News, Views and Opinion

Karen Shore, Ph.D.

Well, the dust has settled and hopefully, we have all had a little time off since April 1, 2000. As a quick summary on Rescue Health Care Day (RHCD), more cities than I was aware of held marches, rallies or teach-ins, and it seems that everyone had a great time on April 1st. The purposes of RHCD were to declare a national vote of "No Confidence" in managed care, raise awareness of the problem and state clearly that managed care must be replaced, and to initiate a national dialogue on alternatives to managed care.

A theme used by many of the rallies, "Blow the Whistle on Managed Care" made for wonderfully noisy and invigorating demonstrations. Our thanks to Jamie Court of Consumers for Quality Care and co-author of "Making a Killing: HMOs and the Threat to Your Health," for giving us this idea. My family's "Don't Rain Dance" that we have been doing for 35 years and has never failed, worked again. My thanks also the Long Island RHCD crew for overcoming their inhibitions and learning and actually dancing the Don't Rain Dance with me. Just about the entire nation enjoyed sunny and warm weather on April 1st. In New York, April 1st turned out to be just about the ONLY nice, warm day in April!

The attendance ranged from 50 to 300 people at the various sites. The cities involved were Fresno, Los Angeles, San Clarita, San Diego, and San Jose, all in California; Denver; New Haven, CT; Washington, DC; Atlanta; Portland, ME; Baltimore, MD; Trenton and Union, both in New Jersey; New York City, Buffalo, Albany, Dutchess County, Hudson Valley region, Mineola, Stony Brook, and Ulster County, all in New York State; Asheville, Durham, Greensboro, Winston-Salem, Charlotte, Wilmington, and Raleigh, all in North Carolina; Cincinnati and Columbus, both in Ohio; Portland, OR; Orlando, FL; Pittsburgh, PA; Austin, TX; Seattle, WA; Madison, WI; and Huntington, WV. If my information is accurate, there were 37 cities involved.

Most of the organizing and attendance at the rallies involved a combination of consumer and professional groups, varying in their balance between the two. Some were heavily clinician-driven. Others, like New York City, had heavy support from both professional and consumer groups, and the Washington DC rally was fully organized by consumer groups. Most had consumers who have been harmed by managed care and health care professionals addressing the crowds and some had their legislators, too.

The best part of all the organizing I have done over the past eight years has been the wonderful people I have met. I know many other organizers have said the same thing. When you get down to it, people are what its about and why we are all activists in the first place. It's about us, our families, our friends, our communities, and our nation as a whole. It's about people. It is about the desire to have a physically and mentally healthy nation.

There were two chief accomplishments. One was the excellent press coverage that our small band of rebels attracted. RHCD made television and newspaper news all over the country, increasing public awareness of the problem of HMOs and other forms of managed care and clearly stating our desire to replace the system. The other major accomplishment was that the RHCD effort, which began in July 1998 with the National Coalition of Mental Health Professionals and Consumers (www.nomanagedcare.org), attracted about 250 consumer and professional organizations. Ron Bronow, M.D., and Physicians Who Care became cosponsors early on and were crucial to the gaining momentum. Both Ron and I and all those who worked on RHCD greatly appreciated the support of these 250 organizations. These organizations can now, if they choose, continue to work together and expand the effort to overthrow the managed care system and replace it with something better.

The biggest lack of success was that we did not get thousands at each rally. All those who want to see managed care end but who did not take the two hours or so to attend have to ask themselves why they did not contribute to a show of strength and support for the event.

The greatest achievement is yet to come, though, and this is the creation of a pro-patient, pro-quality system of health insurance. One of the contacts we made was with an organization called U2K, meaning universal coverage in 2000. U2K is an organization of organizations from the consumer, unions, and faith communities who want to create a better system. U2K was instrumental in organizing the Washington DC and the New York City RHCD rallies. They have a growing list of members of Congress who want to listen to them and work with them. The members of Congress working with U2K are led by Rep. John Conyers (D-MI), whose new health care aide, Joel Segal, led the RHCD effort in Washington, DC until Rep. Conyers hired him. The binding principles of the group are to push for universal coverage and access, a comprehensive plan, affordability, quality, and public accountability.

Others, such as the NYC groups, want to add the principle of the autonomy of the patient-practitioner dyad. The discussion is open to all who wish to take part. U2K is a politically savvy group of really good people and I believe they will have a strong impact. Thus, the National Coalition of Mental Health Professionals and Consumers chose to work with them. We want to be at the table when ideas for a new system are discussed.

There are several groups that want to continue the RHCD effort and have started talking about and planning RHCD 2001. For those who are interested, we have set up a new listerserve, called Rescue Health Care. Organizers will find it easier to communicate and share ideas across the miles than the arrangement we had before. If you would like to consider organizing a RHCD 2001 in your area, begin NOW! You need to work with consumer and professional groups and involve as many as possible right away. Consumers are the key. The date for RHCD 2001 is open at this time and up for discussion. The sharing of ideas for organizing through the listserve will make everyone's job much easier this time around. All who participated learned a great deal and have a lot of suggestions to offer for the next RHCD.

Personally, I will not be able to be as involved as I was because after eight years of involvement, I wish to step back some.... not completely, but some. It is time to tend more to my own life. I'll still be involved and active...just not quite as much. I will continue to serve as President of our National Coalition until June 2001 at which time, our new President-Elect, Deborah Peel, M.D., from Austin TX, will assume the Presidency. Deborah is a strong, accomplished advocate with many political connections. She will be superb, and I am happy to count her as a support, advisor, and friend.

If you are interested in the future of the Rescue Health Care effort, get into the RHC listserve. Go to the RHCD website at www.rescuehealthcareday.com. Then click on the box that says "Join E-Groups" on the first page. Then click "subscribe" on the left of the screen. Then "New member to register". I am afraid that the instructions get a bit fuzzy after this because I'm already registered, so I get a screen at this point that says "My Groups" and I find it there. Look for "rescuehc@egroups.com" or something similar; possibly go to "My Groups" if this shows. Once you are registered in the rescuehc listserve, you will be able to post directly to the list. You can also go to www.egroups.com and may be able to sign up that way.

Again, my thanks to all who gave time, effort, ideas, and/or money to Rescue Health Care Day 2000.

Best wishes,
Karen Shore, Ph.D.,
President
National Coalition of Mental Health Professionals and Consumers, Inc.

www.nomanagedcare.org

www.rescuehealthcareday.com