RIP Medical Debt (Keystone Fall 2019/Winter 2020 Blog Series)

By Nijmie Dzurinko

Did you know that some scholars believe that Jesus died for our debt, not our sins? According to economist Michael Hudson, the word for sin and debt is the same in almost every language. He and other scholars like the Rev. Dr. Liz Theoharis assert that the Bible is about economics, not the distorted moral narrative of Christian nationalism we have been taught to believe. Jesus believed in debt jubilee, the practice of canceling all debts every seven years. He was against the exploitation of the poor by the rich, which is why he was such a threat to the state, and he was crucified, a punishment for political dissidents.

Over two thousand years later, medical debt is one of the leading causes of homelessness in the U.S. today. 

Dealing with a chronic illness is bad enough, without worrying about losing your house! The stress of debt and dealing with insurance companies and bill collectors makes health conditions worse. In 2018, the American Journal of Medicine reported that almost half of cancer patients drain their life’s assets within two years and are almost three times as likely to file for bankruptcy than those without cancer, which puts them at risk for early death.

When the fundraising team of Put People First! PA found out about RIP Medical Debt, we envisioned starting a medical debt jubilee campaign. We saw that various individuals and groups had worked with RIP Medical Debt to raise money to cancel medical debt in the past, but usually not organizing groups, so we had to conduct our campaign differently.

RIP Medical Debt uses donations to purchase bundled medical debt portfolios that have gone through collection agencies for months or years. Using third-party credit data providers, it targets debt incurred by people facing financial hardship, and then forgives it. For every $1 dollar raised, $100 in medical debt is abolished.

The great thing about working with RIP Medical Debt is that they are experts at purchasing debt and they handle the fundraising platform. They helped us identify a set of counties in PA situated right next to each other with debt available for purchase exceeding $1.5 million. That is the minimum amount of debt they need to conduct a campaign, meaning that we were responsible for raising at least $15,000 over the course of four months.

There are three things about OUR Medical Debt Jubilee campaign that made it unique:

  • We framed the campaign in a political way: as a call for debt jubilee and the universal human right to healthcare, not merely as a charity campaign. Everywhere we talked about the campaign we emphasized that we were raising funds to cancel debt because we don’t believe in a healthcare system based on profit. Following in the footsteps of Jesus the revolutionary, we seek to abolish the very mechanisms by which people are forced into medical debt in the first place.
  • We used the Medical Debt campaign as a place for leadership development and developing the clarity, competence, commitment and connection of our own members. Just as everything we do we do to develop leaders, the same with this campaign. 
  • We ensured that everyone who has their debt cancelled through the process has an opportunity to find out about and join Put People First! PA. We are about organizing and building power among the 140 million poor and dispossessed people in the U.S. today, millions of whom are suffering with medical debt. Every person whose debt is abolished gets a letter introducing them to Put People First! PA and inviting them to join or start a Healthcare Rights Committee.

Ultimately we raised over $16,000 and abolished medical debt for individuals in 20 counties in Western and Central PA who make less than 2 times the federal poverty level, have a debt that is 5% or more of their annual income, or who have already declared bankruptcy. Over 1000 households saw debt relief through our campaign and thereby learned that they are not alone with their struggle, that people are fighting back, and that they can join our ranks.

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This content originally appeared in Put People First! PA’s semi-annual newsletter, The Keystone. The Keystone is a great introduction to Put People First! PA, our work, and our community. It’s all written by our members for our own communication and education, and for supporters and new relationships to get to know us better. Each issue features reports from our work, news about our victories, stories about the health care system and the other issues affecting our communities, and poetry and artwork. Check out past and present editions here: Newsletter Archive.

The Closing of Hahnemann Hospital (Keystone Fall 2019/Winter 2020 Blog Series)

This Spring, Hahnemann Hospital, a 150+ year old Philadelphia Institution, declared bankruptcy and began the process of closing its doors. Here is the story of Hahnemann through member stories.

Member Remarks given at the Poor People’s Campaign: A National Call for Moral Revival Hearing
Clarissa O’Conor

My name is Clarissa O’Conor, and I grew up in Lancaster, Pennsylvania. I am currently a third-year medical student at Drexel University College of Medicine and a member of Put People First! PA. 

I had just started my third year of medical school at Chester Crozer Hospital in June when I heard that Hahnemann Hospital was closing. Hahnemann was the main teaching hospital of Drexel. The hedge fund manager who had purchased Hahnemann a year earlier was filing for bankruptcy, having separated the valuable Center City real estate from the hospital itself. 

Hahnemann Hospital opened in 1885, and became the de facto city hospital for the city of Philadelphia, serving mainly people on Medicaid and Medicare. Over 2,500 people are losing their jobs. 570 residents and interns, or doctors in training, had to scramble to relocate. This is a crisis.

I will not have the opportunity to learn from the doctors, nurses, and patients at Hahnemann Hospital. Since the closing, I have learned amazing things about the hospital. For example, Hahnemann midwives and ob-gyns built relationships with home birth midwives so that people laboring at home could be safely transferred to the hospital if needed. I also learned from members of ACT-UP that Hahnemann was the first hospital in the city to offer care to people who have HIV and AIDS. 

There is no doubt that the closure of Hahnemann Hospital is a symptom of our ongoing healthcare crisis and the war on the poor writ large. In the City of Philadelphia the total number of primary care providers accepting Medicaid has declined in recent years. Communities with the lowest supply of primary care providers are more commonly low-income and have high proportions of people of color. There are 520,457 people on Medicaid in Philadelphia (33.2% of the population).

Hospitals are also closing across the country, especially in rural areas. In my hometown of Lancaster, PA, UPMC closed St. Joe’s Hospital, leaving the city with one emergency room.

People in power, like the Drexel medical school administration, want us medical students to “feel bad for the people affected most by the closure.” It’s not hard to see this rhetoric as an attempt to cool our righteous anger and keep us from organizing.  I am here to say that I am directly affected by the healthcare crisis, and I refuse to see my interests as separate from those of the patients and employees of Hahnemann Hospital. My membership in Put People First! PA has allowed me to see the closing of Hahnemann Hospital for what it is – a symptom of the ongoing crisis and war on the poor and dispossessed and an opportunity to organize our community, including medical students and healthcare workers, into our organization and vision of healthcare for all, no exceptions, and a united poor and working class across Pennsylvania.

We as Put People First! PA demand an end to hospital closures; a Public Healthcare Advocate, who will fight for the healthcare rights for all Pennsylvanians; the protection of Medicaid with no cuts or hurdles, the restoration of the adult benefit in Medicaid, the protection of Medicare, and the implementation of single-payer universal health care for all and access to mental health professionals.”

Excerpt from remarks given August 20th at Kingsessing Public Library event on the closing of Hahnemann Hospital
Farrah Samuels

My name is Farrah Samuels, and I am a stage IV cancer survivor, and a proud member of an organization called Put People First! PA (PPF-PA). In the battle for securing all our human rights, we believe in supporting one another, which is why, most recently, we helped co-organize several rallies, protest actions and marches concerning the closing of Hahnemann Hospital in collaboration with PASNAP and District 1199c workers. It represents just one story in the recent onslaught of hospital and health care facility closings nationally that disproportionately affect low income individuals and working families. This deliberate attack on health care providers and the closing of facilities is a main component of this country’s ongoing war on the poor.

Safety-net hospitals such as Hahnemann, have primarily served the lowest income and most vulnerable patients; and they can play an important role in maintaining the health and safety of the public, just as our schools, libraries, police and firemen do. It is a real shame when safety nets such as Hahnemann are driven to closure by real estate entities seeking to turn over a profit on the backs of the poor and dispossessed. I work as a consultant for several of the City’s emergency shelters for the homeless, Center for Hope, SELF, and ODAAT, located in North Philly. Many of the homeless that come off the streets and enter the shelter system are then linked to permanent housing options through initial referrals from hospitals like Hahnemann. The condition of being homeless renders a lot of these folks medically fragile with a host of co-occurring chronic health conditions. Being on the street means they lack basic access to routine medical care. For years, Hahnemann has been the default healthcare provider of many of Philadelphia’s homeless. Sure, the homeless can go to other hospitals, but many of them stay and congregate in the neighborhoods surrounding Hahnemann; and in their fragile conditions, they may not make the journey as far as another hospital. Proximity can mean the difference between life and death very literally.

Hahnemann has also been the healthcare provider for many of Philadelphia’s inmate population from the county jail, Curran-Fromhold Correctional Facility. The jail routinely transported inmates to Hahnemann to address their medical needs. If you believe that healthcare is a basic human right, then you must also believe and support the notion that inmates are also entitled to medical care just like any other citizens. Many of us have experienced the trauma and pain of having a loved one locked up and wondering if they are ok or if they will get adequate care if they get sick. Where will they go now?

Hahnemann has also been a safety net hospital for many individuals covered by Medicaid and Medicare insurance, such as myself; and it has saved countless lives, including my own. In 2015, I was experiencing considerable stomach pain, fatigue and exhaustion.

At the time, I was an Adjunct Professor of a course at a local college and struggling to put my life back together after foreclosure on my home, the death of my father, the loss of my job, and a brief stint with homelessness. It was then that I learned that illness does not discriminate; and we are all just one diagnosis or step away from things falling apart. I made a salary of $5,000 that year, and as such, qualified for Medicaid. One day when the pain got too much to bear, I decided to go to Hahnemann’s Emergency Department. I was examined, diagnosed with fibroids after initial x-rays, and sent home.

I learned that the initial analysis of my x-rays had missed something and that I had a rare form of soft tissue sarcoma cancer called leiomyosarcoma. I was told I had three months to live and that I needed to seek follow-up care with a hematologist and oncologist.

I began a rigorous routine of inpatient chemotherapy on an aggressive combination of four potent chemotherapy drugs and would spend one out of every three weeks, staying at the hospital to receive this treatment.

The entire treatment ordeal lasted 18 months and on Election Day 2016, I woke up in remission and also overwhelmed by the news of who had won the Presidential election. I knew what this change in presidential administration could mean for other uninsured or Medicaid-insured poor people struggling with chronic health conditions and life-threatening illnesses. I cried tears of joy and sadness at the same time. Had it not been for Hahnemann and their due diligence, I would not have been diagnosed, and may never have had the fighting chance I did to make it through the fire and be here today. And had it not been for Medicaid, I would not have been able to afford the treatment that saved my life. Everyone deserves that same fighting chance that I had.

Hahnemann’s closing is a symptom of the larger financial and operational issues affecting hospitals nationwide. On average, in recent years, there have been 30 hospital closures in rural and urban annually; and this seems to be a trend with no end in sight. Meanwhile, hundreds of shiny, high-tech medical centers have opened in more affluent surrounding suburbs to cater to the rich in areas such as the Main Line.

It all begs the question of what health care really is and what we believe about it. Is it a basic human right, as we believe in Put People First! PA? Or is it a privilege for those who can afford it? Is it a commodity to be bought, sold, and traded by for-profit companies and investors more concerned with gentrification and building luxury condos for the rich than saving human lives? Help us secure care for all, stop the closure of more safety net hospitals and prevent needless deaths because every life matters.

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This content originally appeared in Put People First! PA’s semi-annual newsletter, The Keystone. The Keystone is a great introduction to Put People First! PA, our work, and our community. It’s all written by our members for our own communication and education, and for supporters and new relationships to get to know us better. Each issue features reports from our work, news about our victories, stories about the health care system and the other issues affecting our communities, and poetry and artwork. Check out past and present editions here: Newsletter Archive.

Transitions and Transformations: Building the Philadelphia Healthcare Rights Committee (Keystone Fall 2019/Winter 2020 Blog Series)

With support from the statewide Base Building team, we identified in the Spring of 2019 that the Southwest Philly Healthcare Rights Committee (HRC) was not becoming a political center of gravity in our region, even after several years of work. The HRC played a key role in winning our first ever public hearing on rising ACA insurance rates in 2016, garnering hundreds of petition signatures, and mobilizing and testifying at the hearing. However, turn-over of leaders and staff as well as an over-reliance on staff led to a decline in the vitality of the HRC.

Over time, we came to recognize that the HRC was missing key practices that have strengthened our committees in other areas. The practices of successful HRCs include: 

  • Taking advantage of the organization’s internal democracy by having members participate on statewide teams, calls, and planning bodies;
  • Engaging with the campaign plan to grow, build members’ leadership, and win victories;
  • Carrying out sustained base building and door-knocking work to become an organized force in our communities.

In Philly, PPF-PA members had been wrestling for a few years with our organizational structure, and how to best engage people with teams and HRCs. Since several PPF-PA members unconnected to an existing HRC lived in Philly, we decided that it made sense to expand from having a neighborhood-based HRC, to a city-wide one. The new Philadelphia HRC officially met for the first time at the end of May 2019.

Pivoting to the establishment of a Philly HRC was the right decision. We have since taken action against healthcare profiteers around the closing of Hahnemann University Hospital, which was the main hospital serving those on Medicaid/welfare insurance in Philadelphia. We have made new connections by base building and have deepened our relationships with our strategic partners in the PA Poor People’s Campaign: A National Call for Moral Revival. We have stood up to local health insurance giant IBX, demanding that one of our members receive the healthcare he needs. Twice a month we meet together, collectively plan the work of our committee, and engage in political education.

Through the transition to a city-wide HRC, we have begun to accelerate the development of leaders in the Philly region. The biggest victory we’ve achieved through this transition lies in our deepened clarity about the need for our HRC to connect with statewide work, engage with the campaign plan, and consistently base build. Through the city wide committee, the core group of leaders in this region is more connected than before, and more committed than ever to the task of building a center of gravity in Southeast PA for our statewide struggle for healthcare as a human right.

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This content originally appeared in Put People First! PA’s semi-annual newsletter, The Keystone. The Keystone is a great introduction to Put People First! PA, our work, and our community. It’s all written by our members for our own communication and education, and for supporters and new relationships to get to know us better. Each issue features reports from our work, news about our victories, stories about the health care system and the other issues affecting our communities, and poetry and artwork. Check out past and present editions here: Newsletter Archive.

Struggle is a School (Keystone Fall 2019/Winter 2020 Blog Series)

By the Political Education Leadership Development (PELD) Team

Put People First! PA is building the power of the Pennsylvanian poor and dispossessed through uniting across difference and taking action together. In the struggle for our basic human rights, we come up against the most powerful groups in our society, who profit from our poverty and hold onto their power through our disunity and disorganization. We have a strong opposing force that we have to defeat and overcome if we’re going to win.

This means that we have to be smart about how we organize: That our best intentions aren’t enough. Fighting against an enemy means that we have to learn about where they’re strong and where they’re weak; we have to know where our own strengths and weaknesses are, how we get stronger, and how we can make our enemy weaker.

We know that our basic strength is in our numbers: there’s far more of us poor and dispossessed people than there are people in the ruling class. We also know that our numbers are only really a strength if we’re organized. This means we have to learn how to organize ourselves in a massive way, across differences.We learn about all of these things – who we are, who our enemy is, our’s as well as our enemy’s weaknesses and strengths, how to organize, get stronger, and build our numbers – in many different ways.

We learn them through studying history and theory, and actively applying what we’ve learned to the present. We look closely at other efforts to organize the poor, and we study and reflect on our own work, activity, and history as an organization.

All of these ways that we learn what we need to know are connected to each other, and they rely on us actually taking action together.

There’s no way for us to really know what it’ll take to organize massively and across differences besides going out and trying to do it. There’s no way for us to really know how far we’ve built our strength, or if we’ve correctly identified our enemy’s weaknesses, except by actively struggling for our rights.

That’s what it means when we say “struggle is a school.” We make our struggle a school when we draw lessons from our organizing. We make our organizing stronger by reflecting on what we’ve done in light of what we know from our own experiences, from our study of history, politics, the economy, and lessons from other efforts to organize among the poor. 

Through all of these efforts taken together we elevate “struggle is a school” from a concept, to a reality of our organizing that is inherent in all actions taken through organizing. That way “struggle is a school” becomes an active part of our organizing culture, so that we are constantly assessing where we were in the past, so we know where we stand in the present, and can take constructive and educated steps moving forward.

Making our struggle a school means learning from our successes, and failures, our victories and shortcomings. That means having the maturity and the discipline to be honest with ourselves as an organization, and the wisdom to know that we’re in a long process with many steps and stages to it. Making struggle a school isn’t limited to just learning about how to plan better actions, or how to get better at running meetings or knocking on doors or meeting with representatives, though those are all important parts of it. It’s also taking the time to reflect on what we’re learning about our enemy and what it’ll really take to defeat them: What it’ll take to build an organization that can last and can win.

A necessary part of making our struggle into a school is taking the time to collectively evaluate the things that we do as an organization. Evaluation means more than asking what went well and could be better in the future. It also means drawing political lessons from our work: Lessons about what we need to do to strengthen the unity, organization, and leadership of our class in the face of the determined and sophisticated opposition of those in power. Below are some general questions and guidelines for doing evaluation as part of the practice of making struggle a school:

  • What were the goals of the activity being evaluated? In what ways did and didn’t we accomplish those goals and why? Were they the right goals and/or was this right kind of activity for advancing our organization’s strategy?
  • What did we learn about how to build mass, politically independent, organization of the poor today?  
    • What Leadership Across Difference challenges came up during the preparation for the activity and the activity itself?
  • What did we learn about how to lead across difference?  What did we learn about the ruling class’s strengths and weaknesses? What did we learn about our class’s strengths and weaknesses?
  • How can we apply what we’ve learned?

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This content originally appeared in Put People First! PA’s semi-annual newsletter, The Keystone. The Keystone is a great introduction to Put People First! PA, our work, and our community. It’s all written by our members for our own communication and education, and for supporters and new relationships to get to know us better. Each issue features reports from our work, news about our victories, stories about the health care system and the other issues affecting our communities, and poetry and artwork. Check out past and present editions here: Newsletter Archive.

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