Justice Denied, Society Threatened

Where justice is denied, where poverty is enforced, where ignorance prevails, and where one class is made to feel that society is an organized conspiracy to oppress, rob, and degrade them, neither persons nor property will be safe.                      

-Frederick Douglass

The attack on the poor's healthcare continues with new cuts in Medicaid insurance ordered by the Secretary of Health and Human Services. Poor people, just now awakening to the realization that healthcare can improve their lives and the lives of their families, will be deterred from getting critical insurance. Bombing healthcare provisions has the same effect as bombing people and buildings: people will unnecessarily die, suffer, and be frightened about their future. Citizens at many town hall meetings, largely middle class people, are outraged at their Congressional representative's attempt to explain why less benefits, fewer choices of physicians and hospitals, and the abolition of prevention results in "better care."

The American poor are being joined by the American Middle Class in protesting changes in healthcare that are ridiculous for any person who wants to feel secure about their health. Protests have been the order of the day, whether at local, state or national rallies. The Congress has heard and backed off a sad and destructive bill to replace the Affordable Care Act. But Trump is not finished: choking the ACA to death can happen through arbitrary and undiscussed rule changes.

Simultaneous with the attack on the poor, are efforts to widen access to healthcare for everyone. Physician groups, Hospital Groups, and Citizen Groups are joining together to both resist major changes and to rethink just how the healthcare system can be improved for those at highest risk. It is hoped that this effort will continue despite the new rules and the old attitude that healthcare cannot be a right for everyone.

In Cincinnati, the Cancer Justice Network, an organization of 25 agencies that serve the poor in the city and Hamilton County, have come together to step up the healthcare services to the poor. Using a new health role, "navigators," the Cancer Justice Network is going to churches, community centers, and schools where poor people and their families attend. Our goal is singular: we want everyone who is concerned that they may have cancer to get a screening and a timely treatment. Thanks to far-looking grants from Easter Seals and the National Aging and Disability Transportation Center, Molina Insurance, Christ Church Cathedral, Congregation of St. Joseph, Academy of Medicine, and the Woodward Trust,  we are creating a transportation process that "navigates" any low income citizen, aged person, or person with disabilities, to and from cancer prevention healthcare. Normally, the high risk population we are working with has too many transportation obstacles to get to either a screening and or regular treatments. Not being knowledgeable about insurance provisions for transportation or Medicaid stipulations, the person with cancer may give up and choose to use their limited funds for housing, or food, or some recreation for their children. Removing transportation hurdles, accompanying the person to and from their health provider, starts a process that could lead to overcoming cancer in our community.

The process can break down at any time if there is an emergency in the person's life or if they are unsure what to do when they have an urgent medical need. Often people do not have a doctor, do not know how to access the Emergency Room, and sadly have had experiences of being humiliated by healthcare professionals. Our navigators are offering a different kind of relationship: we will go with the person and make sure that the healthcare is outstanding and we will help people negotiate the maze of cancer care and of the local transportation systems. When we have shared this opportunity with people at church meetings or in community centers, we are often met with disbelief: "Why would you do this for me? What do you get out of helping me?" Suspicions connected to prior experiences tend to dominate even when we have face to face meetings with kind and down to earth physicians. Yet, every time we find courageous people who are willing to risk a first step with our navigators, although many people have a change of mind. The power of the anti-poor culture can win out and persuade people that what we are sharing may be a scam. "Who helps the poor?," they seem to say with their behavior of missing appointments.

We know that our process of helping will be a slow one but we are basing our work on the pioneering efforts of Harold Freeman, MD. Freeman, facing high death rates from his patients who came too late for treatment, created a program of community navigators that could bring people to him much sooner in their cancer. In five years, Freeman's program reversed the death statistics: most people survived their cancer. We are following this program in Cincinnati because minorities have the highest death rate from cancer in Ohio. The Cancer Justice Network is the only program that navigates high risk populations to and from healthcare while empowering people to take more control over their healthcare. Largely made up of volunteers, we attend church dinners, meetings at community centers, and programs where the poor come for help. Our navigators are saying that there are more choices for life than death if we seize the chance to get an exam and treatment. We know we have a difficult job to convince people who have been excluded from healthcare, stigmatized by the media, and now facing certain cuts in their essential healthcare. We are determined to make progress by taking time with people, listening to their fears, and, with navigators, going the extra mile to compassionate healthcare. This is what we mean by justice for everyone. Please go to our website for more information: cancerjusticenetwork.org

by Steve Sunderland

This article will appear in a forthcoming issue of Streetvibes, a bi-monthly newspaper published by The Cincinnati Homeless Coalition.