Gallagher’s New Narrative Memoir Poetry Book

Health Care


     Pearl River     My friend and comrade, Jamaica Plains’ own Mike Gallagher, has a new book for poems coming out that he is previewing at several events at the end of August and again in the fall.  If there were such a genre as “organizing poem,” Mike would be one of its leading lights.  His new book is called, Moving Toward, which will be distributed this fall through Social Policy Press.   One of the issues that still animates Mike is hospitals that sue lower-income patients for debts.  We talk about this frequently, but, tragically, it’s not a new issue.  Here’s an edited, sneak preview with Mike’s poem on the subject.

A Closure to Foreclosure

The union represented everyone at Cape Cod

Hospital.  Everybody under the rank of God.

From pharmacists to “tray girls” in the kitchen.

Even included were the clerical workers, who in

Those days toiled in the Business Office.


One told me a story that made me nauseous:

She believed that the hospital’s outside collection agent

Might be suing patients for medical debt payment.

If you could not pay the bill, he would foreclose on your house.

Really? I thought.  Who could be such a louse?

Take away your home because you got injured or sick?

I decided to get to the bottom of her story quick.


I went over to the Barnstable County Courthouse on Route 6A

There in the records were 120 people being sued because they could not pay.

The remedy demanded was foreclosure and sheriff’s sale.

At least they didn’t want to put them in debtor’s prison, send them to jail.

I copied out the list and plotted the addresses on the map

With so many defendants to visit, this would not be a snap.

The conversations were difficult.  First get in the door.

Then get past the shame and fear, get them to open up more.









A widow with children in Harwich whose husband died of cancer

A commercial fisherman in Eastham whose cheap health insurance was not the answer.

All were looking at their furniture thrown out in the street.

House up for auction, disgrace and defeat.

We brought them together to make a plan

We had to get the hospital to change their stand

The hospital was having a big fundraiser featuring Bob Hope

We went and leafleted and picketed but it was no soap.

The hospital refused to alter their practice.

It would be easier to negotiate with a cactus.

Finally, they agreed to a community meeting.

500 people turned out but the hospital was not retreating


In spite of all the bad press

We could not get them to address

The issue of people losing their homes because of medical debt

More actions continued but their feet seemed to be set.

Battered and bruised, yet the hospital still persisted

Refusing to acknowledge that a problem existed.


Until something happened to change the landscape:

The lawyer got a judgement against a family named Silva (a common Portuguese name on the Cape)

The sheriff set up on the front lawn

Out came Mr. Silva: “What’s going on?”

“We’re selling your house, the sheriff replied.

“You have the wrong address.  The Silvas you want live at the other end of the street on

the opposite side.”

Well, for the hospital that was the last straw,

Embarrassed, they fired the lawyer and stopped the foreclosures, no matter the law.


So here is the lesson:  If you want to play the villain, make like Simon Legree

At least take the time to choose your victims more wisely.

Before you decide which orphans and widows to impress with your might

Make sure you get their address right.




The union was SEIU Local 767.  The hospital’s aggressive collections policy was only one of several issues we had with the hospital. Together with community allies we were pushing to require all doctors on staff to accept Medicaid assignment, initiate special programs in women’s health and others I have forgotten.  There was no need at all to go after peoples’ homes; Massachusetts had a free care pool (funded by a small surtax of all health insurance policies) that was meant to reimburse providers for bad debt.  In time the hospital and the union learned to cooperate.  Cape Cod Hospital later negotiated one of the best career ladders (staff development) programs anywhere.

In spite of Obamacare and Medicaid expansion (in most states), it is still a jungle out there.  A Tennessee based for profit hospital chain called Community Health Systems is right now today using the law to garnish the wages of 19,000 former patients who could not pay their bills (some of them single parents and minimum wages earners).  Clearly, something has to radically change.