“Moral Monday” protests sponsored by the NAACP have been drawing larger crowds each week. This Monday, a number of health care workers turned out to protest and be arrested in acts of civil disobedience.
By Rose Hoban
Jonathan Kotch is 65 years old and is something of a political firebrand. As the leader of the group Health Care for All NC, he’s worked to create access to health care as a human right and advocated for a single-payer health insurance plan for all Americans for years. But the public health professor from UNC-Chapel Hill has never been arrested as a form of protest.
Until Monday night.
Kotch was one of several dozen health care professionals who came to the General Assembly on Monday to protest the legislature’s positions on social issues, including health care, and one of a handful who wore their white coats as they were led away in handcuffs by police. The protest was the largest yet in a series of events on Monday evenings sponsored by the NAACP.
“Health care providers were specifically invited to show up here today,” Kotch said as he waited to be arrested outside the large brass doors of the North Carolina Senate. “Health is a major problem that the legislature and the governor are not paying attention to.”
Kotch said the decision to get arrested wasn’t an easy one.
“It’s a major leap to make the decision to put yourself on the line, commit civil disobedience and get arrested,” he said. “It’s a big choice, and I respect people who are not ready to do that yet.”
Kotch was one of more than 150 protesters who were taken away in zip-tie handcuffs. Police estimated more than 1,000 people showed up to protest before the arrests on the mall behind the North Carolina State Legislative Building.
Medicaid expansion decision still argued
“[The legislature] is cutting my taxes by 50 percent and they’re going to tax food, medicines and doctor visits, which will kill the retired and those on fixed incomes,” said prominent UNC researcher Charles van der Horst.
He was speaking to the crowd gathered on the lawn carrying signs that advocated for increased education spending and decried legislative efforts to change voter-registration laws, among other messages.
But van der Horst’s sharpest criticism came when he complained about the legislature’s decision not to expand Medicaid, as permitted under President Obama’s Affordable Care Act.
Lawmakers approved a bill to reject Medicaid expansion as one of their first acts after the General Assembly convened in January. Gov. Pat McCrory signed the bill into law in early March.
His frustration over that move was expressed by all of the health care providers at the rally interviewed by North Carolina Health News.
“Medicaid expansion would have allowed half-a-million working poor in this state access to health care, preventative services and screening,” said physician assistant Donna Shelton, who sees mental health patients in Morehead City, Jacksonville and Wilmington.
“It would have shut down the free clinic where I volunteer, which would have been amazing. Now we have to keep going because they won’t have access still,” she said.
When asked if she worried about maintaining her license if arrested, Shelton said, “I’ll let the medical board know what happened, that it was for civil disobedience. I don’t anticipate repercussions, but it’s worth the risk.”
A spokesperson for the Medical Board said the organization investigates all arrests of practitioners. David Kalbacker, director of public information for the N.C. Nursing Board, said that “if the arresting authority does not report it to the Board of Nursing, the board would expect the nurse to report it when they renew their license.”
“While we review such information, it is hard to image a minor civil disobedience conviction affecting one’s license,” Kalbacker said. “If it doesn’t affect a nurse’s ability to practice, it shouldn’t matter. It’s more an issue of free speech.”
Shelton was one of several dozen health care providers who wore their white coats to the protest; family-medicine doctors Samuel Warburton and Arthur Axelbank were also among them. The two friends came to Raleigh to show their support at the rally; neither said he would be arrested.
Warburton works for Duke Family Medicine and said that about 20 percent of his clinic’s patients are Medicaid recipients and others are uninsured. The Hillsborough Family Medical Group, where Axelbank practices, sees about 10 percent Medicaid patients and a smattering of uninsured.
“It’s the Medicaid population that’s being shorted,” Warburton said. “Medicaid expansion was an opportunity to provide lots of benefits for people who don’t have it now, and the legislature is being very shortsighted and ideological.”
“I’m upset, and I’m a lifelong Republican, but they’re turning me,” he said.
Beyond Medicaid expansion
The legislature’s decision to not extend access to Medicaid was only one complaint on the lips of most health care providers at the protest.
Beverly Kegley, director of the Franklin County Volunteers in Medicine free clinic, had come to Raleigh to complain to lawmakers about the Senate’s exclusion of the Medication Assistance Program from their budget.
“We have 3,000 patients now, and they can’t survive without these medicines,” Kegley said. She estimated her patients receive more than $1 million in greatly reduced cost medicines as a result of the program.
Other practitioners expressed concern about the state of the mental health system.
Andy Short, a psychologist from Chapel Hill, said he’s worried about mental health patients who would have gotten Medicaid under an expansion.
“It would have made it possible for patients to get mental health services that they won’t be able to pay for now,” Short said. “One of the consequences of that is that we’ll pay for that in terms of physical health care, because we know that people having mental health problems, their physical health deteriorates as well.”
“My major focus has been mental health,” said recently retired nursing professor Ann Newman, who was wearing a green wristband that indicated she was willing to be arrested.
Those who care for the mentally ill are extremely frustrated, she said: “We have to help [the mentally ill] by saying this is not right.”
Other mental health practitioners complained about plans to overhaul the state’s Medicaid program.
“The state is talking about privatizing Medicaid, but Medicaid is working well in this state,” said Shelton. “But in mental health, they’ve already privatized it, and they have us with different managed care organizations that are a disaster.”