TRUTH COMMISSION REPORTS
THE RIGHT TO HEALTH & THE 3RD RECONSTRUCTION:
A TRUTH COMMISSION ON HEALTHCARE
Testimony at the Right to Health Truth Commission illustrated the inhumanity of our current healthcare system, which treats healthcare as a commodity and makes it inaccessible to many poor and low-income New Yorkers.
Lack of health insurance is part of the picture. More than one million New Yorkers are uninsured, and a large portion of the uninsured are immigrants. Olga Vazquez, a member of Make The Road New York, is one of them. She shared the challenges of dealing with a recent broken ankle with no health insurance.
“My recovery will require months of therapy, at least 3 a week, which I needed to start immediately. However, I did not have the income to afford the therapy and am now living with the effects of the delay. My first session would cost $400 and every other session cost $100 each. The total would cost at least $300 weekly for the next 4 months. I delayed starting therapy due to the cost, and spent a long time searching alternative health centers for a lower cost. As a result of all my healthcare needs, I was unable to return to my work taking care of children.”
Olga also has to pay higher out-of-pocket rates for routine preventive care, like cancer screenings. High costs lead many uninsured people like Olga to simply go without needed care, contributing to worse health outcomes.
But having insurance is no guarantee that one can access affordable care, as the testimony illustrated. Dariella Rodriguez, a member of Northwest Bronx Community Clergy Coalition, is carrying $90,000 of medical debt after her son’s appendix ruptured in 2020, even though he had basic insurance coverage at the time.
“My son almost died. By the time we were at the hospital, he needed immediate attention and to be admitted to the hospital, and he needed surgery a month after being sent home from the hospital,” Dariella said. “No mother, no parent, no human being should have to make a decision about whether they can afford to get the care they need, whether their coverage allows for them to get the care they need, whether they are financially in a position to get the care they need.”
The Community Service Society published a powerful series of reports about the prevalence of patients leaving non-profit hospitals in New York carrying debt. As of June 2020, New York hospitals had filed over 40,000 lawsuits against patients over the previous 5 years. CSS found that “the hospitals who sue the most patients provide insufficient financial assistance and rely on professional debt collection law firms to go up against patients who are largely unrepresented.” A 2015 study found that nationally, medical debt is the leading cause of consumer bankruptcy.
Disinvestment in medical facilities and providers, especially in poor and low-income and BIPOC communities, is another impediment to access that hurts workers and patients alike.
Bernetta Urquhart, a nurse at Mt. Vernon Hospital and member of NYSNA, spoke about the devastating impact of closing the ICU and reducing other services in the middle of the pandemic.
“We have such little to work with at Mount Vernon Hospital now, and that is by design,” she said. “Our brother, [Montefiore CEO] Dr. Phillip Ozuah, was given the task to shut down our community hospital, and no one from Montefiore bothered to inform the people about their plan to close a well needed community hospital.”
NYSNA and the Save and Transform Mount Vernon Hospital Coalition released a report in 2021 outlining how Montefiore’s approach to Mount Vernon exacerbated racial and economic disparities in health care. “Private healthcare corporations such as Montefiore seek to maximize their profitability, often leaving behind the very patients that need to be served and reinforcing existing healthcare disparities,” said the report. “Unfortunately, government policies have fallen far short in mitigating disparities and promoting quality healthcare for all.”
New York is also facing a dangerous shortage of home health care workers, with 1 in 4 patients who need home care reporting that they can’t find the care they need. “Three years ago I began a search to find a homecare worker,” Gemma Calinda of Caring Majority shared. “Trust me when I tell you it was an extremely difficult task that no one should have to go through just to receive care. A big reason why it was so hard to find home care is because home care workers only make $13.20/hour in most parts of New York State doing crucial work keeping people with disabilities and older New Yorkers out of nursing homes in our own homes and communities.”
All these stories point to a healthcare system that is failing to meet the needs of millions of New Yorkers. As the line in Rev. Chris Wylie’s poem, shared at the opening of the Truth Commission, goes, “That’s just it / Now, don’t you see? / I live in this world / Not built for me.” Our current healthcare system is not designed for poor, working class, BIPOC, disabled, LGBTQ+, or rural communities. But it is from our communities that the fight and insight to transform this system will come.
Bernetta Urquhart opened the evening of testimonies reminding us of the trust and care that comes out of community relationships and how that carries us through times of need. Urquhart has been a nurse at Mount Vernon Hospital for over three decades “Patients look for us to help and that is why we the nurses and other health care workers at Mount Vernon hospital are trying to help patients in this community, but it is really hard to do so with the reduction in services.” People of color make up over 65% of the population of 70,000 in Mt. Vernon and are on the verge of losing their hospital, while the smaller, predominantly white community of White Plains has a full service hospital. The Save and Transform Mount Vernon Coalition is a group of community members and leaders, including Urquhart, that are fighting the closure of the hospital owned by Montefiore. The experiences of Urquhart and her colleagues caring for their community against the ravages of medical racism and economic disparity are sadly not unique in the Hudson Valley.
Olga Vasquez, of Make The Road has been barred from accessing basic healthcare services because of her immigration status. Vazquez is not alone. Thousands of undocumented New Yorkers contribute to the economy and help keep the state running, yet cannot get healthcare. “I have spent months trying to set up an appointment for a mammogram, a preventative service for women that would be free if I had health insurance and instead it has cost me hundreds of dollars that I find very difficult to pay,” Vasquez shared. Coverage4All, a piece of legislation supported by Make The Road NY, would give Vasquez and the 154,000 other undocumented New Yorkers access to quality, affordable health coverage. Lack of healthcare coverage keeps many undocumented people from seeking care which leads to prolonged illness and even risk of death. “I am living with the effects of delaying care,” Vasquez said after sharing her story of breaking her ankle and not being able to afford the necessary physical therapy. “Out with injustice and in with Coverage4All!” Vasquez declared.
Fair Pay for Home Care Act is another ongoing fight for home health workers to get living wages for the critical care they provide. Gemma Calinda, an organizer for Hand in Hand in the New York Caring Majority, testified to her experience as a person living with Multiple Sclerosis who has to have help with her daily routine. Home care workers enable Calinda and thousands of other New Yorkers to lead independent lives instead of residing in nursing homes, but the state leads the nation in home care worker shortages. Calinda stated, “According to a recent report, the Fair Pay Act would wipe out the home care workforce shortage in less than five years, keep older adults and people with disabilities out of nursing homes, and bring 200,000 New homecare jobs into the field.” The one time bonuses for homecare workers proposed in the state budget by Governor Hochel does not address the need for permanent living wages. Calinda concluded, “We have bipartisan support, we’re counting on our legislators to get it over the finish line!”
Connecting the fight in New York state to the national health care crisis, Sheila Garland-Olaniran, a long time health care organizer, provided history of organizing for government healthcare programs. “Seniors from the grassroots poor rose up and demanded healthcare which is how we got Medicaid and Medicare signed into law under [President] Johnson. It was a demand that came from the root base of society by a group of people who needed it.” The Nonviolent Medicaid Army continues in this rich tradition of organizing from the bottom up for the health of the entire nation. Nijmie Zakkiyyah Dzurinko spoke of the critical importance of base building and political education. “We are objectively united by the situation that we face as a class with regard to the health care system, but we’re not all aware of it,” Dzurinko asserted.
“Healthcare can be a rallying point once again to build unity across lines of division.” - Nijmie Zakkiyyah Dzurinko
The New York Health Act addresses all demands raised in the Hudson Valley Truth Commission on healthcare, from raising the wages of home care workers to universal coverage. It would usher in transformative change, delivering care to all New Yorkers, regardless of immigration status. The NYHA puts people over profit, centering on healthcare as a human right, guaranteeing comprehensive, universal, single-payer healthcare for every New Yorker. The right to healthcare cuts across race, class, religion, gender, and all fabricated categories that are used to drive a wedge between the poor and dispossessed. We will continue to fight until we create a new system where everyone thrives and gets the care they have a right to.
“Poor and working people know what we need.” Rev. Joe Paparone
When medical debt is the leading cause of consumer bankruptcy,
when home care workers are denied a living wage,
when over one million New Yorkers are uninsured,
when those who are insured find themselves in debt and swamped with medical bills due to lack of adequate coverage,
when neighborhoods are losing ICUs in the middle of the pandemic,
when all of this is happening in one of the wealthiest nations in the world,
It begs the questions,
Why? Is this just?
"The poor and dispossessed in this nation are objectively united, but that doesn't mean we are all aware of it." Nijmie Zakkiyyah Dzurinko
Dispossession is a bipartisan program. Denial of comprehensive healthcare is a bipartisan program. One-time bonuses given to those seeking living wages is a bipartisan program. Inclusion, healthcare, and living wages, however, are programs of the poor, and in these programs, everybody rises. One of our speakers, Sheilah Garland-Olaniran, reminded us that the seeds of a healthcare system designed by the poor and dispossessed can actually be traced back to the days of Reconstruction. Sheilah shared, “During Reconstruction 400 hospitals were built in the south. Four million formerly enslaved people had some kind of access to care, you also had 5 million poor whites who benefited from this tremendous shift from the very bottom of society.”
This period of Reconstruction was violently overthrown by those who had a vested interest in maintaining the status quo, power, and control. They sounded a battle cry and utilized tactics of division which have been effective weapons against the entire working class on these shores: systemic racism and dispossession. And yet they failed to perceive that the seeds of a healthcare system designed by the poor would continue to take root. These seeds have taken root, and they are deep. Just as Wall Street's overthrow of Reconstruction can be found 100 miles away from its headquarters in the attempts to close Mount Vernon Hospital, the seeds of a program designed by the poor - a demand for a Reconstruction lead by a fusion movement of unlikely allies - can be found fighting to keep healthcare accessible to its people.