A confluence of economic and political factors means organized labor in healthcare could see considerable growth.
Conventional wisdom says that management gets the union it deserves. Listen to your employees, pay them a fair wage with decent benefits, involve them in decision- making, give them enough support to do their jobs, and you may never face a shop steward. Treat your staff like dopes, scoff at their concerns, lock the doors to the nurses' lounge until morale improves, and the next thing you know Michael Moore is camped out in your lobby and you're the title of a Pete Seeger ballad.
Whatever your view of organized labor, you'd better be ready to deal with it, because some observers believe a number of factors are converging to create an unprecedented climate for union growth in the healthcare industry.
First, the recession and its widespread, well-chronicled layoffs—even as hospitals can't find enough staff—have many workers antsy about job security and angry about the status quo.
Second, hospitals stocked with thousands of relatively well-paid employees are ripe targets for dues-seeking unions. Unlike nuclear power plants or zinc mines, hospitals provide easy public access for union organizers. Hospitals are among the largest employers in any community. Healthcare is a growth "industry" in turmoil, with nurses and other medical staff aware that they're in high demand and in a great position to list demands.
And third—perhaps most important—there's a new sheriff in town. The power shift in Washington, with Democrats controlling the White House, Congress, and the federal bureaucracy, will likely result in a passel of labor-friendly lawmakers passing labor-friendly legislation, and labor-friendly appointees in key federal agencies like the Industrial Relations Labor Board making labor-friendly rulings.
This sea change in labor oversight is best exemplified in the proposed Employee Free Choice Act, which many labor movement observers believe is the most important piece of labor legislation in decades and could bolster union rolls in the United States by about 30%. Under EFCA, as many as 5 million new workers could join the 16.5 million now-unionized workers in the nation who represent about 12.5% of the overall work force. EFCA facilitates organizing workers through a "card check" process.
"If a majority of employees in the proposed bargaining unit sign an authorization card, the employer under this legislation has to grant that union recognition," says Marick Masters, a professor of business at Wayne State University if Detroit. "Under current law, they don't have to recognize and can insist that there is an election with secret ballot. There are still opportunities for secret ballot, but this is an additional opportunity to ease the process of forming a formally recognized bargaining unit."
Another component of EFCA that hasn't gotten as much attention calls for mandatory binding arbitration if unionized workers and their employers can't reach agreement on a contract within 120 days of forming a union. EFCA also sharply increases fines and other penalties leveled against businesses that commit unfair labor practices. Masters says EFCA is expected to breeze through the U.S. House but could face opposition from Senate Republicans.
Jim Trivisonno, president of Detroit-based IRI Consultants to Management, Inc., likens EFCA to a Category 5 hurricane of which most hospital CEOs are blithely unaware. "The day after the [presidential] election I was at a healthcare roundtable in Dallas with senior-level hospital people, 40 of them, all sharp people. When I asked the question, only four of them had heard of the EFCA. That's scary," Trivisonno says.
He says most hospitals have a three-ringed binder for disaster preparedness and another action plan for Joint Commission surprise visits. "EFCA has to have the same level of awareness and be on the same level of priorities, including having a communications and rapid-response team in place, because should this occur you won't have time to react," he says.
But should hospital executives be afraid of unions? "No," says Monica Russo, president of the approximately 15,000-member SEIU—Healthcare Florida.
"Hospital administrators should see their healthcare employees having a voice as being a huge asset for the delivery of care and tackling some of the key issues that confront us. The healthcare system right now is so broken that even hospital CEOs believe it needs to be fixed."