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Change can't wait



Tamecka Pierce knows the trouble with health care in Florida in a way she never expected to. The 35-year-old single mother of three was diagnosed with lupus in 2007, while she was still employed in a state representative's office and carrying a Blue Cross Blue Shield health insurance card. Even then it wasn't easy; the constant flare-ups of the autoimmune disease made working difficult, as did the co-payments that went along with them. She found herself dealing with more and more specialists — her lupus led to stage-three kidney disease and inflammation of the eyes — and caught in an impossible web.

"I can't afford my disease … I have to choose between going to the doctor, filling my prescriptions, and feeding my children, paying my bills and stuff like that," she says.

Now Pierce is unemployed — although she is an unpaid "chair" of Florida ACORN, the activist group that often serves as a right-wing piñata — and faced with the even worse conundrum of Medicaid. At first, her benefit was paid, but now that she receives unemployment checks, she has to meet a $797 deductible before she's even considered for reimbursement. Worse, she's just found out that there are no rheumatologists in Florida who accept Medicaid; her lupus treatment requires a rheumatologist. Pierce is in and out of the hospital, taking chemotherapy for her kidney disease and running out of hope.

"It hurts my feelings," she says. "And I don't complain all day, but sometimes I just cry because I don't have money, or because it's unfortunate that I lost my job. It's unfortunate that I have this disease, that I have to depend on someone who will say, ‘OK, you can feel good today. You can take your medication; you can feel well today.'"

As the health-care debate grinds through Congress, and as politically interested Republicans and their monied allies invest millions of dollars to destroy any hope of real reform — by screaming "socialism" and claiming, as U.S. Rep. Virginia Foxx, R-N.C., did, that Democratic reform will cause old people to be "put to death" — stories like Pierce's serve as reminders of why fundamental reform of our broken, for-profit health-care system is so desperately needed — especially here in Florida.

The numbers don't lie: The Sunshine State ranks third in the nation in uninsured residents. As of 2007, more than 20 percent of Floridians lacked health insurance — and that was when the economy was humming along nicely. Here in the heart of the Great Recession, with the state's unemployment topping 10 percent, those numbers keep getting worse: Another 3,500 Floridians lose their health insurance every week. Minorities are particularly hard-hit.

But in the end, this isn't just about numbers. Nor is it about political gamesmanship. It's about our societal soul: In the wealthiest country in the history of the world, should Tamecka Pierce or millions like her be denied the coverage they need to survive?

The war

"We don't have a choice. This is expected," says Orlando ACORN head organizer Stephanie Porta, taking a break from a phone campaign expected to generate 50,000 calls to Washington, D.C. "There was a big war against health-care reform back in the '90s. We knew it would happen again."

Indeed, it has. The rhetoric surrounding the current health-care debate in the Capitol has been at times surreal, even by cable-news standards. Republican U.S. Sen. Jim DeMint of South Carolina, for instance, bellicosely declared that if his caucus could derail reform, it would be President Obama's "Waterloo" — and in effect, destroy his presidency. The conservative punditry has warned that including any sort of public option in the nascent health-care legislation is a first step toward tyranny.

So far, the scare campaign has succeeded brilliantly. The most progressive health-care reform, creating a single-payer system, is not even on the table. Despite overwhelming majorities in the House and Senate and control of the White House, Democrats have been so far unable to congeal around and gain traction on any specific proposal. The health-insurance industry is pumping $1.4 million a day into lobbying Congress. The conservative Blue Dog coalition and moderate Democrats in the Senate are stalling and bending over backwards to accommodate recalcitrant Republicans, which may end up watering down any legislation to the point of futility. Meanwhile, support for reform in the abstract — and President Obama specifically — is falling in polls, an ominous sign for those who see a once-in-a-generation chance to make things better.

An army of progressive foot soldiers, including Porta — many of the same people who phone-banked or knocked on doors for candidate Obama last year — are trying desperately to even the scales by pressuring Democratic lawmakers to commit to voting against any ostensible reform that doesn't include a viable public option or other meaningful updates.

A new report detailing just how bad things are in Florida, especially for the underprivileged and for racial minorities, may strengthen their hand.

Last month, the national nonprofit Health Care for America Now released "Unequal Lives: Health Care Discrimination Harms Communities of Color in Florida." In doing so, HCAN — a coalition of more than 1,000 organizations, including labor unions and ACORN — pointed out what to many has been the obvious racial underpinning in the health-care argument.

"A high-performing health care system must deliver quality care to everyone, regardless of race, ethnicity, sex, income or any other demographic characteristic," the report concluded. While in 2002, 21 percent of white Americans were at some point uninsured, 28 percent of African Americans and 44 percent of Latinos had no insurance. On the whole, minorities received poorer care, had higher infant mortality rates and shorter life expectancy, and were less likely to be properly diagnosed or treated.

"We continue to demonize the poor," says Porta. "This isn't just about the poor. Most middle-class income families don't have affordable health care. Americans are already paying for this. We are paying for the people without health insurance every day. The fact is that `Americans` don't see it."

Statewide, some 3.7 million Floridians were uninsured as of 2007. Fifty-three percent of the working-age poor — those between 19 and 64 who live under the poverty line — live without insurance.

A step further

Though there are several different bills circulating through congressional committees, the reforms all center on reducing the number of uninsured from the current 47 million. According to Democrats on the House Committee on Energy and Commerce, one such proposal, the America's Affordable Health Choices Act, would have dramatic results in Central Florida.

In Florida's eighth congressional district, represented by Orlando Democrat Alan Grayson, the legislation would grant 126,000 of the district's 150,000 uninsured residents access to coverage, and that would enable more than 1,500 families to escape bankruptcies associated with skyrocketing medical costs.

Last month, Grayson went on record in support of the public option — the nonprofit, government-run insurance program that would compete with private insurers to, theoretically, drive down prices.

Neighboring District 24's Suzanne Kosmas, another Democrat, has remained noncommittal — as has the state's consistently wishy-washy Democratic senator, Bill Nelson. Republicans, including U.S. Sen. Mel Martinez, are almost uniformly opposed.

"What I find interesting is that Republicans are saying, ‘You guys aren't playing fair, you're not negotiating,'" says Porta. "We gave up single-payer. We've already given on our side."

Conservatives in the state Legislature want to go a step further.

Last month, state Rep. Scott Plakon of Longwood and state Sen. Carey Baker of Eustis introduced House Joint Resolution 37, a proposed constitutional amendment that would in effect inoculate Florida from any federal health-care reform.

If Congress forces insurers to end the practice of rejecting those with pre-existing conditions, Plakon and Baker want such rules not to apply to Florida — you would continue to be at the mercy of for-profit insurance companies' whims.

If they can get a three-fifths majority approval in each legislative body, that proposal will go to the November 2010 ballot. Sticking to talking points common among the AM radio crowd, Plakon told the Associated Press that the federal health-care plan amounted to a "power grab" by Obama. Baker, who is running for state agriculture commissioner, called it the "socialization" of medicine, and direly predicted that a public option would lead to the rationing of health care.

But that kind of bombast won't keep people like Pierce from trying to put a face to the problem.

"People don't realize that there are working people that can't afford health care," she says. "I was in that situation. Now I'm walking in the shoes of an unemployed single parent who doesn't have good health care, who has to depend on Medicaid. I want a job, but unfortunately I'm sick all the time, so I don't know who would want to hire me, but I'm going to try.

"People need to hear the story. I don't think many people know that there are no rheumatologists in the state of Florida who will take Medicaid. There's somebody out there just like me, so when they hear my story, they'll want to tell theirs. The more people who will tell their stories, the more people will work for change."

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