Category Archives: Workers

The Democrats’ single-payer trap and Why Not Obamacare?? Let’s Start the Discussion of Medicare!!

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Richard North Patterson’s latest article started off with the statement- back in 2017-Behold the Republican Party, Democrats — and be warned.

The GOP’s ongoing train wreck — the defeat of its malign health care “reform,” the fratricidal troglodyte Roy Moore, and Donald Trump’s serial idiocies — has heartened Democrats. But before commencing a happy dance, they should contemplate the mirror.

They will see the absence of a compelling message. The party desperately needs a broad and unifying economic agenda — which includes but transcends health care — to create more opportunity for more Americans.

Instead, emulating right-wing Republicans, too many on the left are demanding yet another litmus test of doctrinal purity: single-payer health care. Candidates who waver, they threaten, will face primary challenges.

As regarding politics and policy, this is gratuitously dictatorial — and dangerously dumb.

The principle at stake is universal health care. Single-payer is but one way of getting there — as shown by the disparate approaches of countries that embrace health care as a right.

Within the Democratic Party, the discussion of these choices has barely begun. Senator Bernie Sanders advocates “Medicare for all,” expanding the current program for seniors. This would come at considerable cost — Sanders includes a 7.5 percent payroll tax among his list of funding options; others foresee an overall federal tax increase of 25 percent. But the dramatically increased taxes and the spending required, proponents insist, would be offset by savings in premiums and out-of-pocket costs.

Skeptics worry. Some estimate that Sanders’s proposal would cost $1.4 trillion a year — a 35 percent increase in a 2018 budget that calls for $4 trillion overall. It is not hard to imagine this program gobbling up other programs important to Democrats, including infrastructure, environmental protection, affordable college, and retraining for those dislocated by economic change.

For these reasons, most countries aspiring to universal care have multi-payer systems, which incorporate some role for private insurance, including France, Germany, Switzerland, and the Netherlands. The government covers most, but not all, of health care expenditures. Even Medicare, the basis for Sanderscare, allows seniors to purchase supplemental insurance — a necessity for many.

In short, single-payer sounds simpler than it is. Yet to propitiate the Democratic left, 16 senators have signed on to Sanders’s proposal, including potential 2020 hopefuls Elizabeth Warren, Cory Booker, Kamala Harris, and Kirsten Gillibrand. Less enthused are Democratic senators facing competitive reelection battles in 2018: Only one, Tammy Baldwin of Wisconsin, has followed suit.

This is the harrowing landscape the “single-payer or death” Democrats would replicate. Like “repeal and replace,” sweeping but unexamined ideas are often fated to collapse. Sanderscare may never be more popular than now — and even now its broader appeal is dubious.

Democrats must remember how hard it was to pass Obamacare. In the real world, Medicare for all will not become law anytime soon. In the meanwhile, the way to appeal to moderates and disaffected Democrats is not by promising to raise their taxes, but by fixing Obamacare’s flaws.

To enact a broad progressive agenda, the party must speak to voters nationwide, drawing on both liberals and moderates. Thus candidates in Massachusetts or Montana must address the preferences of their community. Otherwise, Democrats will achieve nothing for those who need them most.

Primary fights to the death over single payer will accomplish nothing good — including for those who want to pass single-payer. Parties do not expand through purges.

Democrats should be clear. It is intolerable that our fellow citizens should die or suffer needlessly, or be decimated by financial and medical calamity. A compassionate and inclusive society must provide quality health care for all.

The question is how best to do this. The party should stimulate that debate — not end it.

Generous Joe: More “Free” Healthcare For Illegals Needed

Now, R. Cort Kirkwood notes that Presidential candidate Joe Biden wants American taxpayers to pay for illegal alien healthcare. Indeed, he doesn’t just want us to pay for their healthcare, he says we are obliged to pay for their healthcare.

That’s likely because Biden thinks illegals are American citizens and doesn’t much care how many are here as long as they vote the right way.

What Biden didn’t explain when he said we must pay for illegal-alien healthcare is how much such beneficence would cost.

Answer: A lot.

The Question, The Answer

Biden’s demand that we pay for illegal-alien healthcare answered a question earlier this week from a reporter who wanted to know whether the “undocumented” deserve a free ride.

The question was this: “Do you think that undocumented immigrants who are in this country and are law-abiding should be entitled to federal benefits like Medicare, Medicaid for example?”

Answered Biden, “Look, I think that anyone who is in a situation where they are in need of health care, regardless of whether they are documented or undocumented, we have an obligation to see that they are cared for. That’s why I think we need more clinics in this country.”

Biden forgot to put “free” before clinics, but anyway, the candidate then suggested that Americans who disagree likely have a nasty hang-up about the border-jumping illegals who lie with the facility of Pinocchio when they apply for “asylum.”

“A significant portion of undocumented folks in this country are there because they overstayed their visas,” he continued. “It’s not a lot of people breaking down gates coming across the border,” he falsely averred.

Then came the inevitable. “We” need to watch what we say about all those “undocumented folks.”

“The biggest thing we’ve got to do is tone down the rhetoric,” he continued, because that “creates fear and concern” and ends in describing “undocumented folks” in “graphic, unflattering terms.”

Biden thinks those “undocumented folks” are citizens, as Breitbart noted in its report on his generosity with other people’s money.

In 2014, Biden told the worthies of the Hispanic Chamber of Commerce that entering the country illegally isn’t a problem, and Teddy Roosevelt would agree.

“The 11 million people living in the shadows, I believe they’re already American citizens,” Biden said. “Teddy Roosevelt said it better, he said Americanism is not a question of birthplace or creed or a line of dissent. It’s a question of principles, idealism, and character.”

Illegals “are just waiting, waiting for a chance to be able to contribute fully. And by that standard, 11 million undocumented aliens are already American.”

Roosevelt also said that “the one absolutely certain way of bringing this nation to ruin, of preventing all possibility of its continuing to be a nation at all, would be to permit it to become a tangle of squabbling nationalities,” but that inconvenient truth aside, Biden likely doesn’t grasp just what his munificence — again, with our money — will cost.

The Cost of Illegal-Alien Healthcare

I mentioned the cost of healthcare for the illegal-alien population and  Biden is right that visa overstays are a big problem: 701,900 in 2018, the government reported. But at least those who overstay actually entered the country legally; border jumpers don’t.

But that’s beside the point.

The real problem is the cost of the healthcare, which Forbes magazine estimated to be $18.5 billion, $11.2 billion of it federal tax dollars.

In 2017, the Federation for American Immigration Reform reported a figure of $29.3 billion; $17.1 in federal tax dollars, and $12.2 billion in state tax dollars. More than $15 billion on that total was uncompensated medical care. The rest fell under Medicaid births, Medicaid fraud, Medicaid for illegal-alien children, and improper Medicaid payouts.

The bills for the more than half-million illegals who have crossed the border since the beginning of fiscal 2019 in October are already rolling in.

Speaking at a news conference in March, Brian Hastings, operations chief for Customs and Border Protection (CBP), said about 55 illegals per day need medical care, and that 31,000 illegals will need medical care this year, up from 12,000 last year. Since December 22, he said, sick illegals have forced agents to spend 57,000 hours at hospitals or medical facilities. Cost: $2.2 million in salaries. Between 25 percent and 40 percent of the border agency’s manpower goes to the care and maintenance of illegals, he said.

CBP spent $98 million on illegal-alien healthcare between 2014 and 2018.

Hastings spoke before more than 200,000 illegals crossed the border in March and April.

NYC Promises ‘Guaranteed’ Healthcare for All Residents

Program to bring insurance to 600,000 people, including some who are undocumented

As the Mayor of New York City considers whether he wants to run for President and join the huge group of 21 candidates Joyce Frieden noted that the city of New York is launching a program to guarantee that every resident has health insurance, as well as timely access to physicians and health services, Mayor Bill de Blasio announced Tuesday.

“No one should have to live in fear; no one should have to go without the healthcare they need,” de Blasio said at a press conference at Lincoln Hospital in the Bronx. “In this city, we’re going to make that a reality. From this moment on in New York City, everyone is guaranteed the right to healthcare — everyone. We are saying the word ‘guarantee’ because we can make it happen.”

The program, which will cost $100 million annually, involves several parts. First, officials will work to increase enrollment in MetroPlus, which is New York’s public health insurance option. According to a press release from the mayor’s office, “MetroPlus provides free or affordable health insurance that connects insurance-eligible New Yorkers to a network of providers that includes NYC Health + Hospitals’ 11 hospitals and 70 clinics. MetroPlus serves as an affordable, quality option for people on Medicaid, Medicare, and those purchasing insurance on the exchange.”

The mayor’s office also said the new effort “will improve the quality of the MetroPlus customer experience through improved access to clinical care, mental health services, and wellness rewards for healthy behavior.”

For the estimated 600,000 city residents who don’t currently have health insurance — because they can’t afford what is on the Affordable Care Act health insurance exchange; because they’re young and healthy and choose not to pay for insurance, or because they are undocumented — the city will provide a plan that will connect them to reliable care at a sliding-scale fee. “NYC Care will provide a primary care doctor and will provide access to specialty care, prescription drugs, mental health services, hospitalization, and more,” the press release noted.

NYC Care will launch in summer 2019 and will roll out gradually in different parts of the city, starting in the Bronx, according to the release. It will be fully available to all New Yorkers across the city’s five boroughs in 2021.

Notably, the press release lacked many details on how the city will fund the plan and how much enrollees would have to pay. It also remained unclear how the city will persuade the “young invincibles” — those who can afford insurance but believe they don’t need it — to join up. Nor was arithmetic presented to document how much the city would save on city-paid emergency and hospital care by making preventive care more accessible. At the press conference, officials mostly deflected questions seeking details, focusing instead on the plan’s goals and anticipated benefits.

“Every New Yorker will have a card with [the name of] a… primary care doctor they can turn to that’s their doctor, with specialty services that make a difference, whether it’s ob/gyn care, mental health care, pediatric care — you name it, the things that people need will be available to them,” said de Blasio. “This is going to be a difference-maker in their lives. Get the healthcare you need when you need it.” And because more people will get preventive care, the city might actually save money, he added. “You won’t end up in a hospital bed if you actually get the care you need when the disease starts.”

People respond differently when they know something is guaranteed, he continued. “We know that if people don’t know they have a right to something, they’re going to think it’s not for them,” de Blasio said. “You know how many people every day know they’re sick [but can’t afford care] so they just go off to work and they get sicker?… They end up in the [emergency department] and it could have been prevented easily if they knew where to turn.”

As to why undocumented residents were included in the program, “I’m here to tell you everyone needs coverage, everyone needs a place to turn,” said de Blasio. “Some folks are our neighbors who happen to be undocumented. What do they all have in common? They need healthcare.”

Just having the insurance isn’t enough, said Herminia Palacio, MD, MPH, deputy mayor for health and human services. “It’s knowing where you can go for care and feeling welcome when you go for care… It’s being treated in a language you can understand by people who actually care about your health and well-being.”

De Blasio’s wife, Chirlane McCray, who started a mental health program, ThriveNYC, for city residents, praised NYC Care for increasing access to mental health services. “For 600,000 New Yorkers without any kind of insurance, mental healthcare remains out of reach [but this changes that],” she said. “When New Yorkers enroll in NYC Care they’ll be set up with a primary care doctor who can refer them [to mental health and substance abuse services], and psychiatric therapy sessions are also included.”

“The umbrella concept is crucial here,” said de Blasio. “If John or Jane Doe is sick, now they know exactly where to go. They have a name, an address… We want it to be seamless; if you have questions, here’s where to call.”

Help will be available at all hours, said Palacio. “Let’s say they’re having an after-hours issue and need understanding about where to get a prescription filled. They can call this number and get real-time help about what pharmacy would be open,” or find out which urgent care center can see them for a sore throat.

Mitchell Katz, MD, president, and CEO of NYC Health and Hospitals, the city’s public healthcare network, noted that prescription drugs are one thing most people are worried about being able to afford, but “under this program, pharmaceutical costs are covered.”

Katz noted that NYC Care is a more encompassing program than the one developed in San Francisco, where he used to work. For example, “here, psychotherapy is a covered benefit; that’s not true in San Francisco… and the current program [there] has an enrollment of about 20,000 people; that’s a New York City block. In terms of scale, this is just a much broader scale.”

In addition, the San Francisco program required employers to pay for some of it, while New York City found a way around that, de Blasio pointed out. The mayor promised that no tax increases are needed to fund the program; the $100 million will come from the city’s existing budget, currently about $90 billion.

Now on to Medicare for All as we look at the history of Medicare. I am so interested in the concept of Medicare for All as I look at my bill from my ophthalmologist, which did not cover any of my emergency visits for a partial loss of my right eye. Also, my follow-up appointment was only partially covered; they only covered $5 of my visit. Wonderful Medicare, right?

The invoice was followed this weekend with an Email from Medicare wishing me a Happy Birthday and notifying me of the preventive services followed with a table outlining the eligibility dates. And the dates are not what my physicians are recommending, so you see there are limitations regarding coverage and if and when we as patients can have the services.

Medicare as a program has gone through years of discussion, just like the Europeans, Germany to start, organized healthcare started with labor. In the book American Health Care edited by Roger D. Feldman, the German policy started with factory and mine workers and when Otto von Bismark in 1883, the then Chancellor of newly united Germany successfully gained passage of a compulsory health insurance bill covering all the factory and mine workers. A number of other series of reform measures were crafted including accident insurance, disability insurance, etc. The original act was later modified to include other workers including workers engaged in transportation, and commerce and was later extended to almost all employees. So, why did it take so long for we Americans form healthcare policies for our workers?

Just like in Germany and then Britain, the discussion of healthcare reform began with labor and, of course, was battered about in the political arena. In 1911, after the passage of the National Health Act in Britain, Louis Brandeis, who was later to be appointed to the Supreme Court, urged the National Conference on Charities and Corrections to support a national program of mandatory medical insurance. The system of compulsory health insurance soon became the subject of American politics starting with Theodore Roosevelt, head of the Progressive or Bull Moose. H delivered his tedious speech, “Confession of Faith”, calling for a national compulsory healthcare system for industrial workers.  The group that influenced Roosevelt was a group of progressive economists from the University of Wisconsin, who were protégés of the labor economist John R. Commons, a professor at the university.

Commons an advocate of the welfare state, in 1906, together with other Progressive social scientists at Wisconsin, founded the American Association for Labor Legislation (AALL) to labor for reform on both the federal and state level. Roosevelt and other members of the Progressive Party pushed for compulsory health insurance, which they were convinced would be endorsed by working-class Americans after the passage of the British national program.

The AALL organization expanded membership and was responsible for protective labor legislation and social issues. One of the early presidents of the organization was William Willoughby, who had authored a comprehensive report on European government health insurance scheme in 1898.

The AALL next turned its attention to the question of a mandatory health insurance bill and sought the support of the American Medical Association. The AMA  was thought to support this mandatory health insurance bill if it could be shown that the introduction of a mandatory health insurance program would in fact profit physicians. This is where things go complicated and which eventually doomed the support of the AMA and all physicians as a universal health insurance plan failed in Congress. Why? Because the model bill developed by the AALL had one serious flaw. It did not clearly stipulate whether physicians enrolled in the plan would be paid in the basis of capitation fee or fee-for-service, nor did it ensure that practitioners be represented on administrative boards.

I discuss more on the influence of the AALL in health care reform and what happened through the next number of Presidents until Kennedy.

More to come! Happy Mother’s Day to all the great Mothers out there and your wonderful influence on all your families with their guidance and love.

Why We Celebrate Labor Day, a Holiday that had a Violent Start and What About Our Health Care Workers?

40305161_1691609390968713_2600545733576753152_nTomorrow is Labor Day, a day to relax, enjoy and get ready for children of all ages to return to school. Susan Miller a writer for USA Today reviewed why we celebrate Labor Day. We are waving so long to the summer of 2018.

You sizzled us, you soaked us, and you satiated us. And like every other summer season, your sprint to Monday – Labor Day – seemed a blur.

For many, Labor Day is all about capturing that last blast at the beach, backyard barbecues, school retail bonanzas and the grudging realization that sun-soaked play days are no more.

But the day has a deeper meaning and marks a pivotal moment in U.S. labor history — and it had a pretty violent start.

In the late 1800s, the state of labor was grim as U.S. workers toiled under bleak conditions: 12 or more hour workdays; hazardous work environments; meager pay. Children, some as young as 5, were often fixtures at plants and factories.

The dismal livelihoods fueled the formation of the country’s first labor unions, which began to organize strikes and protests and pushed employers for better hours and pay. Many of the rallies turned violent.

On Sept. 5, 1882 — a Tuesday — 10,000 workers took unpaid time off to march in a parade from City Hall to Union Square in New York City as a tribute to American workers. Organized by New York’s Central Labor Union, It was the country’s first unofficial Labor Day parade. Three years later, some city ordinances marked the first government recognition, and legislation soon followed in a number of states.

Then came May 11, 1894, and a strike that shook an Illinois town founded by George Pullman, an engineer, and industrialist who created the railroad sleeping car. The community, located on the Southside of Chicago, was designed as a “company town” in which most of the factory workers who built Pullman cars lived.

When wage cuts hit, 4,000 workers staged a strike that pitted the American Railway Union vs. the Pullman Company and the federal government. The strike and boycott against trains triggered a nationwide transportation nightmare for freight and passenger traffic.

At its peak, the strike involved about 250,000 workers in more than 25 states. Riots broke out in many cities; President Grover Cleveland called in Army troops to break the strikers; more than a dozen people were killed in the unrest.

After the turbulence, Congress, at the urging of Cleveland in an overture to the labor movement, passed an act on June 28, 1894, making the first Monday in September “Labor Day.” It was now a legal holiday.

In the coming decades, the day took root in American culture as the “unofficial end of summer” and is marked by parades, picnics and family/friend time. Post offices, banks, courts, and federal and state offices are shuttered.

My questions are:

Why was Labor Day invented and Have we Lost the Real Spirit of the Holiday?

Labor Day came about because workers felt they were spending too many hours and days on the job.

More history, as you remember in the 1830s, manufacturing workers were putting in 70-hour weeks on average. Sixty years later, in 1890, hours of work had dropped, although the average manufacturing worker still toiled in a factory 60 hours a week.

These long working hours caused many union organizers to focus on winning a shorter eight-hour workday. They also focused on getting workers more days off, such as the Labor Day holiday, and reducing the workweek to just six days.

These early organizers clearly won since the most recent data show that the average person working in manufacturing is employed for a bit over 40 hours a week and most people work only five days a week.

Surprisingly, many politicians and business owners were actually in favor of giving workers more time off. That’s because workers who had no free time were not able to spend their wages on traveling, entertainment or dining out.

As the U.S. economy expanded beyond farming and basic manufacturing in the late 1800s and early 1900s, it became important for businesses to find consumers interested in buying the products and services being produced in ever greater amounts. Shortening the workweek was one way of turning the working class into the consuming class.

Some Common misconceptions

The common misconception is that since Labor Day is a national holiday, everyone gets the day off. Nothing could be further from the truth.

While the first Labor Day was created by striking, the idea of a special holiday for workers was easy for politicians to support. It was easy because proclaiming a holiday, like Mother’s Day, costs legislators nothing and benefits them by currying favor with voters. In 1887, Oregon, Colorado, Massachusetts, New York and New Jersey all declared a special legal holiday in September to celebrate workers.

Within 12 years, half the states in the country recognized Labor Day as a holiday. It became a national holiday in June 1894 when President Grover Cleveland signed the Labor Day bill into law. While most people interpreted this as recognizing the day as a national vacation, Congress’ proclamation covers only federal employees. It is up to each state to declare its own legal holidays.

Moreover, proclaiming any day an official holiday means little, as an official holiday does not require private employers and even some government agencies to give their workers the day off. Many stores are open on Labor Day. Essential government services in protection and transportation continue to function, and even less essential programs like national parks are open. Because not everyone is given time off on Labor Day, union workers as recently as the 1930s were being urged to stage one-day strikes if their employer refused to give them the day off.

In the president’s annual Labor Day declaration in 2015, Obama encouraged Americans “to observe this day with appropriate programs, ceremonies, and activities that honor the contributions and resilience of working Americans.”

The proclamation, however, does not officially declare that anyone gets time off.

Controversy: Militants and founders

Today most people in the U.S. think of Labor Day as a noncontroversial holiday. There is no family drama like at Thanksgiving, no religious issues like at Christmas. However, 100 years ago there was controversy.

The first controversy that people fought over was how militant workers should act on a day designed to honor workers. Communist, Marxist and socialist members of the trade union movement supported May 1 as an international day of demonstrations, street protests and even violence, which continues even today.

More moderate trade union members, however, advocated for a September Labor Day of parades and picnics. In the U.S., picnics, instead of street protests, won the day.  There is also the dispute over who suggested the idea. The earliest history from the mid-1930s credits Peter J. McGuire, who founded the New York City Brotherhood of Carpenters and Joiners, in 1881 with suggesting a date that would fall “nearly midway between the Fourth of July and Thanksgiving” that “would publicly show the strength and esprit de corps of the trade and labor organizations.”

Later scholarship from the early 1970s makes an excellent case that Matthew Maguire, a representative from the Machinists Union, actually was the founder of Labor Day. However, because Matthew Maguire was seen as too radical, the more moderate Peter McGuire was given the credit.

Have we lost the spirit of Labor Day?

Today Labor Day is no longer about trade unionists marching down the street with banners and their tools of the trade. Instead, it is a confused holiday with no associated rituals.

The original holiday was meant to handle a problem of long working hours and no time off. Although the battle over these issues would seem to have been won long ago, this issue is starting to come back with a vengeance, not for manufacturing workers but for highly skilled white-collar workers, many of who are constantly connected to work.

How About Considering the Health Care of our Workers?

But maybe we should consider the health care of our workers on this day. According to Gallup, as I already mentioned, the average adult works more than 40 hours per week. Long workweeks without adequate rest can damage Americans’ health. For example, the European Heart Journal published a study in 2010 showing that people who reported working more than 10 hours a day had the highest risk of coronary heart disease. Long work hours also may lead to stress, which can cause health issues like obesity, depression and high blood pressure, among others.

Along with harming individual’s personal health, these chronic health conditions can lead to high costs for the U.S. health care system. According to the National Research Council and Institute of Medicine, Americans spend almost twice as much on health care than people in other advanced countries, yet we still have more injuries and illnesses.

And whether it is a complication of a chronic condition or a seasonal cold, Americans continue to show up sick to work. This is known as “presenteeism,” a term used to describe employees with health conditions who are at work but unable to perform at full capacity. Health-related presenteeism has a larger impact on lost productivity than absenteeism, according to peer-reviewed research sponsored by the National Pharmaceutical Council (NPC) and published in the Journal of Occupational and Environmental Medicine in 2009.

“The study found that when considering medical and drug costs alone, the top five conditions driving costs are cancer (other than skin cancer), back/neck pain, coronary heart disease, chronic pain, and high cholesterol,” as NPC explained when the research was published. “But when health-related productivity costs are measured along with medical and pharmacy costs, the top five chronic health conditions driving these overall health costs shift significantly, to depression, obesity, arthritis, back/neck pain, and anxiety.” As a result, when employers focus on medical and pharmacy costs alone, they may miss an opportunity to address these potentially much more impactful conditions.

Also, remember those who don’t get to take a vacation day on Labor Day one group is the healthcare worker.

Jim Mangia, President, and CEO of St. John’s Well Child and Family Center notes that as a child of the labor movement in New York City, Labor Day holds special meaning for me. I grew up walking picket lines to help serve food to strikers and was able to attend college and graduate school because of a union college fund. From an early age, I understood that the fight for decent pay, benefits, and working conditions was a noble one— but not one without consequences. For every memory I have of victories for the labor movement, I’ll never forget seeing police on horseback beating labor activists that gathered to protest jobs from being moved to “right-to-work” states. I learned it takes courage to stand up for worker’s rights and solidarity among workers is key to shaping a healthy and productive workforce.

At John’s Well Child and Family Center, we know that empowered health care employees are essential to society as a whole. Studies show that fair wages are inextricably linked to better service because the reality is that people are motivated to work harder when they’re paid a fair wage. Investing in higher pay for employees has also been proven to reduce illness and increase stamina— two benefits that are absolutely critical for workers in the healthcare industry. Higher paid healthcare workers are less likely to miss work or get sick than their underpaid counterparts, which means that organizations like ours can be fully staffed with healthy people, translating to benefits as concrete as shorter wait times for the patients we serve.

John’s mission for social justice is rooted in a strong relationship with the labor movement because standing up for our employees makes us stronger as a whole. The truth is, we would not be the successful organization we are today without the help of worker’s rights activists. Almost ten years ago, we invited SEIU Local 721 to organize our staff, and in 2015, they helped us become one of the first nonprofit organizations in the United States to implement a $15 minimum wage for our workers. Our workforce makes it possible for St. John’s to operate fourteen different clinic sites and two mobile clinics. As we’ve grown, we’ve been able to employ hundreds of employees who provide high-quality health care to hundreds of thousands of marginalized and low-income patients in South Los Angeles, adding up to an impressive 350,000 annual patient visits.

In addition to celebrating the lifesaving care our workers provide, St. John’s is also celebrating our contributions to one of the most critical fights of this decade: protecting the Affordable Care Act. This summer alone, St. John’s staff, patients, and allies have made nearly a thousand calls to legislators who were set to vote on an act that would have destroyed our life-saving health care system. We are proud to have been part of the resistance effort that saved health care access for millions of Americans. However, our work here isn’t done. We won’t stop working until health care is respected as a fundamental human right.

Alongside our local labor unions, we will continue to push ourselves to improve our benefits, pay, and working conditions— all the while maintaining our commitment to elevating the voices of our staff. The partnership and trust between St. John’s and the labor movement has helped build the political muscle necessary to advocate for increased funding, improved quality of care, and greater access to health care services for our community members. The work of American labor activists is a labor of love for our fellow man— and we’re grateful for their unwavering commitment to justice.

During a time of increased income inequality and toxic political divisions, it’s important now more than ever to take a stand for the folks on the ground who provide high-quality, loving care to the most vulnerable among us. The wealthy few will continue their attempts to threaten our progress, but we will not back down. We will continue fighting to ensure that the Affordable Care Act remains the law of the land, celebrating the hard work of health care workers, and paving the way for healthier communities everywhere.

So as we enjoy Labor Day, let’s remember to take a deep breath, relax and to take care of our own health. It’s not only good for us, but it’s good for all of us. Yet another reason to celebrate the American worker. So if you work all the time and never really take a vacation, start a new ritual that honors the original spirit of Labor Day. Give yourself the day off. Don’t go into work. Shut off your phone, computer and other electronic devices connecting you to your daily grind. Then go to a barbecue, like the original participants did over a century ago, and celebrate having at least one day off from work during the year.

And then How do You Get the Most Out of a Day Off?

Elizabeth Grace Saunders reviewed some suggestions regarding your day off. The idea of “vacation” often conjures up thoughts of trips to faraway lands. While it’s true that big trips can be fun and even refreshing, they can also take a lot of time, energy, and money. A lot of people feel exhausted just thinking about planning a vacation—not just navigating personal commitments and school breaks, but deciding how to delegate major projects or put work on hold just so they can have a stress-free holiday. Because of this, some might put off their time away, figuring they’ll get to it when their schedule isn’t so demanding, only to discover at the end of the year that they haven’t used up their paid time off.

In my experience as a time management coach and as a business owner, I’ve found that vacations don’t have to be big to be significant to your health and happiness. In fact, I’ve been experimenting with the idea of taking “micro-vacations” on a frequent basis, usually every other week. These small bits of time off can increase my sense of happiness and the feeling of having “room to breathe.”

From my point of view, micro-vacations are times off that require you to use a day or less of vacation time. Because of their shorter duration, they typically require less effort to plan. And micro-vacations usually don’t require you to coordinate others taking care of your work while you’re gone. Because of these benefits, micro-vacations can happen more frequently throughout the year, which allows you to recharge before you’re feeling burnt out.

If you’re feeling like you need a break from the day-to-day but can’t find the time for an extended vacation, here are four ways to add micro-vacations to your life.

Weekend trips. Instead of limiting vacations to week-long adventures, consider a two- to a three-day trip to someplace local. I’m blessed to live in Michigan, and one of my favorite weekend trips is to drive to Lake Michigan for some time in a little-rented cottage on the shore or to drive up north to a state park. Especially if you live in an urban area, traveling even a few hours can make you feel like you’re in a different world.

To make the trip as refreshing as possible, consider taking time off on Friday so you can wrap up packing, get to your destination, and do a few things before calling it a night. That still leaves you with two days to explore the area. If you get home by dinner time on Sunday, you can unpack and get the house in order before your workweek starts again.

There may be a few more e-mails than normal to process on Monday, but other than that, your micro-vacation shouldn’t create any big work pileups.

The margin for personal to-do items. Sometimes getting the smallest things done can make you feel fantastic. Consider taking an afternoon—or even a full day—to take an unrushed approach to all of the nonwork tasks that you really want to do but struggle to find time to do. For example, think of those appointments like getting your haircut, nails did, oil changed, or doctor visits. You know that you should get these taken care of but finding the time is difficult with your normal schedule.

Or perhaps you want to take the time to do items that you never seem to get to, like picking out the patio furniture, unpacking the remaining boxes in the guest room, or setting up your retirement account. You technically could get these kinds of items done on a weeknight or over the weekend. But if you’re consistently finding that you’re not and you have the vacation time, use it to lift some of the weight from the nagging undone items list.

Shorter days for socialization. As individuals get older and particularly after they get married, there tends to be a reduction in how much time they spend with friends. One way to find time for friends without feeling like you’re sacrificing your family time is to take an hour or two off in a day to meet a friend for lunch or to get together with friends before heading home. If you’re allowed to split up your vacation time in these small increments, a single vacation day could easily give you four opportunities to connect with friends who you otherwise might not see at all.

If you struggle to have an uninterrupted conversation with your spouse because your kids are always around, a similar strategy can be helpful. Find days when one or both of you can take a little time off to be together. An extra hour or two will barely make a difference at work but could make a massive impact on the quality of your relationship.

Remote days for decompression. Many offices offer remote working options for some or all of the week. If that’s offered and working remotely is conducive to your work style and your tasks, take advantage of that option.

Working remotely is not technically a micro-vacation, but it can often feel like one. (Please still do your work—I don’t want to get in trouble here!) If you have a commute of an hour or more each way, not having to commute can add back in two or more hours to your life that can be used for those personal tasks or social times mentioned above.

Also, individuals who work in offices that are loud, lack windows, or where drive-by meetings are common, working remotely can feel like a welcome respite. Plus, you’re likely to get more done. A picturesque location can also give you a new sense of calm as you approach stressful projects. I find that if I’m working in a beautiful setting, like by a lake, it almost feels as good as a vacation. My surroundings have a massive impact on how I feel.

Instead of seeing “vacation” as a large event once or twice a year, consider integrating into micro-vacations into your life on a regular basis. By giving yourself permission to take time for yourself, you can increase your sense of ease with your time.

Some herald the new beginnings that dot the post-Labor Day months – the NFL in full swing, election season in high gear, the first frost, fall’s colors and remember the Mid-term elections and possible transfer of power as the Democrats try to impeach the President. Oh, the surprises ahead beyond who is going to make it to the Super Bowl and which college team will make it to which Bowl game?

But for those mourning another summer that slipped from sight, starts the countdown clock, remember that Memorial Day 2019 is only 267 days away.