Seachange Bulletin #121November 3, 2003Seachange Bulletin ArchivesEmail the editorSeachange Bulletin #121: Hawai'i Nurses' Rebellion, Healthcare Crisis & Reform The staff nurses of Hawai’i rose up on October 23rd, asserting their strength and projecting their vision. Organized as the rank-and-file Committee to Save the Hawai’i Nurses Association (HNA), in convention they forced through a bylaw amendment to guarantee the HNA Board of Directors a solid staff-nurse majority and thwarted the drive by HNA’s Collective Bargaining Organization (CBO) Board of Directors and Labor Director Sue Scheider to bring the CBO into ANA’s United American Nurses (UAN). HNA had established a separate collective bargaining program through amending its bylaws in 1979 to create a CBO insulated from management influence and domination. This separation evolved into two distinct organizations, each now suing the other in court for control of dues income and power to decide the future of HNA. This innate tension was brought to the fore with the importation from DC of CBO director Sue Scheider early in 2002 and a series of poorly run and inadequately supported strikes in 2002 and 2003. (See Seachange Bulletins #106 and #120 for background on this.) Staff nurses and their supporters were told to hold car washes and yard sales to promote their issues. Charges of fiscal mismanagement and corruption flew back and forth, with a federal court to decide which side, if either, is entitled to collect the members’ dues, with the cash in the meantime going into a special holding account. HNA bylaws are extremely democratic, but few chose to become involved in its internal affairs until this year. As the tension mounted, democratic norms were violated and ranks closed in leadership circles against any independent thinking. For example, the chair of the CBO board Gail Ramiscal was expelled from the CBO for "dual unionism" by the majority of that board and replaced by Bill Richter, who had been groomed by ANA and UAN for a leadership role. Rank-and-file leader Michelle Paik, opposing a proposed dues increase until there had been an accounting of all the fiscal irregularities in the association, and having gathered two hundred and fifty signatures on a petition supporting that opposition, was expelled also from the CBO. Mary Hackney, who had placed a bylaw amendment calling for disaffiliation from ANA before the HNA House of Delegates scheduled for October 23rd, was also expelled. Besides a dues increase, the CBO board and Sue Scheider were calling for the change of CBO’s name to the Hawai’i Nurses Union, its separation from HNA, and its affiliation to ANA’s union arm, UAN/AFL-CIO. They had also proposed bylaw amendments to allow them to do legally what they had already done in practice regarding dissidents, to discipline and even expel members at the discretion of the board. This move was so outrageous, however, that it was pulled before convention. Each body, HNA and CBO, had scheduled Houses of Delegates to take place on October 23rd, HNA in the morning and CBO in the afternoon. The stage was set for the staff nurses to rebel and to transform the situation into a united HNA under their leadership, independent of ANA and its UAN, able to fund a program of action to meet the members’ needs. The 2002 House of Delegates had resolved to invite other unions to come and participate in the discussion and debate on whether the staff nurses of Hawai’i would be better served by being part of the UAN or independent, able to seek out other affiliations. This invitation was never officially extended, so Hawa i’i staff nurses invited their colleagues from California, Maine and Massachusetts, members of the American Association of Registered Nurses, to come and engage in the dialogue. These guests from other states participated in town meetings as living proof that there is life outside ANA and that staff nurses can organize for power using their own resources, extending the hand of solidarity to like-minded nurses everywhere. They also participated in crash courses in parliamentary procedure and get-out-the-vote phone banking. The HNA House of Delegates started quite late and dragged on until the pre-ordained adjournment at noon, thus preventing time to consider the bylaw amendment to delete ANA from HNA’s affairs. Hired security guards played a major role in these delays by vigorously restricting admission to the meeting and even harassing elected delegates, such as Michelle Paik, who did not meet the approval of the HNA Board. So tight was admission that even ANA president Barbara Blakeney had to plead with security to be allowed in. However, she was not even given time to address the meeting. Some of the staff nurse guests from other states had signed up as members and paid dues in order to be able to enter the hall to observe and document. Deborah Burger, president of the California Nurses Association, for example, passed muster with the HNA staff but was blocked by the security guard who refused to admit her with her California driver’s license. The conduct of the meeting itself was deplorable, according to many who left early in disgust. "We should have parliamentary procedure in there," was one member’s response to the refusal to recognize delegates standing at the mike. Another observed that "the union has lost the vision." One member noted that there was no voting delegate from the big island of Hawai’i, since the one elected delegate could not make it to O’ahu, and complained that "past practice" was to seat a member from an under-represented district as a delegate to maintain broad representation. Noting all the empty seats in the hall, another member asked rhetorically, "Why aren’t vacancies filled?" Nevertheless those present, despite strong opposition from those on the podium, managed to amend the proposed bylaw amendments to restructure the HNA board to create a solid staff nurse majority, with one seat for each two hundred members, with each bargaining unit guaranteed at least one seat. A special HNA House of Delegates is to be convened in six months to take up whatever business was not yet addressed, namely disaffiliation from ANA. After a lunchtime caucus, the staff nurse insurgency continued into the CBO House of Delegates. The first fight was over who would be admitted as a voting delegate. The 2002 CBO House only had nineteen participants. The CBO Bylaws Committee had met several days before and decided on a strict reading of the CBO bylaws, whereby those elected each summer do not take their seats until January first, even though past practice, since 1979, had been for those most recently elected to take their seats right away. This proclamation evoked a clamor of outrage. When asked whether the delegates themselves could decide on the credentialing procedure, CBO director Sue Scheider announced, "Our members cannot decide that." It was then announced that recently elected delegates could be seated to fill the vacancies left after seating the small 2002 delegation. The staff nurses who were expelled by the illegal actions of the CBO rump board were explicitly locked out. On several occasions, the security guards became distracted and small groups of the excluded were able to slip in. The Honolulu Police Department was called to eject those who had been expelled from the CBO, but the only disturbances they saw were caused by the old guard on the podium. Those expelled were thus left in place to continue the meeting. One member left the CBO House early, stating that he was "so disgusted." During a brief break in the proceedings, the staff nurses caucused, compared notes and counted heads. Then, feeling their strength, they went back in to vote down every proposal coming from the podium. By the end of the day, the discredited CBO board was being outvoted by a margin of nearly three to one. The proposal to change the name from CBO to HNU, and separate from HNA, was soundly defeated. The dues increase to allow for a per-cap payment to the Hawai’i AFL-CIO likewise went down in flames. The chair’s wish to allow the representatives of the UAN time to speak was solidly rejected. The proposal to affiliate to the UAN was withdrawn and never put to a vote. Then Colleen Lee took the mike to move that the entire board be removed and replaced by a staff nurse slate committed to democracy and independence. That motion was ruled out of order by Bill Richter, even though bylaws specifically provide for such a move. Calls to appeal the ruling of the chair were likewise ruled out of order. A vice president of the Hawai’i AFL-CIO, sitting on the daïs beside usurper Bill Richter, betrayed his principles as a professional parliamentarian by letting this travesty take place. The meeting went into extra innings, not adjourning until 6:30, half an hour beyond the scheduled time. The Hawai’i staff nurses demonstrated extreme steadfastness and ability in weaving through all the roadblocks placed in their way by two sets of bureaucrats, the stacking of delegations and the ANA-UAN presence. One such roadblock is a temporary restraining order obtained by the CBO board to block the implementation of any decisions by the HNA House, pending a ruling of the federal court on their allegation that HNA was acting in violation of the National Labor Relations Act. A hearing on October 31st ruled that this question would be joined to the financial inquiry, scheduled to be heard on January 5, 2004. Nevertheless, with hard work and purity of vision, the Committee to Save the Hawai’i Nurses Association, gathering strength with each obstacle overcome, will prevail in six months when independence under a staff-nurse-led leadership will usher in a new day for nursing and patients in the State of Hawai’i. Hawaii nurses protest meeting snub Honolulu Star-Bulletin, October 24, 2003 <http://starbulletin.com/2003/10/24/business/story3.html> Members of the Hawaii Nurses Association protested yesterday morning upon being excluded from that organization's annual meeting at the Blaisdell Center. A long-standing dispute between the HNA and the local nurses' bargaining unit over the management of union dues boiled over last month into a lawsuit. The collective bargaining unit, which filed the suit, charges that interference by the HNA board of directors in the fiscal and decision making autonomy of the union is a violation of federal labor law. It also challenges HNA's assertion that the union is a subordinate entity, thereby entitling HNA to manage the union's money. The HNA asserts the bargaining unit is not an autonomous organization. The court has appointed a special master to collect dues and handle the organizations' bills until the case is resolved. The nurses' bargaining unit had its annual meeting later in the day. © 2003 Honolulu Star-Bulletin Michelle Paik, RN, Elected CBO Board Director, January 2004 - December 2005, reflecting on this article, wrote: Hey everyone, This link <http://starbulletin.com/2003/10/24/business/story3.html> takes you to the picture on the first page of the Star-Bulletin business section. This is Pam Keanini Ross of Saint Francis West. This was taken at the HNA House of Delegates on October 23rd after staff nurses had to fight tooth and nail to get a bylaw amendment passed that would allow staff nurses to have a majority vote on the board of directors of their association. It took several tries after thwarted attempts by the HNA leadership, but the staff nurses were successful in getting a majority seating on the board. Without this amendment added it would definitely have silenced staff nurses in our association with the original proposed structure that was intended to go through. I think our association has to think long and hard about what they did and make it right. They purposely let time run out to not allow for a disaffiliation vote on ANA. What these new amendments did allow for, however, was to alleviate the anarchy of the CBO who wanted to bring UAN affiliation to a reality, thereby really crippling the nurses in the organization. In the afternoon CBO House, every proposal and amendment was voted down by the power of the staff nurses in order to protect themselves against a stifling and aggressive UAN whose pure intent is to collect our dues money as well as raise our dues contributions and not allow for dissent by silencing members. Although feeling beat up, our victorious staff nurses have no idea what an impact they have made on their association. I was pained to hear from nurses after the delegation some disturbing comments from Sue Scheider (director of CBO), as a nurse stated hearing her say, "Members don't have a right ... only the board decides" and from Susan Bianchi-Sand (Executive Director of UAN) a nurse states her comment was, "these staff nurses don't deserve anything" (this comment coming after staff nurses voted not to hear her speak). The ANA and the UAN presence did not work in the HNA or CBO house of delegates to persuade any staff nurse who understood that the only reason they were here was to protect their share of Hawaii Nurses' dues money! How dare they not be here for our strikes or when we really needed their support, but only come to claim and protect our contributions we make to their organization! And the audacity they have to insult our intelligence into having us believe that they were there for any other reason is appalling and downright disrespectful!!!! And if we stay a part of the ANA, they can take us anyway in 2005. Remember ANA=UAN - they are not going away until we tell them a second time! I am sorry to say that they did not get the message! I am proud of our staff nurses, Colleen Lee, Pam Keanini Ross and all the rest that contributed into saving our HNA and preserving our voice. We look forward to voting out the ANA on April 23rd, 2004, and keeping our dues money in the state of Hawaii. Hawaii Nurses Win Back their Professional Voice Committee to Save the Hawai’i Nurses Association, October 31, 2003 Through incredible odds and hard-line attempts at blocking staff nurse proposals to obtain a fair representational voice in their Hawaii Nurses Association, staff nurse leaders continued to push through staff nurse representational language in the governing rules of the Hawaii Nurses Association! Although staff nurses were not successful in obtaining perfect language, we were successful in changing our organizing to a one board structure represented by a majority of staff nurses! This will alleviate all the confusion and put the power of the association in our hands. The only way we can exert this power is to put strong representatives in place that can really speak for us! Vote for nurses from your facility that can speak for what you want. We successfully said NO to the name "HNU" and retained our identity - THE HAWAII NURSES ASSOCIATION!! We said no to the UAN and in six months we will take control over our association by breaking our financial ties to ANA and bring our money home to HAWAII NURSES!! CONGRATULATIONS! YOU have taken back your organization!!! Editorial Comment: Solidarity donations to help the Hawai’i nurses complete their uphill march to democracy and independence, advocacy and empowerment, may be sent to this account: Coalition to Save HNA First Hawaiian Bank, Kaneohe Branch Windward City Shopping Center 45-480 Kaneohe Bay Drive, Bldg H Kaneohe, HI 96744 808-261-1898 Judge delays move to oust nurses’ union A dispute between the Hawaii Nurses Association and its collective bargaining unit is set to go to court Jan. 5 Lyn Danninger, Honolulu Star Bulletin, November 1, 2003 <http://starbulletin.com/2003/11/01/business/index1.html> Federal District Judge Helen Gillmor yesterday granted a request by the collective bargaining association of the Hawaii Nurses Association for a preliminary injunction to prevent HNA implementing measures that the union says would effectively disband it. At HNA's annual meeting Oct. 23, delegates voted to set up a governing council on collective bargaining. Yesterday's preliminary injunction freezes that action until a hearing relating to federal lawsuits filed by the two groups can take place. The hearing is scheduled for Jan. 5. Hawaii Nurses Association is the professional organization representing registered nurses, while the union handles salary and benefit negotiations on behalf of nurses with employers. The on-going dispute between the two sides relates to financial management of union dues. The union asserts that interference by the HNA board of directors in its fiscal and decision-making autonomy is a violation of federal labor law. The union also alleges HNA officials failed to adequately manage and account for union dues collected from its members and have interfered with union decisions. HNA has asked the court to dismiss the case while the union has asked the court terminate its association with HNA. HNA asserts the union is not an autonomous body, but a subordinate entity. Therefore it has the right to manage the union's money. HNA also said that the union is required under HNA articles of incorporation to participate in arbitration. The court earlier appointed a special master to oversee all financial matters until a determination on the complaints can be made. HNA attorney Margery Bronster characterized yesterday's proceedings as a temporary delay. "What's important is to recognize the court did not do anything to change the vote. It's just a delay of the implementation," she said. But union attorney Tony Gill said the ruling effectively freezes the result and will give everyone time to resolve the situation. "Our goal is to create a stable situation through this injunction so these issues can be argued out," he said. The dispute between the two groups is not the first of its kind. Nationally, the labor arm of the American Nurses Association, The United American Nurses, a union affiliated with the AFL-CIO, became autonomous on July 1. It represents more than 100,000 nurses at the national level. The Hawaii Nurses Association has been affiliated with the ANA for many years on a professional level, but now a union vote is required to determine whether to affiliate with the UAN. That vote has been postponed by the dispute between the HNA and the union. A smaller labor group that severed its affiliation with the ANA is also interested in representing Hawaii nurses' labor interests. Union representatives from the California Nurses Association and Massachusetts Nurses Association have been in Hawaii. Some within HNA favor an alignment with the California and Massachusetts group as an alternative to the current collective bargaining association, but no vote on that possibility will be likely for about another six months, Bronster said. © 2003 Honolulu Star-Bulletin The following letter was submitted to the Honolulu Star-Bulletin by staff-nurse leader Michelle Paik, RN, staff-nurse director-elect to the HNA Board of Directors, to correct the inaccuracies presented in the article reprinted above: A comment by Ms. Bronster in this article printed November 1st is incorrect. I would like a correction to be reprinted. I have attached the original article to this email. The incorrect information: "A smaller labor group that severed its affiliation with the ANA is also interested in representing Hawaii Nurses' labor interests. Union representatives from California Nurses Association and Massachusetts Nursing Association have been in Hawaii. Some within HNA favor an alignment with California and Massachusetts group as an alternative to the current collective bargaining association ... " The correct information: California Nurses Association and Massachusetts Nurses Association are interested in helping Hawaii nurses' gain independence from ANA, in the same way they have done. A majority of nurses in HNA do NOT favor an affiliation with the United American Nurses (AFL-CIO). Because UAN is a subsidiary of the American Nurses Association (ANA), Hawaii nurses' don't have a choice in becoming a part of the UAN as long as we are still under ANA. A majority of our nurses favor independence from ANA and would like to have a strong association "MODELED" after the California nurses' and Massachusetts nurses' associations and many other state nursing associations that have severed their ties from ANA and have brought their dues moneys home and have become very successful. These nurses' associations communicate with each other in an ongoing effort to promote nursing practice and patient safety issues across the country. Their interest lies in the fact that ANA was a strangle hold for their associations financially and now they have their dues moneys working for their nurses instead of paying it out to a national organization that they felt did not recognize staff nurse issues and patient care advocacy and safety at the level it made the most difference: "the patient's bedside." Although the article states that the UAN is autonomous of the ANA, this is not altogether true. The ANA, through its bylaws, will still dictate the structure and rules of its subordinate organization, the UAN. Hawaii nurses' feel that the only way to protect their patients here in the state of Hawaii is to pull away and become autonomous from this type of political monster that has plagued and prevented Hawaii nurses' from really protecting their practice and patients for too many years. It makes sense that other state nursing associations have done the same, and are sharing their message across the country. With this autonomy, the California Nurses' Association has passed in their own state safer nurse-to-patient staffing ratios that will take effect in January 2004. Massachusetts will be next in passing this legislation in their own state. Although ANA speaks "safe staffing," they were unsuccessful in passing this type of meaningful legislation where it makes a difference to nurses and patients! The only people who are interested in maintaining a relationship with HNA are the organizations who currently collect 25% of our dues money, and are seek ing to collect more if Hawaii Nurses' allow a UAN takeover. Thank you very much for correcting the misinformation. I know that as a journalist you are interested in obtaining and reporting the truth. Please contact me if you have any questions. ... Aloha Health Reform Hawai’i: Bill for universal isle health care barely stays alive Many who testify say the plan is premature and needs more work Pat Omandam, Honolulu Star-Bulletin, February 5, 2003 <http://starbulletin.com/2003/02/05/news/story6.html> A bill that would set up a state authority to create and oversee a universal health care system in Hawaii remains alive but appears to be in critical condition at the state Legislature. The measure, approved by two House committees yesterday, was opposed by Republican legislators along with a few unions, health care organizations and insurers. "I just don't think we have any business trying to aggressively pursue something that half the country has already shot down as being a bad idea," said state Rep. Bud Stonebraker (R, Kalama Valley-Hawaii Kai), a member of the House Health Committee. Even Democrats questioned the majority-backed bill during yesterday's joint hearing. Still, House Health Chairman Dennis Arakaki (D, Kalihi Valley) successfully urged majority colleagues on the Health and Human Services panels to approve House Bill 1617 with amendments so discussion of the medically uninsured in Hawaii can continue. Arakaki said the state spends about $5 billion in health care costs each year, but that money is unequally distributed. He sees no reason why those health care resources can't be utilized by everyone in the state. "I think the idea is not to be spending more," Arakaki said. "The idea is to spend wisely with what we have." The measure, as amended, would create a Health Authority Commission to run a statewide health care system. A separate panel would first determine which benefits should be provided to all Hawaii residents, while the five-member commission would come up with an overall plan to make it work. The bill was sent to the House Labor Committee. Labor Chairman Marcus Oshiro (D, Wahiawa) said yesterday he will likely hear the bill next week. Proponents believe pooling the premiums people pay for health insurance would allow the commission to contract health care providers to insure all state residents. Hawaii has about a 10 percent uninsured rate. "The Health Authority will provide a way to pool the vast resources being committed to a very disparate health care delivery system and turn it into a rational efficient service delivery system," said Jory Watland, executive director of the Kalihi Valley Community Foundation. ... A ‘Costco’ for health Care Entree membership promises discounts but is not medical insurance Lyn Danninger, Honolulu Star-Bulletin, August 11, 2003 <http://starbulletin.com/2003/08/11/business/story2.html> Amid rising health insurance premiums in Hawaii and a high number of working uninsured, the health discount card has entered the marketplace. For a monthly fee of less than $100, depending on the plan, the cards promise reduced rates at participating pharmacies, dentists, hospitals and doctors' offices. Texas-based Care Entree has been selling its product in Hawaii for the last couple of years. A local representative of the company could not say how many Hawaii customers had signed up, and a corporate representative could not be reached for comment. Care Entree recently offered members of Small Business Hawaii a rate of $64.95 per month for a family of four or more. Supporters of the discount card system and those who sell it say it is an affordable option for people unable to either access or afford a health insurance plan. By paying cash at the time of service to providers, members receive discounts. According to its Web site, Care Entree members can receive discounts ranging from 15 percent to 50 percent or more. But members have to pay cash - no credit cards - at the time of service in order to get the discount. ... Health often suffers with lost insurance More isle residents are relying on community centers that cannot treat all ailments Helen Altonn, Honolulu Star-Bulletin, August 21, 2003 <http://starbulletin.com/2003/08/21/news/story9.html> A 52-year-old Aiea man who lost his job nine months ago says he feels he is on a merry-go-round, going in circles trying to find work and take care of his medical problems. Dennis Carreira is one of more than 27,300 uninsured residents depending on the state's 10 community health centers to meet their health needs. Uninsured patients have increased 67 percent since 1997, said Beth Giesting, executive director, Hawaii State Primary Care Association. The Kokua Kalihi Valley center has had the largest percentage increase, but the Kauai center, which just opened, has the greatest percentage of uninsured patients, she said. Centers offering dental services have extensive waiting lists, she said. Carreira goes to the Waikiki Health Center for treatment of myriad health problems, including high blood pressure, asthma, Type II diabetes, bronchitis and psoriasis. He lost his medical insurance when he lost his job at a parking garage, he said. His wife works at a hospital but missed a deadline to get him on her plan, and he did not qualify for the state's QUEST program because his wife earns $20 more than the eligibility limit, he said. ... Health coverage declined in 2002 The situation in Hawaii mirrors the nation, though not as severely Anthony Sommer, Honolulu Star-Bulletin, September 30, 2003 <http://starbulletin.com/2003/09/30/news/story5.html> The percentage of Hawaii residents without health insurance increased between 2001 and 2002, mirroring a two-year national trend. However, the growth in Hawaii was relatively small compared with most other states and the Aloha State remains one of the best in terms of health insurance coverage. A US Census Bureau report issued today showed the percentage of Hawaii residents without health insurance grew to 9.8 percent last year, compared with 9.5 percent in 2001. Joan White, executive director of the Hawaii Uninsured Project, estimates there are about 120,000 Hawaii residents without health insurance. About 50,000 to 70,000 are employed but don't work the required 19.5 hours a week at any one job to be covered by health insurance. "Many have two or three jobs, many earn commissions only, many are part-time workers," White said. About 25,000 uninsured people in Hawaii are eligible for Quest, but haven't applied for a variety of reasons, including language barriers and lack of Quest offices in rural areas, she said. Quest provides managed-care health coverage to low-income families. ... Taking aim at health costs Local insurance giants HMSA and Kaiser present regulators with plans designed to address growing employer concerns about rising premiums Lyn Danninger, Honolulu Star-Bulletin, October 10, 2003 <http://starbulletin.com/2003/10/10/business/story1.html> In an effort to stem the growing number of complaints from businesses about rising health plan premium costs, Hawaii's two largest health insurers are seeking approval of new, less costly alternatives to their most popular plans. The plans are not intended to replace their existing offerings, but are responses to marketplace demands, said both Kaiser Permanente and Hawaii Medical Service Association. The plans were presented yesterday at a meeting of the Prepaid Health Care Advisory Council. The group, which advises the state Department of Labor, is made up primarily of representatives from business and health care. It reviews all health plans offered in Hawaii to see if they meet benefits standards set by the two predominant plans in Hawaii, Kaiser's health maintenance organization plan and HMSA's preferred provider plan. They then make recommendations on plan approval or disapproval to the state's director of Labor and Industrial Relations, presently Nelson Befitel, who has the final word. ... Privatization sought for state health fund Unions are urging the change, but the state has concerns about it Richard Borreca, Honolulu Star-Bulletin, October 14, 2003 <http://starbulletin.com/2003/10/14/news/story3.html> Problems with the new state health fund are forcing an odd role reversal for state management and public employee unions. The unions are demanding more efficiency and are looking to replace unionized state workers with a private company, while state managers say the health fund must also consider the workers' rights and job conditions. The bureaucratic tempest started in 2001 when the Legislature scrapped the previous health fund - which handles at least $240 million in medical insurance - and replaced it with a single health benefits program for public employees, retirees and their dependents. Health insurance costs were growing at such a rate that consultants estimated that by 2013 the state would spend nearly $1 billion on state employee health care. The Employer Union Trust Fund in 2001 was estimated to save the state an estimated $81.6 million over the first four years. Before the change, the unions provided their own medical insurance for members, while the former state health fund, with 13 employees, handled the details for workers who had not joined a union plan. Now, the state's entire 90,000 workers, retirees and dependents are all in one plan, and those same 13 workers are forced to handle the extra load. ... Health care for all is elusive goal A conference later this month will consider how to help those who lack insurance Helen Altonn, Honolulu Star-Bulletin, October 16, 2003 <http://starbulletin.com/2003/10/16/news/story8.html> Rosemarie Madriaga and Bonifacia Cervano waited for help this week alongside other uninsured patients in the crowded waiting room at the Kalihi-Palama Health Center. Madriaga, 32, five weeks pregnant, was there for her first obstetrics checkup. Cervano, 64, needed medicine for her blood pressure. She had been on the state's Med-QUEST program but learned last weekend she and her husband had been cut off when she went to a pharmacy to refill a prescription, she said. Madriaga and the Cervanos are among an estimated 120,000 isle residents without health insurance - the focus of the Hawaii Uninsured Project's "Coverage for All" conference Oct. 29 at the Hilton Hawaiian Village. "When we're talking about the uninsured, it's not like we're talking about them and us," pointed out Jacque Smith, the project's associate director of community relations and grant management. "I could easily be laid off my job tomorrow and lose my health insurance." ... Hawaii’s uninsured population is creating unhealthy situation Nearly 10% of the state residents lack coverage despite the 1974 Prepaid Health Care Act Matt Sedensky, Associated Press, October 22, 2003 <http://starbulletin.com/2003/10/22/business/story3.html> Cindee Villegas can't deny her job as a personal trainer in Waikiki offers some decent perks - a flexible schedule, free gym membership and a workplace that overlooks one of the world's most famous beaches. But while her professional commitment is to keep clients healthy, she has a hurdle to her own wellness: She's uninsured. Villegas is not alone in a nation of 43.6 million uninsured people. But Hawaii is supposed to be different. The state's 1974 Prepaid Health Care Act made Hawaii the only state where most employees are guaranteed health insurance by law. Employees who work 20 hours or more a week for four consecutive weeks must be given coverage with a premium that costs no more than 1.5 percent their salary. But this state - once held up as a model for its near-universal health coverage, boasting uninsured rates as low as 2 percent - is edging closer to the national average. Today, nearly 10 percent of Hawaii's residents are uninsured, hospitals and clinics say they're struggling to care for those patients, and small businesses are pressing for reform of the stringent 1974 laws. "We're reaching sort of a critical stage," said state Rep. Dennis Arakaki, chair of the House health committee. The islands' shift from an agricultural economy of large plantations controlled by strong unions, a number of blows to the state's tourism-based economy, and colossal increases in health insurance premiums have led Hawaii to this point. ... Health Reform Massachusetts: Constitutional Amendment for Health Care Campaign Well Underway but Still Needs Your Help Massachusetts Nurses Association, October 30, 2003 <http://www.massnurses.org/Events/2003/10/AA_Health_Care_Campaign.htm> The Constitutional Amendment for Health Care Campaign, including MNA, the Ad Hoc Committee to Defend Health Care, the Alliance for the Mentally Ill, Mass. Coalition for Healthy Communities and others, has made great progress and continues to collect signatures to ensure that all state residents have permanent access to comprehensive, affordable health insurance including medical care, mental health care, and prescription drugs. We are asking for every nurses' help to finish collecting the 100,000 signatures needed by mid-November 2003; please give half an hour of your time to collect 10 or twenty signatures to assure that this goal is met - TOGETHER WE CAN DO IT! TUESDAY NOV 4 ELECTION DAY is a critical opportunity for Signature Collection. Contact the campaign office to be a part of a team in your area on 11/4/03. Call 617.868.1280 or sign up at <www.healthcareformass.org>. One or two hours of your time will go a long way on November 4th! You can also download a signature petition sheet on-line, sign it, and mail it in - this is cutting edge reform that you need to be a part of. It's easy and you'll know you did something concrete to make health care available to all. And remember, this is time-sensitive so do what you can now!! Visit the Campaign Website <www.healthcareformass.org> to learn more and download campaign materials. This is history in the making and we need you to be a part of it. Thanks! Spread the hope: These changes are possible; we don't need more money in the system, we need to be smarter about how we spend our health care dollars!! Thank You, Ann Eldridge Malone, RN, Sandy Eaton, RN, Peggy O'Malley, RN, Julie Pinkham, RN, and the 16 other health activists who comprise the 20 Original Signers of this ground-breaking effort. Editorial Comment: MNA members who picked up petitions at convention or at regional meetings are reminded to get them back to the Campaign by mailing them to the post office box on the petition or even to MNA in Canton. Campaign workers will need to deliver them to the appropriate city or town election officials by the end of the day on November 19th, except for Suffolk County, which has a few extra days. Every signature counts! And thank you! - SE want safe staffing? Please read, take action, and spread the word to your RN colleagues! Massachusetts Nurses Association, October 30, 2003 <http://www.massnurses.org/Events/2003/11/AA_Leg_Vacation.htm> URGENT ACTION NEEDED NOW!!!! Our collective efforts towards passage of H. 1282, the Safe RN Staffing bill, are at a critical point. With less than 3 weeks left before the legislature's holiday recess, the Health Care Committee may be voting on our bill as soon as next week. WE MUST give another push to move this bill forward. Please contact your state senator and state representative TODAY. Tell them: "I am a registered nurse calling in support of H.1282, the patient safety/safe RN staffing bill. I want to see this bill voted favorably by the health care committee before the fall session ends." To be connected with your legislator’s office: House switchboard: 617.722.2000 Senate switchboard: 617.722.1455 Thank you for your continued activism. "Mass Health Care Trust" is best way to control costs, improve quality, provide secure health care for all Reform leaders call on Health Care Committee to favorably report bill out of committee, allow vote in Senate and House Massachusetts Nurses Association, October 9, 2003 <http://www.massnurses.org/News/2003/10/single_payer2.htm> Boston - More than 700 health care reform advocates swarmed a hearing by the Joint Committee on Health Care in Gardner Auditorium today to show support for a comprehensive proposal to provide more secure health insurance coverage to all residents of Massachusetts. The hearing was on Senate Bill No. 686 - the Massachusetts Health Care Trust - that would create a single state insurance fund to replace the current patchwork of public and private insurance plans. "Our current system is failing us on all three measures of an effective health care system - assuring access, quality, and control of costs," said Peggy O'Malley a leader of the Massachusetts Nurses Association who chairs MASS-CARE. "In just four years, annual health care expenditures in Massachusetts have risen from $36 billion to $48 billion: an increase of over 8 percent a year." "The legislature needs to act before this crisis leads to a medical meltdown," said State Senator Steven Tolman (D-Brighton), a lead sponsor for the Health Care Trust legislation. "The number of uninsured is rising, hospitals are closing, emergency rooms are overflowing. Massachusetts can lead the way with a sensible plan that provides secure, quality care for everybody, and prevents us all from going broke." "A recent state report showed that 39 percent of every health care dollar goes to administrative costs," testified Phil Mamber, President of the Massachusetts Senior Action Council. "Low income seniors are losing their insurance coverage when they need it the most. And Medicare now only pays half of a senior's health care costs. Everyone needs to carry extra insurance and the cost of that is rising by double digits each year." "It is often said that a single-payer system is a good idea, but politically unrealistic," said Dr. Marcia Angell, Senior Lecturer in Social Medicine, Harvard Medical School. "That is a self-fulfilling prophecy, often propagated by those with a vested interest in the current system. The notion that we can somehow both increase access and contain costs by incremental reforms is what is truly unrealistic. A single-payer system is not just the best alternative for providing universal care while containing costs. It’s the only one." Dr. Angell is the former Editor-in-Chief, New England Journal of Medicine. ... Editorial Comment: Patient advocacy lies at the heart of nursing. What a difference an independent, well-funded, democratic, progressively-led Hawai’i Nurses Association can make by becoming a catalyst for change in health policy! - SE Web Directory: AARN <http://www.aarn.org> Australian Nursing Federation <http://www.anf.org.au> California Nurses Association <http://www.calnurse.org> Canadian Federation of Nurses Unions <http://www.nursesunions.ca> CCDS <http://www.cofc.org> Committee for Health Care for Massachusetts <http://www.healthcareformass.org> Irish Nurses Organisation <http://www.ino.ie> Labor Party <http://www.thelaborparty.org> LabourStart <http://www.labourstart.org> Maine State Nurses Association <http://www.mainenurse.org> Massachusetts Ad Hoc Committee <http://www.MassDefendHealthCare.org> Massachusetts Green-Rainbow Party <http://www.green-rainbow.org> Massachusetts Nurses Association <http://www.massnurses.org> MASS-CARE <http://www.masscare.org> New York Professional Nurses Union <http://www.nypnu.org> New Zealand Nurses Organisation <http://www.nzno.org.nz> PASNAP <http://www.pennanurses.org> PNHP <http://www.pnhp.org> Québec Nurses’ Federation <http://www.fiiq.qc.ca> Revolution Magazine <http://www.revolutionmag.com> Saint Louis Area Nurses Coalition <http://www.slanc.org> Seachange Bulletin <http://www.seachangebulletin.org> Southern Arizona Nurses Coalition <http://SAZNC.homestead.com> Union Web Services <http://www.unionwebservices.com> Women’s Universal Health Initiative <http://www.WUHI.org> FAIR USE NOTICE: This site contains copyrighted material the use of which has not always been specifically authorized by the copyright owner. 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