Melanie Shouse didn’t plan a memorial service so much as a memorial rally. And the last speaker, Amy Smoucha of Jobs with Justice, delivered a rousing call to action. She spoke about health care reform, but the core of her message could just as well apply to climate legislation, financial reform, or any other progressive cause. I’ve quoted maybe half of her talk below. I recommend watching all of it, both for inspiration and for information.

Smoucha started by likening Melanie’s attitude to Mother Jones’s: “Pray for the dead, and fight like hell for the living.” After describing Melanie as generous and fierce in telling her personal, powerful story, Smoucha emphasized the importance of personal narratives:

“Her story has been so powerful and so compelling and so clear that her life is a beacon helping to guide the movement now throughout the country. So there is going to be a national march–and I didn’t do this, there’s no one in Missouri who did this–there’s going to be a national march that starts this week in Philadelphia. And folks are walking to DC and they’re calling it the Walk to the Finish Line for Melanie. (Applause) And for the most part, the people who are marching are people who, like Melanie, have their own stories–who have lost their loved ones, who themselves are uninsured or suffering with a pre-existing condition or are unable to afford care.

(…..)

So I’ve got some really important news. … Health care reform is not. dead. (audience member: “That’s right.” Applause.) But more than ever we need a disciplined movement and leaders and activists who, just like Melanie did for many years, stay on message, always show up and always be ready to fight. That’s what we need for the next few months. So John Prine has this folk song that I really love, where it’s like ‘blow up your teevees, throw away your papers.’ Blow up your teevees, throw away your papers and just fight for health care reform. Don’t listen to everybody trying to disorganize us. We’re closer to comprehensive health care reform than we’ve ever been in the history of this country. I also want to be very clear. We’re also closer to losing than we’ve been in the history of this fight, and that’s because Congress is stressed  out. They’re afraid of the election and they’re paralyzed because there’s mistrust between the House and the Senate.

At a national level, the president himself is calling them together trying to organize Congress, trying to organize the House and the Senate to come up with a firm plan to get this done, to get comprehensive heath care reform to the president’s desk.

So here’s what our job is. The president’s organizing Congress to … Here’s what we have to do: two things. We have to keep the yes votes in Missouri’s congressional delegation. And we have to poke at the no votes. All … as it comes down to the final moments of this struggle, all the powerful forces–those insurance companies, those for-profit corporations–are going to be trying to peel off votes and turn votes. We have to be vigilant in keeping our Missouri delegation on the side of our families, on the side of comprehensive health care reform. That’s the role that we have. The other thing we have to do is educate and mobilize the public–talk to our friends, talk to our families, talk to our co-workers. I know we’re tired. I know this has been a long fight. But we have to create a huge buzz around: health care reform must get done, a bill must go to the president’s desk

So ask your pastor to pray for the uninsured and for those who are struggling with medical debt at services. Call in to talk shows. And call your congressperson daily until a bill lands on the president’s desk.

Very quickly, the basis for reform is the Senate bill. That bill has to get passed by the House. Then it can go to the president’s desk and become law. We’re one House vote away from health care reform that is the most sweeping legislation that will ever have been passed in this country. In addition, there are some fixes that can be put into a separate bill and can pass through the House and go to the Senate. And all it needs is a simple majority.  (inaudible) So there is a path. There is hope. Don’t let all the naysayers cloud your mind.

What’s in the Senate bill? I’m only gonna tell you that in all the years that I’ve done this and in my three years in this fight, I never expected to get reform as far reaching and comprehensive as what’s in the Senate bill alone. Even before we fix it.”

At 7:30 in the video, Smoucha begins listing what the Senate bill has that she is so proud of. She finishes that list at the beginning of the second video and concludes:

“All of these are things that we have to fight for. And if this bill wouldn’t land on the president’s desk, it would take us years and years and millions of dollars to try to get piece by piece. All of those things are one House vote away from becoming law. One House vote. (…) All of these significant victories have powerful opponents and that’s why this bill has been so fiercely attacked. So Melanie wanted a political rally (inaudible), so the call to action: in her honor and memory, each of us must make passing comprehensive health care reform a daily task until the bill is on the president’s desk. We must call Congress daily. We have to create such a mandate and buzz that Congress reallizes the dire political consequences if they walk away with nothing. If they walk away from this opportunity without a bill, without any changes to our health care system that significantly advance the situation we find ourselves in, then Congress should be afraid to come home. (Applause)

Smoucha listed two events in St. Louis this week and the march from Philly to DC that begins Sunday the 21st and ends on the 24th, the day of Obama’s summit on health care. She urged everyone to sign the lists on the clipboards in the foyer so they could get up to date e-mails about events. Here’s how you can sign up to get the most current information:

Local events are at this site.

The march on DC info is here.

The two local events this week are:

Wednesday, the 17th, at 4:00: a rally outside the Wellpoint offices at 18th and Chestnut. Melanie spoke at two rallies there and tried to speak to Wellpoint officials, who were afraid to let her inside to talk to them. We’re going back a third time on her behalf.

Friday, the 19th, at 11:30: a rally at Shaw Park near S. Brentwood and Bonhomme in Clayton. Activists will build a monument to Melanie and others like her who have suffered at the hands of our broken system. Please bring items for the memorial-pictures, notes, mementos, flowers, and items to honor our loved ones.  NOTE:  You will not get items back.  They will become part of the memorial.

Dress warmly for both of these. They’re outside.

If you can’t make these events, you can still call your congresspeople. Because that is how we can get health care reform.

By the way, John Prine’s song, which has always been one of my favorites too, isn’t actually about health care reform.

Amy Smoucha has worked on health care issues for Jobs with Justice for three years now. That’s dozens of months, hundreds of weeks, and thousands of hours. And that makes her expertise on the subject worth listening to. So I did. When the e-mail below arrived in my inbox, I paid attention–especially to her fourth point.

In fact, within a few days, I will write in more detail about the “national, non-profit, publicly accountable option for health insurance coverage” contained in the Senate bill. Suffice it for now to say that rather than fight the screaming mob about the public option, the Senate did an end run: it eliminated that program and substituted a plan that has the potential–minus the right wing hysteria–to achieve the same thing. An analysis of how useful (or less than) those two programs may turn out to be will be part of my upcoming posting.

But for now, see what Amy thinks of the progress Democrats have made so far:

An open letter to progressives:  ideology kills people

I have been amazed at the rancor and deceit that many politically “right wing” and conservative leaders have demonstrated during the long, heated struggle to pass health reform legislation.  I’m amazed that for political, partisan and ideological reasons, Republicans and Libertarians are willing to lie to their own voters.  I’m awestruck at the monumental steps people are taking to protect corporations, defend outrageous profits and protect a status quo that working people in any political party cannot afford much longer.

Of course, we expect that sort of vitriol and cynicism from the right wing and from conservative political operatives who have lost ground in the last election and are bitterly losing the health care fight.

I am having a much harder time understanding the fierce attack by some folks who are thoughtful, independently-minded and progressive.  Like any significant human and civil rights struggle, we are in a place where we’ve won a lot, we’ve lost some of our demands, and there’s more work to be done to get a final bill out of conference.  Both the House and Senate health care bills represent an incredible step toward real, affordable, quality health care for every person in our country.   Neither of them accomplish everything we need.

I hope we all evaluate the bills and what they accomplish based on the ambitious reforms they include and an understanding of the context in which the measures are proposed. The bils do many things for our communities–like funding clinics and doctors.   It’s important to consider the flaws in the bills alongside a balanced understanding of just a few examples of what we are gaining and winning:

1. The Senate bill delivers health coverage to 94% of Americans –31 million uninsured people will gain access to affordable health coverage.  (The House bill would cover 36 million-95%.)

2. The proposed expansion of Medicaid will provide a lifeline to 15 million low-income and disabled Americans.  Congress is about to enact a significant expansion of Medicaid for both individuals and families up to 133% of the federal poverty level.   Currently in Missouri a family of three is eligible for the state health insurance program if their income is less than $292 a month.  Both House and Senate bills lift the income rules for the whole country to about $2029 a month for that same family of three.  For the first time adults without dependent children will get this coverage.  These 15 million uninsured, low income individuals will gain insurance through a public health insurance program that is affordable and has very nominal out of pocket costs.  This provision will help laid-off workers and part-time workers.  This expansion will revolutionize life for people with disabilities and people living with mental illnesses.  For many of us, when disability strikes, we will no longer have to prove that we are “permanently and totally disabled” and unable to work just to have access to the public option of Medicaid.  We won’t have to stop working just to get health care.

3. Corporate abuses are curtailed and health Insurance companies have been significantly pushed back in both bills. The Senate bill went much farther than we imagined in reining in insurance company abuses.  What’s really in the Senate bill?  Insurance companies will not be able to turn us down or charge us more if we have pre-existing medical conditions. Insurers will be required to spend 85 cents out of every dollar they receive in premiums on health care rather than profits and administrative costs. If not, people would receive rebates from their insurance companies for the difference.  Insurance companies will be banned from issuing policies that have lifetime or annual limits on benefits.  Consumers gain the right to an independent appeal of any decision by an insurer to deny coverage.

4. Both the House and Senate bills bill create a national, non-profit, publicly accountable option for health insurance coverage.  The House bill contains a national public insurance option.  However, even in the Senate bill, people purchasing insurance in the Exchange will be able to choose from national plans, including at least one non-profit plan, supervised by the same department of the federal government that selects health insurance plans for federal employees.  Before the recent invention of a “public plan” demand, progressive health care activists were asking Congress to either open up Medicare for all or allow people to buy into the plans administered by the Office of Professional Management-the same plans that Congress and Federal employees have.  We just won a long-standing demand.

5. We cannot “start over” and get more progressive reform through Congress any time soon.  Getting landmark legislation passed is a treacherous, long chess game, especially when that legislation has powerful corporate enemies or extends significant civil and human rights.  Unprecedented political capital and economic capital have been spent-the years spent making health reform a key issue in the last election, the storybanks, the canvasses, the phone calling.  We all put our best game on the field.  It’s time for a final push to improve the legislation in conference committee and to plan on how we will take this momentum and build and expand on our victory.  Many leaders in the health reform movement predict that if health reform fails now, we will not have another meaningful effort for 15 to 20 years, if at all.  If health reform fails now, the insurance companies and for profit health care corporations will laugh (at us) all the way to the board room.

This fight has been long and vicious because Congress is creating federal rules that make insurance companies behave.  Insurance companies are going to be regulated, and they don’t like it.  So much is at stake.  It is very dangerous to forgo these incredible victories because they are not far enough, especially since losing means millions of struggling Americans will have to continue in the health care system as it is for many, many years.  I’ve spent the last three years talking to hard working people throughout Missouri who will get real, measurable, concrete help from these legislative changes.  For some of them, their lives literally hang in the balance.  We have a responsibility to stand beside and for the uninsured working people who will gain much from these bills.

As a few progressive groups send emails around to “kill the bill” (along with the tea party) or “a bad bill is worse than no bill,” insurance companies and right wing political operatives throw fuel on that fire. All of us should deeply consider the consequences of
squandering this opportunity to move our health care system several strides forward.  Kill the bill, and insurance companies win.   I believe we are better than that.

Amy Smoucha, of Missouri Jobs with Justice, says that getting health care reform passed is like an election. We have to throw everything we’ve got at it.

Specifically:

Keep writing letters to the editor, and don’t neglect the small newspapers, like the Kirkwood Times and the various Suburban Journals in the St. Louis area. Flood those publications with your thoughts.

Check out Missouri Health Care for All, a coalition of 110 organizations working on the issue. One of their projects is collecting health care stories–and not just the horror stories, though they want those too. (Speaking of them, did you see that Crystal Lee Sutton, the real life “Norma Rae”, died of cancer because her health insurance company refused to pay for necessary medication. Sally Field, who played the movie role said, “It is almost like, in a way, committing murder.”) But back to health care stories besides just the horror stories: the website wants stories from middle income people who are struggling to pay for the coverage they’ve got; from small business owners who complain their their premiums have doubled over a few years; and from pastors talking about the moral obligation we have to care for each other.

The purpose of collecting these stories is to have a stock of them ready. Recently a legislator wanted a small business person to talk to a news outlet about how difficult it is to get insurance coverage for employees. Missouri Health Care for All had someone who could feed that story to the publication. So go tell your own story.

Smoucha stressed “visibility, visibility, visibility”. Signs are one way to be visible. Lots of people are on the fence about this, and seeing a sign in your yard might just tip someone in our direction. You can order a sign here and give HCAN a little love at the same time.

Instead of visibility, you might go for audibility: Call. Yeah, yeah, I know you already did that. But when was the last time? The staunchest progressives, like Emanuel Cleaver and Lacy Clay, need to be thanked. Other supporters of reform need to be kept in our camp. McCaskill, especially, with her desire that the public option be “handcuffed”, needs to be inundated with calls. All through August she was saturated with right wing callers. Trust me; they didn’t limit themselves to one call and maybe not to one call a day. Think of our calls to her as part of a deadly serious tug of war, with teabaggers on the other side. Grab the rope.

And Smoucha even recommends calling Bond. No, he isn’t going to vote for health care reform, but we should treat him as a movable vote–for this reason: the more constant the pressure we keep on him, the less emboldened he will be about filibustering it. Right now, he has been given dutch courage by all the tea party apoplexy. He would identify with that purple faced, vein popping anger. We need to let him know that we have the numbers.

Hell, we need to let the public know that we have the numbers. Enough with this “silent majority” nonsense. It’s time to demonstrate. Opportunities will abound this next month. Seize them. Here are three in the St. Louis area:

Reform supporters gather every Friday in Kirkwood. Here’s a notice they sent:

A group of supporters of health care for all will be demonstrating each Friday in front of Kirkwood City Hall. That’s on Lindbergh Blvd which is called Kirkwood Rd at that point and next to the RR tracks. You can park behind city hall. Franklin McCallie has a load of really great signs, and about 20-25 people show up each time. See below for the schedule. They alternate lunch hour and rush hour every other Friday. For the most part, drivers honk and give the thumbs up to show their approval of our message. This reflects the national polls that say the majority of Americans want REAL health care/insurance reform.

For this coming Friday (18 Sep) we will be there from 11:30 a.m. to 1 p.m.

For the next Friday (25 Sep) we will demonstrate from 4:30 p.m. to 6 p.m.

Also in Kirkwood, OFA is recruiting volunteers to work the Greentree Festival this Saturday, the 19th from 1:00-4:00. Sign up here.

And the biggest one: A demonstration Tuesday, Sept. 22 at noon across from Union Station, in front of the WellPoint offices. Last May, Clark wrote here that WellPoint controls the market in five Missouri cities:

In Columbia, it has 85 percent of the market.

In Jefferson City, 77 percent.

In Joplin, 94 percent.

In Springfield, 68 percent.

In St. Louis, 67 percent.

Let’s challenge that near monopoly. If you live in St. Louis, finagle an extra long lunch hour and show up. I’ll have more details as the time approaches.

As demonstrations are announced, post them here, in the diary section in the right hand column.

We’ve got to be out on the streets for the motorists to honk at. We’ve got to be talking to our neighbors.

And we’ve got to financially support the organizations that grubbing and sweating to make progress on our issues in between elections–not just health care, but all progressive issues. The Supreme Court is currently considering whether to broaden the “free speech” limitations on corporations in elections. If that happens, the only way we’ll have to fight back is to organize, organize, organize. Give money to Jobs with Justice (check out the Kansas City and St. Louis groups), the Missouri Budget Project, ACORN, and any other group that is toiling year round on social justice issues.

Amy Smoucha, health care organizer for Jobs with Justice in Missouri, is taking the long view of health care reform. Not that she doesn’t believe that the country needs a health care reform bill this year. She absolutely does. But she knows the bill will have areas that need significant improvement, so she’s into organizing for the long haul.

On Monday, speaking at the West County Democrats meeting in St. Louis, she said that even if–god forbid–we don’t get a public option on this bill, that doesn’t mean we’ve failed. It means that we’ll get hugely valuable changes and that we’ll organize and start pushing again for a public option. The difficulty in getting the public option is that even if we get it into the conference bill, we’ll need sixty votes to get it out of the Senate. And Ted Kennedy died. The latest on getting a temporary replacement for him this fall is that it’s iffy:

Within the solidly Democratic Massachusetts political establishment, there’s widespread desire to fill the vacancy with a placeholder who can give the state a second Democratic vote in the Senate until a replacement for Kennedy is selected in the January special election. But the idea of scrapping the state’s 2004 succession law — and the message it would send to voters — is troubling many lawmakers and giving them pause. […]

Overriding that law so soon afterwards with another one, again with an overt political design-to provide a possibly critical vote in favor of President Barack Obama’s agenda this fall-is proving too much for some legislators to swallow.

“Should our loyalty be to being protective of the democratic process rather than to our partisan positions?” asked Democratic state Sen. Stephen Buoniconti. “A lot of members are uncomfortable and leaning toward saying we did a good job in 2004.”

While I can sympathize with their reservations, I agree with Steven Benen’s point that Republicans have never had any such hesitation. And anyway, call me unprincipled, but I’d change the law, on the assumption that the health care of millions is more important than behaving in a non partisan fashion on this.

Democrats can get a bill passed if they replace Kennedy; or if they forgo a public option, thus luring one or two Republicans to vote in favor; or if they use reconciliation. (But that could only be used for the budgetary aspects and something like forbidding insurance companies to drop people for pre-existing conditions might not make it through the legislative maze on its own.)

Smoucha urges people not to underestimate the importance of controlling the “pre-existing condition” scam or the importance of other aspects of the bill:  

• The current bill forbids insurance companies to dump people for pre-existing conditions. Michael Bersin wrote recently about a family whose child was born with congenital heart disease. Although the mother had insurance that paid for the baby’s delivery, the insurance company then claimed that the child had a pre-existing condition and refused to pay for any treatment.

  Here’s another jaw-dropper: “[I]n eight states, plus the District of Columbia, getting beaten up by your spouse is a pre-existing condition.”

  If we can stop such immoral, outrageously greedy behavior, we haven’t exactly failed.

• Medicaid will cover more people. Eleven million Americans currently without health care would get it through Medicaid. That’s not failure.
• We lack enough health care professionals. Rural Americans, for example, even if they have coverage, often find it difficult to get treated because we don’t have enough doctors to supply rural areas. The bill provides for funds to pay for medical and nursing school for students, contingent on their willingness to work a number of years after graduation in underserved areas. Rural and inner city Americans would not feel the bill had failed them.
• Insurance companies would not be allowed to drop people because they got sick. If they’re forced to stop doing that, we haven’t failed.
• Hard caps would exist on out-of-pocket expenses to stop bankruptcy that many people with catastrophic illnesses face even if they have coverage. We could succeed in stopping hundreds of thousands of bankruptcies a year.
• The bill would require insurance companies to spend a given percentage of the premiums they collect–say, 85 percent–on actual health care. Currently they spend as much as 40 percent of the premiums on other costs–like the paperwork involved in denying claims. They often have a policy of denying one out of every five claims. Requiring companies to pay for treatment is success.
• There would be no more cherry picking. If someone applies for insurance, he gets it. Does that sound like failure to you?

So the bill so far is full of boffo reforms. Still, you know we need that public option. And we have to push hard for it this next month. More on Smoucha’s ideas about that tomorrow.

Don’t just sit there fuming because the Allen Icet entourage is attempting to turn down 100 million free Medicaid dollars for people earning less than half of poverty level. Get your little heinie down to the west side of the Old Courthouse in St. Louis this Sunday afternoon at 2:00 for a protest rally. Give the Post-Dispatch an excuse to publicize what the Republican House caucus is up to.

That was the most important message Jobs with Justice organizer Amy Smoucha had for me. She sees the budget fight in the state lege this year as seminal. Out of the current economic crisis and the stimulus funds being used to counter it, Missouri will emerge either as a state with smaller government and few, if any, social services (go ahead, guess which group wants that outcome) or as a state that is more responsive to the needs of the people in the community (and guess who wants that end result). Federal stimulus funds are coming, but Icet et.al. are doing their damnedest to take education and transportation money while concocting a succession of excuses for turning down additional Medicaid money, as well as for chopping … but I stray. I started out to tell you about Amy Smoucha. Let me reserve more info on the vagaries and cruelties of the House budget for the end of this posting.

Smoucha organizes statewide action on health care issues. She started out in the health care trenches as soon as she got out of college, working at Regional Hospital in St. Louis, where she helped people apply for Medicaid benefits. The job in itself was an eye opener because most of the people she helped were African-Americans. She’d been raised in a white, fairly racist culture in Chicago, but she was impressed by how similar her clients were to her own mother–a clerk at Sears, who had never had health insurance.

Amy had barely adjusted to the harsh reality of what her clients faced, when local and state officials began pushing to close down Regional Hospital, as well as neighborhood clinics in St. Louis. These were the only places where uninsured people could go for treatment–88,000 of them. The mantra from the officials was that other clinics would have to absorb those folks. As if that were possible.

A long fight, with ACORN in the forefront, ensued, with the result that the clinics were saved and a few hospital beds. Smoucha moved on to do similar work at Legal Services, but two years ago, she had had enough of holding her finger in the dike. She saw a job opening for a health care organizer posted at Jobs with Justice and she went for it. She wanted to effect systemic change instead of–always and forever–only helping people into lifeboats while the Titanic slips lower into the water.

Now Smoucha works to make Missourians aware that this health insurance crisis affects us all: from those that have insurance but have to forgo raises because the insurance is costing their employers so much money, to the low wage workers who don’t have insurance at all. She sees her job as helping to build a movement toward affordable health care for all. That means working across party lines (and, after all, Jobs with Justice is a non-partisan 501c3).

Missouri is quite the challenge for someone like her. Try as she will to convince working people that they need elected officials who understand the need for health care for all, she knows full well that our state is a proving ground for competing ideologies. To illustrate, I give you two words: Allen Icet.

In addition to spurning the 104 million free dollars that is being made available in Medicaid funds for people earning less than half the poverty level, the House Appropriations Committee is also slashing social services, thus effectively refusing to use federal stimulus money on those areas.

The Missouri Budget Project estimates that based on the proposed funding cuts, at least 77,120 Missourians will be directly impacted by the cuts. At a minimum, Missouri will forfeit $232 million in critical federal funds which, could result in a loss of as many as 5,100 Missouri jobs.

emphasis MBP’s

(MBP has an analysis of the proposed House cuts.)

Smoucha points out that Missourians won’t pay any less in federal taxes just because we snub federal stimulus funds. And might I add: This is nuts! Fortunately, there are enough sane Republicans in the Senate to help Democrats put the brakes on before the ideologues in the House can run the state train off a cliff. Senator Eric Schmitt, R-Kirkwood, assured attendees at last night’s town hall meeting that the Senate had voted this week to accept the bulk of that free Medicare money. As for the rest of the House cuts to social services, it remains to be seen how much the Senate will attempt to restore. Once their budget is complete, the two chambers will work to resolve the differences.

Meanwhile, Amy Smoucha is doing her part. She and the many people she works with are lobbying legislators, cooperating with local faith leaders to get out the message about how cuts in the state budget are harming the poor, urging activists within her purview to write letters to newspapers and call legislators–not just to leave a message, either, but to request that the lawmaker call them back or at least write a response. And right now, Smoucha is looking forward to that rally at the Old Courthouse this Sunday and arranging for media coverage.

So, as I said, get your little heinie down there. We need bodies for the local TV stations and the Post-Dispatch to photograph. I’ll be there videotaping it. See ya.

This posting is the third in a regular series about activists that I’m writing with the assistance of the St. Louis Activist Hub. The first two postings are here and here.