Alto Mary Farrell shares her experience of working with the Kensington Miners’ Clinic in a time of transition.
In the mid-1970s, I had the opportunity to get a sense of the life of a mining community in Western Pennsylvania. Miners in New Kensington were mining bituminous, not anthracite coal. It wasn’t the era of Breaker Boys, but it was still a hazardous demanding occupation.
The United Mine Workers Union, led from 1919 to 1940 by John L. Lewis (whose words inspired the third movement of Anthracite Fields), had negotiated contracts that provided very good—and needed—health benefits (as well as retirement pensions), for miners and their dependents. These benefits were administered in part by the United Mine Workers’ Health and Retirement Fund, a separate organization from the Union, designed to ensure provision of the health benefits to Union members and their families.
I came to coal country in 1977 because the United Mine Workers’ Fund (UMWF) had determined that their previous support of Mine Workers’ Clinics was more generous than was sustainable in the current circumstances. The UMWF had sponsored clinics for many years; building them, and supporting their operating costs in order to ensure that members and their families would have access to needed medical care as a matter of right.
But coal mining was a declining industry. Oil had supplanted coal as a major source of energy. In the mid-70s the Trustees of the Fund decided that a model similar to the Fee-for-Service system that was in place for most health care consumers was needed if the Fund was to continue their tradition of covering the extraordinary costs of care required by their constituency.
The Fund’s 1977 decision to change their model of support, specifically of the New Kensington Miners’ Clinic, hit like a hammer blow. Not only would the Clinic not receive their accustomed operating subsidy, covering the bulk of operating expenses for the Clinic, but now the clients/patients would be required to contribute directly to the costs of their care. I had the opportunity, as a public health student intern, to work with the New Kensington Miners’ Clinic’s team trying to craft a plan for this transition.
Don’t get me wrong. The Fund still provided very good health benefits to its beneficiaries, but the model had changed. Instead of walking into their clinic assured that they could receive whatever health care they desired as a right, they now needed to adjust to a “fee for service” model, anticipating they would be charged for any and all services required. Their Fund benefits still provided a good insurance benefit, but the paperwork burden increased and the cost was more explicitly theirs.
Understand, the miners still needed more than the average level of care. Miners might well have been diagnosed with black lung disease, in conjunction with more usual conditions, such as chronic obstructive pulmonary disease (COPD), hypertension, diabetes, alcoholism, and depression. After spending a career in the mines, it was hard to emerge as healthy as a neighboring auto worker or laborer, despite the benefits conferred by the Mine Workers’ contracts. Miners still worked underground throughout their shifts, breathing coal dust and subject to injury.
It is never easy to address all the needs evident in society as we find it. My experience in New Kensington revealed an amazing response on the part of the Clinic and the community to acknowledge and meet the needs of workers in an industry still vital to the energy demands of our country.