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Hospitals Have to Limit Liens and Lawsuits

 LoveKitchen-SistersHouston      Two twin sisters in Knoxville, Tennessee both became nurses and when they retired, they organized something called Love’s Kitchen that provided meals and clothes to what they called the “five H’s: the hungry, homeless, helpless, hopeless, and homebound.”  One sister, Ellen Turner, passed away recently at 87.  The whole operation was funded by donations and run by volunteers.  That is what charity is.

Public hospitals have an obligation to provide charity care.  Private nonprofit hospitals have the benefit of tax exemptions because they literally swear to the government that they exist for charitable purposes.

Yet these same hospitals with their lofty slogans and “do no harm” mantras are regularly and with impunity suing the heck out of lower income families, eligible even under their own self-certified policies over health care bills.  Looking at court records in Texas and North Carolina and talking to families, organizers, lawyers, and journalists, it is sometimes a head scratcher to figure out two things:  are they charities at all and how do these hospitals think they can get blood from families that are stone broke.  In both Texas and North Carolina, state law do not allow them to garnish wages, so when they file suit they are trying to attach property, most often houses, but also incredibly sometimes personal property, if there is any, from families too poor to own their own homes. How much do they think they can sell someone’s family Bible for?

A lawyer working for legal services in Charlotte pulled some cases for us on Carolinas HealthCare Systems, North Carolina’s largest hospital network, and a public nonprofit.  Half of them were renewals.  When asked, he explained that once you have a property lien in North Carolina, you have to file every ten years to renew the lien or you can’t collect.  So, this huge chain is hanging around, a vulture perched on the wire, obviously waiting for someone to die so they can poach what little might be in their estate, or for some family barely hanging on to be forced to sell or have their house foreclosed, so they can take whatever they can.

Of course these families are in these court cases for some pretty serious crimes.  They committed the criminal act of getting sick, while poor.  Or at least to sick and too poor for the likely inflated charges still sticking to them decades later that are now falling on them and then to their sons and daughters and the sons and daughters of their sons and daughters.  The lien and the debt becomes generational in the same way bondage works for generations working off debt in rock quarries in India. When we looked in Missouri, Arkansas, Texas, and elsewhere we also found that the amount of the debts triggering these liens were sometimes in the six-figures, but mostly were relatively small, five hundred here, two thousand there, and so forth.

Stories filed by investigative reporters for the Charlotte Observerindicate that the same patterns exist in that state as well.  Several months ago Ames Alexander reported the “good news” that Carolinas Healthcare Systems only “filed about 1400 lawsuits against patients last year [2013] – roughly half the number it filed in 2010.”  That number they reported was almost half of the 3200 filed statewide, down from 6000 in 2010.

The new rules under the Affordable Care Act require nonprofit hospitals to clarify and promote their policies around charity care.  Clearly one policy has to be to NOT sue poor families for chump change.  Perhaps the limit should be cases over $10,000.  Furthermore, their charity policies should mandate acceptance of good faith offers to pay.

Another story by the Charlotte Observer team interviewed former patients who were the brunt of these lawsuits.  All of whom were eligible under the Carolinas HealthCare systems own charity policies.  Most of them had offered a payment plan, usually $100 per month that they didn’t have, nonetheless the hospital rejected the plans and sued them.

I met a women in Charlotte who had recently gotten a bill from a New York hospital for over a half-million dollars for care twenty years ago!  We have met no one while visiting families being sued in Houston, Texas by the giant Herman Memorial who were ever told that a charity care policy existed.

Whatever all of this is, I’m sure of a couple of things.  First that it’s just plain wrong, and, secondly, that the Knoxville sisters at Love’s Kitchen could tell all of these hospitals that whatever they are doing, it’s definitely not charity.

Comcast’s Internet Essentials and Lousy Customer Service Brought Them Down, Too

comcast-sucks-2Austin       The failure of Comcast’s monopoly-merger mania would almost be Biblical in the “pride cometh before a fall” sense if it were not so predictable, and if, we, and thankfully a whole lot of other people in a whole lot of other places, had not repeatedly tried to tell them so and warn them repeatedly.  But, it’s really not Biblical, it’s more a P.T. Barnum problem of their thinking that because they could fool the people once, they could fool them all the time.

And, speaking of pride, I swelled up a bit reading the lead paragraphs in the New York Times analyzing their mega-fail and starting with the fake digital divide effort Comcast pretended to make on their so-called “internet essentials” program where the FCC had ordered that they provide a low-cost access to lower income families in order to gobble up NBC/Universal, and as we have frequently outlined they spend more on wining and dining local politicians and making so-called contributions to groups they wanted to have stand up for them before the FCC than they ever spent on actually doing the outreach or following through on the program.  Though they claim that only paid a fine on one condition of the order, they gloss over the fact that they had to pay $750,000 and add a year for their huge failure and fake effort on helping to bridge the digital divide.

This Comcast scam is too egregious and finally its comeuppance is too delicious not to quote in full:

“Critics, however, call Internet Essentials, a public relations stunt that failed to deliver on its promise, with restrictive qualifications, limited reach and poor service.  Comcast committed to making the program available to 2.5 million low-income households.  The company announced in March that the program had connected 450,000 families – or about 17 percent of eligible households….’Regulators were sold a bill of goods,’ said John Bergmayer…at Public Knowledge, a consumer advocacy group that has criticized the effectiveness of Internet Essentials…’I’d be curious whether they spent more time marketing in D.C. to policy makers than to people who qualify for the program.’”

That’s not a curiosity, that’s a statement of fact, and not just in DC but in any city hall and governmental jurisdiction where they operated.

In the same piece the report says, “Comcast officials say that the population is difficult to reach and that getting people to sign up for the service has been harder than they thought.”  Balderdash!  We told David Cohen, the chief flak, repeatedly and to his face that handing out leaflets to beleaguered school teachers was NOT an outreach program.  WE told him to his face, in writing, and repeatedly up and down the Comcast chain in Congressmen’s offices and with his governmental relations folks that the program was too complex, there was no follow through, you couldn’t sign up, they tried to upsell people, the computers didn’t work, etc, etc, and they accused us of “shaking them down.”  Look who is busted now.

Turns out now that the deal has collapse, that they also couldn’t get over the fact as well that their customers, many of whom are also voters, don’t like high priced, crummy cable and internet coupled with rude and non-existent customer service.  Really?  Is that a surprise to anyone but Comcast?  And, did Brian Roberts, the Comcast chief, really think promising the FCC’s Tom Wheeler that they would deliver “first in class service” had any credibility whatsoever.  Justice was sure there were antitrust problems and the FCC was sure not only that the deal was not in the public interest, but also that there was no way that they could hold Comcast accountable.  Comcast proved that to them on NBC Universal.

It’s not over.

They may call Philadelphia their corporate headquarters and they may be waving around the fact they are building a second high rise, but they are now facing a franchise renewal hearing.  What goes around, comes around and our campaign partner, Action United in Pennsylvania will undoubtedly be at the hearing to remind Comcast how lame their internet essentials program has been, how terrible their service is, and what they demand Comcast is going to have to do to get right with the people in the City of Brotherly Love, as opposed to Wall Street and Washington.

Beat Goes on with Action NC

 11136137_965406756845662_625913521779237434_oCharlotte     Pat McCoy, the executive director of Action NC, and I visited with a class of students at Charlotte School of Law who were trying to learn the often delicate dance required of partnering with community organizations, offering stories and advice, even if perhaps not helpfully in some cases.  More fruitfully, we talked about campaigns and conferenced in the whole team to look at the prospects for nonprofit hospital accountability in North Carolina.  We visited with Action NC leaders and organizers, telling old stories and hearing new tales.  Young organizers from the ACORN days were now seasoned veterans with nearly a decade under their belts.  It was all fun and friendly.

Nothing prepared me for the evening though.  Somehow what I had noted on my calendar as a meeting with Hector Vaca, Action NC’s Charlotte director, and some local Latino journalists, sharing information on their immigrant organizing work and ACORN International’s work in Latin America, turned out to be something much, much different and very, very special.  Brother McCoy may have neglected to fully brief me, but he was as tight on the details for this reception as he has been on the main thrust of his work in Carolina over the last half-dozen years.  There were three kinds of tea, including the mandatory sweet tea so many required here, and probably as many different kinds of pizza, though I got to that late in the game.  Before it was all said and done we were meeting with more than thirty Action NC leaders, members, and staff, many from the North Carolina ACORN days, and, even more, newly recruited from Action NC campaigns, but all raising their hands with questions about ACORN, ACORN International, citizen wealth, and all the work we were all doing or might even do together in the future.  It all felt like a wonderful and warm homecoming, a rare, sweet slice of heaven in the struggle and still a standard measure of community in the South.

That was personal, but the business was even more special and serious.  Faced with rebuilding after the attacks on ACORN, Pat and his team in the rebranded Action NC had hunkered down, concentrating in Charlotte, but maintaining important operations in Durham and Raleigh, the state capital.  They had strategically repositioned themselves in campaigns that followed their base, especially in dealing with horrendous and exploitative tenant issues, and then listening to many of the tenants from the immigrant community and concentrating Hector’s work in building a base and campaign around immigration rights and the myriad issues of the undocumented.  They joined numerous coalitions, whether as senior or junior partners, to build a stronger North Carolina base in the vacuum created by ACORN’s elimination as their national support center.  They pushed on housing, education, healthcare, and other classic issues and made progress.

Interviewing Pat on KABF and WAMF’s Wade’s World one campaign stands out as typical.  Many of their members from the immigrant rights campaign kept bringing up their forced detachment from their own children and their education because of local school regulations and bureaucracy.  In Charlotte, to volunteer to help in a class or enter the school grounds required identification of course, but for some reason Charlotte demanded a Social Security number which for undocumented families was impossible.  Ostensibly the schools wanted to do a criminal background check, but no manner of other assurances were acceptable.  The campaign was on!  School board members were met.  Administration officials were buttonholed.  Meetings with law enforcement officials showed progress for independent 24-hour records checks.  Study committees were assembled as Action NC pressure increased.

Like so much of our work, the story is not quite finished yet and the fight continues.  But like the continuum of members, leaders, and organizers that have tirelessly stayed the course in North Carolina from Carolina Action to North Carolina ACORN to Action NC, and just as ACORN International has continued to unwaveringly built ACORN over the last 45 years from Arkansas to Canada, India, Kenya, Honduras and a dozen other countries, standing with the gang in Charlotte, answering questions about ACORN and citizen wealth, signing books for companeros and companeras, laughing and taking pictures with people, there was not one doubt in my mind that as we always chanted, the People United Will Never Be Defeated!

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Discovering Precarious Work and “Hotel Mama”

fast-food-strike-AP46472623_620x350Charlotte         Is it just me or is the mainstream starting to discover precarious employment?   Maybe it’s the “fight for $15” push that’s opening eyes?  Maybe it’s a residue of the Occupy 1% theme?  Maybe it’s the yawning gap between the rich and the rest of us?  I’m not sure, but I know two things.  One, that, like spring, tales of the precarious are starting to sprout up everywhere, and, secondly, that it has to be a good thing, no matter how odd some of the pieces come out.  None of this is George Orwell down and out in London and Paris, but most of it is more a long look through a telescope at Mars full of observations with very limited, well gloved participation at most.

The New York Times of course has the occasional story of a fast food worker trying to live and raise a family on barely minimum wage, but that’s hardly new.   Recently though, The New Yorker ran a story by William Finnegan, their esteemed reporter on all things south of the US border, where he followed an informal mineworker – one of an estimated 400,000 — in the gold fields of Peru at 17,000 feet who tried to make a hardscrabble living as his fuse burned to an early death.  Elsewhere in the magazine for the life of me it almost seemed that the reader was being encouraged towards at least a glimmer of empathy for Somalian pirates because of the dire economics and precarious prospects for making a living in that failed state.  Interestingly, the business end of piracy seems to be small time, marginal workers hardly a half-step above precarious making “investments” in the success of the ransom demands.  Don’t misunderstand me, I’m not recommending this for marginally employed workers, but the New Yorker’s door opening for their readers into the other worlds of work outside Manhattan is truly fascinating!

The Economist recently expressed concern for the increasingly precarious situation for Japan’s working poor where even with almost full employment, defined at 4% or less, a record-level 16% of the population is now living on less than half the national median income.  Bestsellers are being written in this orderly society on how to live on less than $16700 per year.  American low-wage workers would love to read some books with valuable advice there!   The bottom line is irregular employment.  The Economist noted that “the number of irregular workers – often earning less than half the pay of their full-time counterparts with permanent employment contracts – has jumped to over 1.5 million.  Casual and part-time employees number nearly 20 million, almost 40% of the Japanese workforce.”

Many reports are now wondering, “How are people living like this?”

In Japan, many, especially younger workers, are living at home with parents as their primary housing and welfare agency.  That’s not unusual it seems.   Precarious employment is forcing huge numbers of younger workers around the world into what is being called “Hotel Mama” in Eastern Europe.  In the US 15% of adults 25 to 34 live with their parents.  In Slovakia 74% between 18 and 34 and 57% between 25 and 34, in Bulgaria 51%, Romania 46%, Serbia 54%, and Croatia 59%.

As more and more observers discover the ubiquitous nature of informal employment as if this is a new exploration into a previously unknown world, it’s a good thing, though I have to wonder how they avoided it so long.  Unfortunately, the observations decoupled from participation, still seem woefully short on solutions or even recommendations, even as the recognition of the growing crisis increases.

Lessons from Greece, Spain, and Chicago for Progressives

VoteFraudNew Orleans        Recently Dan Cantor, the long-time head of the Working Families Party of New York and now director of their multi-state efforts to create a progressive alternative party, co-authored a piece that ran in the publication, In These Times, about lessons we could learn from the electoral victories of Syriza in Greece and the upsurge of support for Podemos as an alternative, progressive party in Spain.

The eight lessons were:

Lesson 1: Clearly identify the enemy.

Lesson 2: Against the oligarchs and the “totalitarianism of the market” which serves as a cover for their interests, we, the forces of democracy, have to fight back.

Lesson 3. Inequality is objectionable, but more fundamental is people being denied the things that they need.

Lesson 4. Draw a link between what working people need and what society as a whole needs.

Lesson 5. Have a program. Say what you will do—don’t get dragged into debates about how you will do it. 

Lesson 6. A program needs spokespeople, and it really helps when those spokespeople are or will be in government.

Lesson 7. Like Greeks, Americans think that their political system is broken—and they want an alternative.

Lesson 8. No mourning for golden days.

The easiest of the eight is probably not mourning for “golden days,” because goodness knows when that might have been, but let’s not get distracted.  These lessons are not just valuable as a guide for what the Working Families Party might envision, but generally inform how progressive politicians even within the Democratic Party like Senator Elizabeth Warren from Massachusetts or New York City’s Mayor Bill DeBlasio might operate.  Reportedly, even presidential candidate, Hillary Clinton, is in New Hampshire at least sounding like a progressive for a minute or two.

None of this is easy and Cantor points out how different the world is when he notes

“By way of comparison, the WFP in Connecticut and New York got about the same percentage of the vote in their 2014 legislative races that Podemos got in the European legislative elections that put them on the political map, but the U.S. system does not turn minor party votes into a percentage of a legislative body.”

Importantly, the Working Families Party is finally broadening its reach – and appeal – by abandoning its primary tactic of fusion and running on its own line, noting that the Connecticut branch of the WFP just elected their first state legislator anywhere on their own independent party line.

Talking recently to colleagues who were involved in the progressive challenge in Chicago to the newly re-elected Mayor Rahm Emmanuel, they also note that any realistic alternative challenge must find a way to weld together the black and brown voters and issues within the progressive forces, which failed to happen in Chicago.

The letter from the progressive wing of the US Senate including Warren, Minnesota’s Franken, Vermont’s Sanders, and several others to the FCC demanding the monopoly merger between Comcast and Times-Warner cable be rejected is another good example of the bounty of available planks we have for our program.

Ideas and initiatives abound.  We need more “grit” and get in the organizing now to make it happen.

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Bad Romance: Women’s Suffrage (this is a Parody)

Yevgenia Chirikova and Other Environmentalists on the Run

Yevgenia Chirikova  (AP Photo/Mikhail Metzel, file)

Yevgenia Chirikova (AP Photo/Mikhail Metzel, file)

New Orleans       The Organizers’ Forum has conducted an International  Dialogue with community and labor organizers and activists in various movements around the world since 2002.  In our first trip to Brazil we almost miraculously stumbled into the wild excitement in Sao Paolo and Rio de Janeiro around the election campaign of Lula de Silva from the PT or Workers’ Party then.   Subsequently, we have been to thirteen different countries including South Africa ten years after the fall of apartheid  and Egypt right after the ill-fated revolution.  This year we will go to Poland.   Even after all of these years, some organizers will say, “Why Poland?   What can organizers learn there?”  My answer might be Yevgenia Chirikova.

In 2007 more than 15 of us visited Moscow and St. Petersburg, Russia. We were often asked, “Why Russia?  What in the world can organizers learn about organizing in Russia?”  You would be surprised.  We met a rank-and-file autoworker who had sparked the organization of a Ford Plant some distance from St. Petersburg and was involved in another half-dozen organizing drives with other labor activists.  We heard about the efforts to curtail and regulate nonprofits, which over the last eight years has been common in scores of countries, including the United States.

By happenstance we also met Yevgenia Chirikova who at that time was a  soft-spoken, young woman of 30 years old who was taking her first tentative steps as a grassroots community activist concerned with the  environment.  I never tire of telling her story of being a young mother  living in an outer ring suburb of Moscow and taking her daughters, one still in a stroller, walking near the apartment where she and her husband had moved, and almost stumbling on a sign indicating coming highway construction through what was supposedly the federally protected Khimki Forest.   Subsequently, the Save the Khimki Forest Campaign focused on the $8 billion construction project that ignored other, less environmentally intrusive routes, and exposed dark dealings by Prime Minister Putin and his cronies involved in the project being built by a French construction company.  We were moved by her organizing and have helped her campaign over the last eight years in small ways, while she has deepened her commitment and expanded her range.

One of the things we learn in our dialogues is the prices paid by organizers in other countries.The Khimki Forest fight has been marked by frequent arrests and brutal beatings including one that left a reporter brain damaged and terminal.   Global Witness, an international campaigning organization recently issued a report noting that the killings of environmental activists has risen by 20% in the last year.  Their report said there were 116 deaths worldwide in 2014, including 29 in Brazil, 25 in Colombia and 15 in the Philippines.  Others were sometimes kidnapped, beaten, and abused.

In the eight years since we met Yevgenia her profile has risen, she has won awards and prizes for her activism, but all at a price.  The police several years ago threatened to take her children from her, only dissuaded perhaps by an immediate video she did of her rage at the  threats that pushed them back.  The news now is that she has moved with  her children to Estonia because of the constant repression of activists in Russia.  She has no plans to change her citizenship so that she can continue to be active in organizing in Russia.  She told The Guardian,

“As soon as a person starts to be efficient at what he does, they begin to threaten you with taking away your children, or slapping you with criminal charges,”  She added that the only way to campaign in Russia now may be “leaderless resistance so that it’d be unclear who to target”.

Russia, Myanmar, Vietnam, Bolivia, India, wherever we go we meet organizers who wake up and work for change every day, just as we must do, and face the odds, whatever they may be.  Everyone pays a price, which is the cost of admission in the fight for justice and change.  It is good to look at the ledger and continue to make sure that the balances are being accounted in the solidarity of struggle throughout the world.

We’ll learn a lot in Poland, too.It is often a surprise for people in the United States, but actually it’s a big world and it takes a lot of  people to change it for the better.