Healthcare Survey
Tell your healthcare story!

power logo: portland organizing to win economic rights



 

Frequently Asked Questions
 
Other ways to tell your story:

Download a print-able version of the survey:
Word format
PDF format
To return survey by mail: POWER, Pob 4281, Portland, ME 04101

Contact POWER
& with a mailing address (or email) & we can send you a copy of the survey.


Frequently Asked Questions

QUESTIONS??

Please don't hesitate to contact us. We can help you document your story:

CONTACT US!

 UNIVERSAL
 SINGLE PAYER HEALTHCARE
Facts & Resources


What are economic human rights?




drawing of statue of liberty holding a caduceus instead of a torch, by a POWER member.

SPECIAL HIGHLIGHT

HEALTH CARE CRISIS USA:

Resources for
more information

 
 
Health Care by the Numbers
 

18,000 deaths blamed on lack of insurance
USA Today
 
 
US Health Care Expenditures
 

Medical bills trigger half of bankruptcies
MSNBC
 
 
The Case for a National Health Program
 
 
We don't need insurance: we need GUARANTEED HEALTHCARE!
 
 
TOP TEN REASONS FOR ENACTING A SINGLE PAYER HEALTHCARE SYSTEM
 
Click here for:
PDF Version
 
 
Cost of Healthcare: More Americans Priced Out of Care
 
Click here for:
PDF Version
 
 
UN Human Development Report [PDF] (see page 27!)
 
 
World Health Organization Report 2000 [PDF]
 

Facts & Sources from Michael Moore's SiCKO movie
 
 
'SiCKO' Truth Squad Sets CNN Straight!
 



power healthcare demonstration photo
POWER's Demonstration for Healthcare Justice.
November 27, 2007,
Portland, Maine

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  economic human rightsHEALTHCARE JUSTICE!tell your story  


Liberty with caduceus --drawing by a POWER member.Liberty with caduceus --drawing by a POWER member.Portland Organizing to Win
Economic Rights

 
HEALTHCARE JUSTICE
SURVEY

As part of our healthcare organizing efforts, POWER is documenting violations of our human right to healthcare. If you've ever had problems accessing affordable, quality healthcare when you needed it, please take a moment to fill out our new Health Care Justice Survey & TELL YOUR HEALTH CARE STORY!

Feel free to answer as many or as few questions as you like (only #1 is required). We only ask that you respond as honestly as possible. For more information, please see Frequently Asked Questions
or contact us with additional questions. Thank you!

*Please note that the phrase healthcare/medical care includes ALL aspects related to healthcare including prescription meds, dental care, mental health, eye care, etc.

A print version of this survey is also available in the following formats: 
Healthcare_Survey --Word format | Healthcare_Survey --PDF format

  1. I give POWER permission to use my story in their efforts to win healthcare for all. 
    Yes [REQUIRED]
     
  2. Have you ever had trouble finding and/or receiving quality medical care* that you could afford?
    Yes No        Feel free to describe:  
     
  3. Have you ever delayed proper medical care* or failed to meet a healthcare* need due to cost? 
    Yes No       Feel free to describe:  

     If yes: Has your health ever worsened as a result? 
    Yes No       Feel free to describe:  
     
  4. Has any member of your family gone without proper medical care* due to an inability to pay?  
    Yes No       Feel free to describe:  

     If yes: Did his/her health worsen as a result? 
    Yes No       Feel free to describe:  

  5. Have you had visit the hospital emergency room to meet basic healthcare* needs, either to treat a nonemergency condition or a condition that could have been prevented if you had had access to regular medical treatment when you first needed it? 
    Yes No      Feel free to describe:  
     
  6. Do you and/or your family currently have any sort of healthcare* coverage?
    Yes No    

    If yes, please answer a, b, & c below:
         a) Does this coverage adequately meet your health needs?
           Yes No
         b) Does paying for this coverage cause you financial strain?
            Yes No
         c) What sort of coverage do you have? 
        
         Note: to choose more than one option, hold
         down the control key while making selection.
         
         If other, please describe:  
     
  7. Do you support the creation of a national universal single payer healthcare system?
    Yes No  

    In the absence of a national system, do you support the creation of a universal
    single payer healthcare system in the state of Maine?
    Yes No   
     
  8. POWER recently hosted a Healthcare Truth Commission where individuals testified about violations to their human right to healthcare. In the future POWER will likely be holding similar events -- would you be interested in telling your story at one of these events?
    Yes No  (if yes, provide contact info below so POWER can get in touch with you)  
     
  9. POWER's Video Committee is making a healthcare video to document stories of healthcare rights violations & show how the healthcare crisis is affecting people here in Maine and how it ties into the national picture. Are you interested in being interviewed for POWER's healthcare video project? 
    Yes No  (if yes, provide contact info below)  
     
  10. Would you like to receive more information about POWER?
    Yes No  (if yes, please provide contact info below
     
  11. Tell more about your specific health care story (optional)
    Please feel free to use the space below to share more about your personal healthcare story. 

  12. Note: Please click here for information about sending in additional documentation
    with your healthcare story. For example, copies of hospital bills, photographs of
    you and your family, children's drawings, etc...
  13. How can we make this survey better?

Contact Information (optional)
While providing your contact information is entirely optional, please
note that any contact information you provide will be kept confidential.
Click here to skip ahead & submit your survey (or scroll down).

           Please keep my story anonymous: Yes No  (default is 'yes')
           When possible, identify my story using my name: Yes No  (default is 'no')

Name:   

Phone:   Email: 

Address: Apt #

Town/City: State:   Zip:

Additional Information (optional)
Any additional information you provide is kept confidential.
Click here to skip ahead & submit your survey (or scroll down).

Age:   Gender:  Race/Ethnicity:
 
How many children do you have?
 
How would you describe your current economic situation?
poor/in poverty; low-income; working class/blue collar; middle class;
professional upper middle class/white collar; rich / wealthy; 
Other - please define:       

Has your economic situation changed since your childhood? Yes No  
...If yes, how has your economic situation changed?
   

SUBMIT YOUR SURVEY

Please click "Submit Survey" to send in your survey:
 

Or click "Reset Survey" to start over.
 

p.s. If can't submit your survey, please click here & make sure you checked off 'Yes' in the required field.

 

THANK YOU FOR TAKING PART IN THIS SURVEY!!!
YOUR SUPPORT HELPS US BUILD THIS MOVEMENT TO END POVERTY!

Portland Organizing to Win Economic Rights = POWER!

www.povertyontrial.org / 207-650-5092 / pob 4281 Portland, Me 04101

 

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To send additional materials about your story:
If you'd like you may send us any additional documentation. Of course, this is completely optional, but it really does help to show that we are REAL people with REAL health care stories. Any additional documentation will be kept anonymous and confidential until and unless you tell us otherwise. You can get as creative with this documentation as you like. Here are just a few ideas: photos showing you at home with your family; photos that help illustrate your health care problem; copies of medical bills, insurance denials, prescription receipts, bankruptcy/foreclosure papers etc; children's drawings or letters; your own personal writings and reflections, artwork, music, etc; Feel free to send any sort of documentation you feel would help express your health care story best.

To send any additional documentation, please write to:
             POWER, Attn: Healthcare Survey,
             Po Box 4281, Portland, ME 04101

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ABOUT THIS SURVEY: FREQUENTLY ASKED QUESTIONS 
  • Q: Do I have to answer all the questions in order to take the survey? --No. Feel free to answer as many or as few questions as you like. Of course, the more you answer, the more helpful it is for us. 
  • Q: Can I take the survey anonymously? --Yes. Giving your contact info is entirely optional. 
  • Q: Will my contact information be kept confidential? --Yes. Absolutely.
  • Q: Are there other ways to take this survey? --Yes. A print version of the survey is available: You can either download it from our website as a Word document, or you can contact POWER with your mailing address and we'll send you a copy of the survey by mail. An email-able version of the survey is also available by contacting POWER
  • Q: Do I have to be poor or low-income to take the survey? --No. Anyone may take the survey. 
  • Q: Do I have to be from Maine to take the survey? --No. Anyone may take the survey. 
  • Q: Where can I find out more about Universal Single Payer Healthcare? --For starters,
    please visit the website of Physicans for a National Health Program: www.pnhp.org, or  www.guaranteedhealthcare.org. Additional resources can be found listed in the left-hand column.  
  • Q: What are economic human rights? --Economic human rights include our rights to food, housing, healthcare, living wage jobs, education, and income for those who need it. These rights are outlined in the Universal Declaration of Human Rights: for more info click here or visit our human rights page
  • Q: What are some examples of economic human rights violations? --For example: problems getting healthcare when you needed it; struggling to pay your rent or mortgage; working jobs that don't pay enough to make ends meet; skipping prescriptions because they were too expensive; taking on student loans you later can't afford to pay... These are just some of the many examples of economic human rights violations that millions of us are experiencing all across the nation. 
  • Q: When I tried to submit the survey, I received an error message. What do I do?
    --Please click here to make sure you checked off "YES" in the required field. 
  • Q: How can I help distribute this survey to other people?--One way you can help is by printing out the survey out & making copies to distribute. To download the printable version of the survey: Healthcare_Survey --Word format | Healthcare_Survey --PDF format
    Or contact POWER with your address & we'll send or deliver copies of the survey to you. You can also help out by distributing the email version of the survey - contact POWER
    THANK YOU!

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MORE ABOUT ECONOMIC HUMAN RIGHTS

Conditions of poverty represent violations of our economic human rights. As part of the struggle to end poverty, we're working to document these violations wherever they occur.

The Universal Declaration of Human Rights is a landmark international treaty signed by the United States in 1948. It clearly states that economic human rights are guaranteed to all human beings.

Economic Human Rights are specified in Articles 23, 25, & 26 of the Universal Declaration of Human Rights, as outlined below. Or read the full text of the Universal Declaration of Human Rights. More info is also available on our human rights page

Article 23:
The right to LIVING WAGE JOBS, to safe working conditions, and to form and join unions.

    1. Everyone has the right to work, to free choice of employment, to just and favourable conditions of work and to protection against unemployment.
    2. Everyone, without any discrimination, has the right to equal pay for equal work.
    3. Everyone who works has the right to just and favourable remuneration ensuring for him/herself and his/her family an existence worthy of human dignity, and supplemented, if necessary, by other means of social protection.
    4. Everyone has the right to form and to join trade unions for the protection of his/her interests.
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Article 25:
The right to well-being of a person and their family, including: HOUSING, HEALTHCARE, & FOOD, CHILDCARE, & SECURITY for all those who are unemployed, unable to work, or working at home raising children, or caring for other family members.  

  1. Everyone has the right to a standard of living adequate for the health and well-being of him/herself and of his or her family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his or her control.
  2. Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.
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Article 26:
The right to EDUCATION, including higher education & training. 

    1. Everyone has the right to education. Education shall be free, at least in the elementary and fundamental stages. Elementary education shall be compulsory. Technical and professional education shall be made generally available and higher education shall be equally accessible to all on the basis of merit.
    2. Education shall be directed to the full development of the human personality and to the strengthening of respect for human rights and fundamental freedoms. It shall promote understanding, tolerance and friendship among all nations, racial or religious groups, and shall further the activities of the United Nations for the maintenance of peace.
    3. Parents have a prior right to choose the kind of education that shall be given to their children.
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For the full text of the
UNIVERSAL DECLARATION OF HUMAN RIGHTS CLICK HERE!



mothers of the disappeard marching past the portland city hall , very large crowd. Photo by POWER.

POWER's Demonstration for Healthcare Justice.
Portland, Maine, November 27, 2007.


When we unite to claim our rights together we have POWER!



Portland Organizing to Win Economic Rights = POWER!
Contact POWER


Winning our economic rights;
Putting poverty on trial;
Building a Maine that truly is the way life should be - for ALL of us!!!

 


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