:: to the teeth ::    thoughts on social justice, medicine, race, hope and beats

"Another world is not only possible, she is on her way.
On a quiet day, I can hear her breathing." :: Arundhati Roy ::

"The most common way people give up their power is by thinking they don't have any." :: Alice Walker ::
Monday, August 16, 2004  

Albuquerque update on health access organizing

it's been my intention to share more of the details of the organizing process happening here, so many rich, beautiful, hopeful details, too many really. i'm just gonna have to share some of the highlights and appreciate the reality that anyone who decides to do this kind of work will find their own beauty in the struggle. :>

ever heard of permaculture? it's a philosophy in the environmental movement that believes that humans can have a profound impact on healing the earth by making subtle shifts at key points in a process and by layering ones efforts so that the same action/effort can impact one's process on many dimensions simultaneously. leverage is a key concept. but not just physical leverage. it's about timing and alignment and nurturing parallel processes which eventually combine to accomplish higher order goals. if you are interested in profound social change, not just violent revolution or academic critcisms, i recommend studying permaculture. look it up.

this has been a part of our style of organzing in albuquerque. the notion is that if you put all your eggs in one basket, it's really easy for the opposition to disrupt that basket and destroy your process. along with adequate interpretation services, one of the goals we have chosen is to deconstruct the 50% up front fee required of all self-pay patients prior to receiving non-emergent medically necessary care. this is the biggest burden for indigent patients who cannot qualify for financial assistance or afford insurance. it was constructed by an unfairly vicious lawyer in association with an unfairly vicious family practice doctor administator with the full support of top level administration with the goal of blcoking care to mostly undocumented immigrants and other "self-payers." so what's the big deal? health care's a privilege right? well, this is a public hospital i'm talking about serving the poorest people in the poorest state with a mission to serve anyone who needs it. if people don't have the 50% up front, they get their health care and they still get a bill which they have to pay over time. ain't that how the social contract goes in a capitalist society?

so after a few years of planting and watering seeds, shifting earth around, digging deep trenches and alot of other earth metaphors, which translates to doing alot of friggin policy and history research, team building, public education, talking with elected officials, forming a legal analysis of the public hospital's lease agreement with the county, working with med students to gather specific data on who is affected, forming relationships with doctors on the ethics committee, working closely with patients directly affected by this policy and engendering profound trust with them so they are willing to speak out, etc, the battle is now engaged publicly.

our team is challenging the sanity, legality and ethics of this policy in open forums with elected officials, the board of the hospital and the medical staff leadership. we already know the CEO, the decision-maker, isn't gonna budge without power equal to his pushing against him.

at today's meeting with the CEO, a county commissioner and a state legislator, we had a room full of young kids and their recenlty pregnant spanish speaking mom's who related horror stories of toxic front desk treatment, huge bills, zero interpretation services. there was also a lawyer, a doctor and a nurse present and an advocate/interpreter. it was a powerful, diverse, fun team with alot of voices represented in unity around the goal of improving health. we've done these meetings without the lawyer, without the doctor, without the advocate, without the community. all of us were needed to share the truth of a fragmented, corrupt system with people in charge who fundamentally do not believe that there is anything wrong with them or their actions or their institution. it's how the mind of power works. any failure is explainable in and of itself, it's not a symptom of a greater dissonance, it's anecdotal and ignorable.

you can see this kind of thinking in the church 1000 years ago as they try to explain how the earth is the center of the universe becaue it suits their purpose of control and power, not the truth. the social revolution will happen when enough of us, a critical mass, decide to gather together our many diverse voices, to trust each other's hidden experiences of violence and share them in public with the pride of warriors not victims. it'll happen when we stop letting the mind of power divide us into individuals with anecdotal stories of pain and joy. it'll happen as enough of us realize that we all contain the mind of power, the capacity to dominate, manipulate and exploit. ain't no good or evil people, just choices.

the weave continues, the relationships build, care for each other and the earth leads the way home.

just another day in paradise.



posted by andru | 8/16/2004 10:10:00 PM | |


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