AMSA and the Occupy Movement

Since the American Medical Student Association came out in support of the principles of the Occupy movement last week, we have been inundated with responses – many positive but a few questioning this decision and citing concerns with aspects of the Occupy movement. I’d like to take some time to explore what it means for AMSA to support this movement, why it makes sense for us to do so, and what the movement is actually about. Warning – this is fairly lengthy.

Links to section headers:

AMSA’s Guiding Document – our “PPP”
About Occupy Wall Street
Misconceptions
AMSA’s Positions
Why the Occupy Movement?
AMSA Members and Occupy

AMSA’s Guiding Document – our “PPP”

AMSA is guided by our Preamble, Purposes and Principles, or PPP. This document was initially adopted in 1977 and is amended annually by our members through the resolution process in our House of Delegates. I will cite a few key passages from the 2011 version of our PPP which forms the basis of our support but will try not to overwhelm with examples. The entire text of our PPP is available on the AMSA website as well as information about the resolution process. If there are things you disagree with in our PPP or if you feel something is missing, we strongly encourage our members to participate in the process by submitting resolutions and speaking & voting in the HOD.

I want to start by quoting briefly from the Preamble:

We define health as a positive, dynamic state of physical, mental and environmental well-being, and therefore, believe that health care should be oriented toward the achievement of health and not solely a treatment of disease

We believe that access to quality health care is a right, not a privilege. This implies equal access to equally high standards of health care regardless of economic status, political beliefs, cultural background, geographic position, race, creed, national origin, age, sex, sexual orientation and gender identity, physical handicap, mental handicap or institutionalization for criminal, medical or psychiatric reasons. Since resources are limited, they should be allocated so that they equitably promote the public health; thus, health-care issues must be addressed in the public forum.

This passage highlights both AMSA’s perspective that health is more than just health care, that health care is a right, and that resources should be allocated to promote public health. In conjunction with this, I’ll next cite the entire text of the Principles Regarding Activism:

The American Medical Student Association:

1. SUPPORTS the use of nonviolent direct action as a strategy for activism within the struggle for social change. (2001)

"Direct Action" is a term that describes a range of actions taken to directly confront or highlight an issue. (2001)

About Occupy Wall Street

I think this, then, is a good opportunity to introduce the principles behind the Occupy movement. From the working draft of the Occupy Wall Street Principles of Solidarity, they constitute themselves “as autonomous political beings engaged in non-violent civil disobedience and building solidarity based on mutual respect, acceptance, and love.” In their Declaration, they “urge [us] to assert [our] power.”

Exercise your right to peaceably assemble; occupy public space; create a process to address the problems we face, and generate solutions accessible to everyone.

In New York, and around the country, Working Groups have formed using consensus–based models to identify and address problems – for example, environmental issues, arts & culture, women’s issues, student debt, LGBT issues, and of course, health care. The Healthcare for the 99% Working Group sums up its mission as

We organize with #OWS to raise awareness of corporate greed in healthcare and the need for a healthcare system based on people instead of profit.

An editorial in the New York Times elucidates further what is meant by "the 99%":

When the protesters say they represent 99 percent of Americans, they are referring to the concentration of income in today’s deeply unequal society. Before the recession, the share of income held by those in the top 1 percent of households was 23.5 percent, the highest since 1928 and more than double the 10 percent level of the late 1970s.

That share declined slightly as financial markets tanked in 2008, and updated data is not yet available, but inequality has almost certainly resurged. In the last few years, for instance, corporate profits (which flow largely to the wealthy) have reached their highest level as a share of the economy since 1950, while worker pay as a share of the economy is at its lowest point since the mid-1950s.

Income gains at the top would not be as worrisome as they are if the middle class and the poor were also gaining. But working-age households saw their real income decline in the first decade of this century. The recession and its aftermath have only accelerated the decline.

Some have criticized the Occupy movement for not having specific demands. As outlined in the following excerpt from the extremely informative and valuable FAQ on The Nation’s website, the lack of specific demands is on some levels intentional and can be viewed as a strength of the movement:

In the weeks leading up to September 17, the NYC General Assembly seemed to be veering away from the language of “demands” in the first place, largely because government institutions are already so shot through with corporate money that making specific demands would be pointless until the movement grew stronger politically. Instead, to begin with, they opted to make their demand the occupation itself—and the direct democracy taking place there—which in turn may or may not come up with some specific demand. When you think about it, this act is actually a pretty powerful statement against the corruption that Wall Street has come to represent. But since thinking is often too much to ask of the American mass media, the question of demands has turned into a massive PR challenge.

The General Assembly is currently in the midst of determining how it will come to consensus about unifying demands. It’s a really messy and interesting discussion. But don’t hold your breath.

Everyone in the plaza comes with their own way of thinking about what they’d like to see happen, of course. Along the north end of the plaza, there’s a collage of hundreds of cardboard signs people have made with slogans and demands on them. Bystanders stop and look at them, transfixed, all day long. The messages are all over the place, to be sure, but there’s also a certain coherence to them. That old standby, “People Before Profits,” seems to capture the gist fairly well. But also under discussion are a variety of other issues, ranging from ending the death penalty, to dismantling the military-industrial complex, to affordable healthcare, to more welcoming immigration policies. And more. It can be confusing, but then again these issues are all at some level interconnected.

Since that FAQ was written, some strides have been made towards developing demands – for example, the October 11 occupation in Freedom Plaza in DC has released a consensus-based “99%’s Deficit Proposal” – perhaps the first truly progressive & comprehensive proposed solution to the US’s financial situation. The breadth and interconnectedness of the issues, however, and the movement’s hesitation to identify one or two key demands create many opportunities to advocate and engage in direct action around issues in a wide variety of areas.

Lastly, a lack of demands does not necessarily correspond to a lack of influence. If there were any question that this movement is gaining steam and garnering attention, the recently leaked memo from lobbying firm Clark Lytle Geduldig & Cranford to its client, the American Banking Association, certainly reinforces the notion that the 1% are very worried about the collective voice of the 99%:

CLGC’s memo proposes that the ABA pay CLGC $850,000 to conduct “opposition research” on Occupy Wall Street in order to construct “negative narratives” about the protests and allied politicians. The memo also asserts that Democratic victories in 2012 would be detrimental for Wall Street and targets specific races in which it says Wall Street would benefit by electing Republicans instead.

According to the memo, if Democrats embrace OWS, “This would mean more than just short-term political discomfort for Wall Street. … It has the potential to have very long-lasting political, policy and financial impacts on the companies in the center of the bullseye.”

The memo also suggests that Democratic victories in 2012 should not be the ABA’s biggest concern. “… (T)he bigger concern,” the memo says, “should be that Republicans will no longer defend Wall Street companies.” (MSNBC.com)

Misconceptions

Before delving into the key issues that AMSA is addressing by collaborating with this movement, it may be helpful to try to clear up a few misconceptions that are sadly common and continue to be reinforced by the mainstream news media.

1. Occupy Wall Street is a violent movement. Actually, quite the opposite is true – the Occupy movement is based around the principles of non-violent civil disobedience and direct action (just as AMSA supports in its PPP). While any large group of people is likely to contain some bad apples, the vast majority of Occupy supporters – like the vast majority of the 99% - ascribe to these principles. When there have been instances of violence at Occupy camps, the communities have come together to try to address these issues through their principles:

"As individuals and as a community, we have the responsibility and the opportunity to create an alternative to this culture of violence,” the statement reads. “We are working for an OWS and a world in which survivors are respected and supported unconditionally… We are redoubling our efforts to raise awareness about sexual violence. This includes taking preventative measures such as encouraging healthy relationship dynamics and consent practices that can help to limit harm.

One of the most common choruses of disapproval highlights that there have been incidents of rape at OWS. Yes, there have been confirmed accounts of sexual assault. And the women affected were supported by others on site and taken to get the appropriate medical care. These instances remind us that we live in a culture, at OWS and in the US more broadly, where sexual assault (especially against women) runs rampant because of a culture that values the sexualization and denigration of women. Members of the sexual assault survivor's team at OWS issued a powerful statement to acknowledge what had happened:

We are also concerned that segments of the media have attempted to use this incident as another way to disingenuously attack and discredit OWS. It is reprehensible to manipulate and capitalize on a tragedy like this to discredit a peaceful political movement. OWS exists within a broader culture where sexual assault is egregiously common: someone in the US is sexually assaulted every 2 minutes, most assaults are never reported, and most rapists are never held to account. We live in a culture of violence in which sexual assault is often ignored, condoned, excused and even encouraged. We note that it is particularly difficult for survivors of assault at OWS to feel confident in reporting crimes to the NYPD – the NYPD’s unjustifiably aggressive and abusive policing of OWS has undermined trust in the police force amongst protesters.

In reality, the greatest violence associated with the Occupy movement has been inflicted on individuals expressing their constitutionally-protected rights to free speech and peaceful assembly – see for example, the now-infamous campus police officer who casually pepper-sprayed students who were engaged in a non-violent sit-in, or the beating of a former US Poet Laureate in Berkeley. And if you don’t believe that the media continues to underplay what is happening, check out this clip from the Colbert Report in which Stephen explores the AP’s reporting of riot police using their batons to “nudge” protestors.

2. The Occupy movement is a threat to health & public safety. Mayor Bloomberg used this line of reasoning to explain is middle-of-the-night, surprise eviction of Zuccotti Park in New York City. It is true that the Occupy movement can cause some inconveniences – large crowds of people protesting against, say, multimillion dollar benefits packages being given to the same Wall Street executives that created our current recession, are likely to make it a little more difficult to buy a latte at the nearby Starbucks. Perhaps the most compelling refutation of this argument, though, is the one given by the Executive Board of the Committee of Interns and Residents:

As physicians, we need to call attention to the threats to the public’s health and safety which we believe far exceed those at Zuccotti Park
In these communities, too many of the 99 percent are suffering from unregulated environmental health issues and a frayed healthcare safety net. If Mayor Bloomberg wanted to address an emergency public health issue, he could have sent the NYPD after Bronx landlords whose poor environmental standards have led to epidemic rates of childhood asthma, or financial consultants seeking to profit off struggling safety net hospitals in Brooklyn. In addition, current proposals in Congress to slash Medicare and Medicaid would do significant harm to the health of our communities and the 99% of the people who rely on the physicians trained by these programs.
As citizens protest the policies that exacerbate poverty and deepen public health crises, city officials unfortunately see silencing this speech as a more important use of public resources than initiatives that could address inadequate healthcare in our poorest communities.

3. The Occupy movement is a bunch of lazy, pseudo-intellectuals who can’t be bothered to get a job. This is a very popular notion used to try to discredit the movement – presidential candidate Newt Gingrich opined that “they ought to be either getting a job, starting a small business, or going to school to learn a skill so that they could get a job, but sitting around and living off of others does not strike exactly a noble pursuit,” and this trope is common in the media. While many of the Occupiers who remain overnight in camps are younger, people from all walks of life have spoken out in support of the principles of the Occupy movement and participated in rallies, demonstrations, speak-outs and other methods of non-violently exercising their constitutional rights to speech and assembly. These include soldiers, veterans, teachers, physicians, nurses, other health care professionals, economists, authors, celebrities, unions, business leaders, and many others. People from diverse backgrounds share their stories on the We Are The 99% tumblr, and many are stories of people working hard, pursuing the American Dream, and being crushed by an unjust and inequitable system. Professionals – including physicians and economists, for example - sign on to letters of support and solidarity. Matthew Connors, a professor at MassArt, has been taking portrait photos of protestors at Occupy Wall Street and posting them online – whether it is his intent or not, they represent a stunningly beautiful visual of the range and scope of everyday Americans from all walks of life that have chosen to participate. All over the internet and in real life, vast swathes of folks who make up the 99% (and some who are in the 1%) have turned out or spoken up in support of this movement.

4. The Occupy movement is costing a huge amount of money, worsening our deficit. It is true that some cities have chosen to deploy additional police forces to monitor or disband protests, sometimes with paramilitary levels of force. The AP estimates that over the past 2 months, police costs have run to approximately $13 million. There is no doubt that this is a lot of money; however, it is worth noting how this stacks up in comparison to, for example, the loss of wealth in the US caused by the misdeeds on Wall Street that have led to our current financial situation. The recession in 2009 resulted in the destruction of $50 trillion dollars of global wealth – about 1.5 million times more than the costs over the past two months. For more perspective, the US wars in Iraq & Afghanistan cost the same amount - $13 million – for every 40 minutes. There is also the question of why some cities have chosen to spend so much money on expensive and heavy-handed techniques in quelling peaceful protest – in some cities, such as Boston, MA, or Lansing, MI, the city leaders have opted to respect and support the First Amendment rights of the Occupiers resulting in significantly lower costs – Boston reports having spent an extra $575,000 in police overtime while New York City has spent more than $7 million and Oakland has spent $2.4 million. And in Des Moines, IA, the parks director indicated that the protestors may actually have saved the city money by removing their own garbage and shoveling snow. Perhaps most tellingly, many news articles cite the strain that overtime costs put on already slashed budgets in main cities – further reinforcing that the police are a part of the 99% too, being nickel-and-dimed while the 1% grows wealthier.

AMSA’s Positions

With all of that background, this seems like a good time to explore what AMSA’s views are and how they fit into the Occupy/99% movement.

The first is likely the most obvious, as it is clearly outlined in our PPP and our aspirations, and has been echoed by many other groups and individuals participating in the Occupy movement. It is of course the goal of quality, affordable healthcare for all. Occupy is a movement about changing our priorities, about coming up with solutions to the problems we face. Access to healthcare is a fundamental issue for which AMSA has been advocating for decades. Our PPP states (p26)

The American Medical Student Association:

1. BELIEVES that access to comprehensive health services must to be recognized and protected as a basic human right.

2. SUPPORTS a publicly and progressively financed, privately delivered federal single payer system of high quality, affordable health care for all persons.

It also opposes accrual of profits at the expense of patient care and “URGES that private and public health-care system guidelines serve the interest of the patient and the ethical practices of medicine.” Many physicians groups and other health professionals who hold similar goals have identified that the principles of the Occupy movement are fertile ground for public discussions about reforming our system, and for calling on our elected officials to consider real, patient-centered changes to our healthcare system.

Healthcare, however, is just a small part of overall health. And, incidentally, is also just one part of the many interconnected problems identified by supporters of the Occupy movement. AMSA advocates for healthcare for all, but also pursues policies that benefit the overall health of our patients and the population by addressing health equity. This is what we mean when we say “Health Students for Health Access” – we want everyone to have access to the necessary resources to live a full & healthy life. There are many aspects of our PPP that address these social determinants of health – the right to freedom from hunger and access to adequate nutrition, support for anti-pollution and environmentally-friendly programs, encouraging public health measures to reduce violence, supporting reformation of the welfare system to address the causes & effects of poverty, urging access to safe, affordable housing, elimination of health disparities, and improving affordability and accessibility of education. And the PPP also very explicitly states that AMSA

URGES all health professionals and students to advocate for Health Equity as described above. AMSA will accept these principles and the Health Equity Campaign will adopt these principles as a platform and working document based on membership action, community initiation and support.

All of these (and many more) are recognized as factors in achieving and maintaining a healthy life and all of them are issues that cannot be addressed in a system where 1% of the population accrues more and more of the wealth. This is what the Occupy movement seeks to address, and so once again proves to be a valuable forum in which to discuss these issues and raise awareness of the problems and possible solutions. In addition to the factors of health equity described above, it is worth noting that greater degrees of income & wealth inequality themselves are statistically significantly correlated with poorer health outcomes across the board, for both rich and poor (although obviously much worse for the poor) when compared to countries with more equitable distribution of wealth.

Lastly, the Occupy movement is fundamentally about the protection and exercise of our rights. AMSA, through our PPP, also has a strong history of supporting human rights.

The American Medical Student Association:

1. BELIEVES in the following general principles regarding human rights:

a) Human rights are in essence the protection of human dignity, per the UN Declaration of Human Rights. (2004)

b) Human rights principles include:

i) Civil and political rights enumerated in the International Covenant on Civil and Political Rights;

ii) Economic, social and cultural rights enumerated in the International Convention on Economic, Social, and Cultural rights. (2004)

2. With regards to health care:

a) BELIEVES that every individual has the right to the highest attainable standard of health; (2004)

b) RECOGNIZES the principle in Article 12 of the International Covenant on Economic, Social, and Cultural Rights that states that health care must fulfill the following criteria to attain the highest standard of health: accessibility, availability, acceptability, and quality; (2004)

c) RECOGNIZES that the right to health is closely related and dependent upon the realization of other human rights, including the right to food, housing, work, education, participation, the enjoyment of the benefits of scientific progress and its applications, life, non-discrimination, equality, the prohibition against torture, privacy, access to information, and the freedoms of association, assembly, and movement. (2004)

3. With regards to the application and enforcement of rights:

a) BELIEVES that governments and third-party entities have an obligation to uphold human rights principles. Third-party entities include transnational corporations, financial institutions, and third-party governments. (2004)

b) BELIEVES that governments, both national and international, are primarily responsible for enforcement. (2004)

c) DENOUNCES governments engaging in acts that violate human rights and UPHOLDS the principle of positive rights, such that governments are responsible for providing certain services in order to fulfill the right of individuals to certain necessities, such as education, health, shelter; (2004)

d) BELIEVES that inaction by a government to eradicate health disparities exhibits a failure to adhere to international human rights law. (2006)

6. BELIEVES that health and human rights are integral to one another, such that:

a) The protection of human rights is integral to health. (2004)

b) The right to accessible, quality health care is a human right. (2004)

c) Poor health is both a reflection and symptom of social inequities and disparate provisions of social services.

Why the Occupy Movement?

Hopefully the information above creates a clearer sense of how the foundations of the Occupy movement and AMSA’s guiding principles are strongly compatible with one another. This doesn’t answer perhaps the most fundamental question, however – why should AMSA stand in solidarity with the Occupy movement? There are two ways to look at this question – how does it benefit AMSA’s goals and how does it benefit the 99%?

AMSA’s main benefit is in participating in a movement that is gaining traction in providing a voice for individuals and groups that can envision a more just and equitable future. All of the positions above that we are advocating for through the Occupy movement are things that AMSA has long been advocating for. Now, however, we are able to join with many other voices to spread our message and further our work. Does this replace our policy efforts and our work on Capitol Hill? No – we continue to be involved in a variety of coalitions and in mobilizing and educating our members around policy issues. What it does do is enable us to reach more people with our voice, to gain new advocates for the causes we believe in, and to continue working to effect the changes we support.

Our involvement can also convey a benefit to the 99%. As Occupy has become more established, it has drawn the attention of some very powerful & very wealthy entities that have a vested interested in discrediting the movement – the CLGC memo and Newt Gingrich’s comments being just a couple of small examples in a vast sea of misinformation. As more professionals and professional organizations come out in support of the core principles behind the movement, it becomes harder and harder for opponents to discredit the movement as lazy, unemployed hippies or as a small group of pseudo-intellectuals with no mainstream support. The Occupy movement is empowering discourse on a variety of issues surrounding equality and equity, and it behooves AMSA and other progressive organizations to support that continuing discussion.

AMSA Members and Occupy

As with any large organization, our members hold a wide variety of views and beliefs. AMSA does not purport to speak for our individual members but solely on behalf of the guiding principles that are voted on by our membership. It is likely that some AMSA members may not agree with the Occupy movement or some of the principles behind it, and they are in no way obligated to endorse them. Other members may agree with the principles but have no interest in being involved, and of course they are in no way obligated to participate. Many of our members have expressed their appreciation for AMSA’s support of the 99% and are excited to find ways to contribute to the effort, and we are working to create opportunities for them to do so. We have created a discussion group on Inspiration Exchange for our members to share their thoughts on the Occupy movement and AMSA's involvement.

Whether or not you agree with AMSA’s position on the Occupy movement, whether you oppose or support our involvement, whether you feel we are doing too much or too little, AMSA is an organization that is driven by our members and we encourage you to participate. Our PPP can be amended through the resolutions process in the House of Delegates; more immediate concerns can be addressed through motions to AMSA’s Board of Trustees. If you have questions about the HOD, you may contact Liz Wiley (Vice President for Internal Affairs) and Nida Degesys (Secretary); if you would like to submit a motion to the BOT, you may contact Danielle Salovich (National President). Additionally, AMSA is a multifaceted organization with a variety of members holding a range of beliefs. True to our mission statement of “empowering a generation of future physicians through education and advocacy,” we continue to offer opportunities to our members to grow and learn as future physicians. Whether or not you choose to participate in AMSA’s advocacy efforts for health access for the 99%, we encourage you to explore the variety of options available to you.