/* Written 9:11 AM Apr 1, 1998 by jshell@netcom.com in igc:labr.all */ /* ---------- "Boston Globe commentary" ---------- */ Forwarded message: > From andersd@spot.colorado.edu Tue Mar 31 15:29:02 1998 > Subject: Boston Globe commentary (fwd) > > A broader role for unions > By Robert Kuttner, 03/29/98 > > The California Nurses Association recently won a remarkable contract with > Kaiser-Permanente, the nation's largest HMO. The contract puts nurses in the > role of quality watchdogs at Kaiser hospitals. Under the plan, part of a hard- > won, four-year contract, nurses can force management to deal with lapses in > high-quality care. > > For now the contract affects only the 2.7 million subscribers in Kaiser's home > territory in Northern California, and it must still be ratified by the union > membership. But it could become a model. > > There are several larger lessons here. First, nurses are the hands-on > caregivers in hospitals. With managed care, patients have to be sicker in the > first place to get admitted, their stays tend to be shorter, and budgetary > pressures keep reducing nurse staffing ratios. > > Nurses bear the brunt of all of this as workers, and consumers pay the price > as patients. So it makes sense to align nurses' interests with patients' > interests. This approach of quality control at the bedside could be a better > counterweight to the excesses committed in the name of managed care than > bureaucratic remedies. > > Second, please note that it was a union that fought for, and won, this > innovation. And note that Kaiser, still a nonprofit, is among the best of the > nation's HMOs. As a socially motivated HMO, Kaiser has a ''partnership'' with > its AFL-CIO unions that involves unions in management planning and discourages > work stoppages. > > Interestingly, however, the California Nurses Association is a more militant, > independent union, not affiliated with the AFL-CIO. This agreement came only > after a year of bitter skirmishes punctuated by one- and two-day nurses' > strikes that hurt Kaiser's public image and cost the HMO many millions of > dollars. So the watchdog agreement is the fruit of an unusually militant union > reaching a settlement with an unusually public-minded HMO. > > This raises a third question. Can such institutions survive? > > Unions do best not just as self-interested workers with their hands out but as > a broader social conscience on behalf of vulnerable people. Indeed, if labor > fails to play this role, it is just another interest group, and it loses > public support. > > The AFL-CIO national office in Washington displays a set of pens that > President Lyndon Johnson used to sign historic Great Society legislation: > Medicare, federal aid to education, Head Start, and the three great civil > rights acts - not one of them, strictly speaking, ''labor legislation.'' But > labor movement stood for a broader vision of the good society and fought hard > for their enactment. > > By coincidence, California is also the opening battleground of a bid by > business groups and the Republican Party to strip labor of much of its > political power. A ballot initiative billed as a ''paycheck protection act'' > would bar unions from spending money collected in union dues for even > nonpartisan political activity except through special levies collected from > one member at a time. > > This initiative has inspired similar measures in other states and in Congress. > Grover Norquist, head of the right-wing Americans for Tax Reform, underwrote > much of the cost of collecting the necessary signatures to put the initiative > on the ballot and has said his goal is to ''crush unions as a political > entity.'' Corporations, of course, spend hundreds of millions in politics, > without asking permission of their employees or shareholders. > > Since unions are the single most potent counterweight to organized business in > politics, this proposal would only intensify the right-wing tilt of American > politics. Though the AFL-CIO's $35 million spent in the 1996 election was > widely publicized, business as a whole outspent labor by about eight to one. > > Most voters, of course, are not members of unions. Labor will beat this > initiative only if it can persuade citizens that unions are advocates not just > of their own self-interest, but of a decent society generally. > > Initiatives like the nurses' Kaiser contract help reinforce that now-tenuous > bond. It also helps to have companies like Kaiser, whose values transcend the > corporate bottom line. Most hospitals fiercely resist unionization. Kaiser, at > least, welcomes unions as social partners and then negotiates hard about the > particulars. > > Such institutions are oases of broader public values in a social desert of > radical individualism, whose credo might as well be ''everyone for himself.'' > In recent decades, for-profit institutions have been crowding out nonprofit > ones, and unions have representing a dwindling share of US workers. > > If labor recovers, it will rebound not just by redoubling its organizing, but > by standing for broader public purposes. And if nonprofits survive, they will > do so by demonstrating greater heart than their for-profit competitors. > > Robert Kuttner is co-editor of The American Prospect. His column appears > regularly in the Globe. > > This story ran on page E07 of the Boston Globe on 03/29/98. > © Copyright 1998 Globe Newspaper Company. |