Richard Kirsch is no stranger to activism.
After college, one of Kirsch’s first jobs was working for longtime liberal activist Ralph Nader, organizing public interest research groups, better known as PIRGs. This experience helped teach him all of the techniques and tactics that would be needed to wage a successful fight for health care reform in America, Kirsch writes in a new book titled “Fighting For Our Health: The Epic Battle to Make Health Care A Right in the United States.”
Kirsch, 59, is the co-founder of Health Care for America Now, a liberal coalition of more than 1,000 organizations that formed in 2008 with the goal of getting a federal health reform bill passed. The group’s efforts culminated in President Barack Obama’s signing of the Affordable Care Act.
Kirsch will speak about his book Wednesday at 7 p.m. at First Reformed Church in Schenectady. His talk will take place as the U.S. Supreme Court considers the constitutionality of the federal health reform bill, in particular the provision that requires uninsured people to purchase private health insurance — a controversial measure known as the individual mandate.
Joe Doolittle, a member of First Reformed’s Social Justice Action Council, said health care should be a basic right, which is why the Social Justice Action Council is highlighting the issue by bringing Kirsch in to speak. “Having [millions of people] uninsured, not getting timely needed care and aggravating the cost spiral is simply not what a civilized society should tolerate,” he said.
A resident of the Columbia County town of Spencertown, Kirsch serves as a fellow at the Nelson A. Rockefeller Institute of Government at the University at Albany and a senior fellow at the Roosevelt Institute in New York City.
Kirsch said he wrote “Fighting For Our Health” to help people understand how to organize a winning, grass-roots effort around a major policy issue, to celebrate and share the stories of the everyday people involved in that grass-roots effort and to document recent history.
“We learned a lot of lessons, and I really wanted to show those lessons,” Kirsch said. “History tends to ignore the role regular people play in making change.”
push to organize
In “Fighting For Our Health,” Kirsch shares the stories of people who were denied health care because of pre-existing health problems, and people who lost friends and relatives because they had no insurance and were unable to access good health care. Telling these stories to people in power was essential to getting the health care reform bill passed, Kirsch said.
“The only way to defeat the Washington insiders and the Beltway mentality and the power of corporate lobbyists is to have an organized campaign from the outside,” Kirsch said. “The insurance industry alone had more than 2,000 lobbyists, compared to a couple hundred pushing reform.”
A key part of Health Care for America Now’s strategy was getting people to visit the offices of elected officials in their home districts and talk about how the health care bill would benefit them personally, Kirsch said. “Many members of Congress have no idea what it is like to be a struggling family,” he said. “They don’t really understand this. … But there are exceptions.”
Polling data indicates that the health care reform law is not popular.
In an April survey conducted by the Kaiser Family Foundation, 42 percent of respondents said they had a favorable opinion of the bill, while 43 percent said they have an unfavorable one.
Conservatives have denounced the health care law as an unlawful intrusion on individual rights, while some liberals have also criticized the law, saying it forces people to buy a flawed product.
But Kirsch estimates that it will become more popular once key provisions, many of which do not go into effect until 2014, are implemented.
Among other things, the health care law bars insurance companies from denying health insurance to patients with pre-existing medical conditions, bans insurance companies from dropping patients when they get sick, eliminates copayments for preventive services, increases funding for community health centers and expands Medicaid eligibility.
“The final bill was a huge, historic accomplishment,” Kirsch said. “For the first time, this country has a legal obligation to make health care affordable to people. There are 32 million uninsured people. Fewer people will die and be burdened by high medical debt.”
He said that the bill isn’t ideal and that the goal would be to continue to improve and refine it. He noted that popular government programs such as Social Security have changed over time.
Kirsch said that it would be a “huge blow” if the Supreme Court overturned the individual mandate but said that many of the law’s provisions would remain intact, such as new rules allowing people under age 26 to remain on their parents’ health insurance and eliminating lifetime caps on how much money an insurance policy will pay out, which should benefit people who have suffered a catastrophic accident or who have chronic illnesses.
In an introduction to “Fighting for Our Health,” Thomas Gais, the director of the Rockefeller Institute, praises Kirsch’s account of the battle for health care reform. “… the Institute strives to provide neutral analyses of state and local policy issues,” he writes. “Yet there’s nothing dispassionate in Kirsch’s exciting, insider account of the tortuous process by which the Affordable Care Act of 2010 became law …”
Kirsch stepped down from his job as executive director of Citizen Action of New York, where he had worked since the mid-1980s, to head Health Care for America Now. At Citizen Action, he had worked to expand health care coverage in New York state, and was active in successful efforts to broaden the state’s Medicaid coverage guidelines and force hospitals to provide charity care to poor patients. He was also involved with failed efforts, such as the Clinton administration push to create a national health care system.
HCAN became active in the summer of 2008 with the goal of building support for health care reform prior to the presidential election.
Kirsch stepped down from HCAN in 2010, but he has continued to defend the health care reform law.
“It’s a constant battle to defend and improve the law,” he said. If the law is overturned, “the high costs and number of uninsured people are not going to go away.”