Why attack the most vulnerable here to pay for wars over there?
Cartoon by Charles Stone
"We must all share the pain!" Mantra of most politicians.
"The sick person is a parasite of society." Friedrich Nietzsche in "Twilight of the Idols, Morals for Doctors."
"The way to judge a country, is by the way they treat the disabled." "Patients are driven into poverty under the current health care system...(they are) victims of social Darwinist euthanasia policy under which the rich can buy all the care they need while the poor must do without." Marta Russell in "Beyond Ramps"
Why attack the most vulnerable here to pay for wars over there?
People living in the U.S. like to think that all of that is "behind us," and all of us are able to pursue the "American Dream." But now the masses are questioning that premise, particularly after the prodding by the Occupy movement.
The social networks have been under attack since they were set up, and that has escalated since the current "economic crisis" and the new "period of austerity."
When Arnold Schwarzenegger (aka "The Terminator") was elected Governor of California, at the first "State of the State" address he actually promised to terminate health care for the poor and the In Home Support Services (IHSS) program. The IHSS program provides services for the state's poor disabled and elderly so that they can live in their homes rather than being locked up in Nursing Homes. He even wanted to reduce the wages of home health care workers back to the minimum which was $6.75 at the time. He justified these cuts by declaring that 25% of those in the IHSS program were committing fraud. Real studies revealed only 1-2% fraud. Compare that to the scandals of the banks, Wall Street and politicians on all levels!
The disabled, elderly and home health unions fought against those cuts and heaved a sign of relieve when the Terminator's term was up. And now we have Governor Jerry Brown who like many other politicians are calling themselves agents of "CHANGE!"
Well, what has Brown done since inheriting the Terminator's mantel? So far, besides hits to education on all levels, he supports cuts to people with physical and mental disabilities, seniors and hundreds of thousands of workers. First there was a temporary reduction 3.6% hours for all recipients in the IHSS program. And fingerprinting and background checks were required by all workers, which they had to pay for.
To share even more pain, there was a proposal to cut 20% more hours for each consumer, which has been blocked by a federal district court order pursued by both unions and the disabled. Brown hopes to overturn that injunction.
Another proposal was to eliminate domestic and related services for recipients who live in certain "shared living" arrangements. So if you were unable to get out of bed, cook your own meals, clean up after yourself, or manage your medications -- if you lived with relatives, friends or roommates, it would be expected that they would spend hours on these tasks for free! One can only imagine how easy it would be for anyone to find adequate housing, especially if you were living on SSI ($750 to $1000 a month) and already were forced to choose between paying for housing, food or your share of health care!
These reductions will be heard in state committees in the months before the budget is due on July 1st, and could be enacted as early as August 1st.
Lots of time for people to make Plan B's! (if that's an option at all).
Merging Medi-Medi into managed care
Now if the previous cuts are not enough pain to share among the poorest, there's another plan to force those who are on both Medicare and Medicaid (Medi-Cal in California) to fold over into a Managed Care program. This plan of Governor Brown's is called the "Coordinated Care Initiative" and would affect 1.2 million people.
There was a conference on May 11 by Project Olmstead, a consumer-led group of people with disabilities and those who provide services for them. Panels were comprised of disabled activists, care providers, and lawyers.
Deborah Doctor, Legislative Advocate at Protection and Advocacy, Inc. has worked on long term care issues since the '70s. She began by stating that this program was the most complicated she had ever seen! The proposal is to have 10 pilot programs in the largest counties, and then integrate services in a way that will save the state as much money as possible as soon as possible. It could be enacted within several months and 1.2 million lives would be at stake.
Depending on how Coordinated Care is organized, there could be positive improvements, such as better access to programs, and better coordinated care management. Or, at worst, it could: separate consumers from their primary care doctors and specialists, delay surgeries, eliminate visual and dental care, and go back to a medical model rather than the consumer-driven IHSS program the disability movement has fought for over several decades.
Part of the program would be to settle the issue of how to license home care workers. In Napa county there is a requirement to require permits to assist others in both the IHSS program and private homecare agencies. Workers going into the private homes of the elderly and disabled surely need to know what they are doing, and any with previous felonies related to mistreating the vulnerable need to be denied homecare work unless it is clear they have changed. But having such a complex law that requires those who have been working with the same people for 25 years to take basic caretaking courses can be a waste of time and money. Many have already been trained by their patients or their patients' doctors for years, and we are all learning that there is no "one size fits all" procedure in health care, although certain classes could be helpful. One homecare worker commented that the program sounded like "if you pick up meds for your elderly house-bound neighbor without a permit, you could be arrested!"
So, as in many instances, "the devil is in the details." One big issue is who will be designing the details. We all know the difference between a plan devised by a bureaucrat in Sacramento with no experience with those disabled and one taking the time to get input from those affected! Many speakers at the conference kept emphasizing the need for preserving what we know works. And stating that all consumers should have the right to opt-out of the Managed Care program.
One of the most fundamental concerns was to have an ombudsman and a board representing all involved, to have oversight with enforcement powers, particularly to insure the basic rights won in the federal Olmstead law.vThat means that forcing people into institutions like Nursing Homes, when they are capable of living in their communities is discrimination and should not be allowed.
The strategy of forming new coalitions was emphasized, so that all involved work together and avoid conflicts of the past, such as the agreement the SEIU had made with the Nursing Home Corporations that took away the right of workers to assist patients in filing lawsuits when they were harmed in the the Nursing Home.
Unions fight back together
The SEIU ULTCW union had a Northern California conference the day following the Project Olmstead meeting. The president of the California Local 6434, Laphonza Butler, gave a rousing speech saying, "We need more than just change! We need transformation -- dramatic change!" She lauded the seven women in Los Angeles who rode on a bus to start the homecare union, which is now part of the SEIU with 2.1 million members. The homecare section was quite a challenge since there is no common workplace to organize out of. Butler called 2012 the year that can "transform our country and finish providing Health Care for All!"
Many people at both meetings were leery of the Managed Care system and wanted the organizations to campaign for Single Payer or Medicare for All. They claim that the latter would put the needs of the people over the need just to save money for the state or to insure profits for the Insurance Corporations.
Butler emphasized the strategy of of working to elect politicians who would fight for our programs. She mentioned that all over California 3 out of 5 County Board of Supervisor members were up for re-election. And of course there is the presidential election where the union is organizing members to walk door-to-door, phone bank and demonstrate to support Obama and defend the unions' right to contribute to the campaigns.
Mary Kay Henry, the president of the national SEIU, saluted those who cared for 30 million patients. "We are the eyes and ears of healthy America! But we have mountains to climb!" The 400 member crowd shouted, "Amen!" Henry continued, "We must use the unions on behalf of the 99%!"
Henry reminded those present that the SEIU started in 1902 when janitors who made $20 a month, working from 5am to 10pm, kept organizing for more wages and rights. And that we needed to continue the fight since workers' wages have not increased in the last ten years.
There was discussion about supporting the Homeowner Bill of Rights, a rally in Sacramento to support a stronger home care, support of the disability demonstration in Sacramento for a "homecare system that works for consumers, providers and their families." There was a call to get support for Governor Brown's initiative to tax those households making over $500,000 plus an increased sales tax, which was a compromise of the earlier "Millionaires' Tax" initiative organized initially by a teachers' union. And two other unions, the UDW (United Domestic Workers of America) and the CUHW (California United Homecare Workers) are all joining together with the SEIU for the fight to "Let's Get Healthy at Home!"
Groups of 8-10 ULTCW members did role playing, bringing up all the issues they expected to confront in the political campaigns. Members, many from different cultures and not having English as a first language, connected enthusiastically with one another and pledged to work together.
Disability rights back in the streets
On May 17, a militant group of disability rights activists, ADAPT (American Disabled for Attendant Programs Today) held a protest in Washington DC over the proposed cut of $800 billion from the federal Medicaid budget. A US District Court judge has ordered 74 disability activists from around the nation to appear in person in court in Washington on May 22.
"This is unprecedented and the single most punitive act on disability activists in more than 20 years," said Marsha Katz of Montana ADAPT. Rahnee Patrick of Chicago ADAPT added, "Many of the people who were arrested are living on fixed incomes of less than $700 a month...and now the courts are personally penalizing us for trying to defend ourselves against these vicious attacks." The arrests are coincidental with the state Medicaid budget cuts. ADAPT's "My Medicaid Matters Campaign" has included nearly 100 national organizations. Adam Ballard of Chicago ADAPT stated, "Defending our freedom should not be regarded as a criminal act, and I will not be intimidated into silence by these tactics because My Medicaid Matters!"
Workers' private identities released
One more recent problem that IHSS providers and consumers face is that in mid-May we were notified that the Sacramento agency that issues paychecks for homecare workers had somehow released 701,000 persons' personal IDs such as social security numbers, and that their bank accounts and credit cards could be stolen. One can't help but remember Naomi Klein's remarkable book, "The Shock Doctrine" warning us that governments confront populations with an increasing number of crises, hoping to divert us from defending our rights.
There are many differences all of us 99% have not yet worked out, such as Obama's health plan vs. Medicare for All, or supporting Obama vs. organizing a real third party, or which is the best "bottoms-up" organizing strategy.
At the same time we have vets in Chicago demonstrating at the NATO meeting, hurling back their war medals, calling on all governments to stop spending our money on endless war, but for peace and social services and education for the 99%! What is absolutely clear is that unless we all hang together and fight, we will hang separately! We need to reinforce our belief that -- yes, another world IS possible!
Barri Boone is a long time union and disability activist and writer.