After wincing a bit from the free flu shot, my young patient turned to me and said, “What you’re doing here is awesome – it’s so hard get health care!”

“Here” happened to be New York City’s Zuccotti Park in mid-November, the epicenter of Occupy Wall Street, just days before the encampment was broken up by hundreds of Mayor Michael Bloomberg’s armor-clad police in the dead of night. But it could have been anywhere in the United States.

Health care is in fact increasingly unaffordable for the 99 percent. More than 50 million Americans lack health insurance and thus reasonable access to treatment. A recent Harvard study showed about 45,000 excess deaths annually can be linked to lack of insurance.

Even people with insurance face formidable barriers to care like rising co-pays and deductibles. As a result, they are putting off care, getting sicker and ending up in our emergency rooms with serious complications – often facing crushing medical bills later.

This increased “cost sharing” by patients helps explain this week’s report by U.S. Health and Human Services showing the use of medical services has slowed. People can’t afford it.

But lack of care invites serious illness or worse. That’s part of the reason why I and scores of other doctors, nurses, medical students and social workers came down to Zuccotti Park and volunteered our time to give out free flu shots.

But I confess that my desire to help went beyond the Samaritan impulse of preventing illness and aiding the sick, an impulse that, remarkably, still persists among our nation’s health professionals despite the toxic atmosphere of our for-profit health system.

I and many others were impelled to take action because the Occupy movement struck a chord with us. We’re angry that our health economy – like the overall economy – has more than sufficient resources to take care of all of us, but the resources are siphoned off by profit-driven corporations in the interest of “the 1 percent.”

Working on the front lines of health care, we see that economic and social inequalities in our present system make our patients sick. The lack of jobs and decent wages, affordable housing, healthy food and quality education takes a heavy toll on the mind and body, and each workday we see the casualties mounting.

We also recognize that the private health insurance industry and Big Pharma exemplify one of the Occupy movement’s central themes: that unchecked corporate greed tramples human needs. Need I recite the billions in profits these companies make each year, or the outlandish salaries of their CEOs, based on skyrocketing premiums and denials of care?

The private insurers, with all the bureaucracy and paperwork they inflict on us, add enormous costs to the delivery of health care, but add no value. Yet, unfortunately, they remain at the very center of our health system under the federal reform law.

There is a clear solution to our health care crisis. Put patients ahead of corporate greed and establish a nonprofit single-payer health care system – an expanded and improved Medicare for all – with no co-pays or deductibles.

A single-payer system would provide high-quality, comprehensive care for everyone – without exception – for no more money than our nation is paying now. We’d save about $400 billion annually due to lower administrative costs. Such a system would also give us tools to rein in costs, like the ability to negotiate lower pharmaceutical prices.

While helping out at Zuccotti Park, I was gratified to hear others chant a slogan I and millions of other Americans have long embraced: Health care is a human right. We will not stop fighting until that principle is enshrined in law and delivered in practice.

Now that will be truly awesome.

Mary O’Brien, M.D., practices internal medicine and serves on the faculty at Columbia University’s College of Physicians and Surgeons in New York. She is a national board member of Physicians for a National Health Program and co-editor of the book 10 Excellent Reasons for National Health Care.

Join National Nurses United on Tuesday, June 7th for their national rally and lobby day on Capitol Hill. Please RSVP here.

NNU represents 175,000 nurses across the country, and is ready to bring a new deal to Washington DC: the Main Street Contract.

They support Medicare for all to make healthcare a human right, they oppose cuts to Social Security, and they are calling for higher quality of life for everyone in the United States. Is it any wonder that nurses are the most trusted profession in the nation?

The nurses need our support. Join NNU and allied organizations. Please let us know if you can make it on Tuesday, June 7th by registering here.

To reserve a seat on the bus leaving Philadelphia, questions about regional transportation, or for recommendations on lodging, contact katie@healthcare-now.org.

Thanks for all you do!

After this past weekend of horrific storms and tornadoes, it was clearly appropriate for our elected officials to declare a federal disaster in some areas. With the designation comes some federal money and help for the storm-ravaged areas and residents. Few would quarrel with our government stepping up and stepping in when so many lives and so many livelihoods have been damaged and lost. It is the right thing to do, and some suffering will be mitigated.

Over the past four years since the making of SiCKO, Michael Moore’s 2007 documentary, an estimated 45,000 people each and every year have died simply because they lacked access to healthcare. The US healthcare dead are dead not because the care wasn’t available – it just wasn’t available to them. They did not have the financial means (either the cash, credit or correct insurance coverage) to demonstrate to a healthcare provider or doctor that they should be treated and that their lives should be saved.

That’s tipping toward the quarter-million dead mark soon enough. The US healthcare dead could fill Trenton, NJ, or the Palm Springs area of California, or Daytona Beach, FL, or Canton, OH, or Boise City, ID, Rockford, IL, or Ann Arbor, MI – to name just a few of the cities with populations roughly equivalent to those killed by greed not disease or injury just since 2006 and 2007 when SiCKO was being produced and when it was released.

And the bankrupt due to healthcare crisis? That’s a tsunami of devastation raging through working families and communities where no one steps in to help. Homes and dreams are lost. Future plans are altered forever. In 2010, nearly 1.6 million people filed for bankruptcy in the US. Estimates that more than 60 percent of those who filed did so because of medical crisis would make the number of US financial casualties due to healthcare crisis a million or so every year gone broke.

Is that not a disaster with enough dead and enough suffering and enough long-term human and economic consequence in these United States to warrant a column-inch or two above the fold or radio or television coverage once in a while or a leading news position somewhere? Mainstream media? Liberal media? Anyone? Who does the daily death count? 123 dead every day. Who reports the financial death? 2,739 gone bankrupt every day. Who reports?

How much death and how much suffering will be enough to warrant our collective attention in appropriate proportion to the damage being done? Talk about a war on your own people? As far as I am concerned, we have nothing to say to other countries about human rights when we so blatantly participate in the death and pain for so many of our own.

When the nation launched into the healthcare reform debate following the 2008 elections, it seemed that patients and their families provided some good background color for the political arguments – much like the military troops and their families are sometimes used to color our discussions of military actions or patriotic devotion.

But in the direct war on working Americans that is being waged within the broken healthcare system, we now seem to have forgotten the healthcare dead and the healthcare broken. The patients and their families apparently served their intended purpose as political props, and now it’s back to business as usual. The dead keep dying and the broke keep going broke, and the money keeps flowing to the top of the healthcare food chain.

At least if we’re not going to declare this an emergency, I wish we’d at least report it as significant. 123 dead for lack of healthcare access a day in the United States in 2011. 2,739 bankrupt due to medical crisis every day in the United States in 2011. The numbers don’t lie. We do. We lie to each other when we ignore the shared reality of the torture and pain behind those numbers.

And to hear assaults on Medicare and Medicaid and any other programs that might reduce even a bit the rising tide of pain is an affront to any sense of common decency any of us might have imagined was present in our society.

If you don’t tell at least one other person today who doesn’t already know it that 123 people died today in this country not from a hole in a jet’s fuselage or an air traffic controller asleep in the tower or even due to a war or a conflict, but because we were too selfish and too greedy to change what could be changed in our healthcare system, then you don’t actually believe it’s a crisis. If we don’t count them, who will?

123 dead today. 2,739 broke today. Your fellow Americans. My fellow Americans. Every day until the day when we actually implement something different, like a progressively financed, single standard of high quality care for all without financial barriers. We know how to do it. We just haven’t demanded that a disaster be declared and that action be taken to mitigate the suffering.

Donna Smith is a community organizer for National Nurses United (the new national arm of the California Nurses Association) and National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign. She is also on Healthcare-NOW!’s Steering Committee.

In advance of President Obama’s speech Wednesday on the budget deficit, the nation’s largest union and professional association of nurses today called on the President to oppose any cuts in Medicare, Medicaid, and Social Security – and strengthen the nation’s economy by restoring fair taxes on corporations and the super-rich, ending the wars, and creating good paying jobs.

“America is not broke, it’s just deficient in political courage and leadership,” said Jean Ross, RN, co-president of the 160,000-member National Nurses United. “It’s time to tell Wall Street and the politicians they finance in Washington and state governments that the American people have sacrificed enough. There can be no more cuts in healthcare programs for seniors, the disabled, and the disadvantaged, and no reductions in retirement security.”

NNU’s national executive board recently passed a resolution stating that it will not endorse any federal candidate in 2012, from the President to Congress, who votes to cut Social Security.

“We expect the President and our elected leaders in Congress to stand up, and protect our most basic safety net programs, which start with Social Security, Medicare, and Medicaid,” said Ross. “For 30 years, we’ve seen a massive shift of our nation’s wealth and resources transferred from Main Street to the executive suites. The result, record profits, and unbridled corporate corruption and thievery, while wages for working people stagnate, and income and health insecurity soar.”

If the President and the Democrats want to cut the deficit, said Ross, they should end the wars in Afghanistan, Iraq, and Libya, reduce military spending, close all the corporate tax schemes that have allowed more than 40 percent of corporations to avoid taxes, restore a fair tax system, and re-invest in America to create good paying jobs in the U.S., not China or India.

NNU is also calling for a Main Street Contract for the American People, a second bill of rights, that includes jobs at living wages, guaranteed healthcare for all, a secure retirement, a safe and healthy environment, a secure retirement for everyone, and respect for union rights.

Republican proposals to privatize Medicare, slash Medicaid, and make further deep cuts in safety net programs are “obviously reprehensible,” said Ross. “But without real leadership from the other party and the White House, and a clear road map for an alternative vision, these mean spirited proposals, and continued handouts for the wealthy and corporate elites, will surely follow. It’s time for the President to stand up for the working people of this country, not the corporations which brought us an economic tsunami.”

It’s a club I will never be in. Michael Moore told us about them this week. The Forbes 400. The richest 400 people in America. They own more stuff and have more cash and assets than half of the rest of us (roughly 150,000,000+ people) combined.

But I had to dig deeper. It wasn’t offensive enough to me that just 400 people own so much that was as the result of the hard work and suffering of so many of the rest of us. I was willing to bet it was a deeper profile of power in 2011 America than that repugnant statistic alone indicated.

I was right. In the Forbes 400, most of the people are white guys. In fact, 365 are guys. Very few non-white people, and only 35 women are in the club. And Oprah is the only black woman. 365 plus 34 and Oprah.

That just about says what we need to know about our society. It’s a good ol’ mostly white boys and a few mostly white girls plus Oprah club. Their money controls our industries; their industries control our access to the good life or lack thereof. And they are still mostly male, mostly white and drenched in wealth – even 235 years after a bunch of mostly white, all male folks declared that all men had rights unalienable. They weren’t lying about the men part. I’ll give them that.

Sometimes when I am thinking we’ve advanced so far since the Founding Fathers set forth upon this continent a new nation that I forget reality slapping me in the face. I am not on the Forbes 400 or the Forbes 4,000 or the Forbes 4,000,000. And I never will be. I’m a working class white girl.

I guess I will have to content myself with the notion that I’m in a more exclusive club than they are. I am a cancer survivor who weathered financial collapse that followed being an American with inadequate access to healthcare and then had my story told in Michael Moore’s 2007 film, SiCKO. About a dozen of us were featured in that film, and we’re not in the Forbes cohort.

Just yesterday, the report came out that bankruptcies due to medical crisis had not been significantly reduced by the Massachusetts healthcare bill known as RomneyCare, or Chapter 58, the mandated purchase of private insurance, passed in 2006. More than half of all personal bankruptcies still flow from medical crisis and of those going broke, 89 percent had health insurance.

I think that my club, though small, is pretty diverse and full of good-hearted people (men, women and kids of all races, colors, sizes and shapes) who would trade the chance for all the influence and power on earth and a slot on the Forbes 400 list – and our moments of fame in SiCKO — for a transformed healthcare system that provided a single standard of high quality care for all without financial barriers. I like my club better.

Donna Smith is a community organizer for National Nurses United (the new national arm of the California Nurses Association), National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign, and Healthcare-NOW! Steering Committee member.

Marching to defend workers' rights and benefits in Madison

The feeling of solidarity was palpable. The slogan on one T-shirt connected all the issues for the nurses: Union Rights, Human Rights, Patient Rights.

Leslie Curtis, an organizer for NNU, set the tone: “What’s happening in Wisconsin is a fight for all of us.” She held up some of the picket signs we’d be carrying. The one that got the biggest cheer proclaimed, “Don’t Blame Workers for the Crisis, It’s Wall Street Greed.” Then she reminded us when the bus got back to Chicago to “tip our union brother,” our bus driver.

As the bus hit the road, a nurse wearing a Sicko T-shirt walked up the aisle with a box of Joe in one hand and a bag of dairy creamers and paper cups in the other. Following her was another nurse with a box of Einstein bagels and cream cheese. We were all well fed and caffeinated by the time we rolled into Madison two hours later.

On the bus, the nurses had no shortage of health care horror stories. RNs from the University of Chicago Medical Center–which is located on the South Side, a few miles from some of the poorest neighborhoods in the city, talked about the difficult and at times dangerous conditions in the hospital inpatient units and in the emergency room.

Nurse Reasheal Lehmann works in the ER and discussed the overcrowding and long waits–sometimes over 13 hours. That’s because another South Side facility, Provident Hospital of Cook County, just closed its ER to ambulance runs. Now patients are diverted to U of C, which expects eight to 10 more ambulances a day, a 50 percent increase. Since 1986, six South Side hospitals have closed, putting enormous stress on the few health care institutions left to serve low-income and uninsured patients.

Reasheal said some patients that need to be admitted wait in hallways for more than 24 hours until a bed is available. Hospital management has a system called “bed geography” but the nurses report the system doesn’t work. The anger and frustration in the ER leads patients to walk out without being treated.

Among the ER patients who suffer the most, according to Reasheal, are those in sickle cell pain crisis. She said, “Sickle cell is still terrible on the South Side,” and added, “By the time a patient in a pain crisis is seen, they need IV morphine–that’s how bad the pain is.” Another nurse described a flooded ER with water contaminated with human feces. Several rooms had to close. After the blizzard that hit Chicago a few weeks ago, the ER was deluged with dialysis patients who missed dialysis treatment. Most were so sick they had to be admitted to the hospital for stabilization.

The bus burst into laughter when Reasheal called out the tagline that advertises the University of Chicago Medical Center: “At the Forefront of Medicine.”

When asked about the solution to the health care crisis, Mona Cetner, an RN on the inpatient general medicine unit at U of C, said without hesitation, “Single-payer. Health care is a right, not a privilege. Our health care is shameful. We should hang our heads in shame. Medicine shouldn’t be for profit. It’s corporate greed.”

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IN MADISON, the minute we disembarked from the bus, placards in hand, union members came over and thanked the nurses for coming. We marched with them one block to the Capitol building.

Across the street were two semi-trailers with the word Teamsters emblazoned on it and unionists clogged the sidewalk. When they saw the nurses, they started to chant: “Union, Power, Union, Power.” Over and over, hundreds chanted the words, and then the order flipped: “Power, Union, Power, Union.”

We entered the Capitol to the sound of drums and chanting in the near distance. As we marched down a hall lined with workers, smiles all around, people shook the nurses’ hands like they were celebrities, thanked them profusely for supporting their struggle and added, “Thank you for taking care of us.”

Once in the rotunda, the crowd erupted as the nurses, signs held high, marched in and stood behind the drummers in a semi-circle. Reasheal addressed the crowd and said, “Health care is a human right. We are here from Chicago to support your struggle.” A massive cheer went up. There were dozens of signs in the crowd that spoke to the health care crisis including one that asserted, “Mental health care is a human right.”

Then the firefighters marched into the crowd and through the rotunda in full gear, the piercing red and white lights of their battered, black helmets turned on. They high-fived the nurses. The next group of workers was a huge contingent of sheet metal workers. Who knew there were so many sheetmetal workers and what do they do?

Jimmy Hoffa Jr. of the Teamsters showed up, addressed the crowd and invoked the labor slogan, “An injury to one is an injury to all.” After he left, the woman chairing the ongoing mass meeting in the rotunda held up two fingers that signified for the chanting to stop and for people to listen.

Everyone complied. She stood on a plastic milk crate, took the microphone and read out solidarity greetings from Egypt. When she finished the room exploded into whooping and clapping. A new chant began, “We are one, we are one,” and then morphed into, “One, One, One,” over and over again.

But the chant heard consistently throughout the day was “This is what democracy looks like.” And it did–masses of workers from all parts of the state occupying the building where the decisions that affect their lives are made, and demanding to be heard. Solidarity came from every direction and from some unexpected ones: doctors. They wrote sick notes to excuse Capitol protesters from work. Dr. Lou Sanner, a family medicine physician, confessed he wrote hundreds of sick notes for protesters because they were suffering from stress.

The level of day-to-day organization in the Capitol was seamless, the floor spotless. There was a crew that cleaned up constantly. The “people’s pizza,” pepperoni or cheese, was given away. People with platters of vegetables and strawberries, and crates of apples circulated throughout the crowd. Stacks of bottled water were available. An elderly woman offered Girl Scout mint chocolates to the crowd.

A nurse’s station was located on the first floor, and on the second, there was a table with first aid supplies. Next to it was a table piled high with food: containers of hummus, baby carrots, slices of famous Wisconsin cheeses, crackers and bread. Around the corner was a child care area and children drew on large sheets of paper spread out on the floor. In the women’s bathroom, there were boxes of tampons and pads, free for the taking.

Around 2 p.m., it was announced that the legislators were going into session. The drummers and hundreds of protesters dashed up the stairs, but were blocked by police a few feet from the entrance to the chamber. The four drummers started drumming furiously. A trumpet player joined them. The sound was so thunderous that the air vibrated. A chant of, “Go, Go, Go” started.

The words and sounds ricocheted off the stone walls and floors, amplifying the effect to deafening levels. Facebook and Twitter are ways to organize and communicate, but they can’t substitute for the power of booming drums and hundreds of people packed together protesting, voices chanting political slogans. It was a festival of fighters.

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THERE WERE many signs in Madison stating, “It’s not about the money.” But it is about the money. The governor clearly sees it that way. So should labor.

The mainstream media, labor leaders and politicians repeat ad nauseam that state workers “aren’t in it for the money.” Then what are workers “in it for?” For fun, not to pay the bills? The billionaire Koch brothers are in it for the money. Slashing benefits takes money out of workers’ paychecks, and soaring health care costs is the main reason. Walker is more than doubling workers’ contributions toward helath care to a whopping 12.6 percent.

Ann Niemeier, a retired teacher who’d been at the Capitol for over a week, explained, “The poorest workers will be hit the hardest–the nursing home workers and day care workers. They won’t be able to afford the increase. We’ve taken too many concessions. The fight with the governor should be about the benefits, too, not just the right to collective bargaining.”

Over the last decade, family health insurance premiums for Wisconsin workers rose 4.6 times faster than their median earnings. Another reason premiums have increased is because those with insurance pay a “hidden health tax”–$1,017 yearly on average, according to the estimates of researchers–in money that goes to pay for the care hospitals provide to the uninsured.

Wisconsin has between 300,000 and 500,000 uninsured, and 110,000 are children. Walker’s budget also proposes changes in Medicaid and BadgerCare that would eliminate thousands from eligibility from both programs.

The National Nurses United support a strategy of “No Concessions.” Executive Director Rose Ann DeMoro threw down the gauntlet when she wrote a few days ago, “There can be no more concessions, period.”

The NNU is one of the main supporters of a single-payer, national health care system. A single-payer system abolishes employment-based health coverage and is the only way to get bargaining for health care out of every union contract and to make health care a human right for all.

February’s single-payer newsletter includes these articles:

Dr. King and Health Reform
By Claudia Fegan, M.D. – “There are 50 million Americans who are uninsured. African Americans are represented disproportionately among the uninsured. I am referring to the fact that while we represent only 12 percent of the population, we are 20 percent of the uninsured.”

Vermont Governor Lays Out Details for Single Payer Pathway
The Shumlin administration released the legislative details of how to move the state to a single payer healthcare system, with the first steps beginning this summer.

Nurse Protest Prompts Blue Shield to Delay Rate Hike
Blue Shield of California announced a 60-day reprieve for the unconscionable rate hike of up to 59 percent it intends to foist on individuals and families. The announcement coincided with announced plans by nurses, patients, and consumer advocates who stormed Blue Shield’s posh California corporate headquarters in downtown San Francisco.

Will You Cry for Me, John Boehner?
Because we know Speaker of the House Boehner has an emotional side, we want to tell him our stories of struggle – the stories that make us cry – in hopes that instead of pretending to repeal health reform, we should start talking about real improved Medicare for all reform. Over 1,600 people have signed the letter to Mr. Boehner so far. Have you?

House Republicans Consider Privatizing Medicare
Months after they hammered Democrats for cutting Medicare, House Republicans are debating whether to relaunch their quest to privatize the health program for seniors. House Budget Committee Chairman Paul Ryan, R-Wis., is testing support for his idea to replace Medicare with a fixed payment to buy a private medical plan from a menu of coverage options.

If the Obama healthcare bill is just a “government takeover,” why are healthcare industry CEOs being rewarded with so much money?

The alleged expropriation of healthcare by big government is, of course, a major story line of the right and the new leadership of the House which is planning the useless exercise of a vote to repeal the law.

But if the private companies who actually do control our health are hurting so badly, why are they shelling out so much to their top executives?

A report from Kaiser Health News exposes lavish pay packages for some of the biggest players in the private healthcare industry. Billy Tauzin, the head of PhRMA, raked in more than $9 million last year, for example, while his counterpart Scott Serota at Blue Cross/Blue Shield earned a comparitively-miserly $7.1 million.

Other major corporate healthcare figures receiving huge executive pay packages were from the hospital, medical technology, and biotech industry.

As KHN notes, most of these execs supported either the entire law or key aspects of the law. It is a fiction to assert that healthcare corporations have in any way been harmed by this reform, or will be harmed. Their pay practices to top executives make that very clear.

Drug companies won a victory by blocking re-importation of prescription drugs. Insurance companies won a victory, for the time being at least, with millions of forced new customers from the mandate. Hospital revenues are expected to spike, medical technology companies will see a surge in sales, and biotech firms won a dubious 12-year exclusivity for brand name biologic drugs.

Given that, do we really need to replay the same debate over the current law over and over? Will that solve any of the still very real problems that exist? Those notably include the tens of millions of Americans who remain uninsured, many of whom will not be covered even if the law goes into full effect, and the millions more who are slammed daily by un-payable medical bills and ever rising costs that the bill does so little to address.

Reminders of the continuing healthcare crisis come regularly. To name just three:

1. The U.S. ranks just 22nd in health well-being among major industrialized countries, according to a UNICEF report issued in December.

2. Growing numbers of parents with premature babies, or children born with special needs, according to another KNH report, are being socked with huge bills for neonatal care because the health professionals are deemed to be “out of network.”

3. Only 58 percent of private sector employees have access to paid sick leave, according to a report out this week from the Institute for Women’s Policy Research. Among the consequences, many sick employees come to work because they can’t afford the unpaid lost time, especially in a deep recession, at risk of aggravating their illness and facing more serious sickness, more lost time, and higher health costs, and the likelihood of infecting others in their workplace.

It’s time to move on. Let’s end the fiction that the current law was a government takeover. Let’s stop replaying the fruitless debate of the past two years over the false issues the right loves to exploit.

And let’s find ways to address the continuing health problems plaguing so many by working instead:

To really reign in skyrocketing costs, that are primarily driven by the very same profiteering private companies whose executives are being paid so much, and guarantee healthcare for all Americans, best done by expanding the most cost effective, real universal program — it’s called Medicare — to cover everyone.

Deborah Burger, RN, is co-president of National Nurses United, the nation’s largest and fastest-growing union and professional association of RNs, with 160,000 members around the country.

RENO, Nevada — I ventured backward in my memories to the fall of 2006 and wondered what might have happened differently if the Tea Party ruled this nation. It’s not that I am thrilled with the current state of political reality, but I am worried that if the trend toward more greed, more self-righteousness and more far flung and far-fetched ultra-conservatism continues, folks like me will stand no chance. We’ll be washed away like street dust down the storm drains after a fast-moving, summer thunderstorm, and no one will think of us again.

We are — I am — among the unclean. I tried in vain to keep my financial head above water in the face of impending healthcare doom and financial collapse. I failed to negotiate manageable payments with doctors and hospitals and clinics and even a local pharmacy. I did always pay my health insurance premiums, though. I succeeded at least in that way. But belly up I went. That was 2006.

It has been nearly four years since our journey to reclaim our dignity began. Bankrupt and homeless, sick and tired, we decided allowing our healthcare horror story to be told by Michael Moore would at least document our demise somehow.

If the Tea Party had been in control, perhaps the collapse might have been mercifully more brief. Under their view of the healthcare world, people without the appropriate and adequate means of payment should perish due to the lack of those means. Let’s see. That means when I was diagnosed with cancer, I might have found out immediately that since I did not have my full deductible payment up front that I would have to wait for treatment until I did. The reality was that my symptoms — in my case severe bleeding — would have prevented me from working every day I needed to in order to take home a full paycheck and save $10 or $20 a pay period toward that $2,000 deductible. If I had survived the bleeding, the cancer would have advanced. Under the Tea Party view, that would apparently have been just and maybe God’s will for my life outcome.

And what about my husband? We often struggled to meet his health costs — that is until he was eligible for Medicare coverage and the supplemental coverage we purchased. Again, if the Tea Party had been in control, we would have had no way to apply for Social Security disability and finally Medicare, and my husband would not have survived to retirement age. Damaged goods, I suppose, in the Tea Party view.

Again, I am not saying our outcomes were better because of the Democrats or the moderate Republicans or the Independents, the Greens, or any other political party in America. My husband and I survived because of a Michael Moore film and a series of somewhat lesser miracles stemming from our experiences being included in SiCKO — and because we have sacrificed all other goals in our lives to clawing our way out of that storm gutter. No one is cutting us slack.

It took not just one miracle but several to lift us from our healthcare-financial collapse even without the Tea Party in power. It shouldn’t take that, but it did and still does. The work we both have to do and the time we must spend apart is extraordinarily difficult. But if we flinch now, we’ll be washed right back down that drain of failure as if the past 48 months of intense effort never happened. That’s what hard-working Americans face every day. Most don’t have the miracles we had to build on.

Tea Party faithful believe that not only will the weak not inherit the earth but that the weak shall be banished from it. Tea Party faithful think people are weak who must lean on our social safety nets, even if many of them collect Social Security, unemployment benefits and are Medicare beneficiaries. No matter, they think and they proselytize. Do away with all those “wicked” entitlements, they muse.

So, in my backwards time capsule, I bleed my way through a few months or even a year working with cancer and trying to save cash to meet my deductible. During that year, my husband’s artery disease advances due to the lack of a single-standard of high quality care for all and due to the stress of watching me suffer. In the end, after months of painful decline and loss of my job and our only income, we end up dead. We leave bills behind we could not pay and boxes of our personal belongings with no saleable value that will need to be taken to the dumpster.

Think of all the taxes I wouldn’t have paid and the money I wouldn’t have spent in just four years if I had died back then. Some of the people who have benefited from my staying alive would have also had less happy outcomes.

It would have been ugly but swift. In a Tea Party world, the meek and the weak are so because they didn’t work hard enough or long enough. If their vision prevails, which I hear as only a slight morph of the right-wing Republican agenda, there will be a culling out of those who get sick or hurt and don’t have a way to bankroll their recoveries.

But, wait, back to my reality. The Tea Party vision really isn’t very much different from how it is right now. The stark truth of it is that if the same thing were to happen to me today that unfolded pre-SiCKO, there would be no Michael Moore’s SiCKO II and no rescue and no way to recreate the miracles of 2006-2010.

Until we all embrace reality that our healthcare mess — under any system that does not provide a progressively financed, single standard of high quality care for all — is an economic and also very personal expression of our national cruelty toward the weak and towards one another, we will remain Tea Party loyalists in the making. Right now, some just want to pretend they represent some other view, but as far as I can tell, death and failure are imminent for people like me; it’s just a matter of how quickly and how harshly.

So long as the Tea Party is even one step away from control, I’ll work to advance a wiser, more economically bold and sane system that views the loss of life as a cost we collectively cannot swallow.

I’ll keep on keeping on, as the saying goes. I’ll keep hoping and praying and doing the hard work to back up that hope and prayer. But if we move closer to a Tea Party view instead of away from it and if I face another situation in which a new cancer diagnosis arises again, I think I’ll just shut up and bleed.

Donna Smith is a community organizer for National Nurses United (the new national arm of the California Nurses Association), National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign and Healthcare-NOW! Steering Committee member.

The registered nurses of the North Adams Regional Hospital (NARH) voted overwhelmingly July 19 to authorize their union leadership to call a strike if necessary in their ongoing negotiations with hospital management. In a unified show of strength, 99% of the voting members voted in favor of the strike authorization.

“With this vote, the nurses at this hospital have sent a clear message. We are ready and willing to strike in the defense of our patients, our profession and the future of quality health care at NARH,” said Ruth O’Hearn, RN, a nurse in the ICU and co-chairperson of the Massachusetts Nurses Association (MNA) local bargaining unit at NARH. “We entered these negotiations with the understanding that the hospital is in a difficult financial position. In that spirit we didn’t ask for a wage increase and since then have dropped any proposal that would cost the hospital money. They have responded to this olive branch with a hammer. The hospital has refused to remove any of their proposals that would radically gut our contract, allow them to undermine our nursing practice and totally control our lives.”

“The hospital’s proposals would have a disastrous effect on the quality of patient care. Under their plan NARH once again would be allowed to use mandatory OT to staff the hospital, and patient care would suffer. NARH also wants to eliminate contract language that allows a nurse to decline overtime if she is exhausted or sick. As experienced professional caregivers we know when we are unable to care for our patients, but the managers seem to think they know more than we do,” said Mary McConnell, RN and a nurse in the PACU and Co-Chair of the bargaining unit.

“We are first and foremost advocates for our patients and management is seeking to take that away. They want a gag order that would stifle any negative comments, as defined by management. This would mean a nurse wouldn’t be able to even write a letter to the editor without fear of losing her/his job. For patients, this means nurses will be prohibited from speaking out about patient care, working conditions and unsafe staffing,” said O’Hearn.

Management also wants to ignore the posted work schedules, to be able to cancel shifts, to mandate extra shifts at their whim, to change the hours of a shift, and to mandate staff to come in early or stay late. This will leave the nurses unable to plan their lives and child care because they essentially would be on call 24/7.

The negotiations started in January. Management put over one hundred proposals on the table, many of them concessions that would serve to make the present contract meaningless. The MNA has represented the 106 nurse-bargaining unit for over thirty years and bargained numerous contracts over those years but never faced these types of proposals. The hospital has hired a noted “union avoidance” law firm, spending thousands of dollars in legal fees that could have been spent to maintain the quality of patient care.

“We don’t want to strike, but they are leaving us no choice if they continue to insist on their abusive and unreasonable demands,” said O’Hearn. “It is our hope that they will come to their senses and finally treat this community and their employees with the dignity and respect we deserve.”

Founded in 1903, the Massachusetts Nurses Association (MNA) is the largest professional health care organization and the largest union of registered nurses in the Commonwealth of Massachusetts. Its 23,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on health care issues affecting nurses and the public.