I attended a rally yesterday (see Blue Virginia for the original post; also note that, to my knowledge, I was the only "media" there) in Woodbridge, Virginia, as Mayor Adam O'Neal (R-NC) nears the end of his 273-mile walk for health care, rural hospitals, and Medicaid expansion. See below for video and notes on the speakers' key points. But first, here's a fact sheet put out by Mayor O'Neal's team (including Eric Byler and Annabel Park of the "Story of America" project):
Background: Mayor Adam O'Neal is a 45-year-old conservative Republican, former football player with a hard nose attitude. He became Mayor 10 years ago by reaching out to the 2/3 African American majority in his town of 1,700. He has represented them well and been reelected by large margins. Many news outlets misreport O'Neal's alliance with Rev. Dr. William Barber, leader of the Moral Monday movement as a sudden or remarkable turn. The truth is that O'Neal has been working with African Americans from the start, and, when this crisis required him to unite his community, he was uniquely suited to do so.
Rally at US Capitol on Monday at 11:30 AM with Mayor O'Neal and Rev. Dr. William Barber On July 14, Rev. Barber said a prayer to bless Mayor O'neal's 273 mile walk to Washington DC. On July 28, he will be there to greet him, where the two will lead a rally for rural healthcare and Medicaid expansion at the US Capitol.
Endangered Rural Hospital: Vidant Health, Inc. purchased Pungo District Hospital in O'Neal's town of Belhaven, NC in 2012, promising to be the savior for a "Critical Access" hospital that had been a fixture in his community for 60 years. It was the first hospital to open under the Hill/Burton Act of 1946, designed to bring hospitals and emergency care into rural America.
Although the terms of the contract stated that the hospital would remain open, and that Vidant Health would invest $2.4 million in improving services, Vidant Health decided not to invest that money and instead stripped out valuable equipment and profitable serivces. Theyclose the hospital 18 months after taking it over. They said it was losing too much money, and indeed the yearly losses had increased to over $1 million due to mismanagement and creative accounting (for instance, the six figure executive who ran the hospital also ran 2 other hospitals and visited briefly only once a week, yet his entire salary was included in the Pungo hospital balance sheet).
Mayor O'Neal was outraged that the town had not been warned nor consulted, and, many agreed with him that the contract Vidant Health had signed (then then were known as University Health Systems) had been breached. Many suspect that Vidant intended to close the hospital when it purchased it, given that it purchased a neighboring hospital 30 miles away during the same period.
It seems clear that Vidant Health does not want to have an emergency room in this region because EMTALA requires them to treat people who have no insurance and cannot afford to pay
This is a trend in rural areas across America, particularly in states that refused to expand Medicaid. 46 million Americans live in rural areas like eastern NC, where there is only one medical facility serving one or more counties and tens of thousands of people. More such hospitals have closed in the last year than in the 15 previous years.
Health care crisis: 30 miles may not seem like a lot, but the Pungo District Hospital also served the people of Hyde County to the east. Hyde County is one of the poorest and one of the largest counties in the state. It has no hospital of its own. And it has no physicians. Many were already traveling 50 to 60 miles to reach Belhaven. Now they are traveling 80 to 90 miles for preventative and emergency care. The hospital closed on July 1. On July 5, a 48-year-old mother of 3 died for lack of emergency care.
60 percent of funding that keeps rural and Critical Access hospitals afloat comes from Medicare (the remainder comes from Medicaid or from general health insurance). While North Carolina's failure to expand Medicaid has hurt this hospital, it was not a fatal blow as Vidant sometimes claims. There is another provision in the ACA that makes Medicare more efficient by incentivizing health care providers to work with communities to lower costs.
This VIDEO summarizes how ACO's work, and how Vidant found a way to break that settlement using a quasi-subsidiary called Pantego Creek, LLC to block the hospital transfer.
And this video is one of several that go into more depth on ACO's, a provision in Obamacare that could save rural America from medical desserts and make The Affordable Care Act a success
Belhaven's new community hospital board has formed an Accountable Care Organization as part of the ACA, they were almost ready to take over the hospital when Vidant Health backed out of the DoJ-mediated settlement and shut the hospital's doors. The hospital board believes that this is because ACOs have had great success in other rural regions and Vidant decided they'd rather take on DoJ than have a competitor offering superior health care in the middle of their territory.
Vidant Health: Vidant Health is a non-profit company, which means it pays no taxes on income nor on the many properties it owns. But it's operating margin (profit margin) is exceedingly high at 11%. They took in $109 million last year and $127 in 2012. They are the largest employer in the region, they have a near monopoly in the region, and they have a team of lawyers and a PR staff hammering the Mayor in the press, and exerting heavy influence on what local TV affiliates report, and on how local county commissioners vote. They have corporate police officers that often kick Story of America off their property.
Civil Rights Act, Title 6 Complaint: Rev. Barber and the North Carolina NAACP filed a Title 6 Complaint arguing that the closure of the hospital would disproportionately impact minorities and poor people. The DoJ agreed enough to offer mediation. A settlement was reached on March 26 under which the hospital would be transferred back to the community. Vidant found a way to break that settlement when a quasi-subsidiary to block the deal, the NAACP re-opened their Title 6 Complaint. Health and Human Services is now investigating, many suspect, for a possible conspiracy.
Here are a few highlights from O'Neal's remarks.
#Introduces civil rights legend Bob Zellner, who worked with MLK, Jr. and Rosa Parks, was a leader of the Student Nonviolent Coordinating Committee, etc.
#Says they're walking because the state of North Carolina hasn't accepted Medicaid expansion, even though North Carolina taxpayers have already paid the money. That means $2 billion isn't coming into North Carolina, that reimbursements to hospitals for indigent care are falling, that rural hospitals - including "critical access hospitals" - are struggling to break even every year and big healthcare conglomerates are buying up these hospitals and closing them.
#In Bellhaven, the hospital was losing money, so a big health care conglomerate - Vidant Health - took over the hospital in September 2011. Vidant promised to strengthen and maintain the hospital, but instead they closed it down. Vidant made $109 million in 2013 and has over $500 million in reserves, even though it's a non profit, and they want to close a critical-access hospital??!? "That's wrong, that's why you have laws." "We've had our health care stolen."
#Provides an example of a 48-year-old woman with 3 kids and a husband in a neighboring county without a hospital or a doctor. She had a heart attack and normally would have gone to Bellhaven hospital, but since Bellhaven had been shut down, they called for a helicopter. That took an hour, and during that time, the woman died in an ambulance in a parking lot. She didn't have to die. "It's a big deal, people die, this lady has a husband who's crying...When you're making hundreds of millions of dollars a year, you shouldn't be shutting down hospitals - when you're a non-profit..."
#Not a person in power has sent a letter to Vidant telling them to get their act together. The governor of North Carolina "won't meet with us." O'Neal can't understand why the governor won't get involved in this. This is NOT the private sector; Medicare and Medicaid are already the major players in health care. We need to stop playing politics with this.
#"The Republicans in my state, many of them kind of support me in a way. They don't fight with me at all. I think one of the major reasons is there's no real argument against accepting Medicaid expansion. And I'm afraid that my Republican colleagues in NC are going to get killed this fall because of Medicaid expansion. There's 500,000 people in NC that could have insurance coverage the next 2 years and not cost the state a dime, and the state's not accepting that. Now, if you're representing the citizens, how can you not do that?...I don't see how you can represent the citizens of NC and not accept that...So I think we got an issue where folks have dug their heels in on an issue that they need to rethink...and I don't want to rub anybody's face in anything because it's an issue where all of us have to work together. It's not a Republican or Democrat[ic] issue when this lady starts dying. Now, f you're doing something that's causing this lady to start doing, you gotta rethink what you're doing..."
#It's "immoral" for a company to take health care away from people and keep your non-profit designation. We're also walking to see a bill introduced that HHS has to sign off in order to close a critical-access hospital. Also want at least year for communities to try to save their hospital.
#We have a hospital that could have survived, but we have a big conglomerate that wanted to consolidate, force our people to go to another one of their hospitals. "I'm all for private enterprise...what Vidant is doing is eliminating competition..."
#"We're walking for all of rural America," including Lee County right here in Virginia, which lost its hospital.
Now, here's Civil Rights Legend Bob Zellner:
Zellner notes that he was raised on "L.A. - Lower Alabama." His father and grandfather were both in the KKK, and it was very unlikely he'd ever be part of the civil rights movement, let alone walking 273 miles with a white Republican NC mayor. When he was in college, he met Martin Luther King, Jr and Rosa Parks, and he joined the Student Nonviolent Coordinating Committee as the first white southerner to be a field secretary for that organization. What Mayor O'Neal is doing is in the mainstream of the human rights and civil rights movements. "I recognize greatness when I see it...this man is the most determined individual that I've ever met." What's happened in NC is that we have the "Moral Mondays" movement under the leadership of Rev. Barber and the NAACP. The mayor was doing what he was doing already, and he knows that what Vidant has done is a racist situation in his own town, because at least 60% of the people in the town are African Americans. He's brave to say that. We're going to Washington to fight for rural health care. Mayor O'Neal personifies reaching across the aisle, he's captured the imagination of the American people.
Virginia State Senator George Barker thanks Mayor O'Neal for his walk and for "inspiring us," says "we're with you" and that Virginia shares many of the same issues and problems (e.g., with rural hospitals under tremendous financial pressure, being forced to close in Lee County, etc.) as North Carolina. Sen. Barker notes that only 2 legislators in the entire General Assembly out of 140 who represent largely rural areas and who supported closing the coverage gap, and only 1 is a Republican. "They are hurting their own constituents." Sen. Barker notes that his isn't just happening in rural areas, but that people are dying because of lack of health care in urban/suburban areas as well. Bottom line: we need to expand Medicaid ASAP.
Next, Del. Michael Futrell (D-Prince William County, Virginia) explains how he helped put this program together after Virginia New Majority contacted him about the Republican mayor fighting his own party, standing up for what's right for his people, and walking through Virginia en route to Washington, DC.
Futrell emphasizes that this shouldn't just be about great speeches, but about ACTION. What's going to move this needle is people organizing, getting involved, putting pressure on politicians to get this done. This should not be a partisan issue. Futrell points out that the health clinic where we're having this program sits between the Prince William Republican and Democratic committees. Symbolism: health care for people is caught in the middle of politics.
There's a financial cost and a humane cost here. Nobody wants to see people die because of partisan politics. This is more important than winning or losing an election, this is about people's lives. The goal should be to make an impact, a difference. "We have to get things done." Asks everyone to volunteer, knock doors, make phone calls, get this done. "Elections have consequences...people are supposed to fight for us...this man has taken on a journey...when the majority of his party says 'no, we're not going to,' that's courageous..." "It's going to come down to you...My role right here is for a call to action."
Last but not least, here are some videos from health care workers on the real-life impacts of people not having high-quality, affordable health care coverage are.
UPDATE: I got to ask the last question, whether when he met with Virginia Gov. Terry McAuliffe (D), he also met with any of the Virginia Republicans who are solely responsible for blocking Medicaid expansion in the state? Mayor O'Neal responded that Virginia Republicans didn't invite him to talk with them on Medicaid, health care
O'Neal added that he's "depressed" that Republicans are "giving me...the runaround," because this issue should be an issue that's beyond politics. O'Neal said there "isn't an excuse," and that he's trying to "wake our state party up - you'd better get on board with this because it's coming sooner or later, and why do you want to be seen as blocking health care for people when it's coming anyway, what sense does that make?"
I followed up and asked, "Do you really feel like there are going to be political consequences this November for Republicans." Mayor O'Neal's response:
I think there will be, if people understand the issue...I've had Democratic candidates like Senator Hagan...ask them to help them do commercials. I'm not going to do that, I'm going to vote for a Republican candidate. I don't want to help them beat a Republican; I don't agree with them on that issue, but the other issues I do agree with them...I am a Republican, this is not a joke, I'm a conservative guy, but this is an issue I'm not going to dig my heels in with no logic. It doesn't make sense. And when people start dying I sure ain't gonna dig my heels in. (applause)