Hot Night at the Senior Center

When I went back to RIC to get my bachelors I was taught that advocacy is part of public health nursing, so I was back at the debate, with a sign, on Thursday night at the West Warwick Senior Center.

This time the pro-reform crowd was better organized, with signs and stickers. Linda Kushner was there, I saw a couple of my Unitarian friends. I got there before 4:00 and got the last space in the parking lot, the line wound around the building.

Again I got into hot arguments with anti-reform people. This time some men who seemed to be Constitutional fundamentalists. They brought up a lot of issues like the gold standard and Gulf War vaccines. I shared my experience of seeing so much preventable suffering and disability due to lack of care. I got basically the same answers. We can’t afford it, those people should have taken better care of themselves in the first place, they can always go to the emergency room, most of them are illegal aliens anyway. Even when I approached a guy who was holding a sign that said- ‘Obama Lies, Grandma Dies’ about the rationing of health care I could not get through. If rationing is so evil, why are we letting insurance companies do it for profit?

There was a lot of anger about multiple issues. The Constitution guys were very angry at the corporations, and I have to say that the influence of insurance and pharmaceutical corporations is a troubling aspect of this plan. But letting business as usual prevail will not do anything but make them stronger. I’d like to see more than the moderate reforms proposed, but being a believer in harm reduction I don’t disparage measures that help at least some people get access to care.

After harsh words had passed between me and them, I heard one of them call, “Nurse, nurse!” An elderly woman, who had stood in line in the hot sun for an hour was getting short of breath. Someone had found a folding chair for her and given her some water.

I knelt down by her and asked her where she lived, suspecting she might have walked from one of the nearby senior complexes. I asked her if she had an inhaler, if she had used it-yes. “Let me call rescue,” I said, “you can sit in the truck, it’s air-conditioned and they can check you out.”

“No, don’t,” she said, “I don’t want the rescue.”

She was talking easily, her color was okay. “Well, let’s get them to let you go inside where it’s air conditioned, and you can sit for a while and drink some water and see if you feel better.”

I was passing the word up the line for someone to open the door and let the woman in when a police officer climbed over the rail. He said he had called rescue, so I stepped back and let him do his job. Three police escorted the woman inside.

In a few minutes rescue arrived.

I looked at Emergency Services in action. An expression of our common responsibility for one another. A safety net we are used to and would not discard. Would we be able to build a system like this today, when there is so much fear and mistrust, so little willingness to invest in a better future?

Well, work is the curse of the blogging class. I have yet to mention the LaRouchites, but that will have to wait. I’d better get out the door to the day job.

UPDATE: Your correspondent didn’t try to get a seat inside the Senior Center, figuring someone else should have a chance and anyway her ears hurt from all the hollering in Warwick the night before. Projo.com says that the discussion inside was civil and productive. Yea, seniors.

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10 responses

  1. Kiersten,
    Yeah, those anti-reform folks use emotion because they know their feudal (middle ages) thinking is antiquated. What was isn’t working, the facts bear that in mind. You can’t use logic to change their minds, there is a moral imperative at stack for them, we just have to move forward with a new story and aim for reform that considers cost AND … Read Morequality and that means coverage for all. Another issue I have is why does everyone use negative based market based language when talking about health care: “expenditures” rather than “investment”. Will we continue to tolerate an economy that treats humans as widgets or can we see we need to invest in ourselves to actualize our gifts and full capability to contribute to work, society and the “economy.” We are on the cusp of changing how we value life and liberty, and just being market based isn’t going to work–time to acknowledge the other economies: free labor, household, black/illegal, government and environmental markets-to embrace policy.

    Read Riane Eisler’s: , The Real Wealth of Nations that discusses the many economies we have in this world that had capital to the “market”

  2. sikkivit from Cranston | Reply

    ninjanurse:

    So, the people call, “Nurse, nurse!” to come to the aid of an elderly woman in distress. I certainly hope that they checked out her immigration status to make sure she was really an American citizen before you got there and started administering care. I mean, you did make sure she had health insurance before you bothered to run over, right? Oh, wait, she was an older woman, and probably on Medicare. But that’s such a poorly run government program (all government programs are, of course) I’m sure you wouldn’t put yourself out for such lousy reimbursement rates.

    Did anyone in the “Kill Obamacare” crowd seem shocked that you offered your assistance without a free-market profit incentive?

    Didn’t think so.

  3. No one checks immigration status in an emergency,nor should they.Another phony talking point trying to make those who want illegal aliens excluded from publicly funded ROUTINE care sound like villains.Ain’t workin’.Reort me to the commissar when you get a chance.

    1. sikkivit from Cranston | Reply

      But Joe, that’s just the point! The “evidence” that the opponents use as “proof” that reform (specifically HR3200) will result in publicly funded ROUTINE care for illegal immigrants is a deliberate misreading of what the bill says.
      Case in point: One of the many scary opposition talking points, quoted here from an earlier comment to this blog by Don’t Tread on Me (10 Responses to “Shout Down and Drown Out”) states the following:

      “PG 50 Section 152 in HC bill – HC will be provided to ALL non US citizens, illegal or otherwise”

      Here’s what the bill actually says:

      SEC. 152. PROHIBITING DISCRIMINATION IN HEALTH CARE.
      (a) In General- Except as otherwise explicitly permitted by this Act and by subsequent regulations consistent with this Act, all health care and related services (including insurance coverage and public health activities) covered by this Act shall be provided without regard to personal characteristics extraneous to the provision of high quality health care or related services.

      That’s a standard non-discrimination clause (you can’t refuse treatment on the basis of an individual’s race, religion, gender or sexual identity) and doesn’t say anything about illegal aliens. I will concede that if one is not clear on the definition of “personal characteristics” one might believe that it would include non-citizens. But to do so, you have to ignore the following provision in the SAME BILL (as in “Except as otherwise explicitly permitted, above), which specifically forbids federal payments for the undocumented:

      SEC. 246. NO FEDERAL PAYMENT FOR UNDOCUMENTED ALIENS.
      Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.
      I don’t know how many illegals you’ve ever known, but I’ve been acquainted with a few over the years, and while I can’t speak for more than those few, I can tell you that they were terrified to seek any medical treatment, even in emergency situations, for fear of deportation – even after being assured that doctors and nurses aren’t interested in checking anyone’s green card.
      So, if you and I (along with most other Americans, I fervently hope) can agree that no one who arrives at an emergency room bleeding to death or in cardiac arrest should be denied treatment based on their immigration status (which is the law now, thank goodness), than why do we countenance a system wherein the millions of Americans who can’t afford or are denied insurance have to wait until they ARE bleeding to death to get treatment? You and I are paying for that treatment already with our private insurance premiums – wouldn’t it be cheaper for us to come up with a program whereby every American can be assured affordable routine care which might PREVENT the expensive emergencies which we wind up paying for anyway?

      1. How many illegals have I known?A number too large to estimate,since I was an INS agent for 21 years,Thery are NOT afraid to seek emergency OR routine treatment.That is a complete fabrication.The INS and its successor agency,ICE have never hung out around heath care facilities waithing to arrest potential illegals.
        One of my fellow agents left the INS and went into medicine,winding up as a primary care physician in Iowa.He was the only Spanish-speaking doctor in the area and consequently got all the Mexicans,legal and otherwise-he didn’t ask,since he was no longer an INS agent.
        He did notice taht most aptients were from the same town,so he asked why,and was told that there were signs up in that twon advising residents to were going to work in the meat packing insdustry and other agribusiness in that part of Iowa that the particular clinic he wrked at had a doctor who spoke Spanish and no one asked questions about status.Only one example,but not untypical.
        The language of the bill is an invitation to the ACLU or similar groups to get a foot in the door on routine treatment for illegals.
        Since you accept Nancy’s creds as a nurse,I expect you to do the with me oon this particular subject.
        I would like to see a verification of US citizenship or lawful residence as a required step for obtaining federally funded routine medical care.
        The stories about people dying for fear of being arrested at the ER are just not true-go to any busy ER and you will see that immigration status is not an issue for anyone,nor should it be in that specific setting.

  4. sikkivit from Cranston | Reply

    Joe – did you read what I wrote? We already agree on two things: 1) no one should be denied emergency care based upon their immigration status and 2) American taxpayers should not be required to fund routine care for anyone in the country illegally.

    You say:

    “I would like to see a verification of US citizenship or lawful residence as a required step for obtaining federally funded routine medical care.”

    Well, you don’t have to wait. It already is required, and undocumented aliens are not eligible for Federal programs now. Nor would they become eligible based on anything in currently proposed legislation.

    As to your meat-packing plant: it seems to me that your beef (no pun intended) should be with them, and not the health care bills. Where do they get off hiring people they know to be in the country illegally? It is the job of the employer (and the INS) to make sure they are documented, not your doctor friend’s. Health care workers have enough to do without being asked to be INS agents on the side. By the way, I have to assume that your doctor friend does not work for free. Who exactly is paying him for his services?

    Oh, and here is an interesting statistic, of which I was unaware until recently, compliments of the Congressional Budget Office: About half of the undocumented aliens in this country right now have health insurance through their employers. Don’t take my word for it – it’s on p.154 of the PDF version of the CBO’s December 2008 report, available here:

    http://www.cbo.gov/doc.cfm?index=9924&zzz=38392

    As to your fear of my not believing your creds? I don’t really have any reason to doubt you and, for the record, I think you’re entitled to your opinions whether you worked for the INS or not. I am curious, though. When you work for the INS, do you get your health insurance through the government-run Federal Employee Health Care Plan? Just wondering.

    In the end, though, Joe, the whole “health care for aliens” trope is a xenophobic red herring. The real issue is the huge number of Americans who cannot afford or are denied health insurance coverage and, consequently, decent health care.

    1. Thank you for a very constructive response.Where to begin?
      (1)You might have misread me-my doctor friend had no obligation at all to check immigration status.He was paid by the clinic.I didn’t infer he or the clinic were doing anything wrong.
      (2)An illegal alien on private insurance is none of my business.No public funds are involved.
      (3)I did get Federal employee health coverage-I paid for it-it wasn’t free.We got good rates and lots of plan choices because of the size of the employee base and the leverage of the Federal government.You couldn’t be dropped either.
      (3)As a retiree I have to carry Federal for my wife,which means a family plan.I apy the same premium as active employees,but get this:active employees’ premiums are not part of their taxable income.Retirees’premiums are.Is that ****** up or what?I only use my federal insurance for eye care.
      My wife’s job gave her no health insurance option when she retired.That would be the Girl Scouts of RI.Nice.
      I am a disabled Vietnam veteran and due to my diasability level,I get totally free care from the VA.I refused to take a student deferment during Vietnam and enlisted in the service.I thought student deferments reeked of class discrimination.and I have always been sort of a conservative-go figure.
      (4)My opinion regarding immigration issues may be more valuable only because it was my job.I didn’t have to imagine the situation.If I wanted to know about plumbing,I’d take a plumber’s word over a layman’s.
      I don’t aprticularly oppose a well-thought out public option.Which you better believe puts me at odds with some of my political allies,but I don’t let other people think for me.
      Let me say one more thing-I agree with dropping the “5 year rule” for legal immigrants accessing health care
      because I figure if they were invited to live and work here as permenent residents,we shouldn’t put too many restrictions on them EXCEPT for criminal activity,which I believe in a zero tolerance policy for.Yes,that should include DUI-it kills more people than firearms.

      1. sikkivit from Cranston

        Joe – First off, thank you for your service to our country. I don’t know if your disability is service related or not, but I’m sorry to hear about it just the same. Thank you also for your thoughtful response, which seems to indicate even more points of agreement between us (yay!) – to wit:

        1. a) I did not infer that you believed doctors should check patient’s immigration status – you were very clear about that, and I think we agree here. b) If the doctor is being payed by the clinic, or anyone other than the Federal government, then how is the whole “health care for aliens” argument relevant?

        2. We agree that people getting health care on their own dime (including illegals) is none of our business. Since approximately half of the undocumented already have insurance that we agree we don’t care about, that makes the terrifying numbers being thrown out about the millions and millions of illegals both highly overblown and, more importantly, irrelevant since they wouldn’t be eligible anyway.

        3. a) Glad to hear you at least had the option to continue your federal insurance. I’m sure you are aware, given your wife’s situation, that many are not. Suppose she were single and retired but under age 65. You do realize that it would be nearly impossible for her to find a private health plan that would even give her coverage? And if she could find a plan that would take her, the premiums would be astronomical. How nice is that? b) We agree (again!) that it’s f’ed up that the cost of health benefits, whether borne by the employer, employee or retiree should have unequal tax treatment. I say, tax all of them or none of them. c) I assume you’re pretty happy with your VA plan, since you say you use it for all but eye care. I think most Americans believe, as I do, that veterans are entitled to all the benefits they have now, and more besides. But why shouldn’t all citizens have the right to BUY INTO a gov’t program like the VA or Medicare if they so choose and are willing (I can’t emphasize this enough) to pay for it?

        4. a) I’ve conceded that my own acquaintance with the undocumented is limited, but what I’ve reported about the fears of those I’ve known is accurate. And while I agree that a former INS agent has more experience with immigrants legal and otherwise than I ever will, aliens are really not pertinent to the larger issue of health care. b) I also agree both that no one who is here legally should be restricted by the 5-yr rule, and that criminal activity should trigger a loss of legal status. Doesn’t it now? c) If you and I can agree that a strong public option is a good idea, than what are we arguing about? If only you could get your political allies to think for themselves as well, and not allow themselves be used as tools by the mendacious for-profit-big-medical entities that convince them with lies and fear-mongering to work against their own self-interest.

  5. In the Warwick City Halls someone referred to the uninsured. ‘Illegal aliens!’ the woman in front of me shouted.
    I heard more of the same in West Warwick. I have no doubt that this issue is being used as a distraction from the millions of American citizens who are being shut out of access to insurance.
    I was at a meeting on Friday and there was a nurse there who works in an emergency room. she says they are getting slammed with people going there for care because they have lost their insurance along with their jobs and have nowhere else to go.

  6. Yes,my disability is directly attributable to Agent Orange exposure in Vietnam.I’m at 50%,which is the threshold for totally free care.Service connected care is always free,regardless of degree.It turns out AO is now recognized in the onset of at least 12 diseases.Unlike AIDS,those of us affected are not particularly susceptible to infection,but rather to autoimmune syndromes,some relatively common like diabetes, and some not so commomn like primary amyloidosis(100% fatal).I have had Hodgkin’s lymphoma,diabetes,and coronary artery disease,all with no significant family history or other risk factors.I lost my spleen in 1981 from the lymphoma,and I have aftereffects of cobalt radiation.
    I still get my eyecare outside the system because I really like my eye doctor and since I have to carry the insurance anyway,I take advantage to mantain continuity of eye care,important for diabetics.
    My wife has amazingly good health and as a single person she MIGHT be able to afford a policy,but probably not a good one.
    Alien criminals,legal or not certainly are deportable.When I retired in 1996,many alien criminals were still able to evade deportation by legal maneuvering-that has decreased a lot,but I’d like to see an almost airtight system.Why?Because most people in the world,given the chance to come here legally as an immigrant would(and do)make the most of it and aalso make positive contributions.We have enough native born criminals,don’t you think?
    So I guess we are not really arguing here.
    It’s interesting that you bring up the numbers of illegal aliens.I don’t know how anyone,including the census,can get an accurate idea.Twelve million is what I hear the most often,but my educated guess is:?
    i don’t think some of the leading Democrats who are pushing health care reform have exactly been too bright with their approach.Particularly Nancy Pelosi.She is someone I would not want to be acquainted with even if I were a liberal Democrat.
    The class discrimination I brought up was kind of an abstract belief I had,because my parents couldn’t afford a private college-I attended the City University of NY which was tuition free.I started when I was not yet 17.After turning 18 I enlisted.I later finished on the GI Bill.
    I don’t think any Americans should be denied health care.After all,we spend a lot of money around the world.Some of that foreign aid could be better used at home.

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