Larry King, president of Churchrock Chapter and a former uranium worker, doesn’t stand a snowball’s chance in the melting Arctic of receiving federal benefits afforded sick Navajos who worked in the uranium industry before 1971. King isn’t the only one.
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“Maybe now, half a century later, it’s finally time to end the war on drug users — repeal the heavy penalties for possession; pardon the millions of nonviolent offenders; replace mass incarceration with mandatory drug treatment; restore voting rights to convicts and ex-convicts alike; and, above all, purge those persistent stereotypes of the dangerous Black male from our public discourse and private thoughts.”
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Many blame the relatively lower vaccination rates in communities of color on “vaccine hesitancy.” But this label overlooks persistent barriers to access and lumps together the varied reasons people have for refraining from vaccination. It also places all the responsibility for getting vaccinated on individuals. Ultimately, homogenizing peoples’ reasons for not getting vaccinated diverts attention away from social factors that research shows play a critical role in health status and outcomes.
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From Ronald Reagan’s notorious 1961 rant against the horrors of socialized medicine to present-day propaganda of the insurance industry, right-wing and corporate efforts to halt the expansion of public health care seem to strike the exact same notes again and again — and draw on the same bogus arguments.
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Using kitchen table economics is critical for winning workers over to Medicare for All. Before this training, members may be wary of trading something they’re familiar with for something that’s unknown. But in the workshop, they see for themselves that what they have now is robbing them blind—and that Medicare for All would bring them real economic gains.
What threads its way through much of our conversation is that the insurance companies are a big part of why we pay so much for health care. For example, a Center for American Progress study shows that more than 8 percent of U.S. health care spending goes to administrative costs. However, the study put out by the Congressional Budget Office last year indicated that administrative costs under a single-payer system would be 1.8 percent or even less.
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Thousands of city frontline workers — including paramedics and emergency medical technicians — plan to boycott Mayor de Blasio’s Hometown Heroes ticker tape parade Wednesday.
Members of FDNY EMS will not be marching up the Canyon of Heroes unless they are on duty and working, union leaders said Tuesday.
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As physicians and trainees, we take an oath to do no harm. While this orientation may have practical applications within individual treatment plans, it begs some questions: Why stop at the passive “do no harm” rather than actively confronting harm? What is the physician’s duty to their patients and communities they serve? What role can we have in addressing the structural violence that causes harm to patients, such as homelessness and displacement, food insecurity, or trauma from the police and the prison system?
To adequately address these questions, we must make the ideological shift from neutrality to intentional, politicized community engagement to confront harm. Confronting harm can take many forms, including fighting back against corporations and pharmaceutical companies that prey on patients; working to end medical practices that serve as social control and exploit marginalized people; advocating for reparations and reinvestment in communities (including but not limited to health care infrastructure); resisting colonization and state-based repression, even in the face of institutional backlash; and fighting for the liberation of Indigenous communities, both in the United States and globally.
One role the physician can take on when confronting harm is that of witness. Physicians are uniquely positioned to be witnesses to the physical and psychological manifestations of structural violence. In these cases, we must move beyond reactionary practices and begin to see patients’ concerns, symptoms and trauma as not just problems to diagnose but the outcomes of a larger sociopolitical context. It is important for us to not lose sight of the whole picture when dealing with everyday issues like struggling to provide care to a patient who cannot afford medication; while this is an opportunity to advocate for an individual patient, it is also important to note this instance as a manifestation of the harms inflicted by insurance companies and pharmaceutical companies. For many patients, their diagnosed diseases may also be in large part due to structural oppression, with food insecurity, environmental racism, and lack of access to services due to segregation and disinvestment leading to physical harm.
On an interpersonal level, the physician can serve as a witness for patients and work to address these harms through treatment and care that centers the needs and lived reality of the patient. On a structural level, the physician must work to amplify the voices of the most marginalized rather than speaking on behalf of patients. This work must be community-aligned and in service of addressing the structural roots of oppression. The group Doctors 4 Camp Closure is a good example of physicians using their social capital to witness and confront inhumane detention of migrants and refugees who experience harm at the hands of the U.S. immigration prison system. Health Justice Commons is a group that centers the voices of those most impacted by the harms of the medical-industrial complex, and they call into question the lines and implicit hierarchies between providers, patients and community members. These are just some examples of the ways in which physicians can use their position as witness to drive structural change.
A second role that physicians can take on, beyond bearing witness, is that of a worker for wages. As health systems continue to grow, most physicians are workers in an industry increasingly operated by large hospitals, health systems, insurance companies, pharmaceuticals and medical technology companies. This nexus of health care capitalism allows for the exploitation not only of patients and communities, but also us as workers as well. There is a reason there is such severe physician burnout, and it comes to the lack of power we have to make the best decisions for care. These groups that hold power benefit from physicians not organizing as workers and demanding change collectively — health care workers lose power by not building together, and it takes away from the ability to advocate as effectively as we could for ourselves, our patients and communities we serve.
While our wage work may demand that most of us work within large institutions to care for patients, we must make an active choice to align ourselves with the communities we serve over the institutions we work in. Aligning ourselves as a labor force opens radical possibilities of change by giving us greater bargaining power. Take the issue of police in hospitals and emergency rooms during the uprisings of 2020. Many physicians and health care workers took issue with the fact that the police could make arrests in the ER — individually, any one physician may not have the power to escalate this issue. An organized labor force would be able to draw the attention of health care administration and demand the removal of police in the ER and in the health system at large. Organizing collectively also protects workers from institutional backlash, as seen against health care workers who speak out openly in support of the Palestinian struggle for liberation.
This kind of organizing in health care is not new — the National Nurses Union (NNU) works because nurses see themselves as workers who are organizing for themselves and the patients and communities they serve. Just most recently, the NNU published a statement against the Centers for Disease Control and Prevention guidelines for the relaxing of the mask mandate. As witnesses to the devastation of COVID-19, and as workers concerned for their own health and wellbeing, they collectively fight for change. And while less common, resident unions exist in pockets across the country; however, as physicians move up through the hierarchy, those unions tend to disappear. As physicians move through their careers, it is crucial to keep in mind who benefits from doctors not aligning with one another and with other health care workers: hospital systems and corporations. Ultimately, it is crucial for the care of patients and the movement toward health justice that physicians align as workers and witnesses; if not, we will be complicit in the structural harms we claim to stand against.
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At a Bernie Sanders healthcare town hall last year, Rep. Pramila Jayapal glibly stated that the problem to enacting Medicare for All was not more education of the public, but a question of “political will” necessary to actually push it forward. Yet, despite a pandemic, which has laid bare the inequalities and deficiencies of our healthcare system coupled with Democrat majorities in three branches of government, Medicare for All seems off the table. Where is the political will?
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To use the social wealth of a population, to teach science, and to establish a basic norm of scientific literacy are essential lessons of the pandemic. These are lessons well-learnt by the Cubans. This is why Cuba has, against all odds, developed five different vaccines. Abdala and Cuba’s four other vaccines stand as a shield against COVID-19. These vaccines emerge out of the social productivity of socialist Cuba, which has not surrendered to the ugliness of the five monopolies.
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Over the course of the COVID-19 pandemic, Southern states have been among those that have done the least to protect their residents from contracting the deadly virus.
They were some of the last to impose mask mandates and among the first to reopen after temporary shutdowns. And many sectors in the region, like poultry processing, never shut down at all. That makes it particularly striking that essential workers in Southern states disproportionately fall in the Medicaid coverage gap. Not provided health insurance through their jobs and unable to afford it in the private market, these workers risk their lives to keep the economy running — and disproportionately die in the process. Eight of the 12 states that have refused to accept federal funds to expand Medicaid under the Affordable Care Act are located in the South: Alabama, Florida, Georgia, North Carolina, Mississippi, Tennessee, Texas, and South Carolina. All have Republican-controlled legislatures.
A recent report by the Center on Budget and Policy Priorities (CBPP) looked at data from 2019, the year before the pandemic hit, and calculated that over 550,000 people working in essential or frontline industries fall in the Medicaid coverage gap. The states with the greatest number of essential workers in the coverage gap are Texas (209,000) and Florida (98,000) — GOP-led states that have had notoriously ineffective public health responses to the COVID-19 pandemic. In total, over 2 million people living in Southern states fall into the gap.
“A large body of research demonstrates that Medicaid expansion increases health insurance coverage, improves access to care, provides financial security, and improves health outcomes,” the report states.
CBPP also documented glaring racial disparities, finding that people of color make up 60% of those in the Medicaid coverage gap even though they account for only 41% of the non-elderly adult population in non-expansion states. In Texas, 74% of those in the coverage gap are people of color, while Black people account for a majority of people in the coverage gap in Mississippi and 40% in Georgia and South Carolina. At the same time, people of color face a higher risk of COVID-19 infection, hospitalization, and death.
The report notes that about three in 10 adults in the coverage gap have children at home. And a third are women of childbearing age, meaning that if they get pregnant they can apply for existing Medicaid coverage. However, the coverage would not begin until they are determined to be eligible, meaning they could miss out on critical prenatal care during the first months of pregnancy. CBPP points to an Oregon study that found Medicaid expansion was associated with an increase in early and adequate prenatal care.
In addition, CBPP calculates that about 15% of people in the Medicaid coverage gap have disabilities. That includes 7% with serious cognitive difficulties, and more than 6% who have difficulty with basic physical activities such as walking, climbing stairs, carrying, or reaching.
In the years leading up to the pandemic, states that expanded Medicaid cut their uninsured rates by half. That made them better prepared for both the ensuing public health crisis and consequent economic downturn, which resulted in an estimated 2 million to 3 million people nationwide losing employer-based coverage between March and September.
Efforts are now underway in the Democratic-controlled Congress to find a way to bring Medicaid to more essential workers — and Americans in general — despite Republican resistance at the state level.
U.S. Rep. Lloyd Doggett, a Texas Democrat, recently proposed the “Cover Outstanding Vulnerable Expansion-Eligible Residents (COVER) Now Act.” The bill, which already has over 40 cosponsors, would authorize the federal Centers for Medicare and Medicaid Services (CMS) to work directly with counties, cities, and other local governments to expand Medicaid coverage in states that have refused to do so. It’s based on previous successful demonstration projects in several counties in California, Illinois, and Ohio, and it’s won the endorsement of groups including the American Diabetes Association, National Alliance on Mental Illness, and the Texas Academy of Family Physicians.
“The COVER Now Act empowers local leaders to assure that the obstructionists at the top can no longer harm the most at-risk living at the bottom,” Doggett said in a statement.
And over in the Senate, Raphael Warnock of Georgia this week announced that he is drafting a proposal that would bypass his state’s Republican leadership while calling on the White House to include a “federal fix” in the next jobs package. Warnock told reporters that he’s hoping to introduce legislation soon. The Georgia Recorder has reported that Gov. Brian Kemp (R) is pushing a plan to expand Medicaid to about 50,000 additional Georgians, but the Biden administration has put the brakes on it over concerns that it requires participants to rack up 80 hours of work, school, or other qualifying activity every month to gain and keep their coverage.
In a letter sent last month to Senate Majority Leader Chuck Schumer of New York and Minority Leader Mitch McConnell of Kentucky, Warnock and U.S. Sen. Jon Ossoff of Georgia suggested that one possible solution could be a federal Medicaid look-alike program run through the CMS.
“We have a duty to our constituents and a duty to those suffering from a lack of access to health care to provide for them when they are in need,” Warnock and Ossoff said in the letter. “We can no longer wait for states to find a sense of morality and must step in to close the coverage gap and finally ensure that all low- and middle-income Americans have access to quality, affordable health care.”
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Trans youth are under attack around the country. Though we are only halfway through 2021, it has already become the worst year in recent history for legislative attacks on trans youth. 33 states have introduced anti-trans laws across the country, many of which ban trans students from playing sports. Arkansas recently became the first state to ban trans youth from accessing gender-affirming health care, and many other states have either passed or are debating similar bills. All of these laws must be repealed, and we need to build a militant trans rights movement to defend against these right-wing attacks.
The results of efforts to oppress and dehumanize trans people hit trans youth the hardest. The American Journal of Psychiatry reports that trans people are about six times more likely to suffer from mood and anxiety disorders, and over half of trans and nonbinary youth in the U.S. reported having seriously contemplated suicide in 2020.
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UnitedHealthcare hastily announced it would postpone the policy at least until the end of the COVID-19 pandemic. However, consumer complaints reviewed by The Daily Poster — including the incident detailed above — indicate the insurance giant has already been denying emergency room claims, asserting that patients’ medical scares weren’t real emergencies, leaving them on the hook for massive bills.
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El Paso, Texas — Alfredo “Freddy” Valles was an accomplished trumpeter and a beloved music teacher for nearly four decades at one of the city’s poorest middle schools.
He was known for buying his students shoes and bow ties for their band concerts, his effortlessly positive demeanor and a suave personal style — “he looked like he stepped out of a different era, the 1950s,” said his niece Ruby Montana.
While Valles was singular in life, his death at age 60 in February was part of a devastating statistic: He was one of thousands of deaths in Texas border counties — where coronavirus mortality rates far outpaced state and national averages.
In the state’s border communities, including El Paso, not only did people die of covid-19 at significantly higher rates than elsewhere, but people under age 65 were also more likely to die, according to a KHN–El Paso Matters analysis of covid death data through January. More than 7,700 people died of covid in the border area during that period.
In Texas, covid death rates for border residents younger than 65 were nearly three times the national average for that age group and more than twice the state average. And those ages 18-49 were nearly four times more likely to die than those in the same age range across the U.S.
“This was like a perfect storm,” said Heide Castañeda, an anthropology professor at the University of South Florida who studies the health of border residents. She said a higher-than-normal prevalence of underlying health issues combined with high uninsurance rates and flagging access to care likely made the pandemic even more lethal for those living along the border than elsewhere.
That pattern was not as stark in neighboring New Mexico. Border counties there recorded covid death rates 41% lower than those in Texas, although the New Mexico areas were well above the national average as of January, the KHN-El Paso Matters analysis found. Texas border counties tallied 282 deaths per 100,000, compared with 166 per 100,000 in New Mexico.
That stark divide could be seen even when looking at neighboring El Paso County, Texas, and Doña Ana County, New Mexico. The death rate for residents under 65 was 70% higher in El Paso County.
Health experts said Texas’ refusal to expand Medicaid under the Affordable Care Act, a shortage of health care options and the state’s lax strategy toward the pandemic also contributed to a higher death rate at the border. Texas GOP leaders have opposed Medicaid expansion for a litany of economic and political reasons, though largely because they object to expanding the role or size of government.
“Having no Medicaid expansion and an area that is already underserved by primary care and preventive care set the stage for a serious situation,” Castañeda said. “A lot of this is caused by state politics.”
Texas was one of the first states to reopen following the nationwide coronavirus shutdown in March and April last year. Last June — even as cases were rising — Gov. Greg Abbott allowed all businesses, including restaurants, to operate at up to 50% capacity, with limited exceptions. And he refused to put any capacity restrictions on churches and other religious facilities or let local governments impose mask requirements.
In November, Texas Attorney General Ken Paxton filed an injunction to stop a lockdown order implemented by the El Paso county judge, the top administrative officer, at a time when El Paso hospitals were so overwhelmed with covid patients that 10 mobile morgues had to be set up at an area hospital to accommodate the dead.
Unlike Texas, New Mexico expanded Medicaid under the ACA and, as a result, has a much lower uninsured rate than Texas for people under age 65 — 12% compared with Texas’ 21%, according to Census figures. And New Mexico had aggressive rules for face masks and public gatherings. Still, that didn’t spare New Mexico from the crisis. Outbreaks in and around the Navajo reservation hit hard. Overall, its state death rate exceeded the state rate for Texas, but along the border New Mexico’s rates were lower in all age groups.
For some border families, the immense toll of the pandemic meant multiple deaths among loved ones. Ruby Montana lost not only her uncle to covid in recent months, but also her cousin Julieta “Julie” Apodaca, a former elementary school teacher and speech therapist.
Montana said Valles’ death surprised the family. He had been teaching remotely at Guillen Middle School in El Paso’s Segundo Barrio neighborhood, an area known as “the other Ellis Island” because of its adjacency to the border and its history as an enclave for Mexican immigrant families.
When Valles first got sick with covid in December, Montana and the family were not worried, not only because he had no preexisting health conditions, but also because they knew his lungs were strong from practicing his trumpet daily over the course of decades.
In early January, he went to an urgent care center after his condition deteriorated. He had pneumonia and was told to go straight to the emergency room.
“When I took him to the [hospital], I dropped him off and went to go park,” said his wife, Elvira. But when she returned, she was not allowed inside. “I never saw him again,” she said.
Valles, a father of three, had been teaching one of his three grandchildren, 5-year-old Aliq Valles, to play the trumpet.
They “were joined at the hip,” Montana said. “That part has been really hard to deal with too. [Aliq] should have a whole lifetime with his grandpa.”
Hispanic adults are more than twice as likely to die of covid as white adults, according to the Centers for Disease Control and Prevention. In Texas, Hispanic residents died of covid at a rate four times as high as that of non-Hispanic white people, according to a December analysis by The Dallas Morning News.
Ninety percent of residents under 65 in Texas border counties are Hispanic, compared with 37% in the rest of the state. Latinos have high rates of chronic conditions like diabetes and obesity, which increases their risks of covid complications, health experts say.
Because they were more likely to die of covid at earlier ages, Latinos are losing the most years of potential life among all racial and ethnic groups, said Coda Rayo-Garza, an advocate for policies to aid Hispanic populations and a professor of political science at the University of Texas-San Antonio.
Expanding Medicaid, she said, would have aided the border communities in their fight against covid, as they have some of the highest rates of residents without health coverage in the state.
“There has been a disinvestment in border areas long before that led to this outcome that you’re finding,” she said. “The legislature did not end up passing Medicaid expansion, which would have largely benefited border towns.”
The higher death rates among border communities are “unfortunately not surprising,” said Democratic U.S. Rep. Veronica Escobar, who represents El Paso.
“It’s exactly what we warned about,” Escobar said. “People in Texas died at disproportionate rates because of a dereliction on behalf of the governor. He chose not to govern … and the results are deadly.”
Abbott spokesperson Renae Eze said the governor mourns every life lost to covid.
“Throughout the entire pandemic, the state of Texas has worked diligently with local officials to quickly provide the resources needed to combat covid and keep Texans safe,” she said.
Ernesto Castañeda, a sociology professor at American University in Washington, D.C., who is not related to Heide Castañeda, said structural racism is integrally linked to poor health outcomes in border communities. Generations of institutional discrimination — through policing, educational and job opportunities, and health care — worsens the severity of crisis events for people of color, he explained.
“We knew it was going to be bad in El Paso,” Ernesto Castañeda said. “El Paso has relatively low socioeconomic status, relatively low education levels, high levels of diabetes and overweight [population].”
In some Texas counties along the border more than a third of workers are uninsured, according to an analysis by Georgetown University’s Center for Children and Families.
“The border is a very troubled area in terms of high uninsured rates, and we see all of those are folks put at increased risk by the pandemic,” said Joan Alker, director of the center.
In addition, because of a shortage of health workers along much of the border, the pandemic surge was all the deadlier, said Dr. Ogechika Alozie, an El Paso specialist in infectious diseases.
“When you layer on top not having enough medical personnel with a sicker-on-average population, this is really what you find happens, unfortunately,” he said.
The federal government has designated the entire Texas border region as both a health professional shortage area and a medically underserved area.
Jagdish Khubchandani, a professor of public health at New Mexico State University in Las Cruces, about 40 miles northwest of El Paso, said the two cities were like night and day in their response to the crisis.
“Restrictions were far more rigid in New Mexico,” he said. “It almost felt like two different countries.”
Manny Sanchez, a commissioner in Doña Ana County, credits the lower death rates in New Mexico to state and local officials’ united message to residents about covid and the need to wear masks and maintain physical distance. “I would like to think we made a difference in saving lives,” Sanchez said.
But, because containing a virus requires community buy-in, even El Paso residents who understood the risks were susceptible to covid. Julie Apodaca, who had recently retired, had been especially careful, in part because her asthma and diabetes put her at increased risk. As the primary caregiver for her elderly mother, she was likely exposed to the virus through one of the nurse caretakers who came to her mother’s home and later tested positive, said her sister Ana Apodaca.
Julie Apodaca had registered for a covid vaccine in December as soon as it was available but had not been able to get an appointment for a shot by the time she fell ill.
Montana found out that Apodaca had been hospitalized the day after her uncle died. One month later, and after 16 days on a ventilator, she too died on March 13.
She was 56.
This story was done in partnership with El Paso Matters, a member-supported, nonpartisan media organization that focuses on in-depth and investigative reporting about El Paso, Texas, Ciudad Juárez across the border in Mexico, and neighboring communities.
To analyze covid deaths rates along the border with Mexico, KHN and El Paso Matters requested covid-related death counts by age group and county from Texas, New Mexico, California and Arizona. California and Arizona were unable to fulfill the requests. The Texas Department of State Health Services and the New Mexico Department of Health provided death counts as of Jan. 31, 2021.
Texas’ data included totals by age group for border counties as a group and for the state with no suppression of data. New Mexico provided data for individual counties, and small numbers were suppressed, totaling 1.6% of all deaths in the state. (Data on deaths is commonly suppressed when it involves very small numbers to protect individual identities.)
National death counts by age group were calculated using provisional death data from the Centers for Disease Control and Prevention, and included deaths as of Jan. 31, 2021.
Rates were calculated per 100,000 people using the 2019 American Community Survey.
The ethnic breakdown in Texas’ border counties comes from the Census Bureau’s 2019 population estimates.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
This story can be republished for free (details).
Subscribe to KHN’s free Morning Briefing.
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Monopoly medicine has allowed for the normalisation of a neoliberal approach in an arena it should never have penetrated: global health. As a result of pandemic profits, a wave of new billionaires has emerged – in stark contrast with the destitution faced elsewhere, and with the disturbing persisting inequality to access which is quickly becoming a vaccine apartheid.
Since the beginning of the pandemic, nine new people have become billionaires off vaccine fortunes, with a combined net wealth of $19.3 billion (£13.6 billion). According to the People’s Vaccine Alliance, between them, their net worth is enough to fully vaccinate all people in low-income countries 1.3 times over. The Alliance, comprised of nine NGOs including Amnesty International, Oxfam, and UNAIDS, has led campaigns against this wealth proliferation following their analysis of Forbes Rich List data…
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Last year as COVID-19 laid siege to the nation, many U.S. hospitals dramatically reduced their aggressive tactics to collect medical debt. Some ceased entirely.
But not all.
There was a nearly 90% drop overall in legal actions between 2019 and the first seven months of 2020 by the nation’s largest hospitals and health systems, according to a new report by Johns Hopkins University. Still, researchers told ProPublica that they identified at least 16 institutions that pursued lawsuits, wage garnishments and liens against their patients in the first seven months of 2020.
The Johns Hopkins findings, released Monday in partnership with Axios, which first reported the results, are part of an ongoing series of state and national reports that look at debt collections by U.S. hospitals and health systems from 2018 to 2020.
During those years more than a quarter of the nation’s largest hospitals and health systems pursued nearly 39,000 legal actions seeking more than $72 million, according to data Johns Hopkins researchers obtained through state and county court records.
More than 65% of the institutions identified were nonprofit corporations, which means that in return for tax-exempt status they are supposed to serve the public rather than private interest.
The amount of medical debt individuals owe is often a small sliver of a hospital’s overall revenue — as little as 0.03% of annual receipts — but can “cause devastating financial burdens to working families,” the report said. The federal Consumer Financial Protection Bureau has estimated medical debt makes up 58% of all debt collection actions.
The poor or uninsured often bear the brunt of such actions, said Christi Walsh, clinical director of health care and research policy at Johns Hopkins University. “In times of crisis you start to see the huge disparities,” she said.
Researchers said they could not determine all of the amounts sought by the 16 institutions taking legal action in the first half of 2020, but of those they could, Froedtert Health, a Wisconsin health system, sought the most money from patients — more than $3 million.
Even after Wisconsin Gov. Tony Evers declared a public health emergency on March 12, 2020, hospitals within the Froedtert Health system filed more than 100 cases from mid-March through July, researchers reported, and 96 of the actions were liens.
One lien was against Tyler Boll-Flaig, a 21-year-old uninsured pizza delivery driver from Twin Lakes, Wisconsin, who was severely injured June 3, 2020, when a speeding drag racer smashed into his car. Boll-Flaig’s jaw was shattered, and he had four vertebrae crushed and several ribs broken. His 14-year-old brother, Dominic Flaig, tagging along that night, was killed.
Days after the crash, their mother, Brandy Flaig, said she got a call from a hospital billing office asking for her surviving son’s contact information to set up a payment plan for his medical bills.
Then on July 30 — less than two months later — Froedtert Hospital in Milwaukee filed a $67,225 lien against Boll-Flaig. It was one of seven liens the hospital filed the same day, totaling nearly a quarter of a million dollars, according to the Wisconsin Circuit Court Access website used by researchers and reviewed by ProPublica.
“It’s during the pandemic, we’re still grieving, and they go after Tyler?” Flaig said. “It’s predatory.” Tyler Boll-Flaig declined to be interviewed.
Froedtert Hospital is the largest in the Froedtert Health system, which includes five full-service hospitals, two community hospitals and more than 40 clinics. The health care system reported more than $53 million in operating income during the quarter ending Sept. 30, 2020 — double the amount from the previous year, according to its financial filings. It has also received $90 million in federal CARES Act money to help with its COVID-19 response and operating costs, a spokesperson said.
Only Reedsburg Area Medical Center, a nonprofit hospital in Reedsburg, Wisconsin, pursued more legal actions in the spring and summer of 2020, with 139 lawsuits and 22 wage garnishments, the study showed. Medical center officials did not respond to a request for comment.
In contrast, Advocate Aurora Health, the top-suing health network in the state before the pandemic, dropped to zero court filings after February 2020, the report found.
Stephen Schoof, a Froedtert Health spokesperson, said in an email he could not comment on the Boll-Flaig case because of patient privacy laws. He also said the health system was unable to comment on the Johns Hopkins study because it had not yet reviewed all the findings. But Schoof disputed the numbers he was sent by ProPublica, calling them “inaccurate and misleading.”
Schoof objected to how researchers defined and counted legal actions. He said that Froedtert Hospital ceased filing small claims lawsuits in March 2020 but continued to pursue liens on patients involved in accidents that might result in settlements.
“The lien process does not impact a patient’s personal property and is intended to recoup expenses from settlement proceeds from the negligent party’s insurance company,” he said.
That is what happened in the Boll-Flaig case. Jason Abraham, Boll-Flaig’s lawyer, told ProPublica the lien is in the process of being settled with the hospital. He said the sum will be covered by the at-fault driver’s car insurance and workers’ compensation insurance since Boll-Flaig was on the job when the accident occurred.
Liens allow hospitals to get paid quickly and by state law must be filed within 60 days of hospital discharge. Because he was hospitalized during the pandemic, Boll-Flaig was released after about 24 hours, his mother said.
Abraham said the hospital was “trying to get to the front of the line because they think there is a pool of money available.”
Wisconsin Watch, a nonprofit news site, reported late last year that Froedtert Hospital filed 362 liens through Dec. 11, including 251 after May. That was more than the 300 liens it filed in all of 2019, the news investigation showed.
In New York, the Johns Hopkins researchers found 51 hospitals filed legal action against more than 1,800 patients between January 2018 and mid-December 2020. More than half came from just one health system: Northwell Health, a nonprofit that is the largest in the state, operating 19 hospitals with affiliations at four more across the state.
The most litigious in the Northwell system during that time was Long Island Jewish Medical Center, which filed a total of 2,011 court actions, with more than a quarter of those pursued last year, the research showed.
“During the first wave of the COVID-19 pandemic, most hospitals substantially reduced or even ceased all medical debt lawsuits. However, as the pandemic’s first wave subsided, many New York hospitals resumed business as usual,” the study says.
Although he had not seen the Johns Hopkins report, Rich Miller, executive vice president of Northwell Health, said he was skeptical of its findings, in part because the health system stopped all legal action against patients from April through September of last year.
Northwell resumed filing cases for about two months in the fall of 2020, but has since stopped. Any case filed during the brief resumption has now been rescinded, he said.
Miller said his health system does not take legal action against Medicaid patients, those over 65, the unemployed, people with disabilities or military members. Patients are pursued legally only if they have ignored attempts to work out payment plans or if they have “a strong ability to pay,” he said.
All hospitals have specific guidelines and steps they must follow before taking any “last resort” collection actions, said Marie Johnson, vice president of media relations for the American Hospital Association.
Health care systems must balance the need to be adequately financed with “treating all people equitably, with dignity, respect and compassion,” Johnson said.
Still, the problem highlights the murkiness of the U.S. healthcare system, said Nicholas Bagley, a University of Michigan law professor specializing in health law. “Sometimes we treat it like a commodity, sometimes we treat it like a right,” he said. “In the eyes of the law, these are just personal debts.”
But he questioned the wisdom of equating unpaid medical bills, often incurred during emergencies or crisis, with an overdue credit card: “Is this really how we want to process payment disputes?”
This post was originally published on Latest – Truthout.
We will also be celebrating Medicare’s 56th birthday. We hope you will join with us in demanding that Congress take action by passing a national single payer, improved Medicare for All plan. Such a plan would end the tragic denial of care that causes so much suffering and unnecessary loss of life.
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This post was originally published on PopularResistance.Org.
Epidemiologists not constrained by working for the Biden administration have been sharper in their warnings against complacency. Dr. Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, pointed to the danger of regional variations in the US.
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There’s only one person in this photograph/video of last week’s G7 meeting who represents a country where an illness can destroy an entire family, leaving them bankrupt and homeless, with the repercussions of that sudden fall into poverty echoing down through generations.
Most Americans have no idea that the United States is quite literally the only country in the “developed world” that doesn’t define healthcare as an absolute right for all of its citizens. That’s it. We’re the only one left.
The United States spends more on “healthcare” than any other country in the world: about 17% of GDP.
Switzerland, Germany, France, Sweden and Japan all average around 11%, and Canada, Denmark, Belgium, Austria, Norway, Netherlands, United Kingdom, New Zealand and Australia all come in between 9.3% and 10.5%.
Health insurance premiums right now make up about 22% of all taxable payroll, whereas Medicare For All would run an estimated 10%.
We are literally the only “developed” country in the world with an entire multi-billion-dollar for-profit industry devoted to parasitically extracting money from us to then turn over to healthcare providers on our behalf. The for-profit health insurance industry has attached itself to us like a giant, bloodsucking tick.
And it’s not like we haven’t tried. Presidents Theodore Roosevelt, Franklin Roosevelt, Harry Truman, Jack Kennedy and Lyndon Johnson all proposed and made an effort to bring a national healthcare system to the United States. Here’s one example really worth watching (it’s 2 minutes and gets better as it goes along):
They all failed, and when I did a deep dive into the topic last year for my newest book The Hidden History of American Healthcare I found two major barriers to our removing that tick from our backs.
The early opposition, more than 100 years ago, to a national healthcare system came from southern white congressmen (they were all men) and senators who didn’t want even the possibility that Black people could benefit, health-wise, from white people’s tax dollars. (This thinking apparently still motivates many white Southern politicians.)
The leader of that healthcare-opposition movement in the late 19th and early 20th centuries was a German immigrant named Frederick Hoffman. Hoffman was a senior executive for the Prudential Insurance Company, and wrote several books about the racial inferiority of Black people, a topic he traveled the country lecturing about.
His most well-known book was titled Race Traits and Tendencies of the American Negro. It became a major best-seller across America when it was first published for the American Economic Association by the Macmillan Company in 1896, the same year the Supreme Court’s Plessy v. Ferguson decision legally turned the entire US into an apartheid state.
Hoffman taught that Black people, in the absence of slavery, were so physically and intellectually inferior to whites that if they were simply deprived of healthcare the entire race would die out in a few generations. Denying healthcare to Black people, he said, would solve the “race problem” in America.
Southern politicians quoted Hoffman at length, he was invited to speak before Congress and was hailed as a pioneer in the field of “scientific racism.” Race Traits was one of the most influential books of its era.
By the 1920s, the insurance company he was a vice president of was moving from life insurance into the health insurance field, which brought an added incentive to lobby hard against any sort of a national healthcare plan.
Which brings us to the second reason America has no national healthcare system: profits.
“Dollar” Bill McGuire, a recent CEO of America’s largest health insurer, UnitedHealth, made about $1.5 billion dollars during his time with that company. To avoid prosecution in 2007 he had to cough up $468 million, but still walked away a billionaire. Stephen J Hemsley, his successor, made off with around half a billion.
And that’s just one of multiple giant insurance companies feeding at the trough of your healthcare needs.
Much of that money, and the pay for the multiple senior executives at that and other insurance companies who make over $1 million a year, came from saying “No!” to people who file claims for payment of their healthcare costs.
This became so painful for Cigna Vice President Wendell Potter that he resigned in disgust after a teenager he knew was denied payment for a transplant and died. He then wrote a brilliant book about his experience in the industry: Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans.
Companies offering such “primary” health insurance simply don’t exist (or are tiny) in almost every other “developed” country in the world. Mostly, where they do exist, they serve wealthier people looking for “extras” beyond the national system, like luxury hospital suites or air ambulances when overseas. (Switzerland is the outlier with exclusively private insurance, but it’s subsidized, mandatory, and non-profit.)
If Americans don’t know this, they intuit it.
In the 2020 election there were quite a few issues on statewide ballots around the country. Only three of them outpolled Joe Biden’s win, and expanding Medicaid to cover everybody was at the top of that list. (The other two were raising the minimum wage and legalizing pot.)
The last successful effort to provide government funded, single-payer healthcare insurance was when Lyndon Johnson passed Medicare and Medicaid (both single-payer systems) in the 1960s. It was a hell of an effort, but the health insurance industry was then a tiny fraction of its current size.
In 1978, when conservatives on the Supreme Court legalized corporations owning politicians with their Buckley v Belotti decision (written by Justice Louis Powell of “Powell Memo” fame), they made the entire process of replacing a profitable industry with government-funded programs like single-payer vastly more difficult, regardless of how much good they may do for the citizens of the nation.
The Court then doubled-down on that decision in 2010, when the all-conservative vote on Citizens United cemented the power of billionaires and giant corporations to own politicians and even write and influence legislation and the legislative process.
Medicare For All, like Canada has, would save American families thousands every year immediately and do away with the 500,000+ annual bankruptcies in this country that happen only because somebody in the family got sick. But it would kill the billions every week in profits of the half-dozen corporate giants that dominate the health insurance industry.
The Covid crisis — which is producing an explosion in healthcare debt for American families (but not for those in any other “developed” nation) — is starting to create considerable pressure for change, but Americans still must overcome the political corruption the Supreme Court wrote into our system with Citizens United.
It’ll be a big lift: keep it on your radar.
This post was originally published on Latest – Truthout.
Rapid City, South Dakota – In a devastating blow to the Self-Determination of all Native American Indian Tribes in the United States, the Supreme Court denied the Petition in the case, Gilbert v. Weahke. In doing so, the Justices also violated Article VI of the U.S. Constitution, the Indian Self-Determination Act, the Lanham Act, the Transfer Act, and the Abstention Doctrine.
The case began when a federal agency, the Indian Health Service (IHS), gave an Indian Self-Determination Act multi-million dollar contract to a South Dakota non-profit corporation to manage the Sioux San IHS Hospital in Rapid City, SD. As the South Dakota non-profit corporation was not a Tribal Organization under the jurisdiction of any tribe and without federal recognition, this was a violation of Public Law 93-638, the Indian Self-Determination and Education Assistance Act (ISDEAA).
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While many in the U.S. have breathed an understandable sigh of relief as COVID cases sharply decline across the country, cases have continued to climb across much of the world where the number of available vaccines ranges from few to none. And after President Joe Biden came out in support of waiving intellectual property protections for coronavirus vaccines, the pharmaceutical industry began furiously lobbying governments in Germany, Japan, and elsewhere to maintain the patents that block other companies and labs from increasing the global vaccine supply.
The global fight for affordable COVID vaccines is becoming one of the defining issues of our time, and it has many lessons to learn from the struggle to win global access to AIDS treatment drugs. For the past three decades, coalitions like the South Africa’s Treatment Access Campaign have mounted successful campaigns against drug companies making obscene profits from AIDS medications that many sufferers of the disease couldn’t afford. There are many parallels between the impact of AIDS and COVID within the United States as well, especially the disproportionate impact both diseases have had on poor people of color — and the outrageous disregard that policy makers have displayed toward them.
Sam Friedman is an international AIDS researcher who has specialized since the early 1980s in studying HIV harm reduction among people who use drugs. He is also a longtime socialist writer and activist who has written about subjects ranging from rank-and-file organizing inside the Teamsters union to the global movement for access to affordable AIDS treatment. In this interview, Friedman talks about the lessons to be drawn from the movement to lower prices for vital AIDS treatments, why both AIDS and COVID have disproportionately hit poor people of color, and why people who rightfully mistrust pharmaceutical executives should still believe in the effectiveness of their vaccines.
Danny Katch: The current fight against to make COVID vaccines accessible and affordable across the world builds on the long struggle to do the same for AIDS treatments. What lessons can activists can draw today from that movement?
Sam Friedman: First, AIDS activists had to fight the U.S. government to get more research funding and for fast-track methods to make promising drugs available to those getting sick and dying. They won on this, so academic researchers worked with pharmaceutical companies to develop and test promising drugs. The pharmaceutical companies patented them and sold them at high prices to make great profits. Researchers and companies also tried to create vaccines for HIV — with no success so far, but they learned a lot about immunology and viruses that I’m sure contributed enormously to developing COVID vaccines and therapies.
In course of the AIDS struggles, community groups organized first to get research done. Later, they remobilized to make the drugs available all over the world at a price people could afford. That involved lots of struggles — including some mass actions in South Africa — and threats by certain governments (who had pharmaceutical industries in their own countries) to break the patents based on a public necessity argument. This was first fought and won in Brazil, and then India got involved. Now, in 2021, we are waging similar fights to make COVID vaccines available.
Importantly, every time the drug companies change their formulations at all, they can reopen negotiations. So, this led to a series of interminable negotiations over prices that led to the bureaucratization of the community side.
The movements around AIDS have been activist and powerful enough to get the U.S., UN, and foundations to promise to fund treatment for everyone who got infected. This has saved millions of lives, and helped pharmaceutical companies to be among the most profitable in the world — but nonetheless, these countries and institutions have never provided sufficient funds and probably never will. And almost a million people still die of AIDS every year.
Are there common patterns in which populations have been hit hardest by AIDS and COVID?
The viruses have enormously different patterns and ways to spread. COVID peak infectivity lasts for four to seven days; AIDS, initial infectivity lasts for months before the immune system reduces to a lower level, but you continue to be modestly infectious until you die or medicines make you noninfectious. In addition, the viruses spread differently. The three major ways that people get infected with HIV are sex, injection and being born to somebody infected with HIV — in the absence of any protection in each case. COVID spreads widely, mainly through the air.
And yet remarkably, though not surprisingly to epidemiologists or anyone who knows anything about public health, in the United States, Black and Latino people are hit harder by both COVID and AIDS. At first, it looked like COVID was hitting the middle class and the rich countries because they’re the ones who could be in the airplanes and transmit it to their friends, but it rapidly shifted away from that class and away from white folks. The global response to COVID, like AIDS, reproduces racial forms of oppression.
Who gets arrested and put in prisons where people get infected? Who’s working in the meatpacking plants? Who are in the really cruddy jobs in hospitals with patient contact but the least ability in the early days to get access to personal protective equipment? Migrant agricultural workers are another niche for the disease, as are the immigrant concentration camps along the border.
And then with vaccinations, people talk about hesitancy and the fact that racially oppressed communities don’t trust the public health system — which is only reasonable given the history. But in addition, they are more likely to have to take care of kids when they’re not at work because their spouse, if they have one, is working the other shift. So how can you get to a vaccine?
Do you see parallels in the way the people most vulnerable to AIDS and COVID have been treated by political leaders?
In both diseases, those who have died were to a large extent from groups that corporations and/or politicians see as “disposable people.”
In 1989, Ernest Quimby and I wrote an article about the politics of AIDS and the Black community in New York City. We described how what we then called “propriety politics” led to the widespread distancing of community leaders from drug users. It led many politicians and preachers, and those who respected those politicians and preachers, into taking positions against needle exchange programs that could have saved many lives. Basically, the position was, we don’t care, they’re messing up our neighborhoods, let them die. Nonetheless, a lot of people in the neighborhoods that were getting messed up by drugs, drug raids and drug deals were very supportive of needle exchange — it was their children or fathers and mothers who were getting AIDS. But who would talk to them?
Gay men were also seen as disposable. Jesse Helms, senator from North Carolina, proposed an amendment that barred federal funding for AIDS programs that “condone homosexual activities” and it passed the Senate. Ronald Reagan didn’t mention the word AIDS for many years at least in public.
With COVID, the presidential order forcing people back into the meatpacking plants that were spreading the virus was a horrible thing to do and should have been defied and met with a general strike. Then there’s the Great Barrington Declaration, which even some on the left have written in support of, which basically said to use herd immunity in the sense of let everyone get infected, and to essentially put old people in isolation to protect them, which is a horrible thing to do. I’m an old person — I don’t want to be put aside or treated as disposable.
In both epidemics, we have had to fight for everything we could get.
Many people might think that denialism and conspiracy theories around COVID and now the vaccine is a new phenomenon, but wasn’t there also denial of the scientific understanding of AIDS?
Yes, at first some people thought it was caused by drug use and a “dissolute life” — the wages of sin and all the rest — and Peter Duesberg, a scientist from another field, made a case in 1987 that the Koch Principles proving something was an infectious disease hadn’t been met, and that a behavior like drug use directly caused AIDS rather than the HIV virus. It seemed defensible at the time, it got published in a respectable medical journal and had some well-respected supporters. But then medicines were designed to precisely attack the HIV virus, people took them, and cures happened. The medicines attacking HIV were clearly preventing AIDS. At that point, all intellectual respectability for the Duesberg thesis stopped. But he stuck by his guns and he had a lot of followers, which ultimately grew to include the president of South Africa, and through that, became public policy in South Africa in the late 1990s and early 2000s. It became a huge international fight and scandal, and many people died from AIDS.
Later, in the early years of the Iraq War, I remember talking to a member of my antiwar group who was totally convinced AIDS wasn’t caused by HIV. Nothing I said convinced her. She’s currently a COVID vaccine opponent — every day or two, she puts an article or argument against vaccines on our group’s listserv. So, there’s some continuity. I think it goes deeply into the alienation that’s endemic under capitalism, and the well-rooted distrust for institutions. I always tell people: Don’t trust the government, don’t trust pharmaceutical companies, but be intelligent about it. Don’t be paranoid.
So that leads to the million-dollar question: Why should people take the vaccine if we are understandably mistrustful of the pharmaceutical companies that produce them?
The first reason people should take vaccines, and it goes against a lot of the reigning “Me first” ideology of this country, is that not getting the vaccine can kill other people. Every vaccine-hesitant person, every person we’re not able to reach with a vaccine, every person who takes only one shot of a two-shot vaccine, is a potential breeder of mutants. And that may be the mutant which starts spreading and kills 20 million people or more. So, the key reason to take the vaccine is to protect other people. All arguments people make about side effects or this, that, and the other have to be taken with that in mind. I can listen to them case by case with my friends and be sympathetic, but ultimately, they’re playing with other people’s lives, and if they don’t take that into account in their personal calculus, I have no respect for that. Particularly if they pretend to be left or progressive.
But underlying that is the question of why we should we trust the science in this case. First of all, we do have to understand that pharmaceutical companies are in it for the money. Governments are there to keep the people down so that corporations can make money. No one is our friend in an official position. We have to fight them tooth and nail all the time. I do not trust governments or corporations, either.
That said, corporations can’t get away with lying about COVID vaccines. Look at the amount of research that’s already been done by independent groups tracing the effects of the vaccines on public health. Look at what happened to AstraZeneca and Johnson & Johnson because of side effects that basically are negligible compared to the damage that COVID does.
If companies tried to fake the effects of the vaccine in a clinical trial, the chances are reasonably high they’d be caught by the FDA group, but they’re also very high that their own scientists would leak it. Scientists usually respect truth, and even scientists corrupted by pharmaceutical salaries would be reluctant to fudge trial results when they or their friends and families might die from COVID because of it.
There is a populist (as opposed to a Marxist) thread in a progressivism that blames everything on the greed of corporations and doesn’t look at the systematics of capitalism. It doesn’t take into account that the other capitalists need their workers all over the world, doesn’t take into account the fact that the people who do the research are themselves workers and they’re not about to screw themselves and their families for money — a few will, but a company cannot count on all of them to do it. So, you’ve got to step back from the paranoia and ask how likely companies would be to get away with it.
And the good news is that the vaccines seem to be doing remarkably well, with few people having bad side effects. But the bad news is that companies and governments are putting profits ahead of lives once again, and many millions of people who cannot get vaccines are dying.
This post was originally published on Latest – Truthout.
Prices rise for a range of reasons, the current rise largely fuelled by the collapse of sizeable sections of the global economy during the pandemic. Warnings of general inflation due to lockdown-related pent-up demand, shipping bottlenecks, and oil price increases loom over richer states, which – due to the power of the wealthy bondholders – have few tools to manage inflation, and by poorer states, which swirl in a cataclysmic debt crisis.
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New Zealand’s nurses and midwives’ union and district health boards (DHBs) will discuss where to from here after failed pay negotiations led to an eight-hour national strike yesterday.
Thousands took to the streets, including nurses and supporters, to protest for better pay and conditions.
The DHBs and New Zealand Nurses Organisation (NZNO) was today discussing a possible further date for negotiations, and listen to feedback from union members.
Deputy Prime Minister Grant Robertson said the government was totally committed to getting back to the negotiating table, represented by the DHBs.
“Obviously there are some financial constraints in the wake of covid but we do understand the importance of this workforce and we want to negotiate in good faith,” Robertson told RNZ First Up.
The pay settlement in 2018 “made a big difference” but the unfortunate reality was that higher pay rates were available in Australia and had been for some time.
“Nursing is a global environment, but we still think the salaries that are offered are competitive along with other working conditions and clearly, obviously, living here in New Zealand,” Robertson said.
“That doesn’t stop us from knowing we’ve got to sit down and have a good negotiation and do that in good faith.”
Improving conditions just as important as pay – NZNO
NZNO industrial services manager Glenda Alexander told RNZ Morning Report conditions and pay needed to improve so essential workers did not look to other sectors for a better salary.
“They’re kind of interwoven [pay and conditions]. If we don’t pay people what they’re worth, what the job is worth, they’re not going to stay and we’re not going to get new people into the nursing workforce.”
Nurses and midwives were exhausted and there was a need to attract more people to replace an ageing workforce that was set to retire, Alexander said.
“If we can’t improve conditions whereby new nurses come into the system, we’re in serious trouble.
“Nurses do their very best at work to not reveal to patients that they’re caring for what’s really going on but patients see some of that stuff – they see the nurses running from person to person, they note they haven’t had breaks.”
The union wanted systems that were agreed to in the last bargaining period put into place, including ensuring the right people were on shifts and boosting capacity to respond to demand.
“We want to see that put well in place … so that our members have surety that when they come to work they are going to have workloads that are manageable,” Alexander said.
Canterbury DHB clinical nurse specialist Nikki Reid, who is also a union member, said there was a huge amount of public support yesterday with people even signing a petition to Minister of Health Andrew Little.
“The fact we had so many nurses out on the picket line is indicative of the depth of feeling for nursing that we have to get this correct because at the end of the day this is also about, or hugely about, patient safety,” Reid said.
“I would say it is incumbent on the DHBs and the government to produce a better offer so that we can recruit and retain nurses and have a nursing workforce that is safely staffed to ensure best outcomes for those patients.”
Manukau Surgery Centre associate clinical nurse manager Audrey Hauraki, a union delegate, agreed, saying the strike was not just about pay.
“I don’t think our members want to focus entirely on the wages that we’re after — for all those nurses that turned up yesterday, they took a day off without pay because that’s how passionately they feel.”
It was “heart-breaking” to hear stories about nurses turning up to work and finding they were short-staffed, Hauraki said.
“And then to get to the end of the shift and not be able to leave because there aren’t enough nurses coming on to take over from you.
“Everyday our nurses turn up to places like ED where they are assaulted, physically and emotionally abused and it’s just not on.”
DHBs keen to ‘close gaps’
Spokesperson for all the DHBs, Jim Green, said had been making progress with continuous improved offers, but welfare and staffing levels were of still concern to the workers.
“We’ve made offers around all those areas — we’ve made a pay rise increase of up to 8 to 12 percent and of course there’s the pay equity settlement that will be coming in on top of that as well,” he told Morning Report.
“We think we’ve been able to address many of their requirements and we’re looking to see where some of the gaps can be closed by the nurses and the [union] members.
Further negotiations were needed to see how the problems could be resolved, Green said.
Nearly all non-urgent surgery and outpatient clinics had to be postponed yesterday as a result of the strike.
“That will take time to work back into the schedule [the elective surgeries], we’re of course doing a lot of work to catch up after the time lost last year around Covid, so it’ll add to the work we have to do,” Green said.
It was difficult for services to operate during the strike but they had managed, he said.
“It’s always difficult to manage during a strike and it really took all of the efforts of all of the people who weren’t striking — the volunteers, family members, and of course the life-preserving services provided by the union — to get us through that time.
This article is republished under a community partnership agreement with RNZ.
This post was originally published on Asia Pacific Report.
A new film called “Takeover” follows the 12 historic hours on July 14, 1970, when members of the Young Lords Party took over the rundown Lincoln Hospital in the South Bronx in New York City. The Young Lords were a radical group founded by Puerto Ricans modeled on the Black Panther Party. Democracy Now! co-host Juan González, a co-founder of the Young Lords, helped organize the action. Using archival footage and modern-day interviews, “Takeover” chronicles their resistance to institutions founded on wealth and white supremacy, and their collective struggle for quality, accessible healthcare. “The takeover really exemplified what the Young Lords were about,” says director Emma Francis-Snyder, who says she wanted to capture the heroism of the activists. “There’s so much emotion and planning and courage that comes along with direct action,” Francis-Snyder says. “We understood that to get the system to listen and change, you had to disrupt it,” adds González. “You had to find a way to force people to pay attention to the problems.”
This is a rush transcript. Copy may not be in its final form.
AMY GOODMAN: This is Democracy Now!, democracynow.org. I’m Amy Goodman, with Juan González.
We look now at an extraordinary new documentary called Takeover, that follows the 12 historic hours, July 14th, 1970, when members of the Young Lords took over the rundown Lincoln Hospital in the South Bronx. The Young Lords were a radical group founded by Puerto Ricans modeled on the Black Panther Party. They drove out the administrative staff of the hospital, barricaded the entrances, made their cries for decent healthcare known to the world. This is the trailer to the film Takeover.
NARRATOR: This is a story from New York, not the New York of Manhattan’s Broadway, but for perhaps the toughest square mile in the city, in the South Bronx.
CARLITO ROVIRA: I was 14 years old when I joined the Young Lords. The Young Lords were a street gang that became politicized by the Black Panther Party.
We became visible as servants of the people.
One of our targets was Lincoln Hospital.
IRIS MORALES: That building was condemned 25 years ago. Condemned. Condemned for rich people and opened for poor people.
UNIDENTIFIED: It was a place that you went to to die.
UNIDENTIFIED: Lincoln was called the “butcher shop.”
MIGUEL ”MICKEY” MELENDEZ: Bloodstains on the walls. Bloodstains on the floors.
UNIDENTIFIED: And there was a rat in the emergency room.
DR. LEWIS FRAAD: We have seen children get lead poisoning while hospitalized at Lincoln Hospital.
JUAN GONZÁLEZ: We felt now was the time for us to say exactly how we’re going to respond to the killings of our people.
CARLITO ROVIRA: Our plan was to take over Lincoln Hospital.
JUAN GONZÁLEZ: We have to begin to stand up for the people, the Puerto Rican people, and say, “That’s enough. That’s enough.”
CLEO SILVERS: We have been asking for changes to take place. And you’ve paid no attention to us. You’ve thrown us out of your offices, and you’ve called the cops on us. And now we’re putting you out. We’ve taken over the hospital. We’re going to run it. You’re out. And I will walk you to your car.
JUAN GONZÁLEZ: We immediately announced that we were not leaving until the city made a firm commitment to build a new hospital.
About a thousand police were on roofs with high-powered rifles. They had vans all over the place.
If the police came in, it was going to be a bloodbath, because the police hated the Young Lords.
CLEO SILVERS: We were terrified.
JUANGONZÁLEZ:“Power to the people” means including people to gain control of their destiny.
The Young Lords were ahead of our time in terms of recognizing that healthcare is a right.
DENISEOLIVER–VELEZ:We wanted a revolutionary change to the health system in this country. And we still do.
CARLITOROVIRA:Because no oppressor is invincible.
AMY GOODMAN: The trailer to the film Takeover. And one of the voices and images you heard and saw was Democracy Now! co-host Juan González, co-founder of the Young Lords, who helped organize the action. In this clip from the film, we hear other Young Lords explain how the group started in New York. This is Felipe Luciano, Miguel “Mickey” Melendez and Denise Oliver-Velez. We hear first from Iris Morales.
IRIS MORALES: The Young Lords didn’t drop from the sky one day and all of this happened. We were part of a continuum of history, of a legacy that had gone before us.
For that revolution that’s within the United States, we see ourselves hooking up with Black people, with Native Americans, with Asians, with other Latinos to form a united front as oppressed people to wage against the real enemy.
I started out as a cadre in the Young Lords in 1969. I became deputy minister of education. I was a co-founder of the women’s caucus.
FELIPE LUCIANO: I was the first chairman of the Young Lords Party.
We are ideological in that we believe in the principles of socialism, in that we believe in cooperative effort, in that we believe in unified struggle.
MIGUEL”MICKEY”MELENDEZ:It’s all about pride. It’s all about community. It’s all about being together. I was one of the co-founders of the Young Lords Organization in New York City.
DENISEOLIVER–VELEZ:When you joined to be a full Young Lord, you left home, you quit your job. If your family didn’t — if you had a spouse or whatever that didn’t want to be a part of it, you left them. So, when we said you’re a Young Lord 25 hours a day, we meant it.
I became the first woman on the central committee of the Young Lords.
We were coming from a place of love and of respect. But we also didn’t take any [bleep].
AMY GOODMAN: That’s from Takeover. Well, for more, we’re joined by Emma Francis-Snyder, the director of this new short documentary. The film premieres this Friday at the Tribeca Film Festival, will be available to stream online starting Saturday. And, of course, we’re joined right here by co-host Juan González, co-founder of the Young Lords, who was one of those who took over the hospital.
But, Emma, let’s start with you on why you decided to focus on the Lincoln Hospital takeover and, through it, tell this remarkable story of the Young Lords, through incredible archival footage but also reenactments that look like they were archival footage.
EMMA FRANCIS–SNYDER: First of all, thank you so much for having me. This is a dream come true. So, thank you.
You know, for me, the takeover really exemplified what the Young Lords were about. It was not only the biggest, like the largest takeover at the time, but it also had some very concrete, real results, which was, essentially, a new hospital, the Patient Bill of Rights and, ultimately, a call for universal healthcare and community control. And for me, as a young activist that wanted to learn, this kind of started off as my own process of wanting to learn and understand about successful modes of direct action.
And what I found at Lincoln Hospital was like this beautiful cross-section of life and collaborativeness that cut across socioeconomic and racial lines, and in which the community and the workers led and the doctors and residents followed. And I felt like it was just a really beautiful way that we saw — that I saw for people to support and follow community control in a way that was really successful.
And then, on top of it, just as like a filmmaker, it’s a beautiful story, right? You know, we think of cops and robbers and heists as things that don’t actually happen, but, like, there’s so much emotion and planning and courage that comes along with direct action. And I really wanted to sit in those moments and exemplify, like, what it takes to do something like this, not just the planning, not just the thought leading up to it, but like the feelings. I mean, there was a face-off. They took over a building, and there was a face-off with the police. I mean, it’s just like — it is a story in and of itself.
AMY GOODMAN: Juan, it is an astounding story, and it’s your story, Juan. Talk about why you chose Lincoln Hospital, what were the demands, and what these 12 hours, once you marched in — the response of the hospital staff — I mean, operations are going on, etc.
JUAN GONZÁLEZ: Well, I think the reason we took the hospital is because we had been involved — and I think it’s underappreciated, the amount of work that the Young Lords did in what we would normally call today public health. It was not just the issue of the treatment in the hospital and the services in a dilapidated, rundown hospital that the city had been promising to tear down for decades but hadn’t done, but it was also all of the work that we did in lead poison detection, tuberculosis detection, drug detoxification, acupuncture, using acupuncture for the first time in drug treatment, that was developed by the Lords and the Panthers at Lincoln Hospital, that there was — in other words, health was a major, major concern of ours at the time.
But we understood that to get the system to listen and change, you had to disrupt it. You had to find a way to force people to pay attention to the problem. So I think that’s the main thrust of all of our actions that we took in this wide area of public health at the time.
AMY GOODMAN: And one of the stories that Emma tells so well, that you were involved with, was the hijacking of a tuberculosis truck. If you could explain, Juan?
JUAN GONZÁLEZ: Well, we wouldn’t call it “hijacking.” We called it “liberating,” the liberating of a tuberculosis truck. That was, the city was misusing and wouldn’t provide in the East Harlem and South Bronx communities, so we redirected the route of the truck in order to be able to test more people who were actually at the center of what was then a tuberculosis epidemic in the city.
But I wanted to ask Emma, because, Emma, you interviewed me — I guess it was about 10 years ago, when you were first starting this project.
EMMA FRANCIS–SNYDER: Yes.
JUAN GONZÁLEZ: And I have to tell you, I’ve been very impressed by the result of your work, especially in the recreations, because for a while, when I first saw your final version, I thought you had somehow found footage of what we had done back then that I was not aware of. It turns out then that you basically had some actors recreate some of these scenes. But they were so well done, and even some of the characters resembled so much younger versions of Cleo Silvers or Carlito Rovira that I first thought that this was actually archival footage. I’m wondering about the decision to take that route in terms of telling the story.
EMMA FRANCIS–SNYDER: Yeah, absolutely. I think that I — you know, while this is a true story, I think that it also had — as I referred to earlier, it had all these cinematic elements, right? And it’s like, what does it look like taking over a hospital? Like, there is that drama, the tension. And I really wanted us, the audience, to live and breathe in those moments with you,, because so much of the time things like this may get glossed over, and I just really wanted to sit in it and have the audience feel all of these feelings.
I really have to credit the director — I mean, the cinematographer, Tine DiLucia. She and I worked together and really, you know — and honoring the Third World Newsreel movement at that time, honestly. Like, this is directly related to and taken — the style taken from the work that was done, and so just referencing that.
AMY GOODMAN: Well, I want to go to another clip from the documentary, Takeover. The voices include Juan, Juan González, as well as the former New York mayor — deputy mayor, Sid Davidoff, under Lindsay. It begins with Pablo Guzmán, known as Yoruba, the Young Lords minister of information, speaking to reporters during the takeover of Lincoln Hospital.
REPORTER: Yoruba, what’s happened?
PABLO ”YORUBA” GUZMÁN: What’s happening now is that while we were negotiating and while we were trying to reach some kind of a settlement, the first thing that we had come up with was that we would be clear and we would be free to negotiate as long as they moved the pigs back. They said they were going to move the pigs back. And while they were saying this, they tried to sneak a pig in to yank one of the Lords out, to yank one of our brothers out. As this was going down, we then had to tell them, “Look, we know where you’re at. This is a breach of good faith. We can’t deal anymore.” I’m going have to leave now, because they’re trying to mobilize now, and I have to go deal.
UNIDENTIFIED: Mark, the police are coming out right now.
DEPUTY MAYOR SIDNEY DAVIDOFF: We say, look, this is real simple. If we don’t resolve this with you right now, the next thing to come is the guys with the guns. You don’t want the guys with the guns coming in here.
JUANGONZÁLEZ:The police hated the Young Lords. And they’d love the opportunity to get us all in one place.
JEFFKAMEN:Because the Young Lords had seen the killing of Fred Hampton, the leader of the Chicago Black Panthers, by the police officers, they had reason to be afraid.
CLEOSILVERS:We were terrified that they were going to come in there and they were going to beat us into pulp, and no one was going to help us.
AMY GOODMAN: Those last voices, Cleo Silvers and reporter Jeff Kamen, who are featured in the documentary Takeover. Juan, I mean, let’s talk about that time, what you faced as you’re moving into this hospital. Yes, this was about half a year after the police murder of Fred Hampton and Mark Clark in Chicago. You didn’t know if you would be shot, if you would be arrested, if you would be killed.
JUAN GONZÁLEZ: Well, I think the lesson of this for us then and, I think, for activists today is that we were trying to negotiate with the Lindsay administration, which was ostensibly a liberal Republican in those days — there aren’t any liberal Republicans today, but back then there were some — and the question was really to what degree did the mayor of the city control his own police department. And it became increasingly clear, as we negotiated, that he didn’t really control the police department and that the police department had a mind of its own. And so we had to deal with the reality that even if we wanted to negotiate and the Lindsay administration did, the police department had other ideas.
So we had to take that into account in trying to figure out what to do at that stage, once we had spread the message throughout the city and the country about the occupation and the issues involved. And so, we chose, at a certain point, after getting a verbal commitment from the administration that if we left and if we — they couldn’t announce anything at the time, but if we left the hospital, that they would indeed build a new Lincoln Hospital. And they did build a new Lincoln Hospital shortly thereafter. But we then had to decide to either have a complete standoff, and many people injured or hurt, or figure out a way to get out of the hospital while the police surrounded it. And I think Emma did a very good job in terms of telling the story of how that happened —
AMY GOODMAN: And that amazing escape —
JUAN GONZÁLEZ: — and that, miraculously, no one was hurt, and we all managed to get out. No one was arrested.
AMY GOODMAN: And that amazing escape in white coats was incredible. Emma, we just have 10 seconds. How do people get to see this film at the Tribeca Film Festival and beyond?
EMMA FRANCIS–SNYDER: You can watch it virtually. All of our screenings are sold out. So if you just go to the Tribeca website, “Takeover 2021.” Thank you so much for having me.
AMY GOODMAN: Well, Emma Francis-Snyder, director of the new short film Takeover. It premieres Friday at the Tribeca Film Festival. And, Juan, amazing. That does it for the show. I’m Amy Goodman, with Juan González. Thank you so much for joining us. Stay safe.
This post was originally published on Latest – Truthout.
In South Florida, when people want to find a Black physician, they often contact Adrienne Hibbert through her website, Black Doctors of South Florida.
“There are a lot of Black networks that are behind the scenes,” said Hibbert, who runs her own marketing firm. “I don’t want them to be behind the scenes, so I’m bringing it to the forefront.”
Hibbert said she got the idea for the website after she gave birth to her son 15 years ago.
Her obstetrician was white, and the suburban hospital outside Miami didn’t feel welcoming to Hibbert as a Black woman pregnant with her first child.
“They had no singular photos of a Black woman and her Black child,” Hibbert said. “I want someone who understands my background. I want someone who understands the foods that I eat. I want someone who understands my upbringing and things that my grandma used to tell me.”
In addition to shared culture and values, a Black physician can offer Black patients a sense of safety, validation and trust. Research has shown that racism, discrimination and unconscious bias continue to plague the U.S. health care system and can cause unequal treatment of racial and ethnic minorities.
Black patients have had their complaints and symptoms dismissed and their pain undertreated, and they are referred less frequently for specialty care. Older Black Americans can still remember when some areas of the country had segregated hospitals and clinics, not to mention profoundly unethical medical failures and abuses, such as the 40-year-long Tuskegee syphilis study.
But even today, Black patients say, too many clinicians can be dismissive, condescending or impatient — which does little to repair trust. Some Black patients would prefer to work with Black doctors for their care, if they could find any.
Hibbert is working on turning her website into a more comprehensive, searchable directory. She said the most sought-after specialist is the obstetrician-gynecologist: “Oh, my gosh, the No. 1 call that I get is [for] a Black OB-GYN.”
For Black women, the impact of systemic racism can show up starkly in childbirth. They are three times as likely to die after giving birth as white women in the United States.
Nelson Adams is a Black OB-GYN at Jackson North Medical Center in North Miami Beach, Florida. He said he understands some women’s preference for a Black OB-GYN but said that can’t be the only answer: “If every Black woman wanted to have a Black physician, it would be virtually impossible. The numbers are not there.”
And it’s also not simply a matter of recruiting more Black students to the fields of medicine and nursing, he said, though that would help. He wants systemic change, which means medical schools need to teach all students — no matter their race, culture or background — to treat patients with respect and dignity. In other words, as they themselves want to be treated.
“The golden rule says, ‘Do unto others as you would have them do unto you,’ so that the heart of a doctor needs to be that kind of heart where you are taking care of folks the way you would want to be treated or want your family treated,” he said.
George Floyd’s murder in Minneapolis in May 2020, and the subsequent wave of protests and activism, prompted corporations, universities, nonprofits and other American institutions to reassess their own history and policies regarding race. Medical schools were no exception. In September, the University of Miami Miller School of Medicine revamped its four-year curriculum to incorporate anti-racism training.
New training also became part of the curriculum at Florida Atlantic University’s Charles E. Schmidt College of Medicine in Boca Raton, where students are being taught to ask patients about their history and experiences in addition to their bodily health. The new questions might include: “Have you ever felt discriminated against?” or “Do you feel safe communicating your needs?”
“Different things that were questions that we maybe never historically asked, but we need to start asking,” said Dr. Sarah Wood, senior associate dean for medical education at Florida Atlantic.
The medical students start learning about racism in health care during their first year, and as they go, they also learn how to communicate with patients from various cultures and backgrounds, Wood added.
These changes come after decades of racist teaching in medical schools across the United States. Adams, the OB-GYN, completed his residency in Atlanta in the early 1980s. He recalls being taught that if a Black woman came to the doctor or hospital with pain in her pelvis, “the assumption was that it was likely to be a sexually transmitted disease, something we refer to as PID, pelvic inflammatory disease. The typical causes there are gonorrhea and/or chlamydia.”
This initial assumption was in line with a racist view about Black women’s sexual activity — a presumption that white women were spared. “If the same symptoms were presented by a Caucasian, a white young woman, the assumption would be not an STD, but endometriosis,” Adams said. Endometriosis is not sexually transmitted and is therefore less stigmatizing, less tied to the patient’s behavior.
That diagnostic rule of thumb is no longer taught, but doctors can still bring unconscious racial bias to their patient encounters, Adams said.
While they revamp their curricula, medical schools are also trying to increase diversity within their student ranks. Florida Atlantic’s Schmidt College of Medicine set up, in 2012, a partnership with Florida A&M University, the state’s historically Black university. Undergraduates who want to become doctors are mentored as they complete their pre-med studies, and those who hit certain benchmarks are admitted to Schmidt after they graduate.
Dr. Michelle Wilson took that route and graduated from Schmidt this spring. She’s headed to Phoebe Putney Memorial Hospital in Albany, Georgia, for a residency in family medicine. Wilson was drawn to that specialty because she can do primary care but also deliver babies. She wants to build a practice focused on the needs of Black families.
“We code-switch. Being able to be that comfortable with your patient, I think it’s important when building a long-term relationship with them,” Wilson said.
“Being able to relax and talk to my patient as if they are family — I think being able to do that really builds on the relationship, especially makes a patient want to come back another time and be like, ‘I really like that doctor.’”
She said she hopes her work will inspire the next generation of Black doctors.
“I didn’t have a Black doctor growing up,” Wilson said. “I’m kind of paving the way for other little Black girls that look like me, that want to be a doctor. I can let them know it’s possible.”
This story is part of a partnership that includes NPR, WLRN and KHN.
This post was originally published on Latest – Truthout.
“We have other states that have taken into consideration the cumulative impact, the health impact, on these communities and they’re saying no to these companies that are coming,” Joyner said. “You know what? North Carolina has become a cesspool, because everything that everyone else doesn’t want, we don’t have the laws to protect us.”
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The White House announced Thursday its plan to donate 25 million excess Covid-19 vaccine doses to other nations—a plan progressives described as an “inadequate” response to the ongoing pandemic, urging the Biden administration to invest $25 billion to ramp-up global vaccine manufacturing.
According to he Associated Press, the U.S. “aims to share 80 million doses globally by the end of June, most through COVAX,” the United Nations-backed program for global vaccine sharing. “Of the first tranche of 25 million doses, the White House said about 19 million will go to COVAX,” with the remaining 6 million directed to “U.S. allies and partners.”
“The donation of these few doses is welcome but deeply insufficient, and no substitute for a plan of scale and urgency to end the pandemic,” Peter Maybarduk, director of Public Citizen’s Access to Medicines program, said in a statement.
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A hush-hush operation between New York City and the Municipal Labor Council (MLC) to essentially privatize the health care coverage for thousands of retirees has exploded into public view in the past several weeks. The internet has been buzzing with protests against the closed-door negotiations that would take retirees out of traditional Medicare and place them in a Medicare Advantage program run by private insurers, with all its traps and pitfalls.
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Many of Anthony Fauci’s emails during the US Covid-19 outbreak last year have been obtained via Freedom of Information Act and published by BuzzFeed News and The Washington Post. Depending on what ideological echo chamber you inhabit you may have heard that they are completely innocuous or historically damning; the ones eliciting the most controversy right now include a scientist telling […]
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A massive pandemic risk factor has been hiding in plain sight across the United States, growing exponentially in scale over the last four decades with the support of trillions of dollars spent by federal, state, and local governments. But, inexplicably, the current national policy conversation about rebuilding public health, pandemic preparedness, and biosecurity has entirely ignored it.
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