Single-payer universal health care or a national public health program (socialized health care)?

Some people get upset when I say that Barack Obama and the Democrats have successfully killed off any opportunity to win single-payer universal health care now or in the future and they are confused with the suggestion that we move towards building a movement for the real "public option," a national public health care program (socialized health care).

I received an e-mail from a member of the Progressive Democrats of America in Wisconsin asking me to explain my thinking about this; she is really upset that so much work has been put into building support for single-payer because she thinks it will all be for naught.

I received another letter from Carl Davidson of Progressives for Obama... Davidson puts it this way: "I don't support any other health care plan other than single-payer universal health care." Well, this sure is a divisive and defeatist attitude.

And, Sara Robinson of the Campaign for America's Future/America's Future Now says that I am not telling the truth when I state that CAF/AFN is undermining the single-payer universal health care movement; claiming, in spite of all evidence to the contrary, that CAF/AFN remains committed to single-payer universal health care.

And, of course, we have the Democrats claiming that single-payer is a nice idea but it is not in the political cards at this time (if anyone believes these Democrats will ever place single-payer on the agenda they are living in the world of make-believe) because when anyone takes money from powerful corporations, the well-heeled and very influential people with money to oppose something like single-payer they had better do it or these powerful interests will simply replace them in the United States House and Senate.

Then we have Barack Obama, the grand-daddy of all the con-artists and flim-flam charlatans who puts Elmer Gantry to shame as an amateur, saying that single-payer is a great idea if only it didn't go against the "American tradition" of "employer-paid health insurance" as the policies of his Administration through hundreds of thousands of workers out into the streets without jobs--- without employers!--- every month, with no end of rising unemployment in sight.

I received another e-mail from a very astute activist in Michigan asking in a Letter to the Editor, "Will we have to change the entire U.S. Congress before we can get single-payer universal health care?"

On top of this we have wonderful organizations like the All Unions Committee For Single Payer Health Care--HR 676 who day after day keep us informed of all the new support single-payer universal health care is receiving in the form of the most wonderful resolutions from unions at every level in this country; from union locals to the national federations and their affiliates. This is a typical e-mail we receive on any given day from the small, under-financed, over-worked All Unions Committee For Single Payer Health Care--HR 676:

-----Original Message-----

From: singlepayernews-bounces+amaki000=centurytel.net@unionsforsinglepayerhealthcare.org [mailto:singlepayernews-bounces+amaki000=centurytel.net@unionsforsinglepayerhealthcare.org] On Behalf Of Unions for Single Payer HR676

Sent: Tuesday, June 23, 2009 11:32 PM

To: Alan Maki

Cc: News about union support for single-payer health care and HR 676
Subject: Three Maine Labor Councils Call on AFL-CIO Convention to Endorse HR 676

Three Maine Labor Councils Call on AFL-CIO Convention to Endorse HR 676
and Call for March On Washington

Three Labor Councils in Maine, Southern, Western and Central, have
followed the lead of the Maine State AFL-CIO in calling on the national
AFL-CIO September Convention to endorse HR 676 and educate and mobilize
for its passage.

The resolution passed by the 3 councils urges that the AFL-CIO Convention:
“…pursue the passage of HR 676, the ‘United States National Health Care
Act’ to meet the needs of our members, our families, and all America, and
not endorse or support any fallback program of mandated insurance which
includes the wasteful, for-profit insurance industry….”

The resolution further calls on the AFL-CIO to “...help organize and
financially support a ‘Healthcare is a Human right’ Solidarity March and
Rally in Washington, DC.”

Chris Teret, President of the Southern Council said: “The Southern Maine
Labor Council realizes that the fundamental principle of labor is
solidarity—an injury to one is an injury to all. For that reason, the
labor movement can’t support any health care system except one that
includes everybody, no exceptions. We know the insurance companies are
the problem and we’re ready to see them gone….”

The Troy Area Labor Council initiated the campaign to get resolutions
urging support of HR 676 sent to the AFL-CIO Convention which meets in
Pittsburgh September 14-17. The sample resolution and information on how
to submit a resolution are at: http://pefencon.info/HR676/Resolution.htm

Convention resolutions can be submitted at
resolutions-amendments@aflcio.org. The deadline for submitting
resolutions is Aug. 14th. #30#

HR 676 would institute a single payer health care system by expanding a
greatly improved Medicare system to everyone residing in the U. S.

HR 676 would cover every person for all necessary medical care including
prescription drugs, hospital, surgical, outpatient services, primary and
preventive care, emergency services, dental, mental health, home health,
physical therapy, rehabilitation (including for substance abuse), vision
care, hearing services including hearing aids, chiropractic, durable
medical equipment, palliative care, and long term care.

HR 676 ends deductibles and co-payments. HR 676 would save hundreds of
billions annually by eliminating the high overhead and profits of the
private health insurance industry and HMOs.

In the current Congress, HR 676 has 83 co-sponsors in addition to Conyers.
Vermont Senator Bernie Sanders has introduced SB 703, a single payer bill
in the Senate.

HR 676 has been endorsed by 540 union organizations in 49 states including
128 Central Labor Councils and Area Labor Federations and 39 state
AFL-CIO's (KY, PA, CT, OH, DE, ND, WA, SC, WY, VT, FL, WI, WV, SD, NC, MO,
MN, ME, AR, MD-DC, TX, IA, AZ, TN, OR, GA, OK, KS, CO, IN, AL, CA, AK, MI,
MT, NE, NY, NV & MA).

For further information, a list of union endorsers, or a sample
endorsement resolution, contact:

Kay Tillow
All Unions Committee For Single Payer Health Care--HR 676
c/o Nurses Professional Organization (NPO)
1169 Eastern Parkway, Suite 2218
Louisville, KY 40217
(502) 636 1551
Email: nursenpo@aol.com
http://unionsforsinglepayerHR676.org
06/24/09

One has to wonder why the AFL-CIO hasn't been doing what the All Unions Committee For Single Payer Health Care--HR 676 has been doing... but, then, in asking this we begin to find the answer as to what is wrong with the labor movement in the United States today and why the National Association of Manufacturers and the U.S. Chamber of Commerce and the Wall Street coupon clippers take the two major labor federations--- the AFL-CIO and Change To Win--- as nothing more than minor irritants; anyone can read the joint FBI/CIA report--- Family Jewels--- and find out why this is.

On top of this, we have United States Congressman John Conyers who had Cindy Sheehan arrested because she brought a group of people to his office who thought he was sincere about impeaching Bush and Cheney, only to find that all of his talk was nothing but hot air and political rhetoric designed by intent to drum up support for Democrats like Barack Obama who he knew would sink single-payer universal health care; yet, Conyers continues right on talking about how he is supporting H.R. 676, the single-payer initiative that now has fewer Congressional endorsers than it ever did and in the U.S. Senate Bernie Sanders has brought forward a different version of single-payer and he can't even get any support from his fellow Senators.

Then we come to the Physicians for a National Health Program, the major advocates of single-payer universal health care who shot off both their feet before they could ever hit the ground running by assuring all the doubters, cynics and opponents of single-payer universal health care that the charges of "socialized health care" being made against single-payer universal health care were untrue since single-payer with its "privately delivered health care" would fit right in with free enterprise.

The Midwest Casino Workers Organizing Council has been a primary mover in the Midwest behind single-payer universal health care. We have researched the history of health care reform in this country and around the the world going back to the Soviet revolution, Madam Secretary of Labor---Frances Perkins and her New Deal reforms, articulated what the benefits of the Canada Health Act are compared to what we have in this country and explored the Cuban socialized health care model. On top of this, we have been amongst the most active supportive of single-payer universal health care with our activities involving distributing hundreds of thousands of leaflets, organizing support at the precinct level, county, state and national level inside and outside of the Democratic Party for single-payer universal health care as a step towards socialized health care. We have testified at hearings, participated in rallies and marches; we have circulated petitions and open letters. We have shared information and resources with other people and organizations--- including many who stabbed us in the back when it came time for them to speak up about the terrible and atrocious conditions of smoke-filled casinos and over two-million casino workers forced to work without any rights under state or federal labor labor laws at poverty wages in the Indian Gaming Industry by those supporters of single-payer who repeatedly make the claim that a big part of their support for health care reform is teaching people how to stay well. In short, we have participated at every level, in every way in building what support we could for single-payer universal health care.

As a result of our activities on behalf of single-payer universal health care, we have made a number of observations:

First, the single-payer movement has reached maximum strength and this strength simply is not enough to achieve a victory.

Two, the reason that the single-payer movement cannot build beyond its present strength which is very formidable is that the majority of the American people realize the limitations of "private delivery of health care;" and most people want nothing less than what VA and the Indian Health Service offers... free health care for all... or, as we call it, a national public health care system: socialized health care.

The Cubans created such a health care system... largely with help, assistance, advice and often supplies from Americans employed in the field of public health care.

The Cubans took the children of nickel miners and sugar plantation workers who had been treated like slaves before the socialist revolution, and educated them to be doctors and the best health care providers in the entire world--- making health care one of Cuba's most valuable exports, and winning them many friends on all continents while the United States has been exporting poverty, exploitation and war.

The Canadian never got health care reform until the socialist Tommy Douglas was elected the premier of Saskatchewan and challenged the American Medical Association and the for-profit health care providers and the insurance companies... yes, it did take completely changing to a socialist government in Saskatchewan and the Cubans needed a revolution to get their health care reform. The Soviets set the example in the area of health care that is still the model envied by people all over the world who seek to emulate the excellent health care the Soviets provided the people with for over seventy years... "the Bolshevik plot" the American Medical Association still fears.

Anti-communism denied the American people health care reform as part of the New Deal package of reforms; it is this same fear of socialism that now has the movement for single-payer universal health care hamstrung, castrated and unable to influence even the most progressive public officials who, every time they assure us they are not for socialized health care, they deal another death blow to single-payer universal health care.

Of course, like everything under capitalism, there are those who have made quite nice livings from working for single-payer universal health care. There are those organizations like the Progressive Democrats of America and John Conyers who wrap themselves in single-payer universal health care as if it is the American flag knowing full well, they have no intent of opening up the kind of grassroots movement that would really be required to win single-payer universal health care because they know full well, the larger the single-payer movement grows the louder the demand for socialized health care becomes.

The Midwest Casino Workers Organizing Council and our affiliated local Organizing Committees will continue to support single-payer universal health care based upon the Canadian model with the understanding this will be a step towards a national public health care system--- socialized health care.

However, our efforts will be to encourage a broad and far ranging discussion about socialized health care... the only really viable option that will enable us to "bundle" the need for health care reform as part of a complete "people's bailout" package.

We are for continued work inside of the Democratic Party as we expand our primary efforts to working towards building some kind of "people's front" capable of replacing the good-for-nothing Democrats in Congress and the state legislatures with real representatives of the people.

Towards these ends, we will increasingly be talking about, and doing what we can, to help build a political movement constructed upon the progressive foundation we inherited from the real Minnesota Farmer-Labor Party, a party of socialism... which is more of an American tradition than the hoax of "employer provided health care;" especially at a time when so many working people are unemployed--- without employers.

Any country that can finance wars being fought in three countries at the same time, maintain a huge nuclear and biological weapons arsenal, fund 800 U.S. military bases dotting the globe and spend trillions of dollars bailing out a bunch of crooked and corrupt Wall Street thieves can establish 800 major public health care centers spread out across the united states with thousands of public satellite health care centers dotting the country like fire halls, police stations, public schools and public libraries providing the health care the American people need, expect and want.

Socialism really does work whenever the needs of people come before corporate profits.

The American people will be satisfied with a public health care system that delivers as well as the system of public education has for well over one-hundred years in this country. The fee for health care should be no more than checking out a $75.00 book at the local public library and getting health care should be just as easy and efficient as mailing a letter using the United States Postal Service... for those getting the health care services of VA or the Indian Health Service, this is the kind of health care Americans already receive... there is no reason this socialized health care should not be extended to all of us now.

I would point out that the National Indian Gaming Association joins with the American Medical Association, the U.S. Chamber of Commerce, National Association of Manufacturers, pharmaceutical companies, the health insurance industry and the HMO's along with most members of the U.S. House and U.S. Senate in opposing single-payer universal health care.

We can either watch the single-payer universal health care movement die with our efforts being wasted; or, we can build the kind of real grassroots/rank-and-file movement required to win socialized health care... such an outgrowth of the single-payer movement would be the most appropriate way to proceed as we seek out allies from other sections of the people's movements fighting for reforms such as moratoriums on all home foreclosures and evictions, for an end to malnutrition and hunger, for a minimum wage that is a real living wage, for reforming the laws regulating the right of workers to organize more effectively, for social justice and peace and for an end to all forms of racial discrimination in employment, housing, education and health care and for the right of all workers to be employed in healthy and safe work environments and their right to live in communities with clean air and water. We need to begin to explore the option of nationalization through public ownership of the basic industries from steel and auto to banking and communications as the way to save jobs and protect and defend the living standards of working people. No-fee, public child-care has become just as important as no-fee public health care for the labor movement to work for.

Together, we must strive to win through politics those things we cannot win at the bargaining tables... this is the way forward for a genuine labor movement.

It is all about priorities; this big-business dominated government has the priorities of Wall Street in mind when it comes to making each and every decision... yes, we do need a new government and getting such a new government is no more difficult than what it was for those who built the New Democratic Party in Canada or the real Minnesota Farmer-Labor Party... it will take the initiative of grassroots and rank-and-file working people... those at the top have already determined they will sell us out on single-payer just as they have done on every other issue.

I would also point out that the organized labor movement in this country is very weak and small... we will have to move the entire working class--- organized and unorganized--- into action if we want to get results... unless of course one considers the election of Barack Obama a "victory."

Yes, single-payer universal health care is dead. Obama and the Democrats as beholden to Wall Street's interests as the Republicans have killed it. These Democrats should be properly "thanked" at the polls... but, the movement for real health care reform must move on right along with the people's growing movements for real change, peace, social & economic justice.

Health care is a human right and so are a lot of other things like the right to work in smoke-free casinos receiving real living wages and to have a voice at work which working people only achieve to some degree under capitalism with a union contract.

Again, to us as casino workers, we are very disappointed that so few advocates of single-payer universal health care lack any concern for the plights of some two-million workers employed in smoke-filled casinos in the Indian Gaming Industry--- this causes us to wonder how sincere some of these doctors and labor "leaders" really are.

Just recently, the United Association of Journeymen and Apprentices of the Plumbing and Pipe Fitting Industry of the United States and Canada (UA), held their state convention at the smoke-filled Fortune Bay Casino and Resort where workers are forced to sign an affidavit stating they will not engage in union organizing as one of the terms for their employment. This convention was attended by Ray Waldron, the racist President of the Minnesota AFL-CIO... shameful, disgraceful... this is no way to build unity of the working class and the progressive movement. The UA has, historically, been among the most racist unions in the AFL-CIO and here in Minnesota this union has stayed true to its racist and reactionary history. Dick Anfang, the racist president of the Minnesota Building and Construction Trades Council was also present at this convention. Mr. Anfang has encouraged and promoted the racist, anti-labor sweetheart agreements between labor and in Minnesota Indian Gaming Industry for many years. In fact, the agreements made between the Building Trades Unions are so racist that Mr. Anfang doesn't even dare to disclose the labor-management agreements to state legislators or the general public and even those paying union dues are denied the right to see the contracts! Such unions can pass resolution after resolution in support of single-payer universal health care, as these unions have done; but, there is ext to no chance that anyone will take these racist and corrupt union leaders like Dick Anfang or Ray Waldron seriously... certainly not the politicians who take their bribes and then turn away laughing at them.

But, the ultimate "joke" is on working people who suffer without access to health care just as casino workers are forced to work in smoke-filled casinos and just as the "joke" will be on casino patrons when one of these casinos collapses because of the cheap, sub-standard steel girders and beams made from cheap imported steel from which the casinos are being constructed, like the new casino being built by Red Lake Gaming Enterprises.

Tax-payers will ultimately foot the health care bills for tens of thousands of casino workers forced to work in these smoke-filled casinos who are already suffering from cancers, heart and lung problems and complications due to second hand smoke from their existing diabetes and asthma.

To even think that labor federations led by racists like Ray Waldron or Dick Anfang will lead the struggle for single-payer universal health care or any other health care reform when they have not demonstrated one iota of concern for the health and well-being tens of thousands of Minnesotans who are forced to work in these casinos is the epitome of self-delusion... there is a reason why working people have been reluctant to organize in Minnesota and across the country... not because they lack an Employee Free Choice Act, but, because they see a bunch of uncaring racists like Dick Anfang and Ray Waldron living off their union dues who won't lift a finger to support the very single-payer universal health care legislation they claim to have endorsed only because they know their memberships will begin to work at the rank-and-file level for socialized health care if they don't pretend to be concerned... and the single-payer movement, with its middle class base (as opposed to working class), provides them with such a cover of looking like they have the best interests of the workers they are collecting dues from when nothing could be further from the truth.

We have had quite a lot to say over the years about single-payer universal health care and we have always tried to be very gentle with what we perceived to be the the truth that this movement was a movement of the relatively well-heeled middle class professionals and small business people and money-grubbing doctors who most people can't even trust for a truthful diagnosis, always wondering if profit is more the motive of finding problems and expensive "treatments" from which they derive huge profits more a motive than getting them well when sick.

We just felt now is the time for a cold, hard reality check... better to re-adjust our goals towards a public health care system than to let the movement we have helped to build die along with single-payer universal health care now left in the hands of John Conyers who had Cindy Sheehan arrested just like Max Baucus did with single-payer supporters. The present gaggle of Wall street owned and corrupted politicians will not be delivering anything in line with real health care reform... neither will the Democrats who couldn't even deliver this important reform when it had the support of President Franklin D. Roosevelt... there simply is far too much money to be made off of health care in this country to think that these politicians will ever put health care for people before profits.

The cold sad truth.

Alan L. Maki
Director of Organizing,
Midwest Casino Workers Organizing Council

Representing tens of thousands of casino workers employed in the Indian Gaming Industry forced to work under the most severe, repressive and Draconian conditions in smoke-filled casinos at poverty wages without any rights under state, federal or tribal labor laws.

A good union contract is better than any government anti-poverty program and a whole lot less expensive for tax-payers.

The proponents of the Indian Gaming Industry promised $40.00 an hour jobs... we intend to make this a reality for each and every casino worker; along with the right to be employed in smoke-free casinos.

Meet to coordinate health care action; or, another attempt to undermine support for single-payer universal health care?

From: Alan Maki [mailto:amaki000@centurytel.net]

Sent: Thursday, June 25, 2009 9:36 AM

To: mn-politics@forums.e-democracy.org

Cc: joel@joelclemmer.org; info@jamesmayer.org; 'Kip Sullivan'; sen.david.tomassoni@senate.mn; 'Sen.Jim Carlson'; sen.mary.olson@senate.mn; sen.tony.lourey@senate.mn; senator_levin@levin.senate.gov; rep.al.juhnke@house.mn; rep.bill.hilty@house.mn; rep.carlos.mariani@house.mn; rep.carolyn.laine@house.mn; rep.dave.olin@house.mn; rep.frank.hornstein@house.mn; rep.maryellen.otremba@house.mn; rep.tom.anzelc@house.mn; rep.tom.Rukavina@house.mn; rep.tony.sertich@house.mn; elizabeth_reed@levin.senate.gov; teresa_detrempe@klobuchar.senate.gov; 'Carl Davidson'; 'David Shove'; 'Walter Tillow'; nursenpo@gmail.com; 'Joshua Frank'; rhodagilman@earthlink.net; bswenson@bemidjipioneer.com; 'Laurel Beager'; WCS-A@yahoogroups.com; mzweig@notes.cc.sunysb.edu; rachleff@macalester.edu; 'Rachel Maddow'

Subject: RE: [Minnesota] Minnesota Single Payer

This devious and deceitful e-mail is being passed around in Oregon, and similar e-mails are being circulated in Minnesota, Wisconsin, Michigan and Iowa and no doubt in every state in the country (all bold highlighting, larger letters and underlining is mine-A.L.M.):

Subject: Meet to coordinate Oregon health care action

This is an opportunity for single payer groups-especially the 28 unions
endorsing HR 676-- to meet with supporters of more moderate reform.



Groups Invite You To Help Plan Advocacy on Federal Health Reform

The Oregon Center for Public Policy, Health Care for America Now, Oregon
Health Action Campaign and SEIU call on Oregon health advocates to
coordinate messages and actions to make the most of our efforts.
That's why we're inviting you to the first of on-going weekly coordinating
meetings focused on this critical legislation in Congress.


Tuesday, June 30, 2009
10:00 a.m. - 12:00 p.m.

Northwest Health Foundation
221 NW Second Ave, Suite 300, Bamboo Room
Portland, OR 97209

Future meetings will be on Tuesdays at the same time but will be held at
another location to be determined. Stay tuned for that information.
Need to join by phone instead?
If you are unable to attend in person, you can attend by conference call.

1-888-537-7715
Code: 35825818#

(Call-in number for future meetings may be different)
For more information, please contact Janet Bauer, (503) 557-6589,
jbauer@ocpp.org

From the HCAN web site:

On its face this sounds real good--- like we are all going to be getting together to push for health care reform; however, this is what HCAN is all about; taken from their own web site:

What is Health Care for America Now (HCAN)?

Health Care for America Now (HCAN) is a national grassroots campaign of more than 1,000 organizations in 46 states representing 30 million people dedicated to winning quality, affordable health care we all can count on in 2009. Our organization and principles are supported by President Obama, Vice President Biden, and more than 190 Members of Congress.

We are building a national movement to win comprehensive health care reform by helping mobilize people in their communities to lobby their U.S. Senators and Representatives in Congress to stand up to the insurance companies and other special interest groups to achieve quality, affordable health care in 2009.

Well, we all know neither President Barack Obama nor Vice-president Joe Biden support the kind of health care reform the American people want and need… their intent is to expand the public trough, enlarging it so it will hold more tax-dollars for the greedy, money-grubbing insurance companies and HMO’s to profit from.

These are the very people like Robert Borosage, Robert Hickey, Richard Trumka and John Sweeney and the rest of this bunch of doting Obama supporters who went behind the backs of their memberships to establish this organization--- HCAN--- for the sole purpose of saving Barack Obama’s worthless, Wall Street serving, political butt by first undermining--- and then killing--- single-payer universal health care and prevent any discussion of the real “public option,” which is a national public health care system based upon VA/Indian Health Service for all--- or socialized health care.

In fact, not one single one of the “leaders” of these 1,000 organizations ever consulted with their memberships--- all of whom have voted (often repeatedly) that their organizations work to support H.R. 676, single-payer universal health care similar to the Canadian Health Care System. H.R. 676 is very good legislation which needs a couple minor “tweaks” to bring it up to the high standards of the Canadian Health Care System… but, as it is, it is a good start on the way to socialized health care.

Ironically, it was the Progressive Democrats of America (PDA) and Progressives for Obama who got the momentum going for undermining the single-payer movement.

These organizations pretended to be speaking on behalf of the single-payer movement when they allowed--- at Obama’s request--- that all mention of single-payer be kept out of the resolution on health care submitted to the National Democratic Party Convention; and, then, after giving single-payer this mortal blow, they pretended to again be for single-payer in order to suck in support for Barack Obama under the false pretense that “Obama can’t say it or he wouldn’t get elected, but he is really for single-payer.”

Then Robert Borosage and Roger Hickey quickly went into action pulling together this “coalition” of sell-out “leaders” who have joined together for political expediency under the umbrella of HCAN to save Obama’s political butt and preserve the “employer paid” insurance scam which Obama elevates to an American tradition he does not want to break with, claiming he speaks for the American people and pointing to the support he is receiving from HCAN… even though every poll shows that the vast majority of the American people want nothing less than what the Canada Health Act provides for its people.

And now along come these charlatans, flim-flam artists and con-men like Barack Obama--- birds of a feather flock together--- saying, “Come on single-payer universal health care advocates work together with us for more moderate health care reform.”

“Moderate health care reform;” the code-words for keeping profits in health care and keeping people out.

Everyone now understands the perversion of the for-profit health care system which Barack Obama describes as “employer provided health care” even though the majority of the employers in the United States either provide no health care insurance for their employees or are rapidly shifting the health care burden to their employees.

Here in Minnesota, the Progressive Democrats of America have been hard at work trying to undermine the single-payer movement in two ways…

First they tried to re-word the resolution on single-payer universal health care to include “affordable health insurance;” when that didn’t succeed and delegates to the MN DFL State Convention overwhelmingly approved the strongest single-payer resolution in the country, these dirty birds gave it the title of “affordable health care” on the MN DFL web site.

In fact, most Minnesotans are for a “VA for all” socialized health care system as are most Democrats at the grassroots level because, when given the opportunity to vote in precinct caucuses and county conventions, the support for resolutions stating:

“No-fee/No-premium, comprehensive, all-inclusive universal health care; publicly funded, publicly administered and publicly delivered” is what grassroots Democrats, like those who voted unanimously at the Roseau County DFL Convention, want.

It sounds like a big organization, but here in all of Minnesota there aren’t more than twenty dues paying PDA members and they are lucky to get three or four people to meetings. Most of these people can be described as “poverty pimps,” “foundation whores,” and just plain old “party hacks.”

The HCAN people like Robert Borosage and John Sweeney talk about the need for “political compromise” as if health care reform is nothing but some kind of political football to kick around; when, for most working people, health care reform is about life and death and the possibility of losing the family home to pay obscenely high medical bills… in Minnesota, fully 83% of all personal bankruptcies are related to medical bills!

Here in Minnesota, groups like Progressive Democrats of America and Progressives for Obama are supporting a particularly vicious piece of legislation by Minnesota State Senator John Marty, the darling of doctors and other small business types, that further serves to undermine the movement for real health care reform and the leader of PDA, Joel Clemmer, has the unmitigated gall trying to pass this phony health care initiative off as “single-payer;” when in fact, anyone who bothers to take the time to read this legislation becomes aware that this phony health care reform is aimed at placing the full burden of health care costs on the backs of the working class and the poor. In fact, the very supporters of this legislation refused to mount a fight to prevent Minnesota’s Republican governor from cutting tens of thousands of impoverished Minnesotans from the present “public option” health care alternative that was supposedly designed to protect these very people like the working people now finding themselves the victims of a very cruel profit driven economic system as this rotten economic system collapses.

We urge people not to fall for these traps that have been carefully laid and set by those political hacks like Robert Borosage and Roger Hickey together with those like the Progressive Democrats of America, Progressives for Obama, Campaign for America’s Future/America’s Future Now whose nice sounding names run contrary to their dirty deeds and who have betrayed the American people when it comes to real health care reform--- nothing less than single-payer is what we need; socialized health care is what we need to be striving for:

“No-fee/No-premium, comprehensive, all-inclusive universal health care; publicly funded, publicly administered and publicly delivered”

This is the wealthiest country in the world with the most screwed up priorities. If we would learn to get along with the rest of the world instead of Wall Street stealing their resources using cheap labor we could eliminate the 800 U.S. foreign military bases dotting the globe costing trillions of dollars to maintain; and, instead, establish public health care centers spread out across our own country providing free health care for all.

I received an e-mail the other day asking:

“What are we going to have to do to get real health care reform in this country… replace the entire U.S. Congress, the House and Senate?”

It is beginning to look that way… especially when Barack Obama can twist arms to shove through billions of dollars financing senseless wars but has to revert to peddling a pack of lies like a used car salesman trying to sell a clunker passing it off as a luxury vehicle that will just make it off the lot before breaking down in an attempt to try to hoodwink the American people into believing his phony scam he calls “the public option” is the only option politically feasible. War is feasible; real health care reform is not… the sign of a corrupt political system upholding a decadent health care system spit out by a rotten economic system in severe decline.

What the heck is “affordable health care” at a time when millions of Americans are losing their homes because they can’t pay the monthly mortgage or the heating bills?


Alan L. Maki
Director of Organizing,
Midwest Casino Workers Organizing Council

58891 County Road 13
Warroad, Minnesota 56763
Phone: 218-386-2432
Cell phone: 651-587-5541
E-mail: amaki000@centurytel.net

Check out my blog:

Thoughts From Podunk

http://thepodunkblog.blogspot.com/

Cc: Maggie Bird
President,
Midwest Casino Workers Organizing Council

PEOPLE BEFORE PROFITS False hope on the economy — unless …

A guest blog, placed by reader request.

PEOPLE BEFORE PROFITS False hope on the economy — unless …


Author: Art Perlo
People's Weekly World Newspaper, 06/23/09


In March, Federal Reserve Chair Ben Bernanke saw "green shoots" in the economy. Since then, various economists and government officials have seen signs that the recession may be bottoming out, with hopes that economic growth may start later this year. And many journalists in the business media are joining in, acting like paid touts for the stockbrokers.

This chorus has been fueled by a series of reports. Some banks are showing profits again. The stock market is up. Job losses in May, while horrific by any previous standard, weren't as bad as earlier this year. Housing starts in May were a little higher than in April.

There are more than a few skeptics. Much of the "good" news is really "slightly less bad news" or reflects temporary factors. And even in the most optimistic scenarios, unemployment will continue to rise well into next year.

I am more than skeptical. There are major economic obstacles to even a weak recovery. Without decisive government action, these will continue to depress the economy, pushing unemployment to a post-World-War-II record and devastating more families than 100 years’ worth of hurricanes. Four of the obstacles to recovery:

1) One-third of all home mortgages are under water — the homeowners owe more than the house is worth. We are in for another year of record foreclosures and many years of depressed purchasing power, as the banks try to squeeze every last penny out of working class homeowners. Federal and state initiatives are providing some relief, but the majority of homeowners who are in trouble are headed for eviction, and their communities are headed to further decline.

2) The collapse of the auto industry and its ripple effects are devastating the part of the economy — manufacturing — which actually produces things that people need. The layoffs, plant closings, and loss of tax revenue are just beginning. As suppliers and support services cut back, the effects will be felt far beyond the Midwest. Michigan's unemployment rate of 12.9% (and rising) could be headed to your state, too.

3) State and local government fiscal crises are already causing layoffs and cutbacks, overwhelming the positive effects of February's federal stimulus package. This will only worsen as local revenues continue to decline and governments run out of reserves and accounting tricks.

4) For nearly 30 years, there has been a growing gap between rising productivity and stagnant real wages. This has translated into extra corporate profits and extra income for the super-rich. Part of this wealth has been loaned back to the working class to finance homes, cars, education, medical care and daily expenses. Result: financial crisis for working families, instability for the financial system. Part of the wealth has been invested in the unproductive, speculative financial sector, or in real “development” projects (homes, shopping malls, resorts) that outstrip the demand from cash-strapped consumers. Result: more overcapacity, corporate bankruptcies, layoffs, and instability.

These problems — and others — could result in a new wave of financial and industrial crises, with the economy declining into a full-blown depression. It will require radical action to protect working families, and to reorient the economy, not only for growth, but for meeting the needs of people and the environment.

The stimulus package enacted by the Obama administration in February contains many positive features that are only beginning to kick in. But they are inadequate in the face of the developing global depression.

A people's economic program would have two essential features. 1) Return to the working class a greater portion of the wealth it creates, wealth that now lines the pockets of the very rich. 2) Directly meet real needs of the nation and its working families, instead of relying exclusively on the magic of a broken corporate system.

This means higher taxes on the super-rich, on corporate profits and financial transactions, to ease the burden on the working class, especially at the state and local level. And it requires that government play an active role in developing energy, transportation, health, environment and infrastructure policies. It would take direct measures where necessary to put the millions of unemployed to work meeting these vital needs.

Winning even part of such a program requires challenging the entrenched corporate and financial interests that, until now, have been able to shape and plunder the U.S. and global economies as they will. This will not be an easy fight. The huge movements for a national single-payer health plan (or at least a strong public option) and the Employee Free Choice Act are only the start of what is needed to win the kind of change we really need.

Art Perlo can be reached via his e-mail: econ4ppl@cpusa.org

The Ford story

Ford has a brainwash campaign going on called, "The Ford Story."

Closing the St. Paul Ford Twin Cities Assembly Plant after taking tens of millions of dollars from tax-payers then closing the plant after promising to keep it open apparently isn't part of the way the Ford Motor Company tells "The Ford Story:"

http://www.thefordstory.com/?searchid=426441|28125566|205373347

Check out the real "Ford Story:"

http://capitalistglobalization.blogspot.com/

Alan L. Maki

From Capitalist Crisis to Building a Movement to Win a New Era of Justice and Peace: A Worker's Perspective

When I headed out for three weeks with ten-thousand leaflets printed by a United Auto Worker’s local and a United Steel Worker’s local with my “Letter to the Editor” (see below), I never thought so much interest and discussion was going to be generated.

To date I have received over 6,000 e-mails and over 300 contributions in the mail with people offering me housing and meals for my fall follow-up trip where we will set up committees for advocating a real public health care system… the real “public option.”

People are not happy with the direction this country is going… what I found was anger wherever I went in Minnesota, Wisconsin and Michigan… not just anger over the health care mess; but I met people everywhere who were eager to talk… people who are losing their homes or already lost their homes, many filing bankruptcy. Many people did not know where their next meal was coming from or what the future held for them and their families when unemployment compensation runs out... for many the unemployment checks have already stopped with no chance for a job in sight. I stopped at many garage sales as I traveled. People were trying to sell things they worked hard to buy, not to clean out their garages and homes--- but to make a few bucks to purchase groceries or gas… but, even at the cheap prices they were asking for nice things, there weren’t many buyers because the people looking didn’t have much money either… everyone was talking about how tough it has become to survive.

On the Indian Reservations I found deep, deep despair… people have concluded that racist hiring practices that made it darn near impossible for them to get a job when the economy was moving along… Now find that with the economy on the skids, so to are their lives because they know they will be the last to get hired.

I met students who were forced to drop out of college because they couldn’t afford rising tuitions. They dropped out of college looking for jobs hoping to work long enough to get a little money so they could go back to school only to find they can’t even get jobs at McDonalds or Burger King.

Many people would break down and cry as they told me their problems. They just don’t know how they will ever recover.

More than anything what I am experiencing after traveling and talking to people is that people are looking for a way to make themselves heard. They are not happy with the direction Barack Obama is taking the country and what he is doing is nothing like they were expecting… getting rid of Bush was a relief but Obama has been a real let-down and disappointment. Often one person would be talking about what a let-down Obama has been and another person would say, “Give the guy a chance.”

Outfits like the AFL-CIO and Campaign for America’s Future promised coalition organizing and activity to struggle for the kind of change these Obama backers claimed he was for… now, these organizations, like Obama, have retreated and backed away from their promises to struggle for the reforms they claimed they, and Obama, were for. People feel abandoned and they are glad to see someone trying to do something.

The “stimulus money” is creating some jobs, but people of color are are finding themselves not even being considered for the jobs… a lot of the jobs end while the notices are still posted or advertised in the paper and when people show up to apply for these jobs, they are told the jobs were finished days or weeks before… this is especially the trend in the construction industry where people are getting the jobs through friends and word of mouth... if you move in the right circles--- white circles--- you hear about the jobs in time to apply. Autoworkers who used to make thirty to fifty dollars an hour are finding themselves lucky to get jobs paying twelve dollars an hour. Same thing with miners.

People are instinctively figuring out that the further Obama plunges the nation into debt the more unemployment and the lower the wages which results in growing working class poverty. There is a general understanding beginning to take shape where people have figured out that saving the banks ends up killing working people.

Along with growing dissatisfaction and a growing understanding that capitalism is in deep, deep trouble; there is confusion being spread by the mass media which prevents working people from fully understanding the issues.

Working people will continue to suffer because liberals, progressives and left forces who have historically been the centers of resistance to injustices, are themselves very confused and disoriented by Obama and the Democrats who are doing the thinking for most of these people when they should be applying their own thinking skills based upon what is right, what is wrong and what is just and what is needed. Instead, many of these liberals, progressives and the left see their objective as supporting Barack Obama and many are already talking about squelching struggles because these struggles for justice will hinder Obama’s opportunity for a second term.

For working people, politics is not about saving the political butts of Wall Street politicians--- which Obama is; rather, for working people, politics is driven by the purpose of creating better living standards for the working class.

We have seen how Barack Obama has paid back auto workers for their unconditional support he received from them… tens of thousands of auto workers are now without jobs because Obama places the interests of corporate profits before the needs of the people. Workers need jobs to survive; Obama and his middle class liberal, progressive and left supporters have no concept of what it means to working people to be without jobs paying decent wages with good benefits… for these middle class intellectuals, unemployment is a statistic used to play a political game since football is too rough for them and the class struggle involves much more than writing a book or making a speech.

If this is not true, what other reason can there be for so many of the organizations these middle class intellectuals lead backing away from the fight for single-payer universal health care?

Check it out; the high-paid union leaders whose abilities don’t go beyond moving their lips to make a nice speech, have almost all turned their backs on the real health care needs of working people… choosing instead to cover Barack Obama’s political butt. Why should any union leader worry about Obama beyond the extent to which Obama joins the struggle for real health care reform that puts people before profits… and these same middle class intellectuals refuse to condemn Obama’s dirty wars.

We were told by the middle class intellectuals and sell-out labor leaders that electing Barack Obama would open up the door wide to initiate real struggles for real reforms making life better for people. Instead of action; we get excuses.

Those labor leaders like Richard Trumka have taken to railing against racism; but, there is no struggle to end racism in employment matching his militant sounding words… just ask any workers of color if this is not so. If Trumka was sincere, the AFL-CIO would have been helping the two-million casino workers employed in loud, noisy, smoke-filled casinos at poverty wages without any rights under state, federal or tribal labor laws in the Indian Gaming Industry; helping casino workers to organize… instead, we see unions holding meetings, conferences and conventions in these casinos that their union pension funds helped to build. Where is Richard Trumka as plumbers and pipe-fitters are meeting at the Fortune Bay Casino & Resort in Tower, Minnesota on Minnesota’s Iron Range this week?

If these middle class intellectuals were sincere, they would be helping to initiate real grassroots and rank-and-file movements capable of forcing Barack Obama to do what is right and just not what is only politically expedient for his political future.

The time has come for working people to insist on something of substance in return for their votes… a public health care system, the real public option, would be a good start; even the single-payer universal health care like the Canadians have would be better than what we have. Obama needs to be told to go fight his own dirty imperialist wars.

Below is some of the discussion generated when my letter was published in the International Falls Daily Journal in International Falls, Minnesota located on the Minnesota/Ontario border with paper mills in both countries on each side of the Rainy River.

Alan L. Maki
Director of Organizing,
Midwest Casino Workers Organizing Council



Health care reform needed

Submitted by Journal Staff on June 9, 2009 - 12:46pm.

Letters to the Editor

To the editor,

Our country is embroiled in controversy and debate over health care reform.

Focus on the purpose of health care has been lost. Health care has two purposes:

1. Keep people healthy.
2. Get people well when sick.

Our public officials squander our limited and scarce resources — during a period of a crumbling economy — financing wars in three countries; subsidizing the Israeli military machine; and spending trillions of dollars financing 800 U.S. military bases on foreign soil dotting the globe; and then they tell us there is no money for health care.

Instead, we should be building 800 public health care centers stretching out across the United States providing a public health care system which includes:

• No-fees/no premiums.
• Comprehensive (cradle to grave).
• All-inclusive (general, dental, eyes, physical therapy, prescription drugs).
• Universal (everybody in; nobody out).
• Publicly funded.
• Publicly administered.
• Publicly delivered.

The United States is the wealthiest country in the world.

We can afford to provide a first-rate, world-class, free public health care system for our own people — if we get our priorities straight.

We need health care reform based upon: Everybody in; all the profiteers out.

Health care is supposed to be about people, a human right; not about profits.

Representing workers employed in smoke-filled casinos suffering from cancers and heart and lung problems, I know a little something about why we need health care reform now.

Alan L. Maki
Warroad, MN

Discussion:

Sounds good on paper, Mr....

Sounds good on paper, Mr. Maki, but is too ideologically driven to be desirable.

When you say "universal" what you are really saying is "no exceptions." That is the ideological position and one that many Canadians hold, even when it means that things like hip replacements or MRI's are put on hold if there is a swine flue outbreak. Or if there the quota of such "extras" has been met.

To say it is universal is like saying that all children must attend public schools -- no exceptions. What we know, however, is that the best model is a good public system accompanied by a great private system. If your model were applied to education, we would close down Harvard, Stanford, Macalester, and even Oak Hills Bible. The thing that makes our university educational system the best in the world is the combination of public and private each keeping the other honest.

The oldest national health care system in the world [Started by Otto von Bismarck-- hardly a liberal] is the German system that allows the existence of a dual system, public and private. "Currently 85% of the population is covered by a basic 'Statutory Health Insurance' plan, which provides the standard level of coverage. The remainder opt for private health insurance, which frequently offers additional benefits." [Wikipedia] What it means is this: everyone is covered. What it doesn't mean is that there is a state monopoly on health care.

Profits are, for the most part, a good thing. If the Daily Journal isn't profitable, it closes down. If General Motors isn't, it goes into Chapter 11. The fact is that medical advances are made exclusively in countries where innovators can profit form their efforts. That is why Minnesota is the home of Medtronic and St. Judes, among others. That is why Americans created the polio vaccine and will likely solve malaria.

I am known on this blog as a "liberal" -- whatever that means. As you can clearly see, I am a moderate who is less interested in ideological purity than in results. In the world we live in, a mixture of public and private almost always wins. Ideological purity reads like a simple recipe, but the product that comes out of the over doesn't taste very good.

But thanks for posting; we need to be discussing something other than figure skating on this site,

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Submitted by Thomas L. Johnson on June 10, 2009 - 4:08pm.
Thomas L. Johnson, a...

Thomas L. Johnson, a Bismarck-happy self-described "liberal" (see above), writes that Alan Maki's proposal "sounds good on paper".

Indeed it DOES -- which is far more than can be said for the Obama administration's Kafkaesque hodge-podge which is suddenly being fast-tracked in Congress in an attempt to over-run the nation-wide demand for Single Payer NOW. (Note that our cowards in Congress have suddenly put off dealing with the financial debacle until "after the August recess", if ever, in order to try to short-circuit the nation-wide demand for Single Payer NOW.)

Johnson's choice of Dr. Jonas Salk to illustrate the (supposed) "fact is that medical advances are made exclusively in countries where innovators can profit form their efforts ... That is why Americans created the polio vaccine" is particularly inept and dishonest.

To quote Wikipedia back at Johnson, Salk did NOT profit, nor seek to profit, from the development of the polio vaccine to which he devoted much of his life (and developed at a PUBLIC university):

"When news of the discovery was made public on April 12, 1955, Salk was hailed as a "miracle worker," and the day "almost became a national holiday." He further endeared himself to the public by refusing to patent the vaccine, as he had no desire to profit personally from the discovery, but merely wished to see the vaccine disseminated as widely as possible."

Another counter-example would be Gavriil Abramovich Ilizarov, the Soviet Jewish physician who invented the Ilizarov apparatus for lengthening limb bones. Dr. Ilizarov did his early work -- to help war vets who'd survived, because of the development of sulfa drugs, with drastic orthopedic injuries -- with bicycle spokes, in Kurgan, Siberia.

Bravo to Alan Maki for his Letter.

Submitted by Alice Faye on June 10, 2009 - 7:22pm.

I agree with TLJ on this...

I agree with TLJ on this one.

Re a totally national health care plan. So far these plans have ALL resulted in rationing. Recently 2 business associates of mine both required knee replacements. The one in Ohio was back on the golf course inside of 3 months. The one in Canada is not yet through his 4 1/2 month wait for the 1st appointment with the specialist.

How long do you think his wait will be for the surgery after he finally gets to see the specialist?

Re the implied suggestion to quit supporting Israel and withdraw from 800 military bases on foreign soil.........I guess that's OK if you're willing to write off Israel and set a match to a mid-east nuclear holocaust, and just who are you willing to turn over the global military dominance to? Somebody WILL take the position. Al Quaida, Hamas, China, Russia...?
Keep Well


•
Submitted by RJ1127 on June 10, 2009 - 10:19pm.

And bravo to Alice Faye for...

And bravo to Alice Faye for wikipediaing Jonas Salk to discover that the good doctor did not profit from his discovery. But he reaped tremendous rewards and also suffered the privations of fame. But his shining example does not suddenly provide support for Alan Maki's demands that are so ideological as to be frightening.

Freedom-loving people deserve freedom. If we were North Korea or Cuba, we could create a totalitarian health-care system and successfully demand that everyone participate, no exceptions. As far as I can tell, this has not been the American model in very many areas -- and when it has, as with the draft that existed through the Viet Nam era -- it felt all wrong.

A single payer system NOW [gotta love capital letters] would make ideologues happy indeed, but would we love our system? When I talk to Europeans, I am always impressed with the degree that dissatisfactions increase when a system is all-encompassing -- when it is Single Payer and that payer is the same organization that mismanages the mail, the railroads, the military, and a good chunk of education.

When I hear Obama talking as he did in Green Bay this week, I hear a common-sense but committed President who is basing his approach on real solutions to real problems, not some statist ideology. I believe that is why I voted for him and why 62% of Americans approve.

So if his moderation doesn't work you Alice Faye and Alan Maki, so be it. But if it takes a hodge-podge to retain the best of the American system [People really do fly to Minnesota for health care] and solve the problem of underinsurance and non-insurance, then he is headed towards solutions, not "socialized medicine."

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Submitted by Thomas L. Johnson on June 12, 2009 - 11:11am.

We need to expand these kinds of discussions and this kind of dialogue; this is what democracy is all about.

Alan L. Maki
Director of Organizing,
Midwest Casino Workers Organizing Council

58891 County Road 13
Warroad, Minnesota 56763
Phone: 218-386-2432
Cell phone: 651-587-5541
E-mail: amaki000@centurytel.net

Check out my blog:

Thoughts From Podunk

http://thepodunkblog.blogspot.com/

Remembering Thomas Paine, America's Original Muckraker

By Matthew Harwood
Columbia Journalism Review
http://www.cjr. org/behind_ the_news/ world_of_ paine.php
June 12, 2009

Two hundred years ago this week, the radical journalist
and pamphleteer Thomas Paine died an ignominious death.
But during his life, Paine was renowned as the
philosophical architect of the American Revolution, a
true democratic populist who voiced ideas that are
still considered dangerous. Common people can govern
themselves justly and democractically. Liberty should
not be forsaken for security. Both of these principles
must guide our foreign relations.

In many ways the forefather of modern advocacy
journalism, Paine is largely unrecognized as such
today. Still, those modern writers hoping to change the
world with their words could profit from Paine's
example; for in his time, Paine made people believe
they could "begin the world over again"-and they did.

Armed with his democratic principles, an adversarial
idea of what free expression meant, and a pen poised
like a dagger, Paine took aim at everything sacred in
his era: monarchy, aristocracy, and revealed religion.
Common Sense had the temerity to argue that the
American colonies needed no king and could establish a
republican government to govern itself. The Rights of
Man went further, defending any people's natural right
to overthrow hereditary government when it was not
responsive to their needs and interests -- which,
according to Paine, was all the time. And while The Age
of Reason, a withering attack on revealed religion,
earned Paine his exile from America's founding
pantheon, its logic is one that still guides the best
journalism: "When opinions are free, either in matters
of govemment or religion, truth will finally and
powerfully prevail."

Advancing the stories and ideas that challenge the
powerful in order to protect the common good, Paine's
work embodied the best journalistic principles; in many
ways, he was the prototypical crusading journalist.
Many these days are arguing that "crusading journalism"
is the sort of journalism that we need the most, the
sort of journalism that is most likely to succeed in
these dire times of torture, terror, and financial
turpitude. Slate's Jack Shafer even argues for a return
to "yellow journalism" -- not of sensationalism, but of
passion.

Yet despite all Paine did for letters, it's disturbing
to note how few of today's journalists have heralded
his life or his contribution to the craft.

One reason is that many modern reporters tend to forget
that the modern press is ultimately a creation that
favors a particular political system: democratic
government responsive to its citizens' desires.
Concepts as "equal time" and "objectivity" taken to
illogical extremes, along with the profession's
integration into the country's elite, have led many
journalists to play it safe with routine, easy work
that rarely challenges the powerful. (Take The New York
Times's recent prostration before the Pentagon's study
on Guantanamo recidivism, for example.) Paine
understood that the powerful lie to retain their power,
and he excoriated them for doing so.

Professional journalism's recent struggles have much to
do with the Internet, innovation, and economics; but
the profession is also suffering because the mainstream
media have largely forsaken the hard, investigative
pieces that make enemies of the powerful. But while
Paine's spirit is in short supply throughout many
newsrooms today, there is one infinite space where it
flourishes: the Internet. Wired's Jon Katz understood
this more than a decade ago:

[Paine's] mark is now nearly invisible in the old
culture, but his spirit is woven through and through
this new one, his fingerprints on every Web site,
his voice in every online thread. If the old media
(newspapers, magazines, radio, and television) have
abandoned their father, the new media (computers,
cable, and the Internet) can and should adopt him.
If the press has lost contact with its spiritual and
ideological roots, the new media culture can claim
them as its own.

If Thomas Paine were alive today, there's little doubt
you would find him blogging from www.commonsense. org,
challenging concentrated power, conspicuous wealth, and
a culture amusing itself to death. Paine would likely
have cherished the chance to engage his readers in
debate, and spur them to direct action for better
government and a more equitable economy. When people
pick up a newspaper or view it online, they need to
feel that the multitude of voices within are devoted to
them: a democratic people determined to stay that way.
One man, with one voice, did that for the American
colonies -- and it changed the world.

No matter what form journalism takes in the coming
years, it will only remain relevant if it follows
Paine's example and treats people like citizens worthy
of serious conversations. The profession forgets this
at its own peril. Or, as Paine would say: "Character is
much easier kept than recovered."

Racism kills when health care is denied as mobsters and corrupt politicians profit

The Washington Post and other media published a story about the pathetic state of health care on Indian Reservations.

The story is entitled:

Promises, Promises Indian health care needs go unmet

I publish the complete story below or you can click on this link:

http://www.washingtonpost.com/wp-dyn/content/article/2009/06/14/AR2009061400903.html?hpid=sec-health?hpid=sec-health

The Indian Health Service is in fact a model health care program based upon socialized health care; but, the Indian Health Service, like most public programs in this country is being sabotaged by those politicians who want to privatize everything from health care to education to maintaining our streets and sewers and hydro dams.

These politicians sabotage these public programs first by appointing people to administer these programs who are opposed to the very programs they are administering; then these politicians underfund the programs... then they come along and say public programs don't work. Of course the programs aren't going to work if you don't appoint people who will strive to make them work and provide them the needed money and resources required for success.

That the United States Congress allowed and enabled a crooked and corrupt racist bigot like Gale Norton out of the law firm to the mafia and lobbyists to politicians--- Brownstein/Hyatt/Farber/Schreck--- to become the Secretary of the Interior overseeing the Indian Health Service is in itself a racist crime of immense magnitude which tells us a great deal about why there are these serious short-comings in the Indian Health Service. No doubt Jack Abramoff carried enough money around in brown paper shopping bags that he distributed to politicians so that the Indian Health Services could have been funded three times over.

The Indian Health Service is one classic example; here in Minnesota the Department of Health and Human Services is an even better example with Republican Governor Tim Pawlenty appointing one of the most racist, bigoted and viciously anti-working class, anti-people, pro-corporate, pro-free enterprise Neanderthals--- Cal Ludeman--- to head up the Minnesota Department of Health and Human Services.

When politicians appoint those opposed to public programs to oversee these very programs they are opposed to, this is a recipe for disaster.

One has to ask, since the health care needs of Native Americans has been going unmet for so many years, why then, has it taken so long for the media to bring this matter to the attention of the public and politicians? The answer is very simple: The mainstream media is as viciously racist, biased and bigoted as the very politicians who make the decisions and those they appoint to administer social and public programs which are supposed to be about taking care of the needs of the people but are turned into nothing but big government boondoggles where all the friends of these politicians and administrators end up getting rich as people suffer because instead of, in the case of Indian Health Services, you have all these people scamming the system doing everything except providing the government mandated services.

Anyone can look at the budget of the Indian Health Service and see that the problem is a bunch of racist "entrepreneurs" with their dirty, corrupt fingers constantly in "the cookie jar" enabled by a bunch of uncaring administrators.

Barack Obama could pump billions upon billions--- even trillions--- of dollars into the Indian Health Service and it wouldn't improve the health care Native Americans receive because this excellent system of health care is being intentionally sabotaged by a bunch of greedy, profit gouging swindlers who are stealing the funds before these funds can provide the health services people require.

It is ironic that the same tribal governments who operate the casinos send their emissaries out to plead for more funding for the Indian Health Service when the casinos they operate--- and how they operate these casinos--- are responsible for a good share of the health care problems Native Americans are experiencing which is putting a drain on the Indian Health Service which is plagued with corruption--- on and off the reservations.

Here is an example.

This past spring I responded, on behalf of the Midwest Casino Workers Organizing Council as its Director of Organizing, to the Red Lake Tribal Council's presentation to federal government officials who made a presentation at a hearing on the terrible situation regarding Indian health care... I submitted my response to U.S. Senators Amy Kolbuchar (Minnesota Democratic Farmer-Labor Party), U.S. Senator Carl Levin (Michigan Democratic Party), U.S. Senator Debbie Stabenow (Michigan Democratic Party, U.S. Congresspersons Colin Peterson (DFL-Minnesota), James Oberstar (DFL-Minnesota). I would note that these politicians over the combined life of their political careers has solicited, received and accepted MILLIONS of dollars in campaign contributions from the lobbyists of Indian Gaming Industry.

This was my letter to them which received no response:

U.S. Senators Amy Kolbuchar (Minnesota Democratic Farmer-Labor Party)
U.S. Senator Carl Levin (Michigan Democratic Party)
U.S. Senator Debbie Stabenow (Michigan Democratic Party
U.S. Rep. Colin Peterson (DFL-Minnesota)
U.S. Rep. James Oberstar (DFL-Minnesota)

April 6, 2009

Senators and Congresspersons,

The Midwest Casino Workers Organizing Council was not informed of the March hearings on Indian health care even though each and everyone of you has been repeatedly asked to keep us apprised of hearings which relate to these kinds of issues.

It is with this in mind that I request my comments here be included in the hearing testimony.

You, elected officials, claiming to be public servants with the good of the public at heart in your actions, have gone out of your way to deny us casino workers the right to participate in any hearings relating to labor, health care and environmental issues; and, then, you have the unmitigated gall to preach that we live in the world's greatest bastion of democracy.

As you are fully aware, our Organizing Council consists of Organizing Committees in Minnesota, Wisconsin, Michigan and Iowa assisting casino workers in their attempts to organize unions in an industry--- the Indian Gaming Industry--- which all of you have had a hand in creating through your support of the most anti-labor, most racist vile "Compacts" which have forced over two-million casino workers (and given the huge employee turnover in this industry, millions more) to work under the most disgraceful and Draconian conditions in loud, noisy, smoke-filled casinos at poverty wages without any rights under state, federal or tribal labor laws in this industry now comprising over 350 casino operations many of which include hotels/motel, restaurants, a variety of small shops and boutiques ranging from hair-dressers to artists and even water parks and various theme parks.

And here you are sitting and listening to those like the spokespersons for the Red Lake Nation Tribal government--- a supposedly sovereign nation, but a government that has to ask the federal and state governments for approval before doing anything and begging for tax-dollars as casino revenues in the billions and trillions of dollars go completely without any accountability to anyone except for a bunch of mobsters who own the slot machines and table games leaving the Indian Nations stuck with nothing but a pile of debt and poverty--- talking about how the Indian Health Service is underfunded.

We agree that the Indian Health Service is underfunded. But, the funds are being stolen in many cases before they ever reach the stage of their intended purpose of keeping Indian people healthy and getting them well when sick.

The Indian Health Service is a model program which should be serving as a guide for the kind of socialized health care system we all need in the United States. Instead, you are allowing it to be sabotaged by greedy profit gougers at every level as your colleagues in Congress then point out "socialized health care doesn't work."

A program is intentionally underfunded and then greed takes over with "administrative supervision, oversight and approval" and here we are with one big mess of sick people who can't get the health care they are entitled to.

And, to make maters worse, the very people who provided this testimony from the Red Lake Nation did not tell you that the primary reason for the very substantial need to increase the funding for the Indian Health Services is the direct result of the Indian Gaming Industry.

Common sense tells us that if you put people to work--- force people to work--- in smoke-filled casinos day in and day out seven days a week 365 days of the year, these employees are going to suffer serious health problems because we all know the scientific and health consequences people suffer working under these conditions.

The cancers, the heart and lung diseases, the ill affect on pregnant women and the damage to their unborn children; and, in talking about health problems and risks, perhaps among no other population in America, is diabetes such a killer than on the Indian Reservations. And the medical and scientific community has long ago shown the severe adverse impact that second-hand smoke has on those with diabetes.

So, while the Red Lake Nation Tribal Council has sent their representative to plead the case for an underfunded Indian Health Service, these representatives have failed to state that it is the very policies of this very Tribal Council who control Red Lake Gaming Enterprises who by allowing smoking in their casinos are contributing to the ill-health of the people of the Red Lake Nation, many, who because of the racist hiring practices of employers in northern Minnesota cannot find employment elsewhere, are forced to work in these smoke-filled casinos making them sick--- or sicker than they already are--- which in turn requires an expanded Indian Health Service, which in turn requires greater funding.

Our Organizing Council and our Organizing Committees take the position that Congress should appropriate every single penny required to provide adequate health care to Indian people through the Indian Health Service.

We also insist that there be accountability in gaming revenues and these revenues should be confiscated by the federal government to cover the health care problems being created by an unhealthy working environment.

To add insult to injury to this racism, the Indian Health Service is not even monitoring the health of those people employed in these smoke-filled casinos.

Therefore, it is our contention, that these casino enterprises like Red Lake Gaming Enterprises should be billed for the health care received through Indian Health Services for whatever treatment casino workers require for anything.

Quite frankly, we consider the testimony offered on behalf of the Red Lake Nation Tribal Council to be deceitful and dishonest in not bringing forward the role the tribal government plays in making people sick. Needless to say, these representatives did not make any mention of the way present funding is abused and misappropriated by crooks and thieves.

We point out that dishonesty has been a hallmark of the Indian Gaming Industry from its very inception which began with all of you taking bribes to create this industry which has now resulted in two-million workers going to work in smoke-filled casinos at poverty wages in an industry where the workers have no rights under state, federal or tribal labor laws--- truth is not one of the virtues of such thieves and those like yourselves who pander to these thieving mobsters for campaign contributions.

It is rather ironic that the Red Lake Tribal Council which is wholly and fully complicit in stealing from, and abusing, their own people and everyone else in quest of greater profits... would, under these circumstances, have the unmitigated gall to come before any Congressional Committee demanding funding to solve problems they have helped to create.

Might we be so bold as to suggest that you and your colleagues in the United States Congress contribute the bribes you take from the National Indian Gaming Association and the various state Indian Gaming Associations like the Minnesota Indian Gaming Association and contribute this money to the Indian Health Service?

And then maybe if you would stop wasting our money on wars and maintaining military bases all over the world you could provide an expanded version of the Indian Health Service to include everyone residing in the United States including the thousands of undocumented workers employed in the Indian Gaming Industry.

In closing, let me just say that we know you will take issue with the tone of this letter; but, it is your continued lack of response to our concerns over problems you created in the first place in the way you intentionally created these "Compacts" creating the Indian Gaming Industry that any thinking person would know was going to result in these problems; problem you now want to pretend you had nothing to do with their creation--- including the health care problems being experienced by Indian people.

Alan L. Maki
Director of Organizing,
Midwest Casino Workers Organizing Council

I then had the following communication with Dr. Nathaniel Cobb of the Indian Health Service:

From: Alan Maki [mailto:amaki000@centurytel.net]

Sent:Wednesday,April 22, 20099:47 PM

To: Kimi De Leon; Joan Kim

Cc:'Jim Hart';'John Kolstad';'Kip Sullivan';'Carl Levin';'Sen.Jim Carlson'; rep.bill.hilty@house.mn; rep.tom.anzelc@house.mn; rep.tom.Rukavina@house.mn; rep.tony.sertich@house.mn; ddepass@startribune.com; mmiron@bemidjipioneer.com; bswenson@bemidjipioneer.com;'Chris Spotted Eagle'; jgoldstein@americanrightsatwork.org; teresa_detrempe@klobuchar.senate.gov;

peter.erlinder@wmitchell.edu; peter.makowski@mail.house.gov; esquincle@verizon.net;'Walter Tillow'; nursenpo@gmail.com; 'Steve Early'; 'Joshua Frank'; 'Ta, Minh'; 'Rhoda Gilman';'David Shove'; 'ken nash'; 'Ken Pentel';WCS-A@yahoogroups.com; MARKOWIT@history.rutgers.edu; tdennis@gfherald.com; 'Myers, John'; loneagle@paulbunyan.net; 'Thomas Kurhajetz'; mhoney@u.washington.edu;moderator@portside.org; debssoc@sbcglobal.net; 'Tom Meersman'; peterb3121@hotmail.com; laurel1@dailyjournal-ifalls.com; jscannel@aflcio.org; rgettel@uaw.net; gdubovich@usw.org; info@jamesmayer.org; mzweig@notes.cc.sunysb.edu; rachleff@macalester.edu; advocate@stpaulunions.org; elizabeth_reed@levin.senate.gov; 'Alan Uhl';'Charles Underwood'

Subject: Re: Question on Indian Health Summit



To whom it may concern;



Could you tell me if there will be a discussion at the Indian Health

Summit---July 7-9, 2009 in Denver,Colorado---concerning the issue of casino workers in the Indian Gaming Industry and the impact to their health of second hand smoke in their workplaces?



Could you advise me if there have been any discussions about this with the American Cancer Society and/or the Heart and Lung Foundation?



I am very concerned since I find nothing on this important topic among any of the materials you are distributing for the Indian Health Summit.



With health care costs become an important topic for discussion it would seem that this issue would at least merit some kind of mention at an Indian Health Summit considering the large number of Native Americans employed in the Indian Gaming Industry.



Perhaps you would be interested in having me address one of the plenary sessions since this topic has not been considered previously.



I would point out that I have contacted my of the local offices and administrators of the Indian Health Services concerning this issue and no one will speak to me.



With the Indian Health Services being part of the Department of Interior and associated with the Bureau of Indian Affairs, it would only seem logical that no further casino "Compacts" would be approved unless they contain provisions banning and prohibiting smoking.



I would also suggest that the Indian Health Services insist that all existing "Compacts" be re-opened so a ban and prohibition on smoking can be inserted into them.



"Compacts" are nothing more than contracts and the Obama Administration has seen fit to insist that previously negotiated contracts with labor unions be re-negotiated so there is definitely a precedent that has been established for doing this and I am sure you will agree with me that there could not be a better argument made for renegotiating these "Compacts" than to protect the health of hundreds of thousands of workers employed in these casinos who, in addition to working in these smoke-filled working environments are not protected under any state or federal labor laws, which makes this problem of being employed in a work environment detrimental to human health even a more serious concern.



Perhaps the Indian Health Services could make a recommendation to the Bureau of Indian Affairs and the Secretary of the Department of Interior that the Secretary of Labor, Hilda Solis, becomes involved so that the protection of casino worker's rights under all state and federal labor laws protecting all other workers in the United States be included at the time the Compacts are re-opened to protect the health of casino workers.



If you have any doubts second-hand smoke contributes to an unhealthy work environment and that second-hand smoke is recognized as a leading contributor to a variety of cancers and heart and lung diseases please do not hesitate to request additional information. I will be more than happy to attend your Indian Health Care Summit with the necessary resource materials.



With some two-million workers now employed in the Indian Gaming Industry we want to make sure everything possible is being done to protect the health and well-being of these workers.



If I have addressed this letter to the wrong persons, would you please provide me with the name of the proper person/s and department/s this letter should be sent to.



If you think this issue concerning the impact of second-hand smoke on the health of casino workers is not significant enough to be discussed at the Indian Health Summit would you be so kind as to advise me of your decision and how it was reached?



Thanking you in advance for your timely consideration;



Alan L. Maki

Director of Organizing,

Midwest Casino Workers Organizing Council



58891 County Road13

Warroad,Minnesota56763

Phone:218-386-2432

Cell phone:651-587-5541

E-mail: amaki000@centurytel.net



Check out my blog:



Thoughts From Podunk



http://thepodunkblog.blogspot.com/



Cc: Maggie Bird

President,

Midwest Casino Workers Organizing Council







Dr. Nathaniel Cobb’s response to me:



Dear Mr. Maki:



Your email (below) was forwarded to me for response, as the Agency lead for tobacco control. Thank you for your suggestions - I completely agree that environmental tobacco smoke (ETS) in Casinos is a serious health issue for both the employees and the patrons. Labor law is outside my expertise and purview, but I will try to address a few of the many questions you raise:



1. Can we have a session on casino workers and ETS exposure at the Indian Health Summit?

- reasonable suggestion, but the practical answer is that we did invite the public to submit abstracts, that deadline has passed, and we have already finalized the agenda and cannot add another session. We do have a tobacco session scheduled, but nothing was submitted that focused specifically on casinos.



2. Have we discussed this issue with ACS, AHA, or ALA?

- yes. In discussions with ACS, we have agreed that local advocacy may be the most effective way to approach this issue.



3. Can IHS work with BIA to ban smoking in Casinos?

- IHS is an agency of Health and Human Services, not Interior. We have no regulatory role with regard to Gaming compacts, so no direct influence. In our advisory role with regard to health issues, we may make recommendations to another agency. Your suggestion has merit, and I will discuss it with senior leadership within IHS. I note that you have cc'd your email to your congressional delegation. The Congress has much more power to dictate terms of Indian Compacts than we do, so you should continue to work closely with them. A formal letter to a Member of Congress or to an Agency Head, with a clearly worded request, will always get a response.



4. What else can we do?

- It is true that ETS exposure is a health issue, but the solutions are political. We have great respect for Tribal Sovereignty, and unless and until Tribal Leaders support a smoking ban in casinos, it is not likely to happen. So my suggestion is that you contact the National Indian Health Board and ask for a time slot to present the issue at their next Consumer Conference. That meeting is a great opportunity to influence the thinking of Indian Country leadership.



Thank you for your concern, and I look forward to attending your session at the NIHB conference! If you have any educational materials or scientific studies of ETS and casino workers, I would appreciate your sending me copies.



--

Nathaniel Cobb MD

Chief, Chronic Disease Branch

Division of Epidemiology

Indian Health Service

5300 Homestead Rd NE

AlbuquerqueNM87110

(505)248-4132





My response back to Dr. Cobb:



Dr. Nathaniel Cobb, MD

Division of Epidemiology

Indian Health Service

5300 Homestead Rd NE

AlbuquerqueNM87110

(505)248-4132



Dr. Nathaniel Cobb,



Thank you for the quick response.



As I am sure you must have been thinking as you wrote this response to me, I would not find it satisfactory.



I have contacted all the heads of Indian Health at each of the tribes that operate casinos over the last three years on this issue--- NOT ONE SINGLE ONE has responded to my e-mail or been willing to talk to me on the phone.



Quite frankly, I seriously doubt there are circumstances where the impact of second-hand smoke can be dealt with in one fell swoop.



Yet, we both know this is more about casino PROFITS and the way casino PROFITS influence POLITICS.



What are you suggesting, that it will take some kind of revolution in this country before an agency like yours who has a mandate to educate on this serious issue will act?



I find this coming from a medical doctor such as you very strange; that on this one single issue involving human health where so many lives can be saved and health maintained you suggest that it is up to a union to take the action rather than you.



What are you suggesting is that tribal leaderships motivated solely by profits are to be given into on a health care issue so adversely affecting human health as the issue of being forced to work in an environment composed of second-hand smoke because you do not want to rock the boat--- using as your excuse: "sovereignty."



Is human health not an issue for a “sovereign” nation to be concerned about when it comes to the health of its own people?



There seems to be a clear admission here on your part that these tribal governments involved in gaming have been so corrupted by money they don't even care about the health of their own people; let alone the health of anyone else.



As you are fully aware, most of these casinos are run by outside management firms only using sovereignty to bolster their profits in escaping protecting the rights of casino workers to be free from second-hand smoke in their employment.



You come up with this flimsy excuse that the issue of smoke-free casinos cannot be addressed because the details of the conference are already set and established. However, what is preventing those who will be doing the presentations on the serious consequences of tobacco from raising the issue concerning the need for these casinos to go smoke-free because it is a matter of fundamental human rights for workers not to be forced to work in these conditions that we all know are seriously detrimental to human health.



You, as a medical doctor, are requesting that I should send you further information regarding the consequences of working in these smoke-filled casinos?



It is almost unbelievable that you, being a medical doctor, have even written these words.



That you acknowledge you have known about this problem and not insisted the politicians correct this, is a disgrace. You are the expert witness here.



I find it very difficult to understand how the scientific and medical community has managed to turn out the most respected from these professions to testify:



- Against the tobacco companies in law suits;



- At Congressional and State Legislative hearings;



- In support of smoke-free workplaces for everyone else except casino workers.



But, for some reason there is complete, total, overwhelming and absolute silence when it comes to the issue coercing these casinos in the Indian Gaming Industry to go smoke-free to protect the health of two-million casino workers.



At this point, since you agree this is a very serious problem; I would request that you convey my concerns---AND WHAT YOU CLAIM ARE YOUR SHARED CONCERNS--- to each and everyone of those people who will be participating in the tobacco workshops, forums or making any presentations on tobacco and request that they specifically address the problem of second-hand smoke in casinos and make suggestions and recommendations how this issue will be resolved by coercing these casino managements to go smoke-free.



The Manitoba, Canada provincial government has taken the stand that they will not approve any further casino Compacts or upgrades or new licenses for any casino unless it will be smoke-free.



Something is very wrong with the scenario you bring forward here. I find it kind of strange that a public official such as yourself, who has a legislated mandate to provide the leadership in protecting human health, would tell a citizen writing to you to go and do your job for you.



I expect you to communicate your concerns regarding second-hand smoke (environmental tobacco smoke) to each member of the United States Congress, every single state legislator in each and every state; and, I expect that you will convey your concerns as a medical doctor and in your capacity as a public official with the specific mandate to raise this concern with the Bureau of Indian Affairs and the Secretary of the Department of Interior; and further, that you instruct all of those employed at the local and state levels working for Indian Health Services to immediately undertake discussions about this with their tribal governments.



Sovereignty has nothing to do with this issue.



Can you provide me one single instance where the human health and welfare of a nation’s people is compromised under the guise of “sovereignty” as you are blatantly doing here? No; you cannot provide any such example. How could “sovereignty” possibly be compromised by protecting the health and well-being of any people from any nation? Do you realize how utterly stupid this sounds coming from an educated man like yourself and a doctor on top of that?



Your department and agency is involved in this conference. As a result, you have a mandate to bring this issue forward.



I assume you do not request permission from tribal governments to raise any other issues related to human health; so, why would you conceded your mandate on this vital health issue to tribal governments with no demonstrated concern on this issue or for the human health of their own people?



To suggest that this issue can wait until another conference, where both you and I know that I will never receive permission to speak on this issue, is about as insensitive and uncaring a response that anyone could ever expect to receive from a public official who has the scientific and medical background to know and understand that thousands of casino workers will lose their health while others will die from second-hand smoke they are forced to breath as forced and coerced terms and conditions of their employment.



I am requesting that you carry out the mandate you have from the United States Congress and act to make sure this issue is addressed at your upcoming conference with the aim of resolving this issue once and for all.



I expect to receive written confirmation that you have taken such action.



I assume that President Barack Obama would not appreciate you dragging your feet on this issue since he is so concerned about health care costs; I don't think I have to lecture you, a medical doctor, about the costs involved in trying to cure cancers and heart & lung problems associated with second-hand smoke in the workplace.



With all the attention now focused on accusations of frivolous government spending, I would think you would be more sensitive to the need to bring this issue forward at your upcoming conference.



Respectfully,



Alan L. Maki

Director of Organizing,

Midwest Casino Workers Organizing Council



Cc: Maggie Bird

President,

Midwest Casino Workers Organizing Council

With all that has take place, along comes the Washington Post and the rest of the mainstream media acting as if no one has known about the health care problems of Indian people.

I would also note that not one single newspaper, radio or television station has documented what is going on in the Indian Gaming Industry when it comes to the health and welfare of casino workers.

Why didn't the mainstream media examine how the Indian Health Service was doing while Gale Norton was in charge at the Interior Department for so many of the Bush years?

But, the larger question is why has hasn't the mainstream media seen fit to explore the conditions under which two-million people are employed in the Indian Gaming Industry in this country of which Indian Country is a part... if it wasn't, the Red Lake Tribal Council wouldn't have sent its representatives to the United States Congress begging for more health care funding.

The United States government shoved Indian people onto reservations after stealing their land and the natural resources; proclaimed these Indian Reservations to be "sovereign nations," intentionally leaving these "sovereign" nations without adequate resources to create real nations... and then, through the development of these anti-labor, racist "Compacts" designed with intent to allow a group of vicious mobsters to control the political, economic, social and cultural life of these "sovereign" Indian Nations; the politicians of this country stand back and say, "We can't do anything. We don't want to intervene in the affairs of sovereign Indian nations. We don't want to be in the position of creating problems among Indian people."

How racist and arrogant. The politicians set up a system of native "self-government" in a way designed to get people fighting amongst themselves and then these politicians stand back holding their bribes and pay-offs in the form of campaign contributions claiming their hands are tied.

I hope this blog posting has given people something to think about;

Alan L. Maki

PROMISES, PROMISES: Indian health care needs unmet

Note: The slideshow is available at the link:

http://www.washingtonpost.com/wp-dyn/content/article/2009/06/14/AR2009061400903.html?hpid=sec-health?hpid=sec-health

SLIDESHOW Previous Next
People sit in the waiting room of the Indian Health Service clinic in Crow Agency, Mont., Oct. 16, 2008. The Indian Health Service system serves almost 2 million American Indians in 35 states. An oftt-quoted refrain on some reservations is "don't get sick after June," when the federal dollars run out. (AP Photo/Mary Clare Jalonick) (Mary Clare Jalonick - AP)

This July 2005 photo provided by the Little Light Family shows Ta'shon Rain Little Light in Crow Agency, Mont. Five-year-old Ta'shon had stopped eating and walking, and complained constantly to her mother that her stomach hurt. On her first and subsequent visits to the Indian Health Service clinic on the Crow Agency, Mont., Ta'shon's mother was told her daughter was depressed, when in fact she had cancer, and died some months later. (AP Photo/Little Light Family) (AP)

Ta' Shon Little Light, 5, right, who died of cancer following a misdiagnosis by the local Indian Health Service, is seen with her sisters Thea Little Light, 13, left, and Tia Little Light, 10, at their home in Crow Agency, Mont. in this undated photo. Ta'shon died of cancer some months after a repeated diagnosis of depression by the Indian Health Service clinic. (AP Photo/Little Light Family) (AP)

Ada White talks about her great niece Ta'shon Rain Little Light, seen in the photo, during an interview with the Associated Press in Crow Agency, Mont., Oct. 16, 2008. Ta'shon died of cancer in a matter of months subsequent to a misdiagnosis of depression by the local Indian Health Service. (AP Photo/Mary Clare Jalonick) (Mary Clare Jalonick - AP)

In this photo taken Oct. 14, 2008, pedestrians walk past the Standing Rock Reservation Tribal Headquarters in Fort Yates. N .D. The reservation's Indian Health Service staff say they are trying to improve conditions. They point out recent improvements to their clinic, including a new ambulance bay. But in interviews on the reservation, residents were eager to share stories about substandard care. (AP Photo/Will Kincaid) (Will Kincaid - AP)

In this photo taken Oct. 14, 2008, a small child walks toward the front door of the Public Health Service Indian Hospital on the Standing Rock Reservation in Fort Yates. N.D. The U.S. has an obligation, based on a 1787 agreement between tribes and the government, to provide American Indians with free health care on reservations. (AP Photo/Will Kincaid) (Will Kincaid - AP)

In this photo taken Oct. 14, 2008, people sit in the Indian Health Services waiting room on Standing Rock Reservation in Fort Yates. N.D. Statistics for health and disease in Indian country are staggering: American Indians have an infant death rate that is 40 percent higher than the rate for whites, are twice as likely to die from diabetes, are 60 percent more likely to have a stroke, 30 percent more likely to have high blood pressure, and 20 percent more likely to have heart disease. (AP Photo/Will Kincaid) (Will Kincaid - AP)

In this photo taken Oct. 14, 2008, Rhonda Sandland weeps as she talks about almost losing her fingers to frostbite at Standing Rock Reservation Tribal Headquarters, in Fort Yates. N .D. Sandland says the reservation's clinic decided to remove five of her fingers because of the pain, but a visiting doctor from Bismarck, N.D., intervened, giving her drugs instead. She says she eventually lost the tops of her fingers, and the top layer of skin. (AP Photo/Will Kincaid) (Will Kincaid - AP)

In this photo taken Oct. 14, 2008, Ron His Horse is Thunder, chairman of the Standing Rock tribe, talks about the Indian Health Service at Standing Rock Reservation Tribal Headquarters, Fort Yates. N.D. His Horse is Thunder says his remote reservation on the border between North Dakota and South Dakota can't attract or maintain doctors who know what they are doing. (AP Photo/Will Kincaid) (Will Kincaid - AP)

In this photo taken Oct. 14, 2008, Dr. Vincent Barnes points out the great distance he and his staff must travel to treat people on the Standing Rock Reservation at Fort Yates, N.D. Barnes is a psychologist with the U.S. Public Health Service. (AP Photo/Will Kincaid) (Will Kincaid - AP)

In this photo taken Oct. 14, 2008, sisters Marcella Buckley, left, and Tracy Castaway pose at Standing Rock Reservation Tribal Headquarters, Fort Yates. N .D. Castaway says her sister is in $40,000 of debt because of treatment for Stage 4 stomach cancer after being misdiagnosed for years by the local health clinic, including for the possibility of a tapeworm and stress-related stomachaches. (AP Photo/Will Kincaid) (Will Kincaid - AP)

In this photo taken Oct. 14, 2008, Marcella Buckley talks about her medical condition at Standing Rock Reservation Tribal Headquarters in Fort Yates. N .D. Buckley says she visited the local clinic for four years with stomach pains and was given a variety of diagnoses, including the possibility of a tapeworm and stress-related stomachaches. She was eventually told she had Stage 4 cancer that had spread throughout her body. (AP Photo/Will Kincaid) (Will Kincaid - AP)

In this photo taken Oct. 14, 2008, Victor Brave Thunder talks about his medical condition at Standing Rock Reservation Tribal Headquarters, in Fort Yates. N .D. The reservation's clinic failed to diagnose Victor Brave Thunder with congestive heart failure, giving him Tylenol and cough syrup, when he told a doctor he was uncomfortable and had not slept for several days. He eventually went to a hospital in Bismarck, which immediately admitted him. Brave Thunder, 54, died in April while waiting for a heart transplant. (AP Photo/Will Kincaid) (Will Kincaid - AP)


By MARY CLARE JALONICK
The Associated Press
Sunday, June 14, 2009

CROW AGENCY, Mont. -- Ta'Shon Rain Little Light, a happy little girl who loved to dance and dress up in traditional American Indian clothes, had stopped eating and walking. She complained constantly to her mother that her stomach hurt.

When Stephanie Little Light took her daughter to the Indian Health Service clinic in this wind-swept and remote corner of Montana, they told her the 5-year-old was depressed.

Ta'Shon's pain rapidly worsened and she visited the clinic about 10 more times over several months before her lung collapsed and she was airlifted to a children's hospital in Denver. There she was diagnosed with terminal cancer, confirming the suspicions of family members.

A few weeks later, a charity sent the whole family to Disney World so Ta'Shon could see Cinderella's Castle, her biggest dream. She never got to see the castle, though. She died in her hotel bed soon after the family arrived in Florida.

"Maybe it would have been treatable," says her great-aunt, Ada White, as she stoically recounts the last few months of Ta'Shon's short life. Stephanie Little Light cries as she recalls how she once forced her daughter to walk when she was in pain because the doctors told her it was all in the little girl's head.

Ta'Shon's story is not unique in the Indian Health Service system, which serves almost 2 million American Indians in 35 states.

On some reservations, the oft-quoted refrain is "don't get sick after June," when the federal dollars run out. It's a sick joke, and a sad one, because it's sometimes true, especially on the poorest reservations where residents cannot afford health insurance. Officials say they have about half of what they need to operate, and patients know they must be dying or about to lose a limb to get serious care.

Wealthier tribes can supplement the federal health service budget with their own money. But poorer tribes, often those on the most remote reservations, far away from city hospitals, are stuck with grossly substandard care. The agency itself describes a "rationed health care system."

The sad fact is an old fact, too.

The U.S. has an obligation, based on a 1787 agreement between tribes and the government, to provide American Indians with free health care on reservations. But that promise has not been kept. About one-third more is spent per capita on health care for felons in federal prison, according to 2005 data from the health service.

In Washington, a few lawmakers have tried to bring attention to the broken system as Congress attempts to improve health care for millions of other Americans. But tightening budgets and the relatively small size of the American Indian population have worked against them.

"It is heartbreaking to imagine that our leaders in Washington do not care, so I must believe that they do not know," Joe Garcia, president of the National Congress of American Indians, said in his annual state of Indian nations' address in February.

When it comes to health and disease in Indian country, the statistics are staggering.

American Indians have an infant death rate that is 40 percent higher than the rate for whites. They are twice as likely to die from diabetes, 60 percent more likely to have a stroke, 30 percent more likely to have high blood pressure and 20 percent more likely to have heart disease.

American Indians have disproportionately high death rates from unintentional injuries and suicide, and a high prevalence of risk factors for obesity, substance abuse, sudden infant death syndrome, teenage pregnancy, liver disease and hepatitis.

While campaigning on Indian reservations, presidential candidate Barack Obama cited this statistic: After Haiti, men on the impoverished Pine Ridge and Rosebud Reservations in South Dakota have the lowest life expectancy in the Western Hemisphere.

Those on reservations qualify for Medicare and Medicaid coverage. But a report by the Government Accountability Office last year found that many American Indians have not applied for those programs because of lack of access to the sign-up process; they often live far away or lack computers. The report said that some do not sign up because they believe the government already has a duty to provide them with health care.

The office of minority health at the U.S. Department of Health and Human Services, which oversees the Indian Health Service, notes on its Web site that American Indians "frequently contend with issues that prevent them from receiving quality medical care. These issues include cultural barriers, geographic isolation, inadequate sewage disposal and low income."

Indeed, Indian health clinics often are ill-equipped to deal with such high rates of disease, and poor clinics do not have enough money to focus on preventive care. The main problem is a lack of federal money. American Indian programs are not a priority for Congress, which provided the health service with $3.6 billion this budget year.

Officials at the health service say they can't legally comment on specific cases such as Ta'Shon's. But they say they are doing the best they can with the money they have - about 54 cents on the dollar they need.

One of the main problems is that many clinics must "buy" health care from larger medical facilities outside the health service because the clinics are not equipped to handle more serious medical conditions. The money that Congress provides for those contract health care services is rarely sufficient, forcing many clinics to make "life or limb" decisions that leave lower-priority patients out in the cold.

"The picture is much bigger than what the Indian Health Service can do," says Doni Wilder, an official at the agency's headquarters in Rockville, Md., and the former director of the agency's Northwestern region. "Doctors every day in our organization are making decisions about people not getting cataracts removed, gall bladders fixed."

On the Standing Rock Reservation in North Dakota, Indian Health Service staff say they are trying to improve conditions. They point out recent improvements to their clinic, including a new ambulance bay. But in interviews on the reservation, residents were eager to share stories about substandard care.

Rhonda Sandland says she couldn't get help for her advanced frostbite until she threatened to kill herself because of the pain - several months after her first appointment. She says she was exposed to temperatures at more than 50 below, and her hands turned purple. She eventually couldn't dress herself, she says, and she visited the clinic over and over again, sometimes in tears.

"They still wouldn't help with the pain so I just told them that I had a plan," she said. "I was going to sleep in my car in the garage."

She says the clinic then decided to remove five of her fingers, but a visiting doctor from Bismarck, N.D., intervened, giving her drugs instead. She says she eventually lost the tops of her fingers and the top layer of skin.

The same clinic failed to diagnose Victor Brave Thunder with congestive heart failure, giving him Tylenol and cough syrup when he told a doctor he was uncomfortable and had not slept for several days. He eventually went to a hospital in Bismarck, which immediately admitted him. But he had permanent damage to his heart, which he attributed to delays in treatment. Brave Thunder, 54, died in April while waiting for a heart transplant.

"You can talk to anyone on the reservation and they all have a story," says Tracey Castaway, whose sister, Marcella Buckley, said she was in $40,000 of debt because of treatment for stomach cancer.

Buckley says she visited the clinic for four years with stomach pains and was given a variety of diagnoses, including the possibility of a tapeworm and stress-related stomachaches. She was eventually told she had Stage 4 cancer that had spread throughout her body.

Ron His Horse is Thunder, chairman of the Standing Rock tribe, says his remote reservation on the border between North Dakota and South Dakota can't attract or maintain doctors who know what they are doing. Instead, he says, "We get old doctors that no one else wants or new doctors who need to be trained."

His Horse is Thunder often travels to Washington to lobby for more money and attention, but he acknowledges that improvements are tough to come by.

"We are not one congruent voting bloc in any one state or area," he said. "So we don't have the political clout."

On another reservation 200 miles north of Standing Rock, Ardel Baker, a member of North Dakota's Three Affiliated Tribes, knows all too well the truth behind the joke about money running out.

Baker went to her local clinic with severe chest pains and was sent by ambulance to a hospital more than an hour away. It wasn't until she got there that she noticed she had a note attached to her, written on U.S. Department of Health and Human Services letterhead.

"Understand that Priority 1 care cannot be paid for at this time due to funding issues," the letter read. "A formal denial letter has been issued."

She lived, but she says she later received a bill for more than $5,000.

"That really epitomizes the conflict that we have," says Robert McSwain, deputy director of the Indian Health Service. "We have to move the patient out, it's an emergency. We need to get them care."

It was too late for Harriet Archambault, according to the chairman of the Senate Indian Affairs Committee, Democratic Sen. Byron Dorgan of North Dakota, who has told her story more than once in the Senate.

Dorgan says Archambault died in 2007 after her medicine for hypertension ran out and she couldn't get an appointment to refill it at the nearest clinic, 18 miles away. She drove to the clinic five times and failed to get an appointment before she died.

Dorgan's swath of the country is the hardest hit in terms of Indian health care. Many reservations there are poor, isolated, devoid of economic development opportunities and subject to long, harsh winters - making it harder for the health service to recruit doctors to practice there.

While the agency overall has an 18 percent vacancy rate for doctors, that rate jumps to 38 percent for the region that includes the Dakotas. That region also has a 29 percent vacancy rate for dentists, and officials and patients report there is almost no preventive dental care. Routine procedures such as root canals are rarely seen here. If there's a problem with a tooth, it is simply pulled.

Dorgan has led efforts in Congress to bring attention to the issue. After many years of talking to frustrated patients at home in North Dakota, he says he believes the problems are systemic within the embattled agency: incompetent staffers are transferred instead of fired; there are few staff to handle complaints; and, in some cases, he says, there is a culture of intimidation within field offices charged with overseeing individual clinics.

The senator has also probed waste at the agency.

A 2008 GAO report, along with a follow-up report this year, accused the Indian Health Service of losing almost $20 million in equipment, including vehicles, X-ray and ultrasound equipment and numerous laptops. The agency says some of the items were later found.

Dorgan persuaded Senate Majority Leader Harry Reid, D-Nev., to consider an American Indian health improvement bill last year, and the bill passed in the Senate. It would have directed Congress to provide about $35 billion for health programs over the next 10 years, including better access to health care services, screening and mental health programs. A similar bill died in the House, though, after it became entangled in an abortion dispute.

The growing political clout of some remote reservations may bring some attention to health care woes. Last year's Democratic presidential primary played out in part in the Dakotas and Montana, where both Obama and Democrat Hillary Rodham Clinton became the first presidential candidates to aggressively campaign on American Indian reservations there. Both politicians promised better health care.

Obama's budget for 2010 includes an increase of $454 million, or about 13 percent, over this year. Also, the stimulus bill he signed this year provided for construction and improvements to clinics.

Back in Montana, Ta'Shon's parents are doing what they can to bring awareness to the issue. They have prepared a slideshow with pictures of her brief life; she is seen dressed up in traditional regalia she wore for dance competitions with a bright smile on her face. Family members approached Dorgan at a Senate field hearing on American Indian health care after her death in 2006, hoping to get the little girl's story out.

"She was a gift, so bright and comforting," says Ada White of her niece, whom she calls her granddaughter according to Crow tradition. "I figure she was brought here for a reason."

Nearby, the clinic on the Crow reservation seems mostly empty, aside from the crowded waiting room. The hospital is down several doctors, a shortage that management attributes recruitment difficulties and the remote location.

Diane Wetsit, a clinical coordinator, said she finds it difficult to think about the congressional bailout for Wall Street.

"I have a hard time with that when I walk down the hallway and see what happens here," she says.