Deborah Burger

Why labor should oppose the pipeline


OPINION As pressure from the fossil-fuel industry, conservative Canadian and US politicians, and some construction unions mounts on President Obama to greenlight the controversial Keystone XL Pipeline project, a growing coalition has a different message.

On February 17, tens of thousands rallied against the pipeline in cities across the US, including San Francisco — a testament to the climate movement, ranchers and farmers, First Nations leaders, most Canadian unions, some US unions (including my nurses’ organization), transport and domestic workers, and young people who are rightfully alarmed over the global impact of Keystone XL.

For nurses, who already see patients sickened by the adverse effects of pollution and infectious diseases linked to air pollutants and the spread of water and food borne pathogens associated with environmental contaminants, Keystone XL presents a clear and present danger.

First, extracting tar sands is more complex than conventional oil drilling, requiring vast amounts of water and chemicals. The discharge accumulates in highly toxic waste ponds and risks entering water sources that may end up in drinking water, as is already occurring.

Second, the corrosive liquefied bitumen form of crude the pipeline would carry is especially susceptible to leaks that can spill into farmland, water aquifers and rivers on route, threatening an array of adverse health outcomes.

Public health costs from fossil-fuel production in the US through contaminants in our air, rivers, lakes, oceans, and food supply are already pegged at more than $120 billion every year by the National Academy of Sciences. The Environmental Protection Agency warns that exposure to particulate matter emitted from fossil fuel plants is a cause of heart attacks, long term respiratory illness including asthma, cancer, developmental delays and reproductive problems. Global-warming inducted higher air temperatures can also increase bacteria-related food poisoning, such as salmonella, and animal-borne diseases like the West Nile virus.

That’s just the tip of the melting iceberg given the planet altering consequences of rising sea levels, intensified weather events including droughts, floods and super storms already in evidence, and mass dislocation of coastal populations and starvation that may well follow our failing to stem climate change.

Far more jobs would be created by converting to a green economy. As economist Robert Pollin put it in his book Back to Full Employment, every $1 million spent on renewable clean energy sources creates 16.8 jobs, compared to just 5.2 jobs created by the same spending on fossil-fuel production.

And, as one person acerbically commented on a recent New York Times article, there are no jobs on a dead planet.

Further, stumping for the pipeline puts labor in league with the many of the most anti-union, far right corporate interests in the U.S., such as the oil billionaire Koch Brothers and energy corporations, abetted by the politicians who carry their agenda.

The future for labor should not be scrambling for elusive crumbs thrown down by corporate partners, but advocating for the larger public interest, as unions practiced in the 1930s and 1940s, the period of labor’s greatest growth and the resulting emergence of a more egalitarian society.

Deborah Burger is a registered nurse and co-president of National Nurses United, the nation’s largest organization of nurses.

The plight of the insured


OPINION How many horror stories will it take before Congress decides to act on the most ignored problem in the present healthcare debate, denials for people with insurance?

In September, San Francisco’s KPIX-TV reported the story of Rosalinda Miran-Ramirez of Daly City, who woke up one April morning with her left breast bleeding and her shirt soaked in blood.

She was rushed by her husband to the emergency room at nearby Seton Medical Center, where doctors found a tumor. Fortunately the biopsy was benign. Less benign was Miran-Ramirez’ insurer, Blue Shield which initially approved her emergency room claim, then denied it, demanding she pay the full charges, $2,791 under the dubious assertion she "reasonably should have known that an emergency did not exist."

After reporter Anna Werner called Blue Shield, the company decided to pay. Big of them.

We’ve seen this act before. In 2007, Cigna denied a liver transplant, recommended by her medical team, to 17-year-old Nataline Sarkisyan of Northridge. After national protests organized by Nataline’s family, community, and the California Nurses Association/National Nurses Organizing Committee, Cigna relented — a week too late, and tragically Nataline died.

In a recent interview with New America Media, Cigna’s then-communications director, Wendell Potter, now an insurance critic, noted that "this is not an isolated case. People need to realize that there is a corporate executive who often stands between a patient and his or her doctor. That’s the reality."

Why? It pays. Insurance companies make money by selling policies they never intend to make payments on.

In August, researchers with the California Nurses Association and National Nurses Organizing Committee uncovered previously hidden data on the California Department of Managed Care Web site revealing that six of California’s biggest insurers have denied on average nearly one-fourth of all claims every year since 2002. For the first six months of 2009, PacifiCare rejected 40 percent of claims, Cigna 33 percent.

Predictably, the insurers went ballistic, issuing a stream of denials about their denials. It’s all paperwork, or merely battles with doctors and hospitals, they insisted. These denials don’t mean people are being denied care.

But, they are, every day. The insurers claim the procedure is "investigational" or "experimental" or the policy did not cover that procedure, or the patient had neglected to disclose some prior health problem.

Even if many of the denials the insurers themselves reported to the state are just "paperwork," they are a reminder that 30 cents of every private insurance healthcare dollar is wasted, much of it on warehouses of bean counters looking for reasons to deny claims.

Fortunately, California Attorney General Jerry Brown is now investigating the denial scandal.

But Congress and the Obama administration remain appallingly silent. Too timid to propose the most comprehensive reform — single payer — that would actually lift the hands of the insurers off our necks. Too timid to crack down on insurance company price gouging or denials of care.

Deborah Burger, RN is co-president of the California Nurses Association/National Nurses Organizing Committee.

The guns have won


With President George W. Bush proposing to push the price tag for the Iraq War up to nearly $600 billion — more than was spent on the Vietnam War — while seeking new cuts in our health care safety net, it would appear the debate over guns and butter is over. The guns have won.

Polls before the last election found that the two issues foremost in voters’ minds were the war and our ever-worsening health care crisis. More than ever, the two issues seem linked. With record budget deficits, substantially inflated by spending on the war, resources for health care and other critical domestic needs are increasingly starved.

On the same day the president was proposing another $245 billion to prosecute the war this year and next, which would bring the five-year total since the war began to a staggering sum of $589 billion, he also called for slashing $78.6 billion from Medicare and Medicaid over the next five years.

In addition, Bush wants Medicare recipients to pay higher premiums for prescription drugs and doctors’ services and is proposing to eliminate annual indexing of income thresholds, effectively another $10 billion in cuts.

Expanding children’s and preventive health programs and addressing "personal responsibility" by tackling childhood and adult obesity are supposedly atop everyone’s short list of health care priorities. But these now appear to be collateral damage.

Bush is seeking a $223 million reduction in spending for the Children’s Health Insurance Program and the elimination of a preventive health services block-grant program, $99 million a year to the states, used for obesity prevention and programs for chronic health conditions.

He’s also seeking millions in reductions for the National Cancer Institute, at the very moment some progress has been made in fighting cancer, and the Centers for Disease Control and Prevention for disease surveillance monitoring of bird flu and other approaching epidemics.

That’s just the cuts. There’s no mention of additional funding to address the national blight of 47 million uninsured Americans, another 17 million underinsured, the increased closure of public hospitals and clinics, including in half of the nation’s poor counties that no longer have a health center, and all the other dismal statistics that have dropped our country to 37th in the world in health care indicators.

Imagine for a moment how else we could have spent $589 billion.

With those same dollars you could buy health insurance for all the nation’s uninsured people for the next three years. Or you could fund the current federal program of spending on HIV/AIDS antiretroviral drugs for the next 60 years. Or you could cover the cost of educating an additional 39.2 million registered nurses.

And while there’s plenty of money to send more troops into harm’s way, veterans are feeling the pain of cuts in our nation’s health spending. According to the Department of Veterans Affairs, 263,257 veterans were denied enrollment for Veterans Benefits Administration health coverage in 2005. To cut costs, enrollment has been suspended for those deemed not to have service-related injuries or illnesses.

"A nation that continues year after year to spend more money on military defense than on programs of social uplift is approaching spiritual doom," Dr. Martin Luther King said. And, he might well have added, endangering the health security of its citizens at home. *

Deborah Burger

Deborah Burger is president of the California Nurses Association.