Chapter 34   seiu helps pass historic healthcare reform - SEIU contribue au vote d'une réforme historique pour la sécurité sociale
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Chapter 34 seiu helps pass historic healthcare reform - SEIU contribue au vote d'une réforme historique pour la sécurité sociale

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President Obama called SEIU President Andy Stern to thank union members shortly after the House of Representa- tives voted 219 to 212 to pass healthcare reform despite every Republican voting against ...

President Obama called SEIU President Andy Stern to thank union members shortly after the House of Representa- tives voted 219 to 212 to pass healthcare reform despite every Republican voting against the legislation. On March 23, 2010, at the White House signing ceremony, President Obama told Stern the century-long battle to achieve nearly universal health- care could not have been won without SEIU members’ hard work on its behalf.

Le président Obama a appelé Andy Stern, le président de SEIU, pour remercier les membres du syndicat juste après que le House of Representatives ait voté à 219 contre 212 en faveur de la réforme de la sécurité sociale malgré un camps républicain qui était à 100% contre. Le 23 mars 2010, pendant la cérémonie de signature à la Maison Blanche, le Président Obama a dit à Andy Stern que la bataille d'un siècle pour obtenir une couverture médicale presque universelle n'aurait jamais été gagnée sans le travail acharné des membres de SEIU.

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Chapter 34 seiu helps pass historic healthcare reform - SEIU contribue au vote d'une réforme historique pour la sécurité sociale Document Transcript

  • 1. CHAPTER 34 SEIU Helps Pass Historic Healthcare Reform Coverage Extended To 32 Million Lacking InsuranceL oretta Johnson had to quit a job with good pay and bene ts as a deputy courthouse clerk in Lebanon, Virginia, to carefor her terminally ill husband. technicians, doctors, and other healthcare workers who are SEIU members deliver quality care to millions of patients. But those SEIU healthcare providers on the front lines also After he died, she became an SEIU personal care assistant saw the huge failures of a system in which more than 47 millionwho worked “at the bedside every day giving people the same people lacked health insurance and another 47.5 million weretype of care I gave my husband.” But Johnson herself lost health underinsured. Despite bargaining victories that had providedinsurance when she changed jobs and had to rely on a smaller health coverage for many members, there were still tens of thou-paycheck to cover her own healthcare needs. sands of SEIU workers who lacked a ordable, quality coverage About 32 million Americans like Loretta Johnson who for their families and themselves.212faced each day without health insurance got a lifeline thrown tothem when President Obama signed into law the historic health-care reform bills in March 2010 that had been the top legislativegoal of SEIU for years. A s the political debate over healthcare reform was playing out in 2009-2010, Americans were spending more money per capita on healthcare than any other country in the world. It was a landmark moment that will rank with major legisla- Yet the United States ranked 38th among other nations in majortive achievements such as the passage of Social Security, Medi- health indicators, including life expectancy. At the same time,care, and the Civil Rights Act. healthcare premiums had increased four times faster than work- President Obama called SEIU President Andy Stern to ers’ wages. And 8 out of 10 of those without insurance werethank union members shortly after the House of Representa- from working families.213tives voted 219 to 212 to pass healthcare reform despite every Even insured Americans found themselves unable to payRepublican voting against the legislation. On March 23, 2010, their growing share of hospital bills, their co-pays and de-at the White House signing ceremony, President Obama told ductibles, and the cost of lling their prescriptions. ConsiderStern the century-long battle to achieve nearly universal health- the following:care could not have been won without SEIU members’ hard -work on its behalf. nancially with a typical medical emergency. SEIU played such a crucial role in winning passage of the -legislation in part because, as the largest union of healthcare ruptcy because of a health emergency rose by 2,000 percent.workers in North America, no group knew the sorry state ofthe healthcare system better. Every day, more than one million reform found that half of all bankruptcy cases were con-nurses, home healthcare providers, nursing home aides, medical nected to medical bills.
  • 2. 254 STRONGER TOGETHER: THE STORY OF SEIU - Georgeanne Koehler, an SEIU member and hospital worker age Fortune 500 company projected to spend as much for in Pittsburgh, came to the Capitol steps on a frigid day in De- healthcare in 2008 as it made in pro ts. cember 2009—her third visit in three months—to tell the story of how her brother, William, died. He was a 57-year-old pizza deliveryman who was foundA ll the statistics and the harsh Congressional debate about reining in healthcare costs at times obscured the humancosts of failing to enact reform. But SEIU and its allies repeat- slumped over his steering wheel after his de brillator battery ran out. He couldn’t a ord to replace the expensive battery after los-edly focused national attention on those who had su ered un- ing his health insurance when he was laid o in 2003 from hisbearable pain from the failures of a healthcare system dominated job as an electronics technician. With his arrhythmia viewed as aby private insurance companies concerned too often only about pre-existing condition, no insurance company would cover him.their bottom-line pro ts. Georgeanne Koehler carried a bag lled with her brother’s SEIU Secretary-Treasurer Anna Burger told the story of EKG charts as she visited Congressional o ces as part of SEIU’sSEIU Healthcare 775NW member Pat DeJong. Her husband lobbying e ort for healthcare reform. She also carried around aDan, a fourth-generation rancher from just outside Libby, Mon- folding chair as part of her own “No More Empty Chairs” cam-tana, died from Hodgkin’s lymphoma. paign during the holiday season. “ is Christmas we’re going to “During his treatment, the medical bills became so unbear- have an empty chair at the dinner table,” she said.able, Dan and Pat were forced to sell their family’s farm and apply e SEIU Healthcare Pennsylvania member was not al-for Medicaid and food stamps,” Burger recalled. After Dan died, lowed to unfold the chair by the Capitol police, but did deliverPat still had no health insurance from her job as a home care work- about 1,000 holiday healthcare postcards urging the Senate toer and no ranch to sell if she developed her own health problems. pass healthcare reform. About the same time Koehler made her way to the o ces of Pennsylvania’s Senators and Representatives, Loretta Johnson also found herself on Capitol Hill pushing hard for healthcare reform. U.S. Senate Majority Leader Harry Reid and a group of powerful Senators invited the Virginia home healthcare worker to join them at a crowded press conference to unveil core ele- ments of the bill that later passed. Johnson, the only speaker who was not a Senator, appeared as a representative of SEIU and its 2.2 million members. When Majority Leader Reid introduced her at the podium, she praised the Senators for a bill that put America one step clos- er to real healthcare reform, but then said: “Now, in my opin-Loretta Johnson, an SEIU personal care assistant, joined U.S. Senate Major- ion, there’s probably some room for improvement.” She calledity Leader Harry Reid and Senators Tom Harkin and Christopher Dodd at aCapitol Hill press conference in December 2009 to unveil the elements of the for an end to the huge control of insurance companies over thehealthcare reform legislation that later became law. Johnson called for an endto the lack of accountability of the big insurance companies. healthcare system and urged passage of legislation that would
  • 3. SEIU HELPS PASS HISTORIC HEALTHCARE REFORM 255make sure “people can a ord the care they need.” It was a moment in the long debate that recognized bothSEIU’s role for many years as a driving force in advocating a S EIU advocated major healthcare reforms throughout much of its history. It had encouraged President Clinton’s e ort to develop legislation, but that initiative failed to gain tractionprogressive healthcare system and, at the same time, highlighted during his rst term in the early 1990s. In 2002, SEIU estab-the plight of so many Americans, such as Johnson, who lacked lished Americans for Health Care (AHC), a project that soughtany health insurance coverage and su ered as a result. to unite healthcare workers, consumers, small business owners, and others to push for broad-based healthcare reforms. AHC, which became the largest grassroots healthcare re-T he new healthcare reform legislation did not include all the provisions urged by SEIU, but many elements supportedby the union did end up in the bill. form organization in the country, ran state-based campaigns in 20 states and signed up nearly half a million healthcare voters na- e law put new pressures on insurance companies, for ex- tionwide. e group was critical in passing landmark healthcareample, preventing denials of coverage due to pre-existing condi- legislation in Maryland, New Hampshire, and Maine.tions such as diabetes, asthma, or high blood pressure. It also In addition to work at the state level, SEIU and its alliesbanned annual and lifetime limits on insurance coverage and made some progress during the administration of Presidentcontained guaranteed issue and renewal requirements. George W. Bush, although much of the e ort involved blocking Young adults were able to stay on their families’ insurance actions that would have made the healthcare system even worse.plans until age 26, rather than lose coverage after they left home Several victories that did advance reforms included:or graduated from college. e new law provided for the creation of insurance ex- had funding shortfalls for State Children’s Health Insurancechanges at the state level where the uninsured and self-employed Programs so eligible children didn’t lose coverage.could purchase coverage that t their needs. A guaranteed pack- -age of bene ts including free preventive care had to be included tects workers from discrimination based on the results ofin all those plans. genetic testing. Medicaid was expanded under healthcare reform to providehealth insurance to an additional 16 million low-income people. support to many e ective state programs to prevent and SEIU fought successfully for an end to sex discrimination treat HIV/AIDS.in health insurance. Previously, women could be charged more -than men for the same coverage under individual policies. tion to make sure drugs that are approved are actually safe. e new law provided increased investments to train nurses,primary care doctors, and public health professionals. It also additional quality measures in an e ort to help patients andcreated state-level consumer assistance programs to help patients their families compare facilities.understand and defend their new rights. Some experts estimated the legislation would create or save SEIU had strongly opposed Bush in the 2000 campaign inmore than 2.5 million jobs through 2020, in part by reducing part because he dismissed the need for real healthcare reform.healthcare costs for employers. e union’s early backing of Howard Dean in the 2004 race for
  • 4. 256 STRONGER TOGETHER: THE STORY OF SEIU Andy Stern wrote in 2006 in his book, A Country at Works, about the decline of the employer-based healthcare system and called for a new approach built around the same basic tenet as the educational system: universal access. “If every child is guaranteed a public education, every American must be guaranteed access to a ordable healthcare,” Stern argued. “ en we can integrate the nest research, doc- tors, and hospitals in the world into a delivery system that con- trols costs and o ers the highest quality.” Among the models Stern urged as worthy of being adapt- ed to the broader system included the healthcare plan enjoyed by members of Congress themselves, the U.S. Defense De- partment’s healthcare program known as TRICARE that cov-SEIU pushed all the presidential candidates in 2007 to provide detailed plansfor healthcare reform. Barack Obama unveiled his initiative at the University ers more than nine million members of the military and theirof Iowa Hospital and Clinics in Iowa City where he met with SEIU members. families, and the Medicare system, which could be expanded to cover everyone.the Democratic presidential nomination grew out of the fact Stern described the large number of countries that havethat Dean was a medical doctor committed to pushing health- some form of universal healthcare and also report better healthcare reform. outcomes at lower cost. Signaling the growing frustration felt by Candidates campaigning in New Hampshire were greeted many, the SEIU president wrote:at the Manchester airport by a large poster of an SEIU nurse “If all of these nations can gure out universal plans thatchallenging them to spell out their plan to reform healthcare. meet their nations’ interests, why can’t America do the same? e union conducted a healthcare reform march across the Americans deserve a fair debate, not an endless one on how best toGolden Gate Bridge during its 2004 convention. More than provide universal, a ordable, quality healthcare.”21417,000 activists—led by Stern, Burger, Mary Kay Henry, and In July 2006, SEIU wrote a letter to every Fortune 500other top leaders—signaled that the issue would be a top priority CEO asking them to make healthcare reform a national prior-for SEIU voters in the fall. ity. A surprising number responded. While they did not agree Senator John Kerry had strong SEIU support against with many of the speci cs that progressive healthcare reformersBush in the general election, but the Bush victory ruled out advocated, it was becoming clear that major corporations facedany major healthcare reform for another four years—necessi- huge outlays for their workers’ healthcare as costs continuedtating the smaller, incremental approach that led to the gains to escalate. In ation in healthcare costs cut into the bottomdescribed above. line, hurting pro ts and raising labor costs without improving SEIU also used the Bush years to try to stimulate think- actual bene ts.ing about what reforms should be enacted once America had Following long discussions among Stern, Secretary-elected political leaders committed to them. SEIU President Treasurer Burger, Executive Vice President Mary Kay Henry,
  • 5. SEIU HELPS PASS HISTORIC HEALTHCARE REFORM 257SEIU Healthcare leader Dennis Rivera, and other top o cials, -SEIU released its Vision for Reform in 2007. It outlined 10 viding care that is cost-e cient and medically e ective.fundamental principles to guide the union’s work to promotehealthcare solutions: are necessary to increase quality and reduce costs. - care coverage for all Americans. Piecemeal reform is not must be available to consumers. a solution. service, reduce out-of-pocket costs, and maximize oppor- foundation for 21st century healthcare reform, particularly tunities for individuals to receive assistance in home- and given the competitive challenges of a global economy. community-based settings, rather than in hospitals and nursing homes. doctors and healthcare plans without gaps in coverage or - access, and the delivery system must meet the needs of sponsibility for nancing the system. at-risk populations. - care bene t similar to one that is available to federal employees. W ith the union’s set of principles for healthcare reform in place, SEIU activists set out to make America’s grow- ing healthcare crisis a major issue in the 2008 presidential cam- paign (see Chapter 27). e kicko occurred in March 2007 in promote health, control costs, and eliminate economic and Nevada, where SEIU organized a forum sponsored by the Uni- racial disparities. versity of Nevada–Las Vegas (UNLV). It was the rst national healthcare debate of the campaign. Seven of the Democratic candidates outlined their views and faced tough questioning from some of the hundreds of SEIU workers who were there. e gauntlet thrown down by SEIU was simple: any presi- dential candidate hoping to get the o cial support of more than two million members had to o er a detailed, comprehensive plan to provide healthcare to every woman, man, and child in America. e response: all the major Democratic candidates produced healthcare plans and the issue became a major focus on the campaign trail. Over many years, SEIU helped win gains by forming co- alitions and working closely with allies around speci c issues.Mary Kay Henry, then-SEIU executive vice president and head of the union’s While agreeing to disagree on many points, SEIU saw value inhealthcare division, joined children and parents lobbying for the State Childen’s partnerships on important legislative issues with both friends inHealth Insurance Program (SCHIP) in 2007. President George W. Bush hadvetoed two attempts to expand health coverage for uninsured children. the progressive community, but also with others who might be
  • 6. 258 STRONGER TOGETHER: THE STORY OF SEIUstrange bedfellows—particularly certain business groups. are skimping on preventive care because they can’t a ord it, or On the progressive side, SEIU joined with Healthcare for they delay going to the doctor. We’ve become a nation of theAmerica Now (HCAN), a coalition of the nation’s largest grass- walking wounded.”roots organizations, including Change to Win, AFSCME, AFL- In Spring eld, Missouri, the Road to American HealthcareCIO, U.S. Action, Planned Parenthood, and about 1,000 other Tour held a forum for veterans from Iraq, Korea, Vietnam, andgroups representing 30 million people demanding comprehen- World War II who spoke out against Senator McCain’s consis-sive healthcare reform. HCAN proved to be a crucial force in tent record of voting to deny funds for veterans’ healthcare.the ultimate victory of healthcare reform. “If we’re going to send our soldiers to war, and we’re go- ing to spend billions of dollars a day on a war, then we need to take care of the soldiers who go and ght those wars,” saidW hile working in partnership with others, SEIU contin- ued its own vigorous e ort to make healthcare reform atop issue in the 2008 campaign. ousands of SEIU member Akeam Ashford, an Iraq war veteran. He pointed out that Mc- Cain voted against full funding for veterans’ healthcare in 2004,political organizers and sta deployed around the country dur- 2005, 2006, and 2007.ing primary/caucus season working for Barack Obama, who had In August 2008, SEIU conducted a series of nationwide ac-won SEIU’s endorsement. tions questioning health insurance industry tactics. e union’s SEIU activists consistently found that voters talked about big purple bus played a role in Oregon where it pulled up to thetheir problems with the healthcare system—their lack of health state Capitol in Salem for a press conference at which the unioncoverage, or high co-pays and other out-of-pocket costs, denial and its ally, Oregon Action, presented evidence indicting thefor previously existing health problems, and many others. health insurers there. ey outlined how the insurance industry SEIU regularly ran paid television ads in targeted markets used deliberate tactics designed to maximize pro ts by raisingthat drew sharp distinctions between the Republican and Demo- premiums, co-pays and deductibles; refusing coverage or charg-cratic positions on healthcare and what those di erences meant ing exorbitant rates to people with pre-existing conditions; andto working families. even retroactively denying coverage to people with insurance. As the 2008 Democratic and Republican national con- In Spokane, Washington, members of SEIU Local 925ventions approached, SEIU launched “ e Road to American joined the bus tour in front of health insurer Premera Blue CrossHealthcare,” a nationwide bus tour. It made hundreds of stops seeking greater transparency into the rm’s nances and rejec-throughout the nation, such as Tucson, Arizona, where orga- tion rates. “I’m so glad we did that!” said Paula Hall, a child carenizers set up a canopy in the city’s Main Library Place and in- worker from Spokane and Local 925 member. “ e way I seevited passersby to take shelter from the desert sun and listen as it, health insurance companies are answering to their sharehold-SEIU members joined with elected o cials and talked about the ers, so they focus more on pro ts than on patient care. is hashealthcare crisis. to change.” “A lot of folks are hurting and one of the last things folks Even before Barack Obama’s victory in November 2008,need is continued increases in healthcare premiums, co-pays, and SEIU had launched its “100 Days for Change” campaign aimeddeductibles—but that’s what’s happening,” said Dave Mitchell, at pushing through the union’s post-election legislative priorities,president of SEIU Arizona’s Pima County chapter. “People with healthcare reform at the top of the list.
  • 7. SEIU HELPS PASS HISTORIC HEALTHCARE REFORM 259 Treasurer Burger said as the campaign was launched. She said the union would push strongly for healthcare reform as President Obama pledged to see it through Congress at the onset of his new Administration. Change at Works helped build strong pressure in target states in 2009, but momentum for healthcare reform on Capitol Hill slowed as President Obama deferred to certain Congress- ional leaders to craft the speci cs of the legislation. Democrats who chaired relevant committees in both the Senate and the House chose to engage in long, drawn-out dis-Medical doctors who belonged to SEIU Healthcare’s Committee of Interns cussions with Republicans over the healthcare reform bills’ de-and Residents joined the union’s Road to American Healthcare tour in August2008. e union doctors saw every day on the job the huge problems of a tails. Months and months of talks to win at least a few Republi-healthcare system in dire need of reform. can votes for the legislation led nowhere, even after a number of Much of the normal work of the union was set aside, in- huge compromises that disappointed progressive forces.cluding a number of important organizing drives, so that more Advocates of a single-payer healthcare system, similar tothan half of the International Union sta and about 40 percent those of many other countries that deliver quality care at a lowerof all local union sta (excluding organizers) could work on cost, were angered when Democrats rejected the concept beforepost-election accountability. Locals also engaged their members the debate had begun.in the e ort, which was run similar to a political campaign, with Later, the debate shifted to a “public option” through whichdoorknocking and phonebanking, house parties and meet-ups, a government-funded health insurance plan would compete withtown hall meetings, and outreach to community and religious private insurance companies to help keep premiums and othercoalition partners. e goal was to ratchet up pressure on Con- costs more reasonable. Consumers in a number of states facedgress to build support for healthcare reform and other SEIU leg- insurance monopolies in which only one or two companies con-islative priorities, such as the Employee Free Choice Act. trolled the local market for health insurance. SEIU supported e e ort evolved into SEIU’s major national campaign the public option, which was included in the House bill passedcalled “Change at Works” that kicked o in January 2009 in late 2009, but it was not in the Senate version of the legisla-with a state-by-state e ort to pass comprehensive healthcare re- tion that became the basis for the nal healthcare reform law.form, ensure approval of the economic recovery package, and Much of the debate in late 2009 was shaped by the factguarantee workers the freedom to choose a voice at work. that Democrats supporting healthcare reform needed 60 votes SEIU targeted 35 states and hired campaign directors for out of the 100-member Senate in order to force an end toeach of those states. e union created a “war room” at its head- debate and bring a bill to an actual vote. Senate rules pro-quarters in Washington, D.C. Bruce Colburn coordinated the vided for a libuster that meant 41 Senators could block pas-health reform e ort. sage of legislation even though a majority of Senators favored “If we’re going to revive the American Dream, we have to that legislation.build an economy that works for everyone,” SEIU Secretary- e drive for healthcare reform su ered a major setback in
  • 8. 260 STRONGER TOGETHER: THE STORY OF SEIUAugust 2009 when Senator Edward Kennedy, the leading advo-cate of universal healthcare, died after a 15-month struggle withbrain cancer. A small group of very conservative Democrats in the Sen-ate, including Senators Ben Nelson of Nebraska and BlancheLincoln of Arkansas, refused to commit to voting to end the li-buster and allow the reform bill to come to a vote. ey soughtspecial favors at the expense of the broader public and at timesseemed to carry out the agenda of the insurance companies thathad in icted so much damage on their constituents. But nally the Senate adopted a healthcare bill that fellshort of what SEIU had wanted, but nevertheless appeared tomean that reform would become the law of the land. All thatremained was to conform that Senate bill and the version passedweeks earlier by the House. When Congress recessed for the holidays in December, vidual premiums as much as 39 percent. Anthem also soughtPresident Obama and the Democratic and Republican leaders massive premium hikes in Connecticut, including 24 percent forin the House and Senate indicated the nal compromises in the individual policies (rejected by the state) and in Maine, whereHouse and Senate versions were likely to be nalized shortly af- the company sought a 23 percent increase.ter Congress returned to business in early 2010. Anthem’s greed was not alone. Rate hikes by insurance companies that had been proposed during the healthcare reformS cott Brown’s upset victory in January 2010 over Martha Coakley in the election to ll the U.S. Senate seat in Mas-sachusetts—vacant due to the death of Senator Edward Ken- debate included Blue Cross/Blue Shield of Michigan, which sought premium hikes of 56 percent. Regency Blue Cross/Blue Shield in Oregon demanded a 20 percent increase.nedy—sent shockwaves through Washington, D.C. ese incredible rate increases provoked particular outrage e Republican upset in the special election meant the in the midst of the deep economic recession in which many peo-GOP had 41 Senate votes to sustain a libuster and block fu- ple had lost their employer-provided health insurance and hadture legislation. Many pundits and political observers thought been forced to seek individual coverage that was the core of thehealthcare reform was dead. proposed rate hikes. Insurance companies, which spent millions of dollars on And the insurance rms’ rate hikes came while they werelobbyists to try to shape healthcare reform to their liking, be- reporting huge pro ts. WellPoint, UnitedHealth Group, Cigna,lieved they had won a victory with the stalling of the legisla- Aetna, and Humana together took in $12.2 billion in pro ts intive process. ey moved immediately with huge rate increases 2009, up 56 percent over 2008.215 From 2000 through 2009,across the country. Anthem Blue Cross of California (owned by pro ts for the 10 largest insurance companies increased 250 per-for-pro t WellPoint Inc.) announced it would be raising indi- cent—10 times faster than in ation.
  • 9. SEIU HELPS PASS HISTORIC HEALTHCARE REFORM 261 e raw greed of the insurance companies, unleashed by the important social legislation since the passage of Medicare in theapparent defeat of healthcare reform, provoked a massive back- 1960s underscored how far the union had come.lash that helped to breathe new life into the legislative e ort. From a small group of underpaid and overworked janitors Republicans continued their e ort to scrap the legislation, in Chicago nearly 90 years earlier, SEIU had evolved into a 2.2which had been debated for a year before being passed with only million-member powerhouse that delivered at the bargainingone Republican vote in the House and no Republican votes in table, the ballot box, and in the halls of Congress.the Senate. e outcome occurred even though a number of One mark of the union’s e ectiveness was the increasinglyRepublican proposals had been included in the Senate version as shrill volume of attacks from right-wing talk show hosts suchpart of Democrats’ attempts to attract bipartisan support. as Glenn Beck and Rush Limbaugh, whose hate- lled attacks Democrats nally adopted healthcare reform in March, on Stern, Mary Kay Henry, and SEIU became a staple of their2010, but Republicans vowed to repeal the historic healthcare programming in 2010.bill even before President Obama signed it into law in front But for every snarl from a Glenn Beck, there was a smileof a White House audience including SEIU President Stern, from an SEIU member such as Loretta Johnson, who with theSEIU Healthcare leader Dennis Rivera, 1199/SEIU United healthcare reform law could nally look forward to living with-Healthcare Workers-East President George Gresham, and other out the fear of having no health insurance. So, too, could 32SEIU activists. million Americans who lacked healthcare coverage before SEIU President Obama’s sincere thanks to SEIU leaders and and so many other allies worked together to change history formembers for the crucial role they played in winning the most the better. ousands attended a Labor Day rally for healthcare reform in Boston on September 7, 2009.