Building A Grassroots Movement for the Human Right To Healthcare

Most people recognize that the healthcare crisis in this country was not solved with the federal healthcare "reform" this year. The enormous influence healthcare insurance companies and other industry profiteers in Congress enabled them to preserve their system of making money off of our health. For many years elected officials have known that the vast majority of people in this country want a healthcare system that works for everyone but they told us that such a system was not "politically possible." In Vermont, we realized that to have the healthcare system we want — a system that provides high quality healthcare for everyone and is paid for fairly — we had to change what is "politically possible" by building a grassroots movement demanding change. In 2008, we launched the Healthcare Is A Human Right Campaign to establish a healthcare system that treats healthcare as a human right. As a result of a lot of hard work In May 2010, the Vermont legislature passed Act 128, which calls for the design of a complete, comprehensive healthcare system that satisfies human rights principles.

While we still face challenges, we believe that this is a national, and ultimately a global struggle, so we wanted to share our experiences in order to help people organizing in their communities for similar goals.

Putting the Horse before the Cart
When we launched the Healthcare Is A Human Right Campaign, we set out to have the working people of Vermont build power to win the right of healthcare for all by getting organized in every community around the state. Due to our experience of fighting for workers' rights with thousands of working people across the state for over a decade, we knew that the vast majority of people did support healthcare for all. The first thing we recognized when we started planning to launch The Campaign, was that in Vermont and around the country there had been many previous chapters in the struggle for healthcare for all which would provide important lessons for us. We believed important ground work had been laid by single-payer advocates who argued that a Medicare-For-All type system could cover everyone by eliminating all of the profits and the waste. But one only has to look at many of the policies that we have in place to realize that "making complete sense" has less to do with policymaking than the powerful influences on those policy makers.

We began partnering with progressive labor unions (especially nurses' unions), faith community groups, disability rights organizations and supportive businesses in order to build power. One goal was to focus of the healthcare reform debate on the impact of the crisis on our communities and bring forward the voices of those most affected by lack of access to affordable healthcare. Of course, we also realized that the policy specifics were very important and our leaders developed human rights principles as guidelines for the policy fight. During 2008 – 2009 we emphasized that the failures of our healthcare systems amounted to a human rights crisis, and through this discourse began building a grassroots statewide network that would have the capacity to change by 2010.

Bringing Forward the Voices of the Healthcare Crisis
In the beginning stages of this Campaign we went out and interviewed thousands of Vermonters about their experiences and values on healthcare. In this process we met hundreds of extraordinary individuals with powerful personal stories about how their (and their family's) lives have been negatively impacted by their lack of access to affordable quality healthcare. We then held a series of human rights hearings where we put the healthcare system on trial by bringing forth all the ways it is failing our communities and violating our basic right to health. The heart wrenching experiences are now the foundation of what our campaign is all about: In the 21st Century, in the wealthiest country in the history of the world, we must have healthcare for all so no one needlessly suffers or dies because of lack of healthcare. Based on almost fifteen hundred personal interview surveys and the human rights hearings, on Human Rights Day (December 10, 2008) we released a report, "Voices of the Vermont Healthcare Crisis: Healthcare Is A Human Right" [link: http://www.workerscenter.org/healthcare-report ]. But As a result of this work incredible grassroots leaders around the state began emerging as the backbone of this growing campaign.

The First Healthcare Is A Human Right Rally
When we first officially launched the campaign at our 10th Anniversary Dinner on April 29, 2008 we also announced that we would have a Healthcare Is A Human Right rally at the Statehouse the following year. While we knew we would not have the organizational capacity to move comprehensive policy change in the first year of the campaign, we wanted to have something big to be building towards. We picked Friday May 1st to mobilize for what we hoped would be a huge rally, to begin building momentum for change. We started telling people about the rally a year in advance. After we finished conducting the healthcare survey or at the end of all the human rights hearings, we'd always remind participants to say Save The Date. Some people said we shouldn't do the rally on a weekday, because the numbers would be small and it would look bad upon our efforts. But our leaders wanted to make sure that this rally couldn't be missed as it would be a work day for the legislators and the Governor. We started building regional Organizing committees for the Campaign, whose leaders began planning logistics for transportation and organizing a "Ten Club" — a list of people in each region who committed to working to bring ten people with them to the rally. US Senator Bernie Sanders agreed to be the main speaker and the nurses union at Vermont's largest hospital — Fletcher Allen Health Care — scheduled their lobby day during nurse’s week as optimize turnout. Ben Cohen of Ben & Jerry's even helped us get a dunk tank so that we could have a "Dump-The-Insurance-Companies-Dunk-Tank". The rally was a turning point for our movement, as over 1,200 Vermonters came out on a weekday in support of Healthcare as a Human Right, making it the largest weekday rally in the history of the state capitol.

Organizing People's Forums and the Development of Human Rights Principles
After doing all of the surveys and building for this rally, it was clear to us that most people we talked to agreed with the idea that healthcare should be treated as a basic human right, but now it was time to start understanding how this could be realized in law and practice. We had to keep building on the momentum of the rally if we wanted legislative action to be taken in 2010. We organized ten "People's Forums on Healthcare" around the state with over eighty state legislators and over eight hundred total participants where our leaders laid out five principles they believed comprised the human right to healthcare.

They are as follows:
Universality is the principle that human rights must be afforded to everyone, without exception. It is by virtue of being human, alone, that every person is entitled to human rights.

Equity is the principle that every person is entitled to the same ability to enjoy human rights. Healthcare resources and services must be distributed and accessed according to people’s needs, not according to payment, privilege or any other factor. Disparities and discrimination in healthcare must be eliminated, as must any barriers resulting from policies or practices.

Accountability is the principle that mechanisms must exist to enable enforcement of human rights. It is not enough merely to recognize human rights. There must be means of holding the government accountable for failing to meet human rights standards.

Transparency is the principle that government must be open with regard to information and decision-making processes. People must be able to know how public institutions needed to protect human rights are managed and run.

Participation is the principle that government must engage people and support their participation in decisions about how their human rights are ensured.

Or, in other words:

o Every person is entitled to comprehensive, quality healthcare.

o Systemic barriers must not prevent people from accessing necessary healthcare.

o The cost of financing the healthcare system must be shared fairly.

o The healthcare system must be transparent in design, efficient in operation and accountable to the people it serves.

o As a human right, a healthcare system that satisfies these principles is the responsibility of government to ensure.

All of the legislators were asked to support these principles and were informed that the goal was to see action towards comprehensive change in the 2010 legislative session starting in January. We would start A Policy Committee was started that comprised of campaign grassroots leaders who would use these five basic principles to evaluate any healthcare bills (with help of the National Economic & Social Rights Initiative [link: http://www.nesri.org] a great national support group who found out about our campaign and had been helping us develop these principles over the past year). Using these principles as a guideline, the Policy Committee would go on to testify on numerous occasion’s about on specific healthcare bills and proposals. In the end, these principles (in some cases word for word) were included in the final piece of legislation.

When "What Is Politically Possible" Begins To Change
For months leading up to the session, everyone always said, "it wasn't politically possible". But our goal was to be in a place to change that by the time the session rolled around.

October 8, 2009: The first big break was when two of the largest newspapers in the state endorsed the campaign in a powerful editorial called "Inherent Compassion" [link: http://www.rutlandherald.com/article/20091008/OPINION01/910080316/1038/O... ] on October 8, 2009.

December 1, 2009: At one of the last People's Forums on Senator Doug Racine, Chair of the Senate Health & Welfare Committee announced they would have hearings on a single-payer healthcare bill in January, as campaign leaders had requested.

January 6th 2010: For the start of the legislative session, over two hundred campaign members delivered almost five thousands postcards from Vermonters demanding action on healthcare to the Speaker of the House, head of the Senate and chairs of the Senate and House healthcare committees.

January 13th 2010: Then one week later over three hundred and fifty Vermonters filled the Statehouse for the hearings on Bill S.88. Over a hundred people testified, most of whom were from our Campaign and were wearing red "Healthcare Is A Human Right" t-shirts.

January 29th 2010: Over fifty Vermont nurses and health providers held a press conference at the Statehouse announcing their support for the state of Vermont leading the country by establishing real health care for all.

February 25, 2010: We released a short film about the campaign [link:
http://www.workerscenter.org/movie ] and Vermont musicians came out with a benefit album to sell CDs to help support the campaign [http://vermontcareforall.org/ ] The movement was growing and what was politically possible was beginning to change. Throughout February and March thousands of Vermonters would email, call and leave messages with the members of the legislative healthcare committees. Campaign leaders scheduled dozens of face-to-face meetings with legislators and their constituents.

March 18th 2010: One of the world's leading architects of healthcare systems, Dr. WIlliam Hsiao of Harvard University was invited to testify to the joint legislative healthcare committees. Dr. Hsiao told the committee members and the two hundred community members showed up to listen that while he applauded all the different health programs Vermont had put in place, that we still needed a comprehensive system.

April 1, 2010: Dozens of Vermont youth led a press conference for a campaign action called "We-Ain't-No-Fools-Day" and thousands of leaflets were handed out across the state with facts about the need for comprehensive change and a link to a special No Fools Day video [link: www.workerscenter.org/nofools]. All throughout this period of organizing a new version of the bill S.88 containing the human rights principles began to move through the Senate and then the House.

May 1st 2010 : Due to this building momentum, we began building for a second massive May 1st Healthcare Is A Human Right Rally [link: http://www.cctv.org/watch-tv/programs/health-care-human-right-state-hous... ] to push for the bill's final passage and to pressure our conservative lame duck Republican Governor from vetoing the bill (as he had done to a similar bill in 2005).

The bill passed with such a strong vote in the Senate (28-2) and House (91-42) that there appeared to be a very strong shot to overcome the one big reimagining obstacle of overriding a veto. Once again a huge crowd came out to march on the Statehouse and rally with Sen. Bernie Sanders (over 1500 people). Again two of the state's largest newspapers came out to support this grassroots effort, see "Gov. Douglas, Do No Harm" [link: http://www.timesargus.com/article/20100523/OPINION01/5230311/1021/OPINION01]. In the end he didn't veto S.88 and it became Act 128 became law and by late June Dr. William Hsiao was chosen to lead the team of consultants to create the designs for Vermont's new human-rights-based healthcare system.

The Road Ahead in 2011 and beyond
The victory of Act 128 was critical, because as we learned last year while there has been lots of arguments about how a "Medicare-For-All type" of healthcare system could work, there remained many unanswered questions exactly how a state would create such a system. Those questions will be answered (and our campaign is staying on top of the whole designing process to make sure they are), but this is still only the beginning. There is still a long way to go on this campaign -- since we expect an intense struggle over implementation in next year's state legislative session when the best design must be passed in a new bill. There will be tremendous opposition pouring in from the vested interests in the current system. Even if Democrats win the open Governor's seat and retain control of the Legislature (which they have a tough road to do) there is always the tendency to shoot for small incremental changes because fundamental change takes a lot of political courage. The Policy Committee is hard at work monitoring the process of developing the healthcare system designs. The Organizing Committees are out talking to people every chance they get and collecting thousands of signatures on a petition calling for action on the designs in 2011. We are planning a major action on the first day of the legislative session. With many more battles ahead as we get closer to winning, we expect more opposition rolling in from around the country. We will need support from around the country and hope to be part of a growing national and global movement for the human right to healthcare.

We have learned that it all starts with old fashion organizing, talking to people and giving them easy ways to be part of the work. The organizing committees of this campaign were built mainly through one-on-one conversations, but we also utilize a good deal of social networking and new media strategies. Local leaders have built networks of people who we have identified support our campaign and given them easy ways to get involved such as; sign a post card, write an email, leave a voice message, take a photo of them holding a sign, do a quick video interview, etc. People start by signing something and then a few months later they are facilitating a constituent meeting with their elected officials or speaking at a press conference. Since everyone is a stakeholder in having a good healthcare system, practically everyone is a potential leader in the movement to get there. We have also have increasingly realized that the struggle for the right to healthcare is connected to many other issues facing working and low-income people in this country. It not only needs to be considered within the broader framework of people's right to health, including environmental health, but also within a broader movement for jobs, the eliminate of poverty and fighting to undo the systems of oppression - that divide people by race, gender, immigration status and ability - and which enable the greedy few to exploit the vast majority of the people. By building alliances across movements and connecting our struggles not only can we establish a system where healthcare is treated as a basic right, we can build a better world.