliminate
the
local
share
of
Medicaid

(which
would
become
part
of
New
York

Health).
The
bill,
A.5389-‐A/S.2078-‐A,
was

introduced
by
Assembly
Health
Committee

Chair
Richard
N.
Gottfried
and
Senator
Bill

Perkins.
This
series
of
public
hearings
around
the
state

will
review
the
effects
and
costs
of
the
current

health
coverage
system
on
patients,
health

care
providers,
employers,
labor,
taxpayers

and
health
and
health
care.
It
will
review
how

the
single-‐payer
system
would
work
in
New

York.

Everybody In Newsletter - November 2014

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Everybody In Newsletter - November 2014