We need the weight of the trade unions
Andrew D. Coates, MD, is a Council Leader of Division 231 of the Public Employees Federation, AFL-CIO.
Dr. Coates practices internal medicine in Albany, NY, and teaches at Albany Medical College. He is President-elect (for 2013) of Physicians for a National Health Program, the physicians' organization for single payer health care.
This article appeared in the American Federation of Teachers Public Employee Advocate, April 2, 2012.
Union advocacy is this doctor's prescription for health care access and reform
Dr. Andrew Coates has not been on the job that long, but he has quickly learned that the patients he sees need an advocate in the legislative and executive branches of government where decisions are made about the state's delivery and availability of psychiatric care.
Since taking a job with the New York Office of Mental Health five years ago as a Medical Specialist II at the Capital District Psychiatric Center in Albany, Coates says he has "learned a lot of public policy and tax policy" that he would not have learned otherwise.
The reason: The state Office of Mental Health has been downsizing, consolidating and privatizing state psychiatric care; thanks to the state budget enacted in 2011, OMH is allowed to close facilities within 60 days notice.
"I think it is dreadful public policy," says Coates, whose concerns range from the "cruelty" of not having community-based care available for the people who need it, to general public safety when such care is not available, to the state shifting the burden of care onto counties and cities.
"The union is the only voice that will now speak up for these patients," says Coates, a member of the New York State Public Employees Federation. He noted that the accelerated facility-closure process have prevented patients' families from mobilizing against closures that move their loved ones hours away.
"There is a measure of moral distress in working for a system that is collapsing so quickly," says Coates. "We find it harder and harder to get what our patients need." The budget situation that has contributed to OMH's revamp is not deterring Coates' advocacy for his patients — and all consumers of health care.
Coates, who also is medical director at Albany County Nursing Home, is president-elect of Physicians for a National Health Program, which advocates for a universal, comprehensive single-payer national health program.
When Coates takes the helm of PNHP in January 2013, he says, "My goal is to reinforce that when it comes to health care reform, we absolutely need a mass movement. We need the weight of the trade unions, the only institutions in our society that are independent of corporate power."
Between studies that show publicly financed health care delivers superior quality of care at a lower cost, and the federal Medicare and Veterans Affairs systems, Coates says, "there is really no excuse for continuing an employer-based private system that is designed to extract resources that should go to patient care."
[PNHP note: This article, which in the original includes a photo of Dr. Coates, appeared in the April/May issue, Vol. 31, No. 4, page 8.]
Dr. Coates' "The attack on unions,a slide show for fighting back" is available here: http://unionsforsinglepayer.org/news_releases/2011-06-30