VOTE HEALTH'S HISTORY

1984: The Formation of Vote Health

Health care activists created the Vote Health Coalition in the summer of 1984, at a progressive political convention that took place in San Francisco as an alternative to the official Democratic convention which nominated Walter Mondale to oppose Ronald Reagan.

At that time, conservative forces led by Reagan were successfully imposing harsh cutbacks on health care services for the poor. A small number of activists from Alameda County created Vote Health with the idea of presenting a positive agenda for health care reform, so that we were not always in a defensive posture of fighting budget cutbacks.

1985: The Battle for Highland

The organization remained small until 1985, when it became the organization leading the fight for improvements at Highland Hospital, Alameda County's primary public hospital. In 1985 Highland was both sorely under budgeted and poorly managed. Vote Health led a coalition including community activists, health care workers unions, and medical staff of Highland, which joined together to demand increased funds for Highland and a change in the top administration.

The efforts of the Coalition, which included community organizing, complaints to State regulatory agencies and lawsuits, forced the Board of Supervisors to increase Highland's budget by $10 million and to replace the County's three top health care administrators. The campaign suddenly established Vote Health as force to be reckoned with in Alameda County health care politics. Since 1985, Vote Health has helped lead the fight to strengthen Alameda County health care for the uninsured and underserved.

1985 - 1987: Victory Against Patient Dumping

Vote Health board member Joe Keffer at a rally

In 1985 and 1986, Peter Aleshire, a reporter for the Oakland Tribune, began writing front-page stories about patients who had died because private hospitals had refused to admit them, even though they were in emergencies, because they did not have health insurance. Vote Health activists first organized to pass a local ordinance prohibiting patient dumping in Alameda County. Then Vote Health members organized a statewide group called the Coalition to Stop Patient Dumping to organize for a state law prohibiting patient dumping. The new state Coalition grew quickly and successfully lobbied the Legislature to pass the nation's first state law prohibiting emergency physicians from transferring emergency patients until they had been stabilized and were safe for transfer. AB 214, the resulting legislation, was considered the most important patient protection legislation passed in California during the 1980's. Click here to see historic brochure used in the campaign.

At the same time, Vote Health activists were helping to create the California Physicians Alliance (CAPA), an organization of progressive physicians committed to health care reform.

1987: The Formation of Health Access and the Development of a Single Payer Health Plan

The success of the Coalition to Stop Patient Dumping led Vote Health activists to realize that the state-wide coalition that they had formed might well be more important and useful than the fight against patient dumping. The California Physicians Alliance, with the support of Vote Health, initiated efforts to build an ongoing state coalition dedicated to advocating for reforms that would provide access to health care for underserved poor and minority communities. The results of those efforts led to the formation of Health Access, a state-wide coalition that included both state and local health advocacy organizations and unions. Health Access soon became the most important voice in Sacramento on issues related to health care of the uninsured and for those on Medi-Cal.

One of Health Access' first projects was to create a model health care plan that would provide an ideal toward which reform efforts could be directed. Vote Health participated in that effort, which resulted in the Health Access Plan, the first single payer model which incorporated both fee-for-service and managed care. The Health Access plan included universal health care for all California residents, free choice of health care provider, and effective cost controls.

1988 - 1993: Working Towards a Universal Health Care Initiative

Vote Health members heartily embraced the idea of universal health care through a single payer financing system. For the next five years, Vote Health advocated that health care advocates put a single payer plan on the ballot as an initiative. In 1993, Neighbor to Neighbor, along with California Physicians' Alliance and the Congress of California Seniors, were able to organize the resources to place a single payer universal health care initiative on the ballot.

1994: Proposition 186 Goes on the Ballot

In late 1993 and early 1994, Vote Health mobilized hundreds of volunteers to help gather the million signatures needed to put the universal health care initiative on the ballot. Led by Vote Health, Alameda County activists gathered approximately 100,000 signatures. They also hosted house parties all over the county, which did grass-roots organizing, education and fund-raising. The California Health Security Act, Known as Proposition 186, can be found at the following website:

http://www.igc.apc.org/health/chsa/chsa.html

Although Proposition 186 was soundly defeated in November 1984 by a multi-million dollar media campaign funded by insurance companies, the organizing done during the Proposition 186 campaign laid the seeds for continuing efforts to win universal health care in California. After the election, members of Vote Health and others who had been active in the campaign for Proposition 186 formed Health Care for All — California, which has continued the campaign for universal health care for all Californians.

1995 - 1997: High Noon for Highland

The community worked hard before supervisors committed to fund the new Highland Critical Care and Clinics Building.

Vote Health led a multi-year campaign to convince the Alameda County Board of Supervisors to build a new wing at Highland Hospital. During this period, intense debate swirled over whether Highland would be closed instead of being rebuilt. Supervisor Wilma Chan convened a task force on the future of the County Medical Center. The County had initially turned down state matching funds for a new hospital but after several years of intensive organizing, they reversed their decision. In a historic vote, the Board of Supervisors approved construction of a new Critical Care and Clinics Building at Highland Campus. The new facility is currently under construction with completion slated for 2002.

Over the years, Vote Health has held rallies, demonstrations, candlelight vigils, marches, press conferences, and turned out hundreds of activists to support adequate funding of health care and worker needs. In coalition with other community organizations, Vote Health organized to stop the County from washing its hands of the County Medical Center by creating a separate hospital authority. Vote Health worked on county ballot Measure E to keep direct County oversight of the hospital, which was narrowly defeated on the 1996 county ballot.

Enclosed bridges link the new building, to be finished in 2002, with Highland's older structure.

Even with the creation of the Hospital Authority, Vote Health continued to watchdog the County to honor its past commitments to funding support for the Medical Center. Last year the County finally released $29 million of capital funds for the hospitals' aging equipment and infrastructure that had been promised for years but never paid.

1996: Fighting the Ravages of Managed Care

Vote Health members worked hard to pass two statewide ballot measures that appeared on the November 1996 statewide ballot, Propositions 214 sponsored by SEIU and 216 sponsored by California Nurses Association and Ralph Nader. These were consumer protection initiatives that would have provided for a patient's bill of rights similar to measures being debated nationally today. They prohibited HMO's from denying care without a physical exam and using financial incentives to withhold safe, adequate, and appropriate care.
Vote Health members took to the streets en masse both gathering signatures to put the measures on the ballot and later to do community education in support. Sadly, these measures were ahead of their times and were defeated after massive spending by the managed care industry.

Kevin Reilly speaks against medical red-lining

1998 - 1999: Corporate Health Care Challenged

In 1998-99, Vote Health organized along with community groups and health care labor unions to oppose the merger of Summit Hospital with Sutter Health, which already controlled the Alta Bates Medical Center. Attorney General Bill Lockyer joined the struggle to stop Sutter Health on the basis that it was creating a monopoly of hospital beds in the area. Sutter Health is a $3 billion corporation that controls about 26 other acute-care hospitals in northern California. The health care giant won in late 1999, and some our fears about its corporate practices have already come true.

Also in 1999, Vote Health joined other labor and patient activists to challenge plans by Kaiser Permanente Medical Group to close its Oakland hospital. Kaiser proposed to share emergency and operating room space with already crowded local hospitals Summit and Alta Bates. This would have meant reduced access to medical care for thousands of Kaiser members, who had been relying for years on the MacArthur Boulevard hospital. In addition, it would have meant a true monopoly of Sutter Health on hospital beds in the East Bay.

There was strong concern that Kaiser was closing its inner city hospitals and fleeing to the suburbs, in a case of health care red lining. Our members participated in rallies, signature gathering, and public information events. http://www.calnurse.org/cna/news/sfg5699.html After this concerted community effort, Kaiser reversed its decision and announced it will rebuild its Oakland hospital to meet seismic requirements and keep serving the community. This was a thrilling victory for all involved, activists and users of the system.

2000: Defend Health Care and Charity Care Hearings

In April of 2000, Vote Health and its allies presented a town hall meeting to defend health care, which was endorsed by over 40 elected officials and organizations in the area. The purpose: We call on local and state government to establish greater public control over the healthcare system and guarantee:

Over 100 people attended to hear activists, health care workers and patients describe the increasing struggle to provide and receive quality medical services.

In the last half of 2000, Vote Health worked with a broad coalition of labor and community groups to present a Community Hearing on Delivery of Charity Care by East Bay Hospitals. This was sponsored by the office of Assemblywoman Dion Aroner, and took place in January, 2001. Testimony by State Attorney General Bill Lockyer, local public officials, public health experts, labor leaders and patients addressed the issue of care given by hospitals with no expectation of payment. Private nonprofit hospitals are given huge tax benefits but do not return this windfall by providing charity care to the indigent. The result is an undue burden placed on the county medical system to be the sole provider of health services to the uninsured.

Two Alameda County Supervisors have pledged to pursue the feasibility of enacting a Charity Care Ordinance in this county, which would require all hospitals to publicly post their policy of serving people without health coverage. Currently, every hospital has staff who determine the ability of patients to pay before they are treated, except in dire emergencies. If the patient has no coverage and is in the emergency room of a private hospital, the staff makes sure the illness or injury is not life-threatening in the moment, and tells them where the public hospital is. For more information on the state legislature's examination of this issue: http://www.dph.sf.ca.us/DirectorsRpts/DirRpt032001.htm.

1998 - 2000: Rallying support for Universal Coverage

Vote Health works as a local affiliate of Health Care for All -California to rally support for universal coverage. In recent years, this work has focused on the State of California's Universal Health Coverage Study. This campaign started during the 1998 legislative session, when state senators Diane Watson (D-L.A.) then Chair of Senate Health and Human Services, and now U.S. Congresswoman Barbara Lee (D-Oakland) introduced a single payer, health coverage program.

The bill did not pass out of committee, but in the course of the hearings there was broad support for a study to investigate options for financing universal health coverage. Senator Diane Watson introduced Senate Concurrent Resolution 100 (SCR 100) which calls for an evaluation and comparison of alternative strategies for achieving universal coverage and lists criteria to be met by all reform options.

Vote Health next worked to help pass and fund SB 480, a study bill to build consensus on the best way to implement universal health care. On October 10, 1999, Governor Gray Davis signed SB 480, Universal Health Care Coverage, a bill that Health Care for All-California helped to write and for which it led the lobbying effort. Vote Health has represented East Bay constituencies in the multi-year effort to keep universal health care on the forefront of the state health care debate. For more detail, see the paragraph titled Vote Health and Single Payer immediately below.

Vote Health and Single Payer

In 1994, the single payer ballot initiative, Proposition 186, was turned down by the voters. Since then the health care crisis in California has worsened and managed care, which was supposed to show the ability of the market to solve that crisis, has failed. Also during these during years, many activists have been working to return single payer to the center of health care reform. Vote Health members have played a significant role in rebuilding the single payer movement.

Creating Health Care for All-California

During 1995, Vote Health members were active in the four conferences that led to the formation of Health Care for All-California. HCA is the state's dedicated single payer organization. Today it consists of 18 affiliate organizations. Vote Health was an original affiliate. Representatives from the affiliates attend quarterly meetings of the HCA board of directors. The first chair of the board was Vote Health member, Judy Pope, and the current chair is Vote Health member, Dan Hodges.

Succeeding in Sacramento

In June 1997, Vote Health hosted an HCA strategy conference that resulted in a plan to submit a single payer bill to the 1998 legislature. As drafting of the bill neared completion, Vote Health members met with Assembly Member Dion Aroner (Berkeley) for her recommendations of legislative authors of the bill. Based on this meeting, HCA approached State Senators (now Congresswomen) Barbara Lee (Oakland) and Diane Watson (L.A.), who agreed to be authors of SB 2123. Vote Health, along with all other HCA affiliates, then worked to obtain endorsements of the bill from local organizations. The Senate hearings on SB 2123 resulted in calling for a study to compare different models of financing universal health care, including single payer.

In 1999, HCA drafted a new bill, SB 480, which was authored by State Senator (now Congresswoman) Hilda Solis (L.A.). SB 480 called for a process for stakeholders to address the issues facing the state in providing universal health coverage and also a report from the California Health and Human Services Agency (CHHS) to the Legislature. The report would be based on the results of stakeholders' process and the data from the study of universal health care models. As part of HCA's campaign to pass SB 480, Vote Health solicited endorsements from many East Bay organizations. The endorsement campaign was so successful throughout the state that Governor Davis signed the bill.

Implementing the Universal Health Care Study

For months implementation of the universal health care study was stalled because no money had been appropriated to fund it. In the summer of 2000, Vote Health and other HCA affiliates waged a new endorsement campaign to lobby the Davis Administration to apply for a federal grant. The success of the mobilization resulted in $1.2 million from Washington for the state's Health Care Options Project (HCOP). This year additional lobbying campaigns were run to ensure that the California Health and Human Services Agency (CHHS), which is overseeing HCOP, conducts the study in full compliance with SB 480.

HCA has submitted a single payer proposal to HCOP, and it has been accepted by CHHS. Vote Health members are among the core group who are developing HCA's single payer model for the study. The decision by CHHS whether HCA's model will qualify for microsimulation modeling will be made this autumn.

Gearing Up for a New Single Payer Campaign

The success by grassroots organizations, such as Vote Health, in realizing the universal health care study has made it possible to re-introduce single payer as a viable health care reform option. The implementation of the study can provide a thorough comparison of single payer against other models of universal health coverage. For single payer supporters the timing of achieving HCOP could not be better.

Throughout the country there is growing gale of discontent with the health care system. Moreover, there are increasingly powerful state-based movements for real change. HCOP provides at least five elements for building a strong reform movement in California:

Vote Health has been organizing since 1984 to preserve and extend the health care safety net in Alameda as well as to achieve a publicly financed, universal health care system. In the months to come, it is important that single payer supporters contact Vote Health to get involved in the public education campaign about HCOP that is now gearing up. The results of the HCOP/universal health care study will be reported by CHHS to the Legislature in February 2002. Then, the campaign for health care reform will begin. We need you to be active in it! Contact Vote Health today.