by Andy Stern, President, Service
Employees International Union
In September, SEIU and 24 other AFL-CIO unions representing some
64,000 health care workers reached a nationwide agreement with Kaiser
Permanente.
The contract is historic and unprecedented.
Labor powerfully demonstrated the added value that unions bring to
answering the challenge of how to provide quality, affordable health
care for our nation.
The agreement is the first national labor contract in health care
and the largest health care pact ever negotiated in the United States.
More than 7.6 million of Kaiser Permanente's 8.1 million patients
nationwide and members of 25 local unions in California, Oregon,
Washington, Ohio, Texas, Missouri, Kansas, Colorado, Maryland,
Virginia and Washington, D.C. are affected.
To be sure, the pact provides annual pay raises, benefits and
improvements in working conditions. But the significant feature of the
contract is the important voice that front-line staff will now have in
patient care decisions.
The agreement sets a new standard for staffing, setting-up joint
labor-management teams to create annual department-level staffing
plans for every Kaiser facility covered by the agreement. The staffing
plans will cover mutually acceptable numbers, mix, and qualifications
for staff in each unit. Bedside caregivers and other employees will
have a real voice in staffing decisions, so they can make sure
patients get the time and care they deserve.
Another unique aspect was the process under which these
negotiations were conducted. Kaiser Permanente is the largest
unionized health care provider in the nation. In fact, unions helped
get Kaiser started as a non-profit more than a half-century ago to
provide a high-quality, low-cost health care plan that working
families could afford. Both labor and Kaiser Permanente share common
goals as social benefit organizations.
Labor has been increasingly concerned that health care in the U.S.
has become dominated by for- profit health plans that take
decision-making out of the hands of physicians and caregivers. In
1997, the Coalition of Kaiser Permanente Unions, of which SEIU is
part, proposed a partnership to demonstrate that labor and management,
working together with the involvement of caregivers, could provide
superior health care, market-leading competitive performance and an
outstanding workplace for Kaiser Permanente employees.
Management agreed and we went to work to create a process and a
structure to what has since become the largest, most complex
labor-management partnership in history. Given the number of unions,
operating units and employees, the nationwide scope and diversity of
jobs and job skills, we achieved an amazing success.
The current contract is a result of our efforts. We negotiated over
several months using a "common issues" bargaining process
instead of traditional adversarial bargaining. In fact, more than 250
Kaiser employees from across the country brought their issues and
joined with union leaders and management at the bargaining table.
The process showed that health care workers can join with
management to ensure quality patient care when they have a real voice
on the job.
With this agreement, we created new standards for quality and
performance in Kaiser Permanente and for the entire health care
industry. Specifically, the agreement attempts to "align quality
of care goals with workforce practices" by:
increasing the contribution of front-line staff in decisions about
important consumer issues like quality of care, service, staffing and
enhancing patient safety, as well as about business planning.
providing for joint labor-management development, administration,
promotion, and evaluation of a state-of-the-art reporting system to
enhance patient safety and quality of care;
maintaining fair and equitable wages and benefits and improving
standards of employment;
providing for performance improvement through continuing joint
efforts to redesign business systems and work processes that involve
affected employees and their unions, and providing fair opportunity
for current employees to perform new work through retraining or
re-deployment;
providing for the establishment of mutually agreed-upon performance
targets that support the enhancement of quality care and patient
satisfaction, and increased efficiency;
providing greater opportunity for employees to impact
organizational performance and share in the success of Kaiser
Permanente;
enhancing Kaiser Permanente's reputation as the employer of choice
for highly skilled and motivated health care workers.
In addition, the contract provides numerous additional
opportunities for improving the work environment for employees. We
also created a jointly financed and jointly administered Labor-
Management Trust Fund to further training and other requirements of
advancing the partnership at all levels in Kaiser Permanente.
The bottom line is more input to patient care by front-line
caregivers, which in the long run will lead to cost savings and better
care. The implications for health care workers are dramatic, but the
real benefits of this agreement will be enjoyed by Kaiser members and
patients.
At a time when some 43 million working Americans have no access to
health care, union members want to work with good union employers to
provide the best possible care at the most affordable cost. The new
agreement with Kaiser Permanente is just one example of the added
value that unions bring to health care. We encourage all consumers to
look for quality health care from institutions such as Kaiser
Permanente that respect and value the contributions of their union
employees.
Q. Even at union worksites, some co-workers may not understand the
value of the union and may even be skeptics. But I know from
experience that bystanders can be persuaded and even critical voices
can become powerful allies if worksite leaders listen, educate, and
lead the way. What strategies help change apathy into activism?
Grace Blanks
SEIU Local 79, Detroit, Michigan
A. President Stern: Unions win the best contracts where members are
most active. Nothing underscores more the value of having a union than
achieving better pay, benefits, and working conditions at the
bargaining table. And there is a direct tie between contract victories
and member activism.
Unions aren't some far-off third party able to swoop in to handle
any crisis that arises. Workers themselves are the union, and it can
be as powerful and responsive as they are willing to make it.
Tried and true methods of increasing participation in the union are
regular worksite gatherings and meeting with legislators and
policy-makers to familiarize members with the political process. One
key to ensuring wider involvement in the union is speaking in first
person about what activism has achieved and sharing responsibilities
for event planning and other union functions among different members. |