Panel predicts more healthcare unionization

A Wisconsin Health News panel took a deep dive Thursday into why healthcare workers are organizing and what’s next for unions.

Watch the event on YouTube or Facebook.

Edited excerpts are below.

WHN: Why are workers organizing?

Dr. Ahmed Ahmed, resident physician and research fellow at Brigham and Women’s Hospital and Harvard Medical School: We’re seeing rising rates of hospitals merging and consolidating larger healthcare systems. If you look across the country, in most metropolitan areas, either one or two hospitals and healthcare systems govern a lot of the healthcare that’s delivered. These markets are highly concentrated. For context, back in the 1970s, about 90 percent of hospitals were independent. Today, it’s less than a third.

What does this mean for healthcare workers? When you look at hospitals and healthcare systems, their top budget item in terms of expenditure, by far, is labor. You could take what they spend on everything else — drugs, supplies and other expenditures — and add them all up. It still doesn’t add up to labor, which is the number one budget line item. When you’re looking at a healthcare system or a hospital that is trying to optimize its expenditures, labor becomes a pretty enticing area to focus on because of the cost savings that could be generated there.

But this also leads to suboptimal incentives. It can lead to staff having to take on more patients, visit times beginning to decline per patient, and resources not being deployed as adequately as the staff on the ground might advocate for and would want, in a way that’s a bit more patient-centered or staff-centered.

The hard part is: When you have such a large healthcare system, who do you actually communicate that to? What voice do you actually have as a worker? That’s what’s led to a lot of the unrest that we’re observing today and the rise in unionization.

WHN: Why pursue unions?

Sara McCumber, a nurse practitioner and member of the Minnesota Nurses Association, which represents nurses in northwest Wisconsin: What prompted us to unionize was that we wanted to have a real voice in our working conditions. When we’re at the bedside, whether it’s in the hospital or the clinic, we know what we need. We wanted to have a real voice, instead of (advanced practice registered nurses) who are appointed by administration. We wanted to have a direct input into our staffing.

Jamie Lucas, executive director of the Wisconsin Federation of Nurses and Health Professionals: Organizing unions is really hard under the current laws and the current power that healthcare corporations have to put their thumbs on the scale, but it can be done. Workers right now, I think more than ever in my experience working here in the state of Wisconsin, want unions. What it goes back to is what Sara said about having a say in how they do their jobs. Organizing a union at this time in this country is the best way to get workplace democracy.

WHN: How has unionization affected the provision of healthcare?

McCumber: Unionization, at least among registered nurses, has led to safe staffing and nursing ratios. There is research to support that there are better outcomes of care. It’s really sad that the union has to push for adequate numbers of nurses to be at the bedside.

I don’t think any of us sitting at the table here do not understand the pressures on the healthcare system and the lack of reimbursement. But I think we have things that we, as direct care providers or representatives of those people, can do to help improve the care at the bedside and perhaps reduce costs.

WHN: What legislation do you plan to pursue on this issue?

Sen. Jeff Smith, the Brunswick Democrat who is the ranking member of the Senate’s health committee: By now, everyone finally realizes the damage that Act 10 (a law that limited collective bargaining for many public employees) had back in 2011 on our public employees. Of course, the promise from the governor at the time was that they would leave private workers untouched. Well, that went by the wayside four years later, in 2015 when they adopted right-to-work in the state of Wisconsin.

I think we’re going to revisit both of those actions and probably — hopefully — repeal those actions and make sure that the right to organize is a right. It’s not a privilege. You just got to have that voice in the workplace, if you’re going to have a safe workplace. And not just for the workers. In this case, we’re talking about the safety of the patients as well.

WHN: What’s next for healthcare unions?

Ahmed: The climate for unionizing is particularly challenging right now, during this window of time in this (federal) administration. In the short run, it’s really going to be a very tough go for labor organizers and for unions.

I don’t think that’s going to be forever. Certainly, political climates change. They evolve. What we have to remember, this is about basically the nadir of unionizing in America. In terms of unionization rate, there was an era where the majority of American workers were fully unionized, and they derived significant benefits. Those benefits probably reached a point where people took them for granted as just something that was given by the employer and not earned and taken by the workers and advocated for.

As we move forward, especially in this economy where it’s been very challenging for workers both in healthcare and outside of healthcare, we certainly will see growing unionization and worker empowerment. That will come to the fore in the next decade.

Lucas: The future is bright. I think people want a say in how they live their lives and take care of their patients, and so I see that there will continue to be an uptick in organizing unions. Healthcare workers are ready to take some of that power back and make the system reflect the values that got them into healthcare in the first place, so that they can safely care for their patients, they can care for themselves and they can care for their families and their communities. The best way to do that is by organizing unions.

This article first appeared in the Wisconsin Health News daily email newsletter. Sign up for your free trial here.