Not only is the problem not solved by the Affordable Care Act, but it is a likely reason many will continue to demand more effective reform, as in expanding and extending Medicare to cover everyone.

Predatory pricing practices can be found nearly everywhere in healthcare, by the drug companies, insurance companies, medical suppliers, outpatient clinics, boutique medical services, and many others as chronicled this spring in Time magazine

U.S. hospitals are among the biggest abusers, as illuminated in recent data released by Medicare on hospital charges for a variety of common procedures as well as brand new findings by the Institute for Health and Socio-Economic Policy, the research arm of the National Nurses United, based on Medicare cost reports. (See charts here)

The nurses' data augments the Medicare findings, and goes the next step, illustrating a trend of rising high hospital charges while providing context to a very ugly picture and the deplorable impact on anyone who needs healthcare.

Here's the sobering numbers:

• U.S. hospitals charge on average $331 dollars for every $100 of their total costs, in statistical terms a 331 percent charge to cost ratio.

• While hospital charges over costs have been climbing steadily over the past 15 years - the charges took their biggest leap ever in 2011- a 22 point vault.

• From 2009 to 2011 (the most recent year for which the data is available), hospital charges lunged upward by 16 percent, while hospital costs only increased by 2 percent.

• U.S. hospital profits, pushed upward by the high charges, hit a record $53.2 billion, while nurses see more and more hospitals cutting patient services and limiting access to care.

• One case study is California where hospitals soared past the national average with a charge to cost ratio of 451 percent, or $451 for every $100 of costs.

That similar pricing practices occur elsewhere in the healthcare industry is hardly an excuse for the private hospitals to act more like Wall Street corporations than responsible, community based institutions. It should be no shock that the lowest charges are by government-run hospitals that operate in public, not in secret, and have far more accountability and transparency.

Hospitals ought to act as responsible providers of needed medical care, not loan sharks. Piling up profits in large part by jacking up prices is at sharp odds with the glossy feel good ads from hospitals we see so often on our TV screens, newspaper pullouts, sponsorship of sports teams, and on mass transit placards.

Hospital lobbyists have tried for years to convince us all that predatory pricing policies don't matter. These are just "list" prices that few people actually pay, they claim, and it is a random phenomenon that two hospitals in the same city, or even on the same block, might have widely varying prices for similar patient services.

But the grotesque reality tells a different story.

We're not the only ones who think so. As Glenn Melnick, a USC health economist, told a reporter, "If (hospital prices are) meaningless how come hospitals spend all this money on consultants to raise them? Why haven't they stayed flat for the past 15 years? Why do hospitals keep raising them if they have no impact?"

While it is true that major payers seldom pay the list price, hospitals typically bargain with insurance companies over reimbursements. Anyone who has ever bought a car knows that the higher the list price, the more you end up paying. That's true with hospital charges as well.

The inevitable result is insurance companies respond by ratcheting up their charges to employers and individuals. In California, for example, since 2002, premiums have risen 170% -- more than five times the inflation rate, as noted in a California Healthcare Foundation survey last month.

An alarming, if predictable ripple effect follows. As the CHF survey noted, in the past decade, the percentage of California employers providing health coverage dropped from 71 to 60 percent; 21 percent said they'd increased workers' co-insurance premiums while 17 percent said they had reduced benefits or increased other out of pocket costs. More than one-fourth of workers in small firms have deductibles of $1,000 or more on their health plan.

Then there's the uninsured who do not have the collective clout to bargain down the list price. Hospitals say they write off a lot of those bills, but clearly not all of them. How many distressing stories have we all heard about patients staggered by $50,000 or $100,000 un-payable medical bills while being hounded by the hospitals or bill collection agencies to pay up.?

Patients and families, even those paying for insurance, have a stark choice. Use your health coverage and get socked with huge out of pocket costs that may mean choosing between medical bill or filling prescriptions and housing costs, food, or other necessities, or facing financial calamity, or forgo needed care.

As the Washington Post recently noted, the Affordable Care Act has not ended the deplorable story of medical bills accounting for more than half of all personal bankruptcies in the U.S.

Even many of those now paying for health insurance either through their employer or as individuals, or who will be required to buy insurance under the ACA, choose not to use it because of the high co-insurance, deductibles, co-pays, and all the add ins that get thrown in by the hospitals, such as professional fees, facility fees, pathology fees, anesthesia fees, and so on.

A 2011 Commonwealth Fund study found that the U.S. stands out among high income countries with as many 42 percent of Americans skipping doctors' visits, recommended care, or not filling prescriptions due to cost.

Consequently, people end up in emergency rooms for medical problems that should have been resolved earlier at far less cost and pain. It is also why two recent reports disclosed that the U.S. has the lowest life expectancies and the highest first day infant death rate among major industrial countries.

It's long past time to fix this nightmare, and sadly the ACA won't meet that test. At a minimum we need to crack down on price gouging by all the corporations that control our health, with real penalties for lack of compliance.

But a longer vision is needed. Replace our profit focused health care system with one based on patient need and quality care as all those other countries with national or single payer systems that surpass us in access, quality, and cost, have long figured out.

• Hold California private non-profit hospitals accountable to actually meet their obligation to provide charity care and community benefit in exchange for the billions of dollars they receive in subsidies as a result of their tax exempt status.

The California Assembly Appropriations Committee suspense file hearing will decide the fate of a CNA sponsored bill on May 24th.

Charity Care Accountability

AB 975, by Assembly members Bob Wieckowski of Fremont and Rob Bonta of Oakland takes on the abuse of charity care obligations by many of California’s biggest nonprofit hospital chains, like Sutter and Kaiser, that are rewarded with nearly $2 billion in tax exempt benefits beyond what they return to communities.

AB 975 would

• Clearly define charity care to ensure it is care for the poor, not marketing, cutting of services or other schemes, and redefine genuine community benefit, and assure greater public transparency.

TAKE ACTION!

Contact Assembly Appropriations Committee before May 24th, and tell them:

“I’m a nurse and a member of CNA (or a patient) and I pass AB 975 off the suspense file which will improve healthcare delivery and transparency in California.”

Appropriations Committee Members:

Chairman Mike Gatto (Glendale/Los Angeles) P. 916-319-2043 email 

Assembly Member Raul Bocanegra (San Fernando Valley) P.9 16-319-2039 email

Assembly Member Steve Bradford (Gardena/South Los Angeles County) P. 916-319-2062 email

Assembly Member Ian Calderon (Whittier) P. 916-319-2057 email

Assembly Member Nora Campos (San Jose) P. 916-319-2027 email

Assembly Member Susan Eggman (Stockton) P. 916-319-2013 email

Assembly Member Jimmy Gomez  (Echo Park/Los Angeles) P. 916-319-2051  email

Assembly Member Isadore Hall (Compton/South Los Angeles) P. 916-319-2064 email

Assembly Member Nate Holden (Pasadena) P. 916-319-2041 email

Assembly Member Richard Pan, M.D. (Sacramento) P. 916-319-2009 email

Assembly Member Bill Quirk (Hayward) P. 916-319-2020 email

Assembly Member Shirley Weber (San Diego) P. 916-319-2079 email

###

Malinda Markowitz is a registered nurse and co-president of the California Nurses Association/National Nurses United

Please donate using the button below and share this page with others:

You can also make a donation by check payable to:

"CNA Nursing Angels Family Fund"
2000 Franklin Street Oakland, CA, 94612

With the memo line, "Victims of the San Mateo Bridge Limo Tragedy"

Please note that donations to this fund are not tax deductible.

~~~

Thank you so much,

Zenei Cortez, RN and CNA co-president

California Nurses Association

Celebrate National Nurses Week by Helping Nurses win Safe Staffing Ratio Legislation.

Let's Also Vote NNU's Executive Director, RoseAnn DeMoro a Top Healthcare Leader.

National Nurses United, the nation’s largest organization of nurses, today greeted the re-introduction of a bill in the House of Representatives by Rep. Jan Schakowsky of Illinois – appropriately during Nurses Week – that would set specific limits on the numbers of patients each RN can care for in hospitals throughout the U.S. Let's show strong RN solidarity for this exciting national legislation and statewide ratios campaigns below.

Please add your name to three letters supporting safe staffing ratios:

1. Sign the letter supporting the DC Patient Protection Act
   (The DC Patient Protection Act)
2. Sign the letter supporting Illinois RNs in their quest for safe staffing
   (The Hospital Patient Protection Act, H.B. 0012)
3. Sign the letter to Congress requesting support for the National Ratios Bill
   (The Nurse Staffing Standards for Patient Quality Care Act, H.R. 2187)

LET'S VOTE RoseAnn DeMoro A top leader in healthcare again in 2013

Modern Healthcare's annual ranking of the 100 Most Influential People in Healthcare honors individuals in healthcare who are deemed by their peers and an expert panel to be the most influential individuals in the industry, in terms of leadership and impact. "We are incredibly proud to see RoseAnn recognized and honored year after year for both her outstanding leadership and accomplishments and the historic achievements by our national nurses’ movement and organization,” said NNU Co-President Jean Ross, RN.

VOTE HERE for RoseAnn DeMoro and 4 others of your choice

Results to be published in the August 2013 issue of Modern Healthcare.

Thank you so much for all that you do for your patients, your RN colleagues, and your profession!

• Learn more about the national ratios bill here
• Read more about statewide campaigns for ratios

Happy National Nurses Week!

Jean Ross, Karen Higgins, Deborah Burger
NNU Co-Presidents and Proud Registered Nurses

###

Attend Free RN CE Classes

Tune in to NNU on Nurse Talk Radio

I am a Registered Nurse at Affinity Medical Center and although this is a week to recognize nurses, I would like to thank the people of Massillon and the surrounding area for the privilege of allowing my colleagues and me to care for you and your families.

Sometimes, it’s only a few hours we get to know each other and then there are times our contact is much longer.

There are many of you who I have had the pleasure of sharing a laugh with, and others I have been honored to share the tears of final grief with. Our job comes with great responsibility, but there is also an enormous amount of satisfaction when at the end of the day we know we have given all we could, selflessly.

Our profession is constantly changing and evolving, but always know that, you — the patient — is what drives us. There is research that shows when a nurse exceeds four patients there is a 7 percent increase in mortality for every patient a nurse has beyond that on a medical surgical or medical telemetry floor. This is just one of the challenges we are trying to achieve again for you, the patient.

They call health care an industry. I worked in a factory at one time, and I must disagree.

In health care, you don’t shut things off at lunch or at the end of the shift, and as nurses we know we must be ever vigilant and that the knowledge and care we provide must be of the highest excellence, regardless of profits. Although we have an employer, our loyalty and our legal duty lies with our patients.

I again want to thank the community for their support and allowing us into your lives. We, in turn, commit to continue serving you to the very best of our abilities.

Happy Nurses Week to all the nurses out there and to the rest of you, thank you.

Bob McKinney, RN
Massillon

Robin Hood Visits DC April 17 & 20, 2013

SEE and SHARE EVENT VIDEOS & PHOTO LINKS:

Live stream video recordings from the Robin Hood Tax actions in DC

Photos from the reintroduction of the Inclusive Prosperity Acton in DC on April 17

Photos from the Robin Hood Tax Rally in DC on April 20

We Found the Money, and It's On Wall Street

By George Goehl
Executive Director, National People’s Action

On April 17th, Congressman Keith Ellison, Chairman of the Progressive Caucus, introduced the Inclusive Prosperity Act (HR 1579), which would generate hundreds of billions of dollars a year through a tiny tax on Wall Street trading. It's the exact kind of bold leadership and legislation our nation needs right now. April 20th, a thousand people rallied in Washington in support of this bill. Read more.

We Are Going to Be Everywhere!

The U.S. Treasury was renamed “A Citigroup Subsidiary, Jack Lew, Inc. CEO,” as Robin Hood and a merry band of 2,000 hoisted a banner with the Treasury building as backdrop on the corner of 15th St. NW in Washington, D.C. “Who does Secretary Lew work for?” asked Jennifer Flynn of Health GAP, one of the founding organizations of the Robin Hood Tax Campaign.  “The people,” answered all. RoseAnn DeMoro, executive director of National Nurses United, another founding RHT organization, called out, “I see the Treasury; we all see Hypocrisy!” to which she heard a loud and resounding echo from the spirited protesters spilling into the intersection, a stone’s throw from the White House. “We are going to be everywhere!” said DeMoro. Read more.

Let's build on our momentum...
Share the DC Action News widely!

“A HUGE DAY” Rep. Keith Ellison, on reintroduction of the Inclusive Prosperity Act, H.R. 1579
Robin Hood Tax USA Blog, 04/13/13

A Robin Hood Response to the Austerity Lie: Tax Wall Street
The Nation, by John Nichols, 04/17/13

Time for a Sales Tax on Wall Street Financial Transactions
By Ralph Nader, 04/18/13

“America’s New Math: 1 Wall Street Hour = 21 Years of Hard Work For the Rest of Us”
Before It's News, 04/20/13

Robin Hood Tax Only Fair, Advocates Say
DC Media Group, 04/21/13

A Tax System for the 99 Percent
Nation of Change, 04/21/13

Rosa Pavanelli joins thousands in FTT rally in Washington
WorldPSI.org, 04/22/13

>>~~~~~~~~~~~~~~~~~>

Robin Hood Tax USA Campaign

http://RobinHoodTax.org

This is a huge day," Rep. Keith Ellison announced April 17 at a press conference within view of the Capitol, referring to legislation he reintroduced for a Wall Street speculation tax with huge purpose.

Take, for example, this passage from the bill's "Findings."

"The global crisis cost Americans $19 trillion in lost wealth.... American citizens provided the money to stabilize the financial sector.... The global financial crisis, along with wars, unabated and unaddressed climate change, unsustainable tax cuts, and a continuing unemployment crisis, if unaddressed, will deprive a generation of a meaningful role in the larger economy." -- Inclusive Prosperity Act, H.R. 1579, Sec. 2.

Rep. Ellison addresses Washington press conference April 17 surrounded by supporters of HR 1579

The next step is a big march and rally Saturday, April 20 - 12pm EST @ Rally at Farragut Square - 17th Street NW between K and I streets, Washington, DC.

Then a march follows to the U.S. Treasury Department and White House. Symbolic dollar bills to pay for a real recovery will be delivered to the White House. Anyone not able to attend can watch it via live stream here.

Ellison's bill is attracting support from more members of Congress -- Earl Blumenauer (D-OR), Judy Chu (D-CA), John Conyers (D-MI), Barbara Lee (D-CA), James McGovern (D-MA) and Delegate Eleanor Holmes Norton (D-D.C.).

Calling the legislation "remarkable" and "bold," Rep. Barbara Lee told the press conference that HR 1579 would address "out-of-control tactics" on Wall Street and would "lead to critical investments for our future -- in health and development assistance."

Rep. Barbara Lee speaking at the press conference

H.R. 1579 would levy a small sales tax on trading of stocks, bonds, derivatives and other instruments. Brokers carrying out the trades would be charged the tax, unless carried out directly by investors. Households with adjusted gross incomes under $75,000 would be exempted.

Indeed, the tax targets the wealthiest of the wealthy, the bankers and brokers who crashed our economy and were rewarded with bailouts and bonuses while Main Street endured the pain. As to those who insist the effects of the tax will just fall on ordinary Americans, consider this: The top 1 percent own half the country's stocks, bonds and mutual funds. The bottom 50 percent own .5 percent, half of one percent, of all stocks, bonds and mutual funds.

Supporters say the bill would bring real and enduring recovery to Main Street. It also aims to put a brake on high-speed computer trading, avoid bubbles that destabilize markets and sideline capital, and lower costs of essentials, like fuel and food, whose price spikes are linked to speculative trading.

"High-frequency trades are carried out at 'blinding speeds,'" said Wallace Turbeville, former Goldman Sachs investment banker and a senior fellow at Demos, "to the point where 50, 60 or 70 percent are done by 'robo-traders.' This does not give value to the economy, it damages it."

"Wall Street speculation has become a house of cards, a game of computer-driven bets on bets, far removed from real-world investments in real economic activity," wrote Ralph Nader in a statement of support for Ellison's bill.

National Nurses United Co-president Jean Ross at DC press conference

"We have all seen the enormous outpouring of support for a financial transaction tax in this country," said Jean Ross, RN, co-president of NNU, the nation's largest nurses' organization. "The Ellison bill has our strongest support and the backing of millions of members in organizations that endorse Robin Hood - because it would move the country away from austerity, and all the harm that entails, and raise revenue on the scale needed to rebuild the communities still suffering from the financial collapse of 2008."

George Goehl, executive director, National People's Action, thanked Rep. Ellison for his "courage" and for pushing back against "awful austerity." Goehl said that polls indicate that 62 percent of the public support an FTT. "We have a revenue crisis in America," said Goehl, "but the good news is that we know where the money is. It's not in grandma's social security check, it's not in our children's classroom, and it's not in the pockets of working class families. It's on Wall Street."

"The United States has made a commitment to invest in the end of AIDS. Yet, with our current budget crisis this will be impossible, unless we join all of the other major financial markets and implement a Robin Hood Tax. There is no reason not to do this," said Jennifer Flynn of Health GAP. "It's common sense legislation."

Erich Pica, of Friends of the Earth, also spoke, expressing support for Ellison's bill in behalf of his organization's 150,000 members and its goal to address "uncontrolled climate change." He asked, "Does the U.S. have the political will for adaptation that has to occur?"

"We have an FTT at the gates of Congress," said Bobby Tolbert of VOCAL-NY. "With a tiny tax on Big Banks, we can invest in our future by creating jobs, protecting healthcare and solving crises like the HIV/AIDS epidemic and climate change. It's the minimal endowment owed by corporate America."

More than 140 organizations representing millions of members in labor unions, religious groups, as well as health advocates, consumers, housing activists, environmentalists, and others have endorsed the passage of the Wall Street sales tax. Among those showing their support this week were the Sierra Club and the National Organization for Women.

"It's about time Wall Street started paying its fair share," said NOW President Terry O'Neill. "The people of this country are still struggling to get by, six years after the economic downturn began. Women are disproportionately represented amongst the poor and those working for minimum wage with little to no benefits. We need a strong safety net, and who better to pay for it than the financial institutions that caused the economic crisis in the first place?"

Ellison noted that the idea of the tax is not outlandish or unusual, calling it, in fact, "mainstream." Today, dozens of countries have in place a system of financial transaction taxation, including many of the world's biggest economies. Eleven European countries, including Germany, France and Italy, have either implemented or will soon implement an FTT.

The leading Asian financial markets also charge these taxes as do other major economies with the exception of the U.S. But even the U.S. had a tax for half of the last century until the increasingly powerful financial industry lobby succeeded in having it repealed in the 1960s.

"The Inclusive Prosperity Act, which establishes a modest tax on virtually all financial transactions in the United States, is a hugely important policy initiative that addresses three of our most important economic problems today--austerity, financial instability, and inequality," said University of Massachusetts-Amherst economist Robert Pollin.

"This measure is capable of generating in the range of $300 billion per year in tax revenues. These funds would enable us to fight against the austerity-agenda cuts to Social Security, Medicare, public education and other vital social programs. The Act will also discourage excessive speculation in financial markets, by increasing the costs of Wall Street gambling. Everyone shopping on Main Street today pays sales taxes when they buy things. It's time for Wall Street traders to face up to similar obligations."

Follow Deborah Burger on Twitter: www.twitter.com/NationalNurses

Here are some questions to consider: What do the Wall Street firms do that is so vital for the national interest? How does speculation contribute to our society? It's time for Wall Street to step up and provide some answers.

The reckless actions of Wall Street institutions led to the collapse of the the U.S. economy and the deep recession of 2008-09. The Wall Street firms looted and gambled trillions in worker pensions and mutual fund savings. The Wall Street traders made billions of dollars in speculative money -- bets on bets -- holding hostage the real economy where money is made by providing goods and services. And the actions of Wall Street resulted in the loss of more than 8 million jobs.

Despite all the lasting harm caused by the casino capitalists, the big banks are now bigger, richer and more powerful than they were when they were bailed out in late 2008. The only ones who were punished were the U.S. taxpayers, who footed the $600 billion bill for the excesses of Wall Street. Brazenly, many firms still continue to gamble with other people's money.

Something needs to change. One necessary change lies in a financial transaction tax -- often referred to as the "Robin Hood Tax." The Robin Hood Tax movement began in the United Kingdom in 2010 with the support of hundreds of economists, prominent public figures and social justice organizations.

Yesterday, Rep. Keith Ellison (D-Minn.) reintroduced "The Inclusive Prosperity Act" -- inspired by the Robin Hood Tax. If passed, the bill (H.R. 1579) would create a minuscule tax on the purchase and sale of derivatives, options and stocks. The tax would be small, half a percent or less of the transaction value, depending on the product. This amounts to half a penny or less per dollar.

Consider this fact: American consumers in most states pay sales taxes on the necessities they purchase -- cars, appliances, clothes, etc. The rate of such sales tax is, in some areas, as high as 7 percent. For example, a schoolteacher or police officer who buys a $100 pair of shoes pays up to $7 in sales taxes. Most people accept the idea of paying such a tax. But what about the folks on Wall Street? A trader can buy and sell millions of dollars of financial products each day without paying a cent in sales taxes. Why should financial transactions be exempt from a small sales tax?
A financial transaction tax could raise $350 billion annually -- money that could be used to repair critical infrastructure, create decent paying jobs, reduce the tax burden on individuals and start to rein in frivolous high-volume trading.

At the news conference announcing the legislation, Rep. Ellison said: "This is a small tax on financial transactions that will allow us to meet the needs of our nation. And didn't America step up, on very short notice, for Wall Street when it needed help? Well, now the American people need help."

Critics of a financial transaction tax have all sorts of excuses. They argue it would harm ordinary investors; it wouldn't, there are protections in place for small investors. Some say it would drive trading to offshore tax havens; but forty countries already have such a tax in place with little compelling evidence showing an adverse effect.

It's obvious that the casino capitalists won't give an ounce of their moral obligation without a fight. However, the endorsement of more than a thousand economists speaks volumes. One supporter, the Capital Institute's John Fullerton (a former managing director at JPMorgan), has stated that a financial transaction tax could have significant impact in lessening the use of high-frequency trading. He has estimated that nearly 70 percent of equity-trading volume falls under this category of highly speculative trading. In June 2012, Fullerton and over 50 other financial industry professionals wrote a letter to the G20 and European leaders advocating for small financial transaction taxes.

The United States had a financial transaction tax from 1914 until 1966. It imposed a tax of 2 cents on every $100 sale or transfer of stock.

The question I posed at the outset was: What does Wall Street do that is so vital for the national interest? To begin to answer it, they can start paying this small tax. As the Robin Hood tax website succinctly puts it with their slogan, it would be "small change for the banks and big change for the people." The $350 billion raised annually with a financial transaction tax would go a long way in helping American workers and bolstering the economy.

If you agree, stop practicing futility. Show a civic pulse. Write and call your Congressional Representative. Tell them you support "The Inclusive Prosperity Act" and they should support it as well. National Nurses United, the largest union and professional association of registered nurses in the United States, has already done this and much more with their national Robin Hood Tax campaign. Visit robinhoodtax.org to learn more.

 

The Ralph Nader Reader
by Ralph Nader

It's the Media, Stupid
by John Nichols, Barbara Ehrenreich, Ralph Nader, Paul Wellstone, Robert W. McChesney, Barbara Ehrenreich, Ralph Nader, Paul Wellstone

Follow Ralph Nader on Twitter: www.twitter.com/Ralph_Nader

Take, for example, this passage from the bill’s “Findings.”

“The global crisis cost Americans $19 trillion in lost wealth....American citizens provided the money to stabilize the financial sector…. The global financial crisis, along with wars, unabated and unaddressed climate change, unsustainable tax cuts, and a continuing unemployment crisis, if unaddressed, will deprive a generation of a meaningful role in the larger economy.”

Inclusive Prosperity Act, H.R. 1579, Sec. 2.

Ellison’s bill is attracting support from more members of Congress—Earl Blumenauer (D-OR), Judy Chu (D-CA), John Conyers (D-MI), Barbara Lee (D-CA), James McGovern (D-MA) and Delegate Eleanor Holmes Norton (D-D.C.).

Calling the legislation “remarkable” and “bold,” Rep. Barbara Lee told the press conference that  HR 1579 would address “out-of-control tactics” on Wall Street and would “lead to critical investments for our future—in health and development assistance.”

H.R. 1579 would levy a small sales tax on trading of stocks, bonds, derivates and other instruments.  Brokers carrying out the trades would be charged the tax, unless carried out directly by investors.  Households with adjusted gross incomes under $75,000 would be exempted.  Supporters say the bill would bring real and enduring recovery to Main Street.  It also aims to put a brake on high-speed computer trading, avoid bubbles that destabilize markets and sideline capital, and lower costs of essentials, like fuel and food, whose price spikes are linked to speculative trading.

"High-frequency trades are carried out at ‘blinding speeds,’” said Wallace Turbeville, former Goldman Sachs investment banker and a senior fellow at  Demos, “to the point where 50, 60 or 70 percent are done by ‘robo-traders.’  This does not give value to the economy, it damages it.”

“Wall Street speculation has become a house of cards, a game of computer-driven bets on bets, far removed from real-world investments in real economic activity,” wrote Ralph Nader in a statement of support for Ellison’s bill. 

“We have all seen the enormous outpouring of support for a financial transaction tax in this country,” said Jean Ross, RN, co-president of NNU, the nation’s largest nurses’ organization. “The Ellison bill has our strongest support and the backing of  millions of members in organizations that endorse Robin Hood -  because it would move the country away from austerity, and all the harm that entails, and raise revenue on the scale needed to rebuild the communities still suffering from the financial collapse of 2008.” 

George Goehl, executive director, National People’s Action, thanked Rep. Ellison for his “courage” and for pushing back against “awful austerity.”  Goehl said that polls indicate that 62 percent of the public support an FTT.  "We have a revenue crisis in America,” said Goehl, “but the good news is that we know where the money is.  It's not in grandma’s social security check, it’s not in our children’s classroom, and it’s not in the pockets of working class families.  It’s on Wall Street." 

Photos from the press conference.

“The United States has made a commitment to invest in the end of AIDS. Yet, with our current budget crisis this will be impossible, unless we join all of the other major financial markets and implement a Robin Hood Tax.  There is no reason not to do this," said Jennifer Flynn of Health GAP.  “It’s common sense legislation.”

Erich Pica, of Friends of the Earth, also spoke, expressing support for Ellison’s bill in behalf of his organization’s 150,000 members and its goal to address “uncontrolled climate change.”  He asked, “Does the U.S. have the political will for adaptation that has to occur?” 

“We have an FTT at the gates of Congress,” said Bobby Tolbert of VOCAL-NY.  “With a tiny tax on Big Banks, we can invest in our future by creating jobs, protecting healthcare and solving crises like the HIV/AIDS epidemic and climate change.  It’s the minimal endowment owed by corporate America.”

We wanted to share a brief story about one of our Board members, Betty Sparks, a nurse at Newton Wellesley Hospital, who is also a specially trained nurse in providing care and treatment in the wake of all types of disasters.

Betty, who was on the ground to help victims after Hurricane Katrina and in Haiti after the devastating earthquake, was working at the medical tent at the finish line of the Boston Marathon yesterday, and she was there to respond and care for the victims when the bombs exploded.

She is trained to do this, she has seen horrific scenes before, but this time it was different, for at the finish line she knew her son was there with a camera getting ready to photograph her daughter-in-law, who was finishing the race.

“I never had to run out to victims before where one of them could have been someone I knew, a member of my family,” she wrote in an email after the event.

Thankfully, her son and daughter-in-law were fine, and Betty did what she is trained to do. She worked the scene, caring for the victims as she always does in these situations until they were all transferred out to the city’s hospitals.

We salute Betty Sparks as a true hero, for her courage and her professionalism, and we offer our thanks that her family was unharmed, as we continue to mourn and pray for those who were not so fortunate.

LISTEN TO BETTY TALK ABOUT HER EXPERIENCE ON THE RADIO

Coming Up on Nurse Talk Radio

__________________________________

Listen and share the NNU segment:

LISTEN: AB 975: Accountability in Nonprofit Hospitals

Featuring RN Bonnie Castillo

Podcast: Play in new window | Download (Duration: 9:57 — 13.7MB) | Embed

Listen to the Full Show here >>

___________________________________

By Pattie Lockard
Executive Producer
Nurse Talk Radio

AB 975 – Accountability in Nonprofit Hospitals

Have you ever wondered about what a business or an organization has to provide in order to acquire and keep a not-for-profit (aka nonprofit) status?

Well the truth is most of us don’t really think about it…but we should because some of those nonprofit entities, such as hospitals, are not really held to account with respect to their end of the bargain. Now, we are not saying any of these businesses are not doing a good job and are not operating above board, but a recent study (conducted by California Nurses Association) shows some major hospitals may not be providing enough “charity” care to the communities they are suppose to serve.

Our guest, RN and Director of Government Relations for CNA, Bonnie Castillo  will talk about a bill, AB 975 that aims to press California non-profit hospitals to fulfill their charity care obligation in exchange for the substantial public financing they receive through their tax-exempt status. It  passed its first hurdle last Tuesday in the California Assembly Health Committee, overcoming opposition from California’s biggest hospital corporations and its allies.

The bill won broad support in the committee hearing from nurse members of the California Nurses Association who attended the hearing in a sea of red scrubs.

RELATED NEWS:

Bill to Hold Hospitals Accountable on Charity Care Passes First California Legislative Test

Legislation to press California non-profit hospitals to fulfill their charity care obligation in exchange for the substantial public financing they receive through their tax exempt status passed its first hurdle Tuesday in the California Assembly Health Committee overcoming opposition from California’s biggest hospital corporations and its allies. —California Nurses Association, 04/03/13 More »

###

1. Robin Hood Rides in DC Next Week - Join Us!

2. HEAL DC - RNs Rally for Safe Ratios

3. REJECT CUTS to Social Security and Medicare!

4. California Charity Care Bill to Hold Hospitals Accountable

5. Massachusetts RNs protest for patient care

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Robin Hood Rides in DC Next Week - Join Us!

On April 20, Robin Hood will be marching from the IMF and World Bank to the US Treasury to demand a Robin Hood Tax in the U.S. We hope you can join us! On April 17 Congressmember Ellison (D-MN) will be holding a press conference to herald the reintroduction of The Inclusive Prosperity Act which calls for a Robin Hood Tax. Stay tuned for more on that.

In order to send a powerful message to the G20 Finance Ministers who will be meeting in DC in a few weeks, we need to ensure as big a mobilization as possible – and to do this we need your help to reach more people.

Can't make it to DC? Join the Movement Online:

1. Like Robin on Facebook

2. Follow Robin on Twitter @RobinHoodTax and use the hashtag #TaxWallStreet

3. Sign-up for email alerts on our website

4. Visit our Facebook DC event page for details

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

HEAL DC - RNs Rally for Safe Ratios

The participation of every nurse is needed at two upcoming events to demand passage of the Patient Protection Act to ensure minimum mandatory RN-to-patient ratios in DC’s hospitals.

Friday, April 19: Rally at Freedom Plaza
13th and Pennsylvania Avenue, NW.
Buses will leave from the corner of 1st and Irving St., NW
at 4:45 p.m. and return by 6:45 p.m.

Tuesday, May 14: Hearing in the DC Council
Buses will leave from the corner of 1st and Irving St., NW
at 9:45 a.m. and return when the hearing ends.

Call 240-235-2000 or talk to your shop steward to reserve a seat on the bus.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

REJECT CUTS to Social Security and Medicare!

The largest U.S. organization of registered nurses, National Nurses United (NNU), issued its strongest warning today: Cuts in Social Security and Medicare would do harm to America’s elderly and disabled, vulnerable populations whose resources already place them in the margins. NNU called upon lawmakers to withdraw from all considerations of these cuts. Although Social Security contributes nothing to the federal deficit, Congress could increase revenue for the Social Security trust fund by raising the payroll tax income limit.

National Nurses United, 04/08/13 More »

TAKE ACTION: Tell the President NO CUTS to Social Security or Medicare:

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

California Charity Care Bill to Hold Hospitals Accountable

Malinda Markowitz, RN and CNA Co-president

Time for Hospitals To Act as Good Corporate Citizens

Has therapeutic healing and recovery become a vanishing mission among California hospitals? Are California hospitals operating as big corporations more devoted to piling up cash than to assuring the delivery of care? A look at how California's private, not-for-profit hospitals are meeting their responsibilities for providing charity care and community benefit programs suggests many have lost their way. —Malinda Markowitz Commentary, California Healthline, 04/09/13 More »

Bill to Hold Hospitals Accountable on Charity Care Passes First California Legislative Test

Legislation to press California non-profit hospitals to fulfill their charity care obligation in exchange for the substantial public financing they receive through their tax exempt status passed its first hurdle Tuesday in the California Assembly Health Committee overcoming opposition from California’s biggest hospital corporations and its allies. —California Nurses Association, 04/03/13 More »

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Massachusetts RNs protest for patient care

HAVERHILL — Nurses took to the street near Merrimack Valley Hospital in Haverhill yesterday to call attention to what they think is an alarming trend at some local hospitals. —The Eagle Tribune, 04/06/13 More »

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Thanks, and please FOLLOW US online at any/all of the links below!

National Nurses United

Robin Hood Tax Campaign

Tune in to NNU on Nurse Talk Radio

Has therapeutic healing and recovery become a vanishing mission among California hospitals? Are California hospitals operating as big corporations more devoted to piling up cash than to assuring the delivery of care?

A look at how California's private, not-for-profit hospitals are meeting their responsibilities for providing charity care and community benefit programs suggests many have lost their way.

In 2010 alone, not-for-profit hospitals pocketed $1.8 billion dollars in government subsidies through their tax breaks and other benefits above what they returned to patients in charity care, as documented in a California Nurses Association report based on public data.

Nearly half that total was recorded by just two of California's biggest hospital chains, Kaiser Permanente and Sutter Health, which also happened to account for almost half of the 100 not-for-profit hospital executives who received pay packages of more than $1 million a year.

While many hospitals are no doubt good corporate citizens, these numbers undermine credibility for the hospital industry as a whole, especially when some apparently count marketing, cost-cutting and other dubious practices as their community benefit program.

Instead of opposing a common sense bill like AB 975, just as they have fought nearly every reform aimed at strengthening patient protections in California, hospital lobbyists should welcome this legislation as a way to restore public confidence that they are being genuinely transparent, accountable and acting in good faith in the delivery of charity care and community benefit.

California's nurses salute Assembly members Bob Wieckowski and Rob Bonta for introducing AB 975. The bill is supported by California Nurses Association and an array of other labor and consumer groups, as well as elected leaders who believe we need common standards and a level playing field with equal expectations for all not-for-profit hospitals that reap the rewards of their tax exempt status.

Regrettably, implementation of the Affordable Care Act will not end the health care crisis. We continue to see patients skipping needed medical treatment, cutting prescription pills in half, unable to pay exorbitant hospital bills and facing huge out-of-pocket costs for insurance they can barely use.

Until we can achieve more far-reaching health reform, it is more important than ever for hospitals to compete in providing appropriate and equitable levels of charity care and community benefit, and not in who can most resemble Lehman Brothers or Goldman Sachs

Read more

When the usual corporate suspects lined up before the Assembly Health Committee last week to oppose a CNA-sponsored bill to require some non-profit hospital giants to stop treating their tax exempt status like a Cayman Islands tax shelter, they had a special friend in tow.

That was SEIU-UHW rubbing shoulders, again, with the California Hospital Association, CHA (chief lobbyist for the state’s biggest hospitals), Kaiser Permanente, Sutter, Cedars-Sinai Medical Center, and the California Chamber of Commerce (main state advocate for Wall Street).

SEIU-UHW,  which only a year ago was collecting signatures on a similar initiative to hold non-profit hospital corporations accountable for meeting their charity care obligation, now was telling the committee it was worried about the “uniquely uncertain landscape” created by the Affordable Care Act.

So were SEIU-UHW and its president Dave Regan being dishonest last year when pushing their initiative, at a time when the problems with the ACA were already quite clear? Did they just suffer a sudden loss of conscience?

Was that initiative, which conveniently exempted Regan’s top partner, Kaiser, a fraud, quickly dumped when Regan signed a secret deal with CHA?

Or are Regan and company now just making up new pretexts for marching in lockstep with their hospital industry mates?

For more on the charity care bill, read here http://www.nationalnursesunited.org/press/entry/bill-to-hold-hospitals-accountable-on-charity-care-passes-first-california-/

And here http://www.mercurynews.com/breaking-news/ci_22971313/two-bay-area-lawmakers-seek-hold-tax-exempt

Why Kaiser RNs are supporting NUHW-CNA

As thousands of Kaiser health care workers this week begin receiving ballots on whether to dump Regan’s SEIU-UHW and vote to join the CNA-affiliated NUHW,  it’s worth revisiting the sordid record of Regan and his top managers the past two years.

Regan’s attack on RN ratios

Most infamously, Regan last spring agreed to a request from CHA CEO Duane Dauner to lobby California legislators to introduce a bill last year to fulfill the CHA’s decade long goal to overturn the state’s landmark ratio law.

As part of the scheme, Regan was to urge the California Labor Federation, umbrella organization of California unions, to go along with that proposal.  Regan fell on his face, failing to win the support of a single legislator or other union.

Read more here http://www.bizjournals.com/sacramento/blog/kathy-robertson/2012/06/unions-health-care-nurse-ratio.html?page=all

And here

http://www.nationalnursesunited.org/news/entry/cna-wages-war-against-uhw-in-california-claiming-attempt-to-suspend-staffin/

Has Regan had second thoughts about his proposal to sabotage a law that is saving the lives of thousands of California patients, some of whom are even Regan’s own members?

Not at all. “We are proud of it and would do it again,” said Regan in a radio interview last week.  http://www.kpfa.org/archive/id/90399 

Regan’s promotion of ‘Wellness’ schemes to erode health benefits

Regan has teamed with CHA and other hospital employers to promote “wellness” programs supposedly intended to encourage healthy personal habits to reduce overall healthcare costs. The public CHA-SEIU-UHW joint wellness initiative for California is what Regan publicly received in return for abandoning his charity care initiative.

The employers’ real goal, of course, is slashing what they pay for worker health coverage, and forcing workers to pay far more out of pocket for not meeting arbitrary “wellness” goals, even if they have chronic or genetic health conditions that have nothing to do with “life style” choices.

Recent evidence documents that the “cost controls” come from, you guessed it, cost shifting from the employer or insurer to the employee.

The plans, which more hospitals are seeking to make mandatory, also involve substantial invasion of personal privacy. 

Read more here http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/04/corporate-wellness-programs-not-quite-the-cost-savers/ 

And here http://www.labornotes.org/print/4146

Regan’s concessionary contracts

RNs across California who work side by side with SEIU-UHW members are probably already aware of the sweeping concessions Regan and his coterie have signed with hospital managers.

Here’s a list just for Kaiser:

• $1.8 billion in retiree health benefit cuts
• Closed door talks to dump defined benefit guaranteed pensions for 401 (k) plans subject to shaky market swings.
• Higher out of pocket health coverage costs tied to “wellness” goals 
• 1,000 announced layoffs of UHW-SEIU members
• Subcontracting union jobs 
• A 9 cent per hour labor-management “partnership” tax to Kaiser paid by every UHW-SEIU member
• Marketing Kaiser’s business plan goals, including silence when Kaiser cuts mental health and other patient services

And in other hospital systems, SEIU-UHW has agreed to wage freezes, deep cuts in health and pension plans, requiring members to go through a bidding process following seismic rebuilds, and public testimony in support of employers’ corporate initiatives.

Shilling for hospital employers—that’s the Regan legacy, and why so many Kaiser workers are voting this week to replace him.

Wall Street banks and corporations are raking in record profits while our communities continue to suffer job losses and cuts to public programs. Instead of lining the pockets of corporate fat cats, this money should go to our children’s Head Start programs, Grandma’s retirement, and fixing our broken healthcare system.

It’s time for the administration to stand with the people and TAX WALL STREET.

Join us April 20 as we march to the White House and Treasury Department to demand a financial transaction tax on Wall Street trades so we can put the money toward global health needs, addressing the climate crisis, jobs, and education.

RALLY at 12:00 p.m.
Farragut Square on 17th Street NW between K and I streets (NEW LOCATION)

MARCH at 12:30 p.m.
March past the International Monetary Fund and World Bank to the U.S. Treasury Department at 15^th and G streets.

Visit and share our Facebook events page

Contact Robin Hood Tax Campaign Coordinator Francesca Lo Basso with any questions:

Get more details and a map at www.RobinHoodTax.org

Coming Up on Nurse Talk Radio

__________________________________

Listen and share the NNU segment:

LISTEN: Missouri RNs fight for safe lift bill - HB 856

Featureing Missouri RN Emma Stroud

Podcast: Download (Duration: 8:37 — 11.8MB) | Embed

Listen to the Full Show here >>

___________________________________

By Pattie Lockard
Executive Producer
Nurse Talk Radio

Missouri RNs fight for safe lift bill - HB 856

We’ve touched on this issue before but it’s worth talking about again.

The statistics regarding back injuries are frightening! Approximately 80% of adults are expected to experience back injuries in their lifetime with 10% re-injuring! When it comes to health care professionals, the facts get are even worse.

According to national statistics, six of the top 10 professions at greatest risk for back injury are nurse’s aides, licensed practical nurses, registered nurses, health aides, radiology technicians, and physical therapists. Healthcare industry workers sustain 4.5 times more overexertion injuries than any other type of worker.

Well, registered nurses from hospitals in Kansas City and St. Louis, members of National Nurses Organizing Committee (NNOC), with the help of their state legislators, recently introduced HB 856 - the Safe Lift Bill. Sounds like a no brainer right? Listen and find out how challenging it was to get this bill introduced. Trust us – this is important even if it isn’t a sexy topic.

READ THE FULL NNU PRESS RELEASE

###

2. Illinois Jackson Park Chicago RNs Win First Hospital Contract

3. California Nurses Reach Agreement with Sutter CPMC

4. Michigan MNA President, Jeff Breslin on Right To Work

5. Missouri Nurses Push for “Safe Patient Handling” Law HB 856

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

1. Florida Nurses Welcome First Contract

South Florida registered nurses this week are celebrating their first ever collective bargaining agreement at Florida Medical Center (FMC) and Palmetto General Hospital, with terms they say will improve patient care as well as secure economic gains for nurses and their families. —NNOC Florida / NNU, 03/27/13 More »

2. Illinois Jackson Park Chicago RNs Win First Hospital Contract

Registered nurses at Jackson Park Hospital and Medical Center on Chicago’s South Side late Monday reached agreement with hospital officials on their first ever collective bargaining contract that includes significant improvements in patient care protections. —National Nurses United, 03/19/13. More »  Also, listen to and share the Nurse Talk Radio NNU segment here.

3. California RNs Reach Agreement with Sutter CPMC & St. Luke

Registered nurses at two San Francisco Sutter hospitals, California Pacific Medical Center and St. Luke’s Hospital, have, at long last, reached agreement with hospital officials on a new collective bargaining contract for the 800 RNs who work at the two facilities, the California Nurses Association said today. —California Nurses Association , 03/27/13 More »

4. Michigan MNA President, Jeff Breslin on Right To Work

The undemocratic, illegal process used to pass that law was shameful. The bills were rushed through the Legislature in a way Michigan has never seen, without public comment and with citizens locked out of the Capitol at times. —Lansing State Journal, by Jeff Breslin, RN, 03/28/13 More »

5. Missouri Nurses Push for “Safe Patient Handling” Law HB 856

Registered Nurses from hospitals in Kansas City and St. Louis, members of National Nurses Organizing Committee (NNOC), will hold a press conference on Wednesday, March 27 at 12:30p at the Gallery of the House of Representatives Lounge in Jefferson City to underscore support for the “Safe Lift” bill. The bill puts in place known solutions available to reduce patient and healthcare-giver injuries resulting from lifting. —National Nurses Organizing Committee - Missouri, 03/25/13 More »

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Thanks, and please FOLLOW US online at any/all of the links below!

National Nurses United

Robin Hood Tax Campaign

Tune in to NNU on Nurse Talk Radio

Coming Up on Nurse Talk Radio

__________________________________

Listen and share the NNU segment:

LISTEN: Collective Bargaining Win for Nurses and Patients in Chicago
Featureing Chicago RN, Monica Lloyd

Podcast: Download | Embed (Duration: 11:52 — 16.3MB)

Listen to the Full Show here >>

___________________________________

By Pattie Lockard
Executive Producer
Nurse Talk Radio

Big Win for Chicago RNs and National Nurses United!

Jackson Park RN leaders celebrate tentative agreement.

Keeping up with the RNs from National Nurses United—Registered nurses at Jackson Park Hospital and Medical Center on Chicago’s South Side reached an agreement with hospital officials on their first ever collective bargaining contract that includes significant improvements in patient care protections. We’ll talk with RN Monica Lloyd from the great city of Chicago about this and more.  

And did we say Monica is on fire about this good news!

READ THE FULL PRESS RELEASE

###

By: Julia Morrissey, nurse, Ann Arbor

Opinion March 28, 2013 at 1:00 am

I'm a registered nurse who actually knows what patients need when they're in the hospital. So I was outraged by The Detroit News' distorted editorial about a bill to require all Michigan hospitals to meet minimal levels of nurse staffing (March 14, "State shouldn't mandate hospital staffing levels").

Few people realize there are no laws requiring hospitals to have enough nurses on duty at any time.

Some hospitals work well with nurses to manage staffing levels appropriately. With no accountability, though, too many purposely understaff just to save a few dollars.

This widespread practice is dangerous for patients and can even be deadly.

Dozens of scientific studies underscore what most nurses have sadly experienced at some point: When nurses have to take care of too many patients, it's physically impossible to always meet everyone's needs and prevent potentially serious mistakes.

Those studies show a clear link between low nurse staffing and higher rates of preventable problems such as bloodstream and surgical-site infections, hospital-induced pneumonia, falls, and even deaths.

The Detroit News would know these facts had they done more than rely on the hospitals' lobbyists — the Michigan Health and Hospital Association.

But as Rep. Jon Switalski, the House sponsor of this legislation requiring minimum nurse-to-patient ratios, said recently, "Without adoubt, the hospital industry has a firm grip on the Legislature."

They just want to protect their profits. Period.

The hospital industry is thriving financially. And their excuse of a nursing shortage doesn't fly: There are plenty of new graduate nurses who can't find jobs.

Hospitals have choices. Instead of inflating CEO salaries and pouring millions more into lobbying, they should put patients first and invest in nurse staffing.

Patients should be able to get quality care at every Michigan hospital, every time.

Unfortunately, it's going to take a state law to make that happen.

Julia Morrissey, nurse, Ann Arbor

From The Detroit News: http://www.detroitnews.com/article/20130328/OPINION01/303280325#ixzz2OqslA126

Commentary by: Jeff Breslin, RN 

Today is a sad day in our state’s history as the so-called “right to work” law takes effect.

From the start, Gov. Rick Snyder insisted that this radical anti-worker legislation wasn’t on his agenda.

In December, he showed his true colors and signed “right to work for less,” pleasing millionaire Dick DeVos and other corporate interests while betraying the rest of us.

The undemocratic, illegal process used to pass that law was shameful. The bills were rushed through the Legislature in a way Michigan has never seen, without public comment and with citizens locked out of the Capitol at times.

Now Michigan is just another RTW state, handed over to corporations in a race to the bottom.

Gov. Snyder should know this, though: Michigan’s nurses and other working families are committed to overcoming this injustice.

The law is being challenged in court on grounds that it was passed in violation of the First Amendment and the Open Meetings Act and that it violates the constitution and federal labor laws.

Even if these laws are wrongly upheld, Michigan’s working families are focused on replacing the politicians who have torn our state apart.

Michigan voters aren’t stupid — they see that Gov. Snyder and his friends in the Legislature serve their corporate friends, not those of us who actually work for a living.

It’s no surprise that Gov. Snyder’s approval ratings plummeted after he signed “right to work.”

Michigan families will be working hard to overcome this unjust law through the courts and the political process, and most of all we will keep doing what we’ve always done: work hard to take care of our fellow citizens, build Michigan’s unions and our middle class. As the old labor movement saying goes: “Don’t mourn — organize.”

Registered nurses like me, teachers, construction workers and others will be in our workplaces every day, talking to our co-workers to build solidarity and keep our voices strong in the face of corporations that want to silence us.

That, essentially, is what “right to work” is about — corporations and CEOs silencing and dividing workers so they can cut our wages, benefits and safety standards for their own gain.

As for “worker freedom,” I have to laugh every time a politician uses that term. The only “freedom” a worker gets under RTW is the freedom to receive union benefits while letting everyone else pay the costs. The “freedom” to refuse to pay your fair share isn’t the kind of freedom most workers want in their workplace.

“Right to work” is meant to play on this tension between workers — something Gov. Snyder and the GOP acknowledged when they exempted firefighters and police officers.

The law could create divisions among them, they said.

Well, a law that’s good for some workers should be good for all workers – but “right to work” isn’t good for any of us.

Fortunately, the spirit of Michigan workers is stronger than the letter of this law.

That spirit will shine more than ever in the months to come

Jeff Breslin is a registered nurse at Sparrow Hospital and president of the Michigan Nurses Association.

SOURCE >>

Realated news on Right To Work (RTW) 

Originally Posted: 03/26/2013 3:30 pm EDT

Having a baby is just one medical cost that's higher in the United States than in other countries, according to a new report.

Decades of data have shown time and again that the U.S. has the costliest health care system in the world by a variety of measures.

Still, a report released by the International Federation of Health Plans (i.e., health insurance companies) today provides a striking reminder of just how much more expensive health care is for Americans.

The report compared prices in the U.S. with prices in 11 other nations. It found that average prices in the United States are higher for most medical services cited in the report, but at the top end of the range, U.S. health care prices can be staggering compared to what citizens of other nations pay.

Planning to have a baby? At an average price for a normal delivery of $9,775, you'll pay more than a woman in the 10 other countries in the report -- and possibly as much as $16,653, or double what it would cost an Australian woman and more than 14 times the price for a woman in Argentina. The average price of a Cesarean section in the U.S., $15,041, is also higher than any other country -- and it could cost as much as $26,305.

Need life-saving coronary artery bypass surgery? Again, the U.S. average price is the highest at $73,420, and may reach $150,515. The average American price is more than $30,000 higher than the second-place price (in Australia), and more than eight times higher than in Argentina.

The price per-day of being the hospital also finds the U.S. leading the pack. The average daily cost of a U.S. hospital stay is $4,287 -- almost 10 times Argentina -- and it can be more than twice that amount.

How about a basic doctor's appointment? In the U.S., the average price is $95, and it ranges to $176 or more. In second-place Chile, it comes to $38.

There are more examples in the International Federation of Health Plans report, including prescription drugs, diagnostic testing and joint replacement surgeries. The results are pretty consistent across the board.

So what's the total effect of these high prices on the U.S.? This chart showing the share of nine countries' gross domestic product that goes to health care offers a summation of the entire report.

READ THE FULL REPORT:

International Federation of Health Plans 2012 Comparative Price Report by Jeffrey Young

Coming Up on Nurse Talk Radio

__________________________________

Listen and share the NNU segment:

Stephanie Roberson on Why You Should Care About Health Care and Staffing Legislation

Catch The Full Show here >>

___________________________________

By Pattie Lockard
Executive Producer
Nurse Talk Radio

Podcast: Play in new window | Download (Duration: 10:22 — 14.2MB) | Embed

Why You Should Care About Health Care and Staffing Legislation sounds boring? Not so fast! AB 975 Charity Care? Check it out. Or maybe SB 631 Observation Study? You don’t want to end up in a hallway at the hospital for over 24 hours do you? Listen as we check in to see what the California Nurses Association has been doing lately to fight for nurses and their patients.

California State Capitol Building, Sacramento

We have with us Stephanie Roberson the lead lobbyist for CNA working in the Governmental Relations department in Sacramento, Calif. Stephanie has been working with the nurses since 2007. Listen to this Nurse Talk segment and visit the California Nurses Association legislation page for additional information on the bills discussed.

The makers of We Are Wisconsin—the critically acclaimed documentary about the 2011 Wisconsin Uprising and its aftermath—are sponsoring screenings of the film Monday in communities across the country as part of a National Day of Recommitment to labor rights.

“The day is the second anniversary of the signing by Gov. Scott Walker of Wisconsin Act 10, which ended 60 years of progress for Wisconsin workers,” note the filmmakers. “The Walker assault led to battles all over America, challenging us all to stand up for working families, and to organize to put our country back on the right track.”

“Recommitment” is well-chosen word.

Despite the battering that unions have taken in recent years—not just in Wisconsin but nationally—a recommitment to labor rights is really a renewal of ideas and values that America once exported to the world.

There was a time, within the living memory of millions of Americans, when this country championed democracy, freedom of speech, freedom of the press and the right to organize in the same breath.

When the United States occupied Japan after World War II, General Douglas MacArthur and his aides worked with Japanese citizens to write a Constitution that would assure Hideki Tojo’s militarized autocracy was replaced with democracy. Fully aware that workers would need to have a voice in the new Japan, they included language that explicitly recognized that “the right of workers to organize and to bargain and act collectively is guaranteed.”

When the United States occupied Germany after World War II, General Dwight David Eisenhower and his aides urged German citizens to write a Constitution that would assure that Adolf Hitler’s fascism was replaced with a democracy. Recognizing that workers would need to have a voice in the new Germany, they included a provision that explicitly declared: “The right to form associations to safeguard and improve working and economic conditions shall be guaranteed to every individual and to every occupation or profession. Agreements that restrict or seek to impair this right shall be null and void; measures directed to this end shall be unlawful.”

When former first lady Eleanor Roosevelt chaired the International Commission on Human Rights, which drafted the Universal Declaration of Human Rights that would in 1948 be adopted by the United Nations as a global covenant, Roosevelt and the drafters included a guarantee that “everyone has the right to form and to join trade unions for the protection of his interests.”

For generations, Americans accepted the basic premise that labor rights are human rights. When this country counseled other countries on how to forge civil and democratic societies, Americans recognized that the right to organize a trade union—and to have that trade union engage in collective bargaining as an equal partner with corporations and government agencies—must be protected.

Now, with those rights under assault, it is wise, indeed, to recommit to the American ideal that working people must have a right to organize and to make their voices heard in a free and open society. As the Rev. Martin Luther King Jr. said fifty years ago: “History is a great teacher. Now everyone knows that the labor movement did not diminish the strength of the nation but enlarged it. By raising the living standards of millions, labor miraculously created a market for industry and lifted the whole nation to undreamed of levels of production. Those who attack labor forget these simple truths, but history remembers them.”

History remembers, as should we. A recommitment to labor rights is a recommitment to ideals that enlarged America and make real the promise of democracy.

(As part of the National Day of Recommitment, We Are Wisconsin showings will be held across the United States. For more information on National Day of Recommitment events, go to: wearewisconsinthefilm.com/.)

###

SOURCE

Coming Up on Nurse Talk Radio

__________________________________

Listen and share the NNU segment:

Donna Smith's Healthcare for All Segment

Catch The Full Show here >>

___________________________________

By Pattie Lockard
Executive Producer
Nurse Talk Radio

This week one of our good friends returns to Nurse Talk to talk about her new project, Healthcare for All Colorado. None other than Donna Smith is with. Donna as most of our listeners know, worked for five years as National Nurses United Legislative Advocate based in D.C. She just returned to her home state of Colorado and now serves as the Executive Director of Healthcare for All Colorado.

Having (successfully) gone through two bouts of cancer, Donna has great advice on how to make your insurance company accountable–at least to some degree. In her new role she will do what she has done for many years, advocate and educate people about what can be done to access healthcare and to eventually change the current system to a nationwide universal healthcare system.

For more information about Healthcare for All Colorado and National Nurses United visit: http://healthcareforallcolorado.org and http://www.medicareforall.org

And—it’s time to get HIP about the issue of “low bone density.” That’s right it’s time to talk about your “bones.” And no one is more qualified than Dr. Kenneth C. Howayeck. He is an author, lecturer and osteoporosis educator.

Dr. Howayeck is an author of books on self-care, including Bone Health Made Easy.. Here’s a jaw dropper–”If you break a hip and you are over 50, 1/4 will die in the first 12 months primarily from that injury!” Not good! Only three in ten osteoporosis sufferers actually know they have this “silent killer” affliction. For great information from Dr. Howayeck check out http://bonehealthmadeeasy.webs.com.

And from our Scrubs Magazine Top Ten, Interesting Hospital Fashion

Moments: top of scrub pants rolled down complete with pink thong and muffin top hanging out…give me a break! Unroll the tops…it’s a hospital, not a nightclub!

Last but not least-we want to give a big shout out to all of you who are listening to Nurse Talk on Progressive Voices, on the Tune In app, live streaming from the San Francisco Bay Area’s KNEW 960 AM, the iHeart Radio app, iTunes, Nursetalksite.com and everywhere in between.

###

OPINION

By: Deborah Burger, RN, NNU Co-President

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.

Just last month, a study by the National Research Council and the Institute of Medicine found that the U.S. ranks last among 17 affluent countries in life expectancy (all the others have national healthcare systems, unlike our dysfunctional insurance model). 

Now we’re losing ground in another arena – making the financial speculators pay their fair share for revenue needed for economic recovery.

The contrast was brought into sharp focus Monday in conflicting statements from Jack Lew, the Obama administration’s incoming Treasury Secretary, and European Union Tax Commissioner Algirdas Semeta. 

In a Washington speech, Semeta described the rapid movement of 11 EU nations, including such giants as Germany, France, Italy, and Spain, to implement a financial transaction tax. The same day Bloomberg news was reporting a dismissive statement by Lew on an FTT for the U.S.that even went beyond public statements about an FTT from the outgoing Treasury Secretary Timothy Geithner, who was well known as a champion of Wall Street.

The irony of Lew’s position could not be greater in a week in which Washington is frantic with the oncoming sequestration and the obvious need for new revenue sources to protect Main Street communities.

A major answer is staring us in the face – the Robin Hood tax.

The Inclusive Prosperity Act, authored by Rep. Keith Ellison, and expected to be reintroduced soon, would infuse up to $350 billion every year. The revenue would be used for such critical needs as jobs, healthcare, housing and fighting climate change and AIDS, by setting a small tax of just 50 cents on every $100 of stock trades and less on other financial instruments. 

Virtually every other major market has already figured this out, as Semeta pointed out.

“The financial sector is under taxed compared to other sectors,” said Semeta. “We (the EU) are ready to lead the way.” Other EU countries signing on include Portugal, Belgium, Austria, Greece, Estonia, Slovenia, and Slovakia, joining with the fastest growing markets in Asia and other major world exchanges, some 40 nations in all.

“The tax also has supporters here which I want to encourage,” said Semeta. That would be the growing Robin Hood movement, which has held multiple actions promoting the tax, most recently during Lew’s confirmation hearing earlier this month.

This is not a hard sell for nurses who daily see the worsening health consequences of persistent economic crisis facing many families and know our communities need the help a tax on Wall Street can provide.

So why do we have a Treasury nominee who is showing more loyalty to Wall Street than to Main Street?

In a statement by Lew to written questions by Senator Orrin Hatch, top Republican on the Senate Finance Committee, Lew even made the outlandish objection that an FTT “would be vulnerable to evasion.” That hasn’t spurred our government to crack down on the legion of corporate tax evaders, including some of the world’s biggest banks and oil companies who regularly avoid paying taxes and even get rebates.

But, in fact, an FTT would be simpler to enforce since trading is highly automated and more than 70 percent of trades go through computerized central clearing houses, making it easy to monitor and extremely difficult to evade. 

An FTT would also serve to stabilize markets by limiting high-speed, high-volume trades and by constraining price spikes in essentials, like food and gas, tied to speculative trading. In his Washington speech, Semeta noted that high-frequency trading has led to transactions that “do not have any social value,” adding the tax would “reorient the financial sector” around the real economy.

Deborah Burger is a registered nurse and a co-president of National Nurses United

Sequestration threatens to cut vital public services and undermines the economy in order to achieve budget priorities that benefit Wall Street while damaging Main Street.

And, of course, sequestration asks nothing of Wall Street.

That’s austerity, just as it has been practiced in Europe.

That’s austerity, just as it has failed in Europe.

Worse yet, the Simpson-Bowles “Fix the Debt” campaign seeks more austerity. They’re already trying to exploit the sequester mess that will play out this week to achieve the ultimate goals of Wall Street: the acceptance of the “principle” that the only way to balance budgets is by undermining Social Security, Medicare and Medicaid – with schemes like “chained CPI” cuts in cost-of-living increases for seniors, and an upping of the eligibility age for programs to qualify for earned benefits.

This is a critical moment for the proponents of austerity. They’ve lost at the polls, but they want to win in a moment of supposed crisis: using a new variation on the “disaster capitalism” strategies outlined in Naomi Klein’s "Shock Doctrine."

But savvy unions are pushing back, with a message challenging the austerity lie that says there is no alternative to the painful cuts that could cause a new recession. Their message is precisely right: If the CEOs who claim to be so concerned about debts and deficits really want to do something to balance the books, they can start by paying their fair share of taxes.

“Wall Street CEOs, part of the misnamed ‘Fix the Debt’ group, are pushing for cuts in lifeline benefits like Social Security, Medicare and Medicaid to reduce our national debt. But a big part of our debt comes from their refusal to pay their fair share in taxes—and they want to keep the loopholes in place so they can keep right on doing it,” argue members of National Nurses United, the union that has taken the lead in promoting implementation of a “Robin Hood tax” that, by collecting a small fee on high-stakes financial transactions, could steer hundreds of billions into the U.S. Treasury.

NNU members are taking their message to the streets in cities such as Detroit, where the Michigan Nurses Association has organized protests outside banks, arguing: “We can save money — and protect critical social insurance programs — by taking … common-sense steps to close loopholes that cost our country, threaten the middle class and enrich the already wealthy.”

This is smart economics that bets on growth rather than the fantasy that America can cut its way to prosperity. And it ought to get an equal hearing in the debate over how to address debt and deficit issues.

NNU and other unions have “found the money” where too many politicians and pundits refuse to look: on Wall Street. They propose a fair-tax strategy that raises money for the U.S. Treasury while encouraging investment in the United States. To wit:

• Eliminate the tax benefit corporations receive from sending jobs overseas ($583 billion).

• Close other corporate tax loopholes so Wall Street starts paying its fair share of taxes (hundreds of billions of dollars over 10 years).

• Tax the income of Wall Street hedge fund and private equity managers at the same rate as wage income ($21 billion).

• Collect a surtax of at least 5.6 percent on income greater than $1 million ($453 billion over 10 years) so fewer millionaires can avoid paying their fair share of taxes.

• Implement a “Buffett rule” to ensure millionaires pay an effective tax rate of at least 30 percent on all their income ($47 billion).

• Limit the extra benefit of tax deductions for the richest 2 percent of Americans ($293 billion).

• Collect that small “Robin Hood tax” on Wall Street trading of foreign currencies, derivatives, bonds and stocks to discourage harmful speculation (raising more than $350 billion).

There are members of Congress who have picked up on key elements of the NNU plan. Congressional Progressive Caucus Co-chair Keith Ellison, D-Minn., endorsed a version of the Robin Hood tax and joined other progressives -- including Michigan Congressman John Conyers, Illinois Congresswoman Jan Schakowsky and Arizona Congressman Raul Grijalva -- in advancing a “Balancing Act” proposal that rejects the austerity agenda in favor of new revenue and growth.

Ellison and his co-sponsors are right to recognize that there are alternatives that can fix the debt and renew the U.S. economy. Those alternatives aren’t being proposed by the billionaire-funded “Fix the Debt” campaign. They’re being proposed by nurses in Detroit and cities across the country, as they seek to “heal the United States” rather than to cut it apart with austerity.

John Nichols is associate editor of The Capital Times. jnichols@madison.com

Read more: http://host.madison.com/news/opinion/column/john_nichols/john-nichols-avoid-sequester-cuts-by-taxing-wall-street/article_15e29e24-7fc8-11e2-a234-001a4bcf887a.html#ixzz2M38W6wHv

There's heavy pressure from the fossil fuel industry, the politicians they influence, conservative Canadian interests, and some construction unions in the U.S. for the pipeline. But it's not just the President's decision. It's up to all of us to put the pipeline in mothballs and leave the heavy tar sands crude oil in the ground.

National Nurses United, the largest U.S. organization of nurses, has joined with a growing climate movement, many ranchers and farmers, First Nations leaders, most Canadian unions, several other U.S. unions such as transport and domestic workers unions, and young people rightfully alarmed over the ecological impact to oppose Keystone XL.

Nurses already see patients sickened by the adverse effects of pollution and infectious diseases with a worrisome rise in asthma, respiratory and heart ailments, and premature death linked to air pollutants and the spread of water and food borne pathogens associated with environmental contaminants.

Now add in Keystone XL. 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, problems 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. Following the rupture of a pipeline near Marshall, Mi in 2010 state officials found more than half the residents in communities along the Kalamazoo River reported respiratory ailments and other symptoms.

Then there's the broader consequences of a project NASA scientist James Hansen calls "the biggest carbon bomb on the planet" and climate change activist Bill McKibben says would nearly double the atmosphere's concentration of carbon dioxide if all the oil in those tar sands is burned.

Carbon emissions are a major factor in intensifying climate change. Higher air temperatures, for example, can increase bacteria-related food poisoning, such as salmonella, and animal-borne diseases like the West Nile virus.

And that's just the proverbial tip of the melting iceberg considering the devastation that will come with rising sea levels, intensified "weather events" like droughts, fires, floods and storms, mass dislocation of coastal populations and mass starvation that may well be the legacy of our failure to address climate change.

Public health costs from fossil fuel production in the U.S. through contaminants in our air, rivers, lakes, oceans, and food supply today are pegged at more than $120 billion every year by the National Academy of Sciences. The Environmental Protection Agency has concluded that exposure to particulate matter emitted from fossil fuel plants is a cause of heart attacks, breathing difficulty, and long term respiratory illness including asthma, and reproductive, developmental, and cancer outcomes.

Some unions, desperate for needed jobs in a persistent recession that continues to plague American families, are lobbying for Keystone XL. But it's like harvesting for fools gold.

The actual number of jobs that will be created is far less than has been claimed by the industry and its allies, and the U.S. State Department has now conceded that once the project is built, the number of people needed to operate and maintain the pipeline may be as few as 20.

As fossil fuel production has become more capital intensive, employment in the sector has fallen, according to a 2012 report by the International Labor Organization and the United Nations Environment Program. In the U.S., for example, coal production has increased by one-third since the 1980s, but employment has fallen by 50 percent.

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

And union members families too are exposed to the health risks of the tar sands production and transport, as well as the devastating effects of climate change.

Finally, stumping for the Pipeline puts labor in league with the most anti-union, socially and politically regressive corporate interests in the U.S., such as the oil billionaire Koch Brothers, the American Petroleum Institute, and other energy corporations generally, abetted by the rightwing 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, the reputation labor deservedly earned in the 1930s and 1940s, the period of labor's greatest growth and the resulting emergence of a more egalitarian society. Today labor should be on that path again, uniting with the very coalition of those opposing the Pipeline and working to rein in the frightening consequences of climate change the Pipeline would hasten.

Follow NNU on the Huffington Post

Lew, who is White House Chief of Staff, worked on Wall Street during the period of the collapse as an executive at Citigroup. The U.S. government guaranteed $300 billion in bad Citibank assets, invoking “too-big-to-fail.”  For that amount of money, reported Columbia Journalism Review, “the government could have owned Citigroup outright.”  Later, the government loaned Citigroup $200 billion at near zero interest, which was lent back to the government at 3.7 percent interest, “effectively handing Citigroup $7.4 billion a year for nothing,” noted the Review.  “Citigroup has paid no federal income taxes for the last four years after receiving a total of $2.5 trillion in financial assistance from the Federal Reserve during the financial crisis,” wrote Sen. Bernie Sanders last week.

Other Wall Street institutions have also done very well since the collapse.  Just last week there were new revelations about Wall Street’s mortgage scams  leading to the 2008 collapse.  According to court documents and as reported in the New York Times, mega-bank JPMorgan Chase knew of “defective” loans, “altered” them and then “whitewashed” reviews.  “Such investments eventually collapsed, spreading losses across the financial system,” report The Times.   JPMorgan Chase profited from the scheme and continues to do so: the bank’s 2012 profit was its highest on record.

Down the street at Goldman Sachs, the wheels of financial commerce keep churning.   The investment bank paid a multi-million fine for its role in the mortgage sleight of hand, but that was after having received billions in government assistance.  Last year Goldman’s profit was $5.6 billion, and it “handed CEO Lloyd Blankfein and his top lieutenants a total of $65 million in restricted stock…,” reported Bill Moyers.  Goldman profit totaled $26 billion in the last three years.

All told, more than $700 billion in taxpayer money went to bail out banks.  But that’s the least of it.  According to an audit carried out by the Federal Reserve, $26 trillion additional sums were loaned, granted or guaranteed by the U.S. government, bringing the total bailout to close to an astronomic $27 trillion.

Jack Lew is well aware of these events.   To serve this country well and honestly as Treasury Secretary, he must acknowledge the wholesale transfer of trillions of dollars to Wall Street and get behind the Robin Hood Tax, a way to start to provide a real recovery to the many communities still hurting.    

Signs of collapse are everywhere.  Nearly one in four children in the U.S. suffered from  food insecurity sometime during the last year.   Official poverty is approaching 50 million Americans.  More than 22 million adult Americans do not have full-time jobs.   A three-year decline in longevity for older, pre-retirement Americans was reported this month as a result of unemployment, poverty and lack of access to healthcare. 

The goal of the Robin Hood Tax is to stop these declines and to build a real economy.  The Robin Hood tax supports the creation of jobs at living wages, retirement for all with dignity, quality education and healthcare, attention to the environment and rebuilding of infrastructure.   The tax would also be directed to international commitments in research and treatment of HIV/AIDS and for climate control. 

Let them know:  Jack Lew, and the Senate Finance Committee before whom he appears on Wednesday, need to support the Robin Hood Tax and put that revenue to use to heal Main Street.