Montana’s Human Right to Health Care Campaign

NESRI has partnered with the Montana Human Rights Network in their state-wide and local advocacy for health care reform from a human rights perspective. Click here to watch Montanans tell their health care stories and demand their human right to health care. Local Initiatives Montana county moves toward universal health care based on human rights Lewis and Clark County in Western Montana is among the first communities in the United States to recognize its obligation to ensure universal access to health care based on human rights standards. In 2008, the City-County Board of Health adopted a resolution that recognizes the human right to health and health care. With this resolution, the Board set up a task force, comprised of local residents, to develop recommendations and an action plan for achieving universal health care at the county level. The task force presented its community needs assessment and report in October 2011, followed by its final report in May 2011. In an interview with The Helena Independent Record (12/12/08) Alan Peura, then Helena city commissioner and Health Board member who spearheaded the task force's work, described the motivations underlying the project. “Starting with health care as a human right, we thought maybe we can get to places that we never got to before. We said, ‘Let’s see what we can do to change the debate, and maybe end up with some solutions that we don’t even know exist at this point.’” State Sen. Christine Kaufmann, former director of the Montana Human Rights Network, was also quoted: “Our goal is that everyone in Lewis and Clark County has access to health care,” she said. Listen to podcasts with Alan Peura and Christine Kaufmann. Through a community lens: the task force's needs assessment The Task Force completed a community health needs assessment, which included nine focus groups with community members and a survey of primary care doctors and dentists. Click here for a presentation of the findings. Most community participants considered health care to be a human right: "It's everyone's right as a human being." Many reported that costs were preventing them from enjoying this right: "If you don't have money, then you don't have the right to care." Most participants also pointed to a shortage of doctors – a problem shared by many rural communities. Discussing options for reform, participants envisioned a collective responsibility for keeping people healthy, be it through the community or the government. "I’d be willing to pay my share, according to my income, to have something that took care of everybody.” As the task force engaged with community members and listened to their experiences and concerns, they gathered home-grown ideas for reform. These conversations foregrounded shared needs and values, and linked these to human rights standards, rather than to the charged national health care debate. The findings of the first phase of the task force's work formed the basis for the recommendations and action plan presented in the final report. A local action plan for universal health care After many months of planning and negotiations, the task force presented a set of final reports, findings and an action plan to the City-County Board of Health. In a public meeting on May 31, 2011, task force members outlined various steps the county should take to move toward universal access to health care. They argued that because federal health reform has fallen far short of guaranteeing universal access, community-based actions at local and regional levels are now more important than ever. Summary of key recommendations: 1. Ensure that St. Peter’s Hospital - the county's only general hospital - meets the community’s health care needs a) Start a dialogue with the hospital and increase community participation in hospital planning and operations b) Raise awareness of St. Peter’s legal obligation to the community, derived from its tax-exempt status, which could potentially be challenged in the courts, if necessary c) Consider starting the process of creating a public hospital taxing district to increase funding to expand access to health care services at the hospital and the Cooperative Health Center 2. Create a new, community-based health care plan in the county a) Start the process of setting up a CO-OP health plan to apply for federal funding by 2013 b) Assess the feasibility of other alternative health plans, including a Canadian-type plan and publicly financed programs established by other counties across the United States c) Start the process of funding health care expansion through a local option income tax 3. Expand the health services at the Cooperative Health Center, including, primary care, dental, and mental health services, and expand the geographical areas served 4. Initiate a statewide referendum to recognize the human right to health care across Montana State Legislative Initiatives Constitutional Right to Health Care Bill During the 61st Montana Legislature in 2009, the State Senate held a hearing on establishing a constitutional right to health care in the state. The constitutional amendment was introduced by Senator Christine Kaufmann, former director of the Montana Human Rights Network. The hearing included testimony from allied groups across Montana, who all came to express support under the umbrella of human rights. It has been recorded here (starting at 0:20:55, ending at 1:09:40, you need RealPlayer to listen). Despite this support, the bill died in committee. The Network continues to explore whether to turn this measure into a ballot initiative. NESRI has surveyed previous initiatives across the country that attempted to include the right to health care in their constitutions. Our report identified five key lessons learned, including the need for grassroots organizing using human rights standards and messages. Bill to Require Health Insurers to Prioritize Care The Montana Human Rights Network worked with Representative Shannon Augare on a bill that would allow the Insurance Commissioner for the first time to review and regulate the health insurance industry in Montana. The bill required health insurers to spend a minimum percentage of the premiums they collect on actual health care, rather than on surpluses, salaries and administration. A Joint Resolution was adopted recognizing the importance of this issue, which has since been superseded by the medical loss ratio provision in the federal health reform law.