Our health insurance nightmare
Donna Smith is an organizer for the California Nurses Association. In 2007, her story was featured in Michael Moore's documentary Sicko, which highlighted the disaster of the profit-driven health care system in the U.S. At a recent screening of the documentary The Healthcare Movie--which details the history of the struggle for single-payer health care in Canada--sponsored by the California Nurses Association, Smith spoke to .
HOW DID you become a part of Michael Moore's Sicko?
MINE WAS one of about 25,000 e-mails that were sent to Michael Moore, who was searching for health care horror stories. So I was one of the many who went in to meet with the producer. It turned out that I was one of the people who best represented the traumas that people are feeling in our health care system.
AT THAT point, you'd moved in with one of your kids. Is that right?
NOT THEN. At that time, my husband Larry and I were still living in our own home and trying to hang in there on our own. My husband had just had his third cardiac surgery and had just declared bankruptcy.
For a very long time, we were on kind of a slippery slope down into not having much left at all. It was a few months later when we had to move in with our daughter. They came and filmed us there. They hadn't filmed us much at all to that point.
IS THERE anything else you'd like to say about your experience with Sicko?
IT WAS pretty incredible, a pretty amazing kind of process. I think people get the idea that being in a documentary film is the same as being in a feature movie; it's not the same at all. Your story is being told for the world to see, and you have to be open to having your life investigated and sharing all the things that you never thought you would share with the world.
Going to Cuba [in the film] was part of my experience, too. I saw as we toured that country that everybody had health care there that we don't have access to here. I know how easily we could extend that to one another here if we wanted to, and it isn't a matter of lack of resources. It's really a matter of lack of political will and that sort of thing.
ONE OF the things you spoke about at the screening of The Healthcare Movie that really stuck with me was when you talked about how ashamed you felt about your situation--about not having health care and having to go bankrupt. Can you talk a little more about that?
ABSOLUTELY! IT'S one of the things that I think drives my work even now. I realize that a working-class person really needs to be responsible about debts and about finances and about the things that we do in our lives. Both my husband and I had a very strong sense of what we needed to do to keep ourselves afloat and keep our family housed and clothed and fed.
So when suddenly everything was slipping away, it wasn't so much the loss of things that discouraged us as it was the feeling that you had failed, that you couldn't quite figure it out--even though we had always had health insurance. We never went without it; it was a priority. At the same time, health insurance has been changing over the years--it costs more, and it covers less.
What else to read
We certainly were seeing that in our policy. It left us with bills that we had to pay. We hung on just as long as we possibly could because that's what working-class people do: You hang on and try to manage until you can't anymore. I don't know--it's the work ethic run amok.
I READ in one of your blogs that one of your greatest fears was that you were going to die before you paid off all of your health care bills, that your health care debt would outlive you. Are you still paying off medical bills?
YES, WE have to pay about $400 every month, and we still have to pay the doctor. And I have health insurance and a job.
BUT YOUR situation is a lot better now?
YES, NOW that my husband has Medicare and a supplemental policy, which really helps.
WHEN DID you begin working for the California Nurses Association/National Nurses United (CNA/NNU), and in what capacity?
IN FEBRUARY 2008, I went to work in the communications department as a national organizer for single-payer health care.
TELL ME about the chances for single-payer in California.
SINGLE-PAYER has passed twice, in 2006 and 2008, but was vetoed by Gov. Schwarzenegger. This year, it made it out of the Senate Healthcare Committee but didn't pass in the Senate. Sen. Mark Leno is the sponsor. In California, you can pass a law, but there has to be a ballot initiative to fund it. So this would have to go before the public for approval.
We're not giving up! You know, California is one of those places that has always been ahead of the country in passing needed legislation. A bill passes on the West Coast and, over time, passes in the rest of the country.
HOW DOES the California single-payer bill differs from the Massachusetts health care plan?
VERY DIFFERENT! In Massachusetts, people have to go buy insurance from a private insurance company from their connector. They call it "the Connector."
The California bill is very different. Single-payer is the only progressive way to provide health care for everyone. Everyone would pay into a single public pool. It's very much like Medicare. There would be one public pool, and all claims would be paid out of this pool.
No insurance is involved. The Massachusetts bill is fundamentally different from the California legislation. The Massachusetts bill is insurance legislation; the California bill is health care legislation.
Drugs, dental and mental health would be covered. Dental care is, of course, essential to good health. Some state single-payer plans don't cover dental.
IS THERE almost the same difference with the Obama plan as with the Massachusetts bill?
YES. "OBAMACARE" is more like the Massachusetts bill. Everyone has to buy insurance on the federal level.
YOU HAVE said that it really doesn't matter if Obamacare loses in the Supreme Court. It looks like there is a good chance that the Obama insurance mandate, and perhaps the whole bill, will be defeated. Do you think this will make it harder or easier to get a single-payer bill passed?
NO MATTER what the results, our present system is so corrupted by money and politics on a federal level, by corporate lobbyists, that everything is just paralyzed by this. No matter which way it goes, not much will be accomplished. The profit-takers will still be in control either way. There's not going to be much stomach in Washington for health care reform if Obamacare fails.
Either way, families will have a hard choice. Washington will have to go back at it, but probably not for at least another five years. If Obamacare goes, there will still be pressure for change. Co-pays and deductibles will keep people in debt or from taking advantage of their insurance policies, just as it is now.
Single-payer is most promising on the state level. It is just a matter of time until California passes a single-payer bill.
ARE THERE any other states that are close to passing single-payer?
VERMONT, OF course, is very close. Pennsylvania actually has Republican co-sponsors on their bill. Maryland has some good co-sponsors. And there are a bunch more. Colorado and New Mexico have good bills. California and Vermont are the closest.
HAS MUCH work been done by the National Nurses United in Texas?
THERE ARE good bargaining units in hospitals in Texas, and we're very encouraged by that. People should ask their state representatives where they stand in the health care debate. This isn't the first time around, and everything is up for grabs. It will take a lot of hard work and time.
The CNA and NNU have played a big role in Occupy movements around the country. Can you tell me a little about that?
WE BEGAN setting up in Occupy locations as soon as we could. We were actively involved in New York, Chicago, Washington. We were the first tent in Zuccotti Park. Our big support was to step in and give support. That's what nurses do best.
When people are sleeping outside--and it often got quite cold--we wanted to provide them with help. There were some older people there--and some young ones too--who needed medical care. And, of course, we supported many of the goals of the Occupy movement.
We are still actively involved in New York and Washington, D.C., and we have a lot of interaction with Occupy Chicago. The occupiers have moved out of Zuccotti Park.
There are many places where they are not occupying right now. That may start up when the weather gets a little warmer, and we will be ready to support them when they do.