Models of from-below healthcare: Lincoln Hospital Takeover

A slow work-in-progress of surveying/understanding various models of healthcare. Not enough time to go in depth now. Hope is that in a few months I can see this as part of a broader picture.

Thanks cg for forwarding some of these links. Anyone else, send me what you got!:)

For now, are some links on the Lincoln Hospital Takeover by the Young Lords in NYC back in the day. 

- The Lincoln Hospital Offensive in 1970 

- excerpt from The Puerto Rican Movement: Voices from the Diaspora (see chapter by Iris Morales) here

- The Young Lords Ten Point Program
-The Health Initiatives of the Young Lords Party: How a group of 1960s radicals made healthcare a revolutionary concern [16 pages]

This is the same organization that my favorite queer revolutionary, Sylvia Rivera, was a part of. She was a transwoman activist with strong class and race politics, forefronting transliberation struggles at a time when it was invisibilized by the anti-trans gay and lesbian, as well as 2nd wave feminist politics.

Some things that stand out from the 10-point program (posted below)

* Community control over health services

* Community control over hiring and firing at hospital

* Collaboration with medical students (see excerpt description)

* Employment in hospitals

* Free healthcare

* door-to-door health services: bringing healthcare to the people

* Education

* alliance b/w unions/employed people and unemployed through agreement to provision of services and community control

The Lincoln offensive was triggered by the death of a young Puerto Rican woman who had a botched abortion procedure in the hospital. This had great impact on the way the Young Lords took up reproductive rights with the leadership (through struggle!) of women leaders.

3 major ways to reclaim healthcare for community; seeing healthcare as working class issue:

Lead Offensive
TB Offensive
Lincoln Offensive

Organization that was set up: Health Revolutionary Union Movement (HRUM) was influenced by DRUMS in Detroit -- League of Revolutionary Black Workers; HRUM set up by hospital workers of color who saw their labor struggles and struggles in healthcare as part of broader working class struggles (amazing!!)

Conducted direct action to make city more responsive to healthcare needs of poor; community control of such services

Young Lords 
Ten-Point Health Program

1. We want total self-determination of all health services through an incorporated Community-Staff Governing Board for the Hospital. (Staff is anyone and everyone working at the hospital.) 

2. We want immediate replacement of all government administrators by community and staff appointed people whose practice has demonstrated their commitment to serve our poor community. 

3. We demand an immediate end to construction of the new emergency room until the Hospital Community-Staff Governing Board inspects and approves them or authorizes new plans. 

4. We want employment for our people. All jobs must be filled by community residents first, using on-the-job training and other educational opportunities as basis for service and promotion. 

5. We want free publicly supported health care for treatment and prevention. We want an end to all fees. 

6. We want total decentralization--block health officers responsible to the community-staff board should be instituted. 

7. We want "door-to-door" preventive health services emphasizing environment and sanitation control, nutrition, drug addiction, maternal and child care, and senior citizen services. 

8. We want education programs for all the people to expose health problems --sanitation, rats, poor housing, malnutrition, police brutality, pollution, and other forms of oppression. 

9. We want total control by the community-staff governing board of the budget allocations, medical policy along the above points, hiring, firing, and salaries of employees, construction and health code enforcement. 

10. Any community, union, or workers organization must support all the points of this program and work and fight for that or be shown as what they are--enemies of poor people.

Witches, Midwives and Nurses

Read online version here

I hope to develop through this blog, a holistic understanding of health, our bodies, labor, gender and disabilities struggles. I feel like this pamphlet is exactly the kind of foundational texts that need to be made more accessible in our time. Non-institutionalized, accessible, community run healthcare is not the terrain of new age-y, white, middle class hippies. It is the terrain of women of color, of class struggle, of gender struggle that had been severely attacked historically. I feel like it's time to reclaim, normalize and integrate it into my life and politics.

Commodified care expresses how caring work (which involves love, support, skilled labor etc) has been turned into capitalist properties for the purpose of $$ and not for the purpose of furthering and expanding humanity. It takes the form of disableism, racism and patriarchy in that some bodies are more commodified than others, both as bodies which are seen as useless and therefore suitable only as OBJECTS that can gain profits, or as bodies that are not flesh and blood, but rather machines that can be sped up endlessly. 

The foundation of commodified care is that it separates our physical bodies from our mental and emotional health. Like so many things, it is a product of extreme rationalism, Enlightenment philosophy gone sour, which institutionalizes the mind-body split. This mind-body split is also expressed in classed, gendered and bodily ways -- the elite, the male and the able-bodied cisgendered male is seen as the pedestal of rationalism while the poor, women and gender non-conforming folks, disabled bodies are lacking and more controlled by our primitive, bodily needs. Fixing is what we need, in bodily and mental forms -- thus invasive medical procedures and indoctrinating education that devalue us in our own eyes. On a more everyday level, it is how at my workplace, CNAs are expected to do the servant-like menial labor, do the daily grooming and dressing, but not be trained in medical skills or be given time/space in our workday to BUILD relationships with our residents. This is not to say that relationships dont form between us and our residents, but that they form because of the resilience of relationships and love, not because they had been accounted for as an integral dimension of the caring work that we do. 

What I am most excited about by this pamphlet is its description of the Popular Health Movement, as opposed to the "Feminist" movement led by white, middle class Victorian ladies. The Popular Health Movement involved the widespread dissemination of knowledge about herbal medicine, preventative care, and expertise about the body and hygiene, as opposed to the elitism and isolation of doctors, the professionalized medical establishment.
[To continue, read here]  

 

Reading

I am trying to understand the political economy of the healthcare industrial complex, and the nursing home industrial complex. 


I am doing so to understand the broader dynamics that are currently determining my work life, and my relationships with the residents at the home I work in. 


I am constantly reminded of the temporality of my body's abilities, and really like how disabilities liberation framework talks about abled bodies as merely temporarily abled. Part of my resentment with my work is that the speed up forces me to contort my body in destructive ways, using my back muscles to substitute for safety and time. I see my coworkers exert themselves too and understand how we are all vulnerable like this. And how tragic it is that our exploited labor power will not even be able to be reproduced in this country since many of my coworkers will either not receive appropriate retirement and healthcare, or will return home, or will die because of these work-induced disabilities.This dimension of things makes me really interested in understanding Marxism, and reproductive labor, and labor power. 


I also am exploring and trying to understand disabilities liberation, and disableism, with an eye toward thinking about how my struggle for liberation as a healthcare worker, my desire to protect my body and the bodies of the residents, are all intertwined. 


I have felt that the language of safety for the residents/patients that is being used in nursing struggles is not enough, is not satisfactory. It talks about safety in a bland way -- not surprising given many of these struggles are led by the union bureuacracies in an ableist society. I hope to find models that integrate a healthier, more liberatory vision toward all bodies, with the struggles of the workplace. I think the healthcare workers' struggles present a concrete site for struggling around reclaiming liberatory aspects of technology and medicine, while discarding its harmful/capitalist dimensions.


I have been exploring a few articles and blogs that come at the issue from the perspective of the people receiving commodified care, people with disabilities (PWD) who are forced into nursing homes and undesirable/unwanted/damaging treatment.


Here's from Marta Russell: No Nursing Home on Wheels
She strikes me as some kind of social dem, sort of mainstream disabilities rights writer. I am learning alot from her writings and her references though:


On productivity, work and the displacement of non-productive bodies under capitalist standards: 


Not coincidently, the rise of the institution accompanied the rise of capitalism in Western societies. As work became more rationalized, requiring precise mechanical movements of the body repeated in quicker succession, impaired persons - deaf, blind, developmentally disabled, mentally impaired, those with mobility difficulties and others - were seen as less "fit" to do the tasks required of factory workers. They were increasingly excluded from paid employment on the grounds that they were unable to keep pace with the "disciplinary" power of the new mechanized, factory-based production system.   So it was that the operation of the labor market in the 19th century effectively depressed disabled people of all kinds to the bottom of the market.  As industrial capitalism demanded a standard worker body which would conform to the needs of production, disabled persons came to be regarded as a social problem and the justification emerged for segregating individuals with impairments out of mainstream life and into a variety of institutions including workhouses, asylums, prisons, colonies and special schools .


This reminds me of the prison industrial complex; Displaced, Surplus, Unusable Bodies = commodities

When a single impaired body generates $30,000-$82,000 in annual revenues, Wall Street brokers count that body as an asset which contributes to a nursing home chain's net worth. Though transfer to nursing homes and similar institutions is almost always involuntary, and though abuse and violation of rights within such facilities is a national scandal, it is a blunt economic fact that, from the point of view of the capitalist "care" industry, disabled people are worth more to the Gross Domestic Product when occupying institutional "beds" than they are in their own homes.


What happens to the disabled residents/patients, happens to the workers too

A rejection by both disability groups and workers of the corporate "care" paradigm means a rejection of the logic that human labor and disabled people's bodies must be reduced to commodities for sale - in order that someone can make a buck. 


Russell is arguing that nursing homes are remnants of this way of factory/institutionalizing PWD. That the better alternative is independent living with paid care work. I am thinking this through and trying to understand what this also means for workers who engage in that kind of care work. Women's labor/domestic labor/caring labor has historically been undervalued. In my work environment, the nursing home sweatshop I work in provides me with benefits and healthcare, which I wont get if I were to do home healthcare. More research!