The muzak track on Northwestern Memorial Hospital’s main phone line boosts the health care behemoth’s transplant program – including “one of the largest living donor kidney transplant programs in the country.” But those services – which include one of the only liver transplant programs in the region – might as well be on another planet for the undocumented and uninsured.
This weekend, more than a dozen critically ill undocumented immigrants in need of organ transplants struck back, taking a six-day-old hunger strike to the doors of one of the nation’s wealthiest healthcare non-profits to demand a meeting with Northwestern Memorial CEO Dean Harrison. Harrison, who earned almost $10 million in 2010, heads up a system of hospitals, clinics and medical practices – including flagship facility Northwestern Memorial Hospital – earned $1.7 billion last year.
The ultimatum Northwestern faced from the protesters was simple: We will not leave — we are fighting for our lives.
On Monday evening, after an avalanche of terrible press that humanized the dire trick bag that undocumented people in need of transplants confront in Chicago, and with no end in sight to the encampment of sick people outside their doors, Northwestern blinked. Hospital officials announced that undocumented patients will be added to their transplant list. Organizers and patients have vowed to return if Northwestern reneges.
Northwestern has drawn a barrage of criticism over the years for failing to put the ‘non’ in non-profit. The system’s new women’s hospital briefly lost its non-profit exemption from the State of Illinois in 2011 for spending less than 2% of its vast revenue on free care for poor people. But Northwestern is hardly the only tax-exempt non-profit hospital to fail to include the poor in their idea of charity – in 1996, a 15-month Senate review found that nonprofit hospitals routinely overcharge or deny care to the poorest patients in their orbit.
And Northwestern has tendered a huge caveat in its offer to the hunger strikers: prospective transplant patients, regardless of immigration status, still need to show they can pony up the money for anti-rejection drugs in the wake of a transplant. Those medications can cost $20,000 a year or more – less than a third of what dialysis costs – and with the undocumented denied the option of coverage under Obamacare, these patients could very well be compelled to pay those costs out of pocket.
The dilemma of the hunger strikers underscores one of the larger lunacies in the U.S. healthcare system: the federal government will pay for a lifetime of dialysis for a person without papers, at a cost of $75,000 a year, but will not fund a $100,000 transplant that would make that dialysis unnecessary.
The real flashpoint here is, of course, class. If you’re working class, as most of these immigrants – and increasingly, most of the rest of us – are, the prevailing system of transplant protocols and the larger national dynamics around immigration and health care policy are pretty much guaranteed to screw you.
Undocumented and uninsured patients seeking medical care will find no relief in Obamacare, which bails out the health care industrial complex while barring the undocumented from accessing the insurance company bailout scheme. Nor will these sick people find any relief in current versions of immigration ‘reform’ legislation, which accommodate companies who seek access to ‘documented’ high-tech workers but leave millions of people currently without papers with a difficult and uncertain path to legal status in the United States.
One in five organs used in U.S. transplant programs like Northwestern’s come from uninsured people, while barely 1% of those organs go to uninsured people who need them.People without documents are estimated conservatively to donate organs at more than three times the rate they receive them. And for people without documents, even having health insurance is no guarantee that you’ll get a lifesaving transplant if you lack legal standing as an immigrant. Those kinds of inequities are A-OK with anti-immigrant legislators like U.S. Representative Dana T. Rohrabacher of California, who has said of immigrants, “If they’re dead, I don’t have an objection to their organs being used. If they’re alive, they shouldn’t be here no matter what.”
Obama apologists will be tempted to jump on Rohrabacher’s repulsive remarks to blame Republicans for the challenges that poor people, including immigrants without documents, confront in the nation’s healthcare system. But that’s bullcrap. Recall that Obama moved last year to enshrine this country’s miserable treatment of undocumented youth as official policy with his “Dream Act” executive order, which lets youth without papers fight and die in this nation’s imperial wars or take on the increasingly enormous economic burden of higher education in exchange for a two-year deferment to deportation — but denies them or their family members a clear path to legal status. Meanwhile, Republicans are actively floating a scheme to directly trade legal status for military service – a scheme that at least some Democrats can be expected to embrace.
The hunger strikers and their supporters, who range from local minister Jose Landaverde and the Moratorium on Deportations Campaign to the press crew that grew out of Occupy Chicago, have more than Northwestern in their sites. The University of Illinois Hospital & Health Sciences System, Rush University Medical Center and Advocate Christ Medical Center are among their tick list of local non-profit health care institutions who need to pony up what their civic missions all purport to support: health care for those who need it. But until labor is afforded the same freedom to cross borders as capital, and until health care is treated as a right instead of a privilege for the wealthy few, the health and wellbeing of these poor workers and their families remain at grave risk.
Meanwhile, the poor, critically ill immigrants in Chicago who staged the hunger strike at Northwestern have embraced one salient historical truth and one path forward: direct action gets the goods – and they will step up that direct action until they win the right to survive and thrive or die trying. Volunteers with the Moratorium on Deportations Campaign put it this way: “This is a struggle to confront two racist and unjust systems that are intimately connected: immigration policy and health care – this is a struggle for life, in the face of a politics of death.”