Jan.-Feb. 2001
Introduction: At the end of 2000 and the beginning of 2001 a fierce struggle rocked Vote Health, a group of public citizens formed in 1984. For over sixteen years it has spoken as the unified voice of progressive activists defending health care for the people of Alameda County, California. Following are documents by participants in the struggle.
These documents were written in Feb. 2001 before the Feb. 26 monthly meeting. At this meeting the members and new attendees affirmed their unity under the banner of Vote Health. The entire Executive Committees and 98% of active members of the group from the last several years rejected the recent actions of outgoing chair Dan Cloak. The meeting took steps to assure that Vote Health recovers the treasury, which Cloak had asked the financial agent to freeze.
Vote Health Home Page
Vote Health Changes
by Nancy M. Friedman, Feb 11, 2001
The letter sent out on February 8th by Dan Cloak announcing that "Vote Health's unity has been shattered" is likely to be confusing to most who read it. For some time now there have been differences on the Vote Health Executive Committee, which has included the same six people for at least four years. Unfortunately, Dan is calling for a split in the organization. I do not believe that is necessary, nor that such a split would help advance our struggle for accessible, high-quality health care. In this letter I would like to:
- Be more specific than Dan was in his "Unity has been Shattered" letter
about the two main issues as I understand them;
- Propose specific measures that could keep Vote Health a vigorous and
inclusive organization working "to achieve accessible, affordable,
high-quality health care for all" as our mission states.
Inter-Union Fights
Many Vote Health activists know that there have been long-standing differences between Service Employees International Union (SEIU) and the California Nurses Association (CNA). Vote Health has historically refused to chose sides between the unions. Rather, it has worked with various unions on projects that promise to advance our mutual goals concerning health care access and quality. We have been successful in many local battles by pursuing this strategy. Two members of the Executive Committee are on the staff of CNA. Dan has been key in building alliances with SEIU Locals 250, 616, 535, Health Access, California Physicians Alliance and Neighbor to Neighbor. Vote Health has been able to count on a worker presence and the healthcare workers' unions have been able to count on community presence when our organizations have needed bodies, voices and letter-writers.
Dan surprised virtually everyone by nominating nine people to the Executive Committee, some of whom had attended between 0-3 previous meetings. He did this to solidify his alliance building before he left the organization. CNA staff, members and others reacted with mistrust and confrontation, effectively driving out Dan's recruits. Having failed in his effort to force expansion, Dan is now calling on Vote Health members to quit the organization. He used the Vote Health database to do this, the latest of many unilateral steps he has taken.
At the end of the January meeting, people made six hasty nominations of their own in addition to Dan's, and some of those nominees are also new to Vote Health. The majority of them continue to be willing to sit on the Executive Committee.
The Mission Reaffirmed
The second split within the Executive Committee can be most simply understood as a single payer focus versus coalition-building on multiple healthcare issues. In practice this difference has complex implications about class, race, and politics. Rather than dwelling on these complexities, I would again urge Vote Health to continue its tradition of embracing activities that further the goals we crafted in our mission statement, which would include a greater emphasis on furthering the struggle toward single payer. Vote Health will work to educate members and the public on the impact that taking different organizing tactics has on patient care and worker conditions. Individuals within Vote Health should be free to choose those activities which best reflect their own interests, beliefs, and available energy. I believe it is not too late to unite and build, although bridges must be repaired with the above organizations.
Looking Forward
Given the above situations, I am proposing two motions for the February 26th meeting:
1. Vote Health will continue to pursue multiple strategies "to achieve accessible, affordable, high-quality health care for all" and will not be a battleground for hostilities between healthcare worker unions. Vote Health meetings are not the place for fights among union activists about the merits of "partnerships" or other labor strategy differences.
2. Vote Health will continue to educate our membership and the public on the advantages of a single payer system but will not abandon its heritage of working on diverse local and statewide campaigns to improve health care access and quality.
Although there are additional areas of disagreement, a majority vote on these two resolutions could go a long way in healing Vote Health's rift. From my many conversations with activists in the past two weeks, I believe it is possible to reach consensus and reach out once again to our many allies, letting those who left the table know that it is safe to return. I would be willing to lead an organization whose board and membership agree on these directions for our work.
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Statement
by the Executive Committee of Vote Health, Feb 12, 2001
Dear Vote Health Supporter,
The Vote Health Executive Committee regrets that many of you have received a recent letter and/or electronic message from Dan Cloak. The electronic message was sent from info@votehealth.org to the Vote Health activist email list and the letter sent to our mailing list. Neither the letter or the electronic message had been authorized by the Executive Committee. Both are the work of Dan Cloak acting alone.
We believe that Vote Health needs to be a democratically run organization. That means that when we sometimes disagree on a strategy, we engage in discussion and educate ourselves about the details, and the group determines a course of action. The goals and the mission of Vote Health have not changed and we continue to advocate for patients, health care workers, and a universal, publicly administered, single payer health insurance fund. In November, Dan Cloak announced to the group that he intended to resign as Chair effective at the February 26 [2001] meeting. We discussed recruiting new members to the Executive Committee and obtained Nancy Friedman's consent to serve as Chair. A special meeting was called on December 5 [2000] to invite input regarding program ideas for the coming year and to recommend nominees for the Executive Committee.
As a free association of individuals, Vote Health has no bylaws or other official guiding document other than our mission and goals statement. The Executive Commmittee is not defined anywhere and therefore has no official number of positions. Traditionally, Vote Health would have an annual retreat where we affirmed who was to serve on the Executive Committee. Currently, it is a Committee of six.
Activists at the December 5 meeting recommended expanding that to nine, but eleven candidates were nominated. The group produced a list of proposed program ideas to be presented for discussion to the general membership on January 22.
The Executive Committee met in early January [2001] and did not agree to recommend any specific rules regarding the number of seats or the voting procedure for establishing the leadership body for the coming year. As a result, on January 22 the general membership spent over ninety minutes debating the different proposals in what was unfortunately a heated, contentious meeting that became very personal for some of those involved.
Several of the nominees had not been to a Vote Health meeting before. Because the nominees were new to Vote Health, some activists questioned why they would be willing to serve on the Executive Committee. Some activists spoke up in support of diversifying Vote Health's leadership. The group rejected a proposal to allow all twenty nominees to serve. The group then established that the Executive Committee would be expanded to include up to fourteen members from a pool of twenty nominees.
When the Executive Committee met on February 7, Dan Cloak informed us that six nominees had withdrawn their consent to serve. Several other nominees had also expressed second thoughts about serving. At this point, the number of consenting nominees was less than fourteen and voting by ballot would not be necessary. The Committee made plans to produce the monthly newsletter that would include short statements from each nominee. Dan warned us that at the February 26 meeting he planned to pronounce the organization dead as a result of internal dissension. He left the Executive Committee meeting and within one hour he had sent out his email message without the Committee's knowledge. His letter by mail was posted the very next day. Dan had clearly calculated his actions and was now pursuing his own personal agenda.
Vote Health must continue to advocate for patients, health care workers, and a universal, publicly administered, single payer health insurance fund. We must not let our internal disagreements serve the opponents of health care justice: the health insurance companies, HMOs, and health care administrators. Yet, we must be willing to critique the various legislative, media, or initiative campaigns that are proposed.
The general membership must affirm the nominees at the February 26 meeting or Vote Health may dissolve.
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Open letter to associates and friends involved with Vote Health
by Joe Keffer, Feb. 15, 2001
I want Vote Health to continue; I support advocacy for single payer and safety net issues that arise while the campaign for single payer is being waged. I am concerned about how Vote Health members work together and how we make decisions. Count on me to advocate for these principles:
- The organization should run democratically, which means that decision-making processes are transparent, allowing members to observe each step and understand how they can participate and influence decisions.
- The organization should specify how a decision will be reached (what constitutes formal agreement, e.g., majority vote; consensus; gradients of agreement; or other...?) on whether the name and resources of Vote Health will be used in support of or opposition to a particular issue.
I have been associated with Vote Health over many years. I am convinced that to have an impact on health care in Alameda County and beyond, the organization must be principled and clear about where it stands. Action should be taken in the name of Vote Health on issues where our diverse membership can agree. It is my view that on points which divide us, individuals must follow their conscience, but in the absence of member agreement, Vote Health should uphold neutrality on an issue.
However, Vote Health should not be seen as ducking controversy. In fact, Vote Health can serve as a one-of-a-kind forum for airing differences and building greater understanding. Understanding is no assurance of agreement, however, and the organization must be a place that supports constructive dialogue about our differences.
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We Can Overcome the Crisis in Vote Health
by Charles Andrews, Feb. 12, 2001
We can and must overcome the crisis in Vote Health. The
organization and its activists who have worked for Proposition
186, Highland Hospital, Kaiser's Oakland hospital, and more would
gain nothing by splitting Vote Health into two groups. Only a
united Vote Health is a credible public citizens' group. The two
major health care trade unions in Alameda County, SEIU Local 250
and CNA, especially need one organization of public citizens that
acts on health issues.
In order to keep the unity of Vote Health alive now and in the
years to come, two points are crucial:
1. Vote Health's organizational structure should preserve its
unified public citizen nature. In blunt terms, this means that we
must balance the participation of activists from SEIU Local 250
and CNA. Both health care unions have a right to roughly equal
strength in Vote Health, along with the various other health
activists. It is all these people together who make Vote Health a
credible, militant spokesman for people's interests on matters of
health care in Alameda County.
The two unions disagree on trade union strategies. Their
differences matter to health care workers, but the fact is that
they do not engage the general public. There is plenty of
political space outside Vote Health to struggle over trade union
strategies, leaving Vote Health as a valuable organization of
public citizens. Activists from the two unions can appreciate the
need to keep such differences out of Vote Health. Right now, this
means that SEIU's partnership agreements with employers should be
off the Vote Health table. (Of course, everyone has the right to
offer other individuals polemical literature on any subject.)
To implement this balance, we urge that one or two persons from
Local 250 and from CNA meet with a couple of Vote Health leaders
who want to preserve its unity (Nancy Friedman and one or two
others). If these people want to preserve a vigorous, inclusive
Vote Health, they can propose a unity slate of officers and
Executive Committee members.
2. Vote Health must combine immediate struggles and the struggle
for publicly funded universal health care. Although no one argues
with the general principle, the traditional formula for
implementing it—"Come on down to Vote Health and work on the
issue of your choice"—has in practice played down single payer.
One, there is always a fire to put out, and single payer gets put
off indefinitely. Two, the chairperson and Executive Committee
propose major projects, as leaders should; inviting individuals
to pursue their own projects within the Vote Health umbrella is
not an equal option. Third, it is no solution to tell people to
work in Health Care for All-California. Alameda County cannot
sustain both Vote Health and a vigorous local chapter of HCA-CA.
The core of HCA-CA in Alameda County already carries enough
burden dealing with statewide matters.
Vote Health needs to institutionalize a commitment that a
significant portion of its energy and resources must always be
devoted to single payer work. The organization should obligate
itself to semi-annual summing up that verifies this commitment.
If Vote Health spends more energy and resources on single payer
work, it can expect to tap new support. For example, Vote Health
can develop its ties to the Nader/Green movement as well as to
Labor Party activists.
These two points—an organizational structure that preserves the
unified, credible public citizen nature of Vote Health, and a
commitment to combining current struggles with single payer
work—are the basis for an effective Vote Health. If the two
points presented here are not satisfactory, critics should
suggest modified or new points to the same end. With some
thought, soul-searching, debate, self-criticism, and re-dedication
to serving the people, the health care activists of
Alameda County can prevent a disastrous split and actually
strengthen their unity.
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Vote Health's unity shattered
by Dan Cloak, Feb. 7, 2001
Vote Health's unity has been shattered. The organization may not survive another month.
A faction that wants to change Vote Health's political direction is subjecting our supporters and allies to ill-tempered criticism. In the face of these attacks, many volunteers are withdrawing to work with other health-care-reform organizations. As a result, the minority faction may take over Vote Health by default.
The road ahead is uncertain, at best. Our work to expand and strengthen Vote Health's leadership, to make the organization better reflect the diverse East Bay community, and to strengthen Vote Health's ties with key allies, have all been severely set back.
In six years as Vote Health's chair, I've tried to help build (and keep together) a broad coalition of people who advocate quality, affordable health care for all. It has never been easy, but it has certainly been rewarding. We kept Highland Hospital open and won new investments in buildings and equipment for Highland and the rest of the Alameda County Medical Center. We helped convince Kaiser to reinvest in Oakland and to build a new hospital here. We raised hell against Sutter Health as they took over most other East Bay hospitals and began cutting back services and community benefits. We helped expand statewide eligibility for Medi-Cal and Healthy Families and helped convince the legislature and the Governor to study (at least) ways to implement universal health care in California. We protested the Republican Congress' attempts to privatize Medicare.
We accomplished these things through the hard work and good will of so many Vote Health supporters. But I also attribute our success to two organizing principles:
The first principle is that Vote Health never insisted on, or tried to direct, a single strategy for getting health care to those in need. On the contrary, we welcomed all who agreed with our basic tenet—that health care is a human right. Anyone could come to our open public meetings, participate in the discussion, and volunteer for the projects that interested them. Vote Health sought to make everyone in the broad, diverse movement for health care rights feel they were part of the group, regardless of whether they came to meetings regularly or gave us money.
The second principle is that we worked closely with other health care advocates. In particular, we worked shoulder-to-shoulder with health care workers and their unions. This gave us the numbers and resources to really make a difference in every fight we took on. This principle also meant that, when we walked picket lines, spoke out at public hearings, or lobbied elected officials, we could do so within a group that reflected the East Bay's racial and ethnic diversity.
A faction within Vote Health is passionately devoted to reversing these principles and taking the organization in a different direction.
Here's why I think they're wrong and will lead the organization down a dead end:
I joined Vote Health following the 1994 defeat of the single-payer initiative, Proposition 186. Since that time, most attendees at Vote Health monthly meetings have been white, ideologically committed veterans of past decades' movements for peace and social justice. Vote Health's informal Executive Committee has been all white for the past six years. However, because Vote Health always worked in concert with health care workers and others—and because we avoided any definition of "membership" that could be seen as exclusive—we were able to win the trust of allies within the broader community and to earn the respect of elected and appointed officials and other policy-makers.
I believed that by winning trust and good will among different groups of activists, and by demonstrating how effective we could be working together, Vote Health could, in time, become a truly broad, diverse, representative, and powerful local grassroots advocacy organization.
In short, we accomplished unity (and diversity) on the picketlines and at public speak-outs but failed to do so in our monthly meetings or in our Executive Committee. In an attempt to rectify this shortcoming, I recently proposed that we expand Vote Health's Executive Committee to include a balanced slate of our current leadership plus some union staff, shop stewards, and other rank-and-file activists. I believed it was necessary to bring the different groups together on more-or-less equal terms so that no individual would feel outnumbered and excluded from decision-making. In particular, I worked to recruit experienced, trusted activists associated with SEIU Locals 250, 616, and 535, the statewide advocacy group Health Access, and the California Physicians Alliance. I proposed that activists associated with Health Care for All-California and the California Nurses Association continue on the Executive Committee.
I expected some questions and even some opposition. But at the January 22 Vote Health meeting I was shocked and disappointed when a small group directed angry and personal invective against some of the individuals I proposed, challenging their commitment to health care reform and denigrating their associations with SEIU and with Health Access. The faction also sought to establish, on the spot, new conditions for Vote Health membership and participation. These moves were clearly intended to exclude specific people from leadership and from participation. That some of those targeted were African-American—and had agreed to serve a largely white organization—added to the tension and unpleasant feeling.
At that meeting, many longtime supporters spoke up in support of diversifying Vote Health's leadership and in favor of working closely with health care workers unions and other advocacy groups. But the damage was done. It was clear that, even if the majority favored this direction, an angry and outspoken faction would make it impossible to work together in unity. Since that meeting, six of the nine people I proposed as new Executive Committee members have withdrawn their nominations.
Why did this faction behave with such rash disregard for Vote Health's unity and consensus decision-making process? An unsigned polemic distributed at the meeting excoriates health care rights activists for working on incremental solutions to expanding access to health care that "fail to challenge corporate domination of the American health care system, postpone a comprehensive solution, and in many ways worsen the crisis." The unsigned polemic states: "These measures occupy the time and mobilization efforts of health care activists who end up postponing the struggle and campaign for a universal national insurance solution." Clearly, this view is contrary to Vote Health's current mission and would constitute a radical change in Vote Health's direction. Vote Health cannot unite with those working to defend the safety net and expand patient rights and at the same time accuse these volunteers and allies of "worsening the crisis" in the communities they serve.
By simply refusing to work together amicably, this faction may succeed in taking over Vote Health. However, it would be a gross misrepresentation for them to use the Vote Health name—a name associated with a broad, inclusive approach to winning health care rights—to pursue such a narrow agenda.
A new local coalition is forming to work on:
- Preserving the safety net and keeping Highland Hospital and the Alameda County Medical Center open.
Expanding access to free and low-cost insurance.
- Making the public aware of the enormous human cost of uninsurance.
- Demanding that private hospitals provide their fair share of free care to those in need.
- Supporting health care workers' demands for a say in the quality of patient care.
You will be contacted soon with an invitation to join this coalition and continue this important work.
For those who wish to work on advocating a statewide publicly financed universal (single-payer) insurance system, you may want to join Health Care for All-California (HCACA) if you are not already a member. HCACA can be reached at 1-415-695-7891 or by visiting www.healthcareforall.org.
To the many activists with whom I have shared the past six years of struggle and so many great victories, I express my sincere regrets at this turn of events. I look forward to a few months' rest, then a return to local health care activism—and I hope to see you on the picketlines.
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To conclude, some obvious but wise words from activist Ann Schaeffer:
We may at any given time see one solution to one problem differently from each other, but we all want the same thing—health care for all. ..The only way that I know of that's better is for people of good will to join together and to stick together through thick and thin. We have to talk it over until everyone who has an idea to offer has a chance to talk. Then we have to vote and abide by the result. But splitting up is not an option.
