National Nurses United

transition to universal care," said James Haslam, executive director of the Vermont Workers' Center, one of the key groups in lobbying for Green Mountain Care. California as the most populous state in the United States and the eighth largest economy in the world, achieving a state-based sin- gle-payer system there has represented the greatest opportunity and potential for propelling the nation forward in the fight to pro- vide a single standard of high-quality care for all. Many people believe that winning such a system in a state like California would set the stage for a rapid transition in the United States as a whole, either state by state or even through a federal bill. California's Legislature has passed single-payer, Medicare-for- all bills twice in the past eight years. In 2006 and 2008, bills authored by Sen. Sheila Kuehl successfully made it out of lawmak- ers' hands only to be vetoed by former Republican Gov. Arnold Schwarzenegger. Since then, state Sen. Mark Leno also introduced single-payer legislation. But the path to legislative success for a California state single-payer bill has been somewhat more complicated as the state faced massive budget pressures as well as the design and implementation of the state health insurance exchange required under the Affordable Care Act. Just last year, however, the coalition committed to winning single- payer in California, organized under the name Campaign for a Healthy California, has regrouped and is redoubling its efforts in an ambitious campaign to put a single-payer initiative on the 2016 ballot for voters to decide. The California Nurses Association/National Nurses United continues to be a driving force within Campaign for a Healthy California (CNA/NNU board member Martha Kuhl, RN is treasurer of the campaign and CNA helps staff the effort), and the campaign has put renewed focus on mobilizing the support of labor union members. "Ultimately, the ACA doesn't go far enough. The ACA leaves the health insurance companies in control of who you can see, where you can go," said Malinda Markowitz, RN and a copresident of CNA, at a recent campaign meeting. "The only way everyone will have health- care, not just health insurance, is an expanded Medicare for all." She added that union members like herself would be freed up during contract talks to bargain over other important issues, such as safe staffing, if "we don't ever again have to go to the bargaining table and deal with healthcare issues." The campaign also got a shot in the arm with the naming of Paul Song, a Los Angeles-area oncologist and executive director of the pro- gressive Courage Campaign, and Cindy Zecher, a middle school office manager and board member of the California School Employees Association, as cochairs. For both, single-payer is very personal. Song says that he was "tired of seeing…patients, who in fact had insurance, go bankrupt because they came down with cancer" and of "constantly having to fight with insurance companies to get approval to give [patients] the care that the medical literature supported." Zecher said that many CSEA members are now "dealing with situations where they get a paycheck that has nothing on it and they are writing a check back to the district for healthcare." In other words, those employees work solely in order to be able to buy health insurance through their school districts, and that's it. The plan for 2014 is to highlight and educate the public about how the private insurance industry harms patients. The campaign will do this a number of ways, from pushing a package of legislation that honors a "Patient Bill of Rights" and seeks to close loopholes of Showing Mercy Inspired by the Occupy Wall Street movement, his relation- ship with someone with a chronic illness, and his own med- ical problem, Julliard-trained actor Michael Milligan last year wrote and debuted a solo show, Mercy Killers, in which a man relates his life's spiral out of control when his wife gets cancer. Milligan says he was driven to write the play by a med- ical emergency while uninsured. "I was passing kidney stones, and I did what probably a lot of people do—I went online," he said. "I diagnosed myself with kidney failure. Then I looked up how much it was to go to the emergency room. It was $8,000, so I stayed home. If it had been kidney failure, maybe I would be dead." Mercy Killers tells the story of an auto body shop owner, Joe, who listens to Rush Limbaugh and sympathizes with the Tea Party. He finds his beliefs shaken when his insurance does- n't fully cover his wife's cancer, leading to a divorce so that she can qualify for Medicaid and then finally to bankruptcy. Milligan has taken the show all over the country, includ- ing New York, Colorado, and Ohio, as well as to the Edinburgh Fringe Festival, where it won the "Fringe First" Award. Milligan, a classically trained actor who has per- formed Shakespeare around the world and appeared on Broadway, enjoys bringing Mercy Killers to church base- ments, college classrooms, and union halls to spark conver- sations about single-payer. Mercy Killers viscerally shows how dysfunctional our healthcare system is, said California Nurses Association board member Sherri Stoddard, an RN in San Luis Obispo who helped bring the play to her city. "I can talk about it in an intellectual way, but unless you experience something, you don't really get it," Stoddard said. "This shows the transformation of someone who doesn't get it to someone who does, and that's much more effective than me sitting there proselytizing about it." Milligan says that all around the country, people share personal experiences after the show. Retired RN and former CNA copresident Geri Jenkins saw that after the perform- ance she helped set up in San Diego. Jenkins has plenty of stories herself—her stepdaughter who couldn't get cover- age for years because of a congenital heart disease, an unemployed neighbor who now has a $50,000 bill he can't pay due to a ruptured appendix—that highlight the need for change. "That's what activates people, when it happens to peo- ple they know," Jenkins said. "Healthcare is such a basic fundamental issue that affects everything else." Milligan, who looks forward to bringing the show to wider audiences in more traditional arts institutions, takes as his role model Charles Dickens whose books had a direct impact on laws in England to protect children. He hopes Mercy Killers reaches people on all sides of the debate. "What motivates people to action is the combination of the intellect and emotion," he said. "The play can work across the spectrum." —Emily Wilson 14 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G M A R C H 2 0 1 4

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