SEIU-UHW’s Statewide Ballot Measures On Hospital Costs: Serious Proposals or Publicity Stunt?

by Randy Shaw on November 29, 2011

Last week, SEIU-UHW filed two statewide initiatives for California’s 2012 ballot: the Charity Care Act, which sets a 5% minimum level for charity care payments for nonprofit hospitals, and the Fair Healthcare Pricing Act, which prohibits hospitals from charging more than 25% above the cost of patient care. The measures are part of UHW’s “Let’s Get Healthy California!” campaign, which joins UHW with “healthcare providers, leading nonprofits, businesses and others” to improve healthcare. But SEIU-UHW’s recent history raises doubts about its strategy. UHW has repeatedly aligned with Kaiser, Sutter and other health care giants against the more aggressively pro-worker approaches of NUHW and the California Nurses Association. And restraining hospital costs has not been a UHW priority. UHW’s proceeding with these initiatives without labor allies and while collaborating with hospitals raises questions as to the union’s real motives.

As labor unions across California and the nation join with the Occupy movement to challenge corporate power, SEIU-UHW has remained wedded to its formal alliance with Kaiser and its informal alliance with Sutter Health. The union is now trying to boost its image among health care workers and the public by a “bold voter initiative package to rein in healthcare costs and ensure charity care for the neediest.”

While most support providing greater health access and reining in healthcare costs, the UHW measures are unlikely to accomplish this. Unfortunately, they appear more smoke and mirrors than a building block for improving our health care system.

UHW’s Campaign Limitations

As the failure of the single-payer initiative (Prop 186) on California’s 1994 ballot showed, winning a statewide campaign against powerful healthcare corporations is a tough task. It requires massive amounts of money and a huge statewide field campaign, and SEIU-UHW is unlikely to have either.

UHW lacks the money to seriously wage such a campaign because of the millions of dollars it has spent on post-trusteeship struggles with NUHW. SEIU’s trusteeship of the former UHW leadership diverted huge sums away from organizing and challenging hospitals in contract fights, leaving UHW unable to sustain an expensive statewide campaign.

UHW is hardly a favorite among other unions, having threatened to withdraw funding from the Los Angeles, San Francisco and other Labor Councils. Organized labor has other priorities for November 2012, and will not allocate major resources to a UHW-controlled health care campaign.

Further, I can’t imagine CNA joining with UHW on these initiatives. Without the funds and troops from the state’s most politically powerful health care union, it’s hard to see why UHW believes it can raise the funds necessary to qualify the measures (not to mention financing and assembling the field campaign for passage).

So the likelihood of UHW qualifying and then passing these measures next November is virtually nil. But UHW has other reasons for launching these efforts.

The Rebranding of UHW

SEIU-UHW has a branding problem. It is the favored union for Kaiser, Sutter and virtually every other hospital whose workers are choosing between UHW and NUHW. In Kaiser’s case, the company went so far out of its way to ensure an UHW victory that the NLRB threw out the election results.

Hospitals prefer UHW because they view the union as more “cooperative” and willing to accept weaker contract terms than NUHW. For example, at Catholic Healthcare West, UHW gave up the union’s defined benefit pension plan in the middle of the contract, which will save the hospital $217 million over two years. But when Salinas Valley Memorial Hospital demanded that NUHW workers give up their plans, NUHW workers went on strike – and the hospital backed down.

In hospital after hospital, UHW workers have seen their health premiums rise and layoff protections weakened; NUHW has consistently opposed such changes for its workers.

UHW’s favored status with employers helps it win elections against NUHW because hospitals give UHW organizers greater access to workers. But this alliance with hospital giants has a downside: No union wants to be seen as favored by “the boss,” particularly when, as in UHW’s case, it faces future elections against NUHW.

This is where UHW’s launching ballot measures comes in. By appearing to place UHW in the vanguard of limiting health care costs and expanding health access, the measures refute charges that the union is too chummy with hospitals. And when the measures are described as part of a larger campaign that will “recruit and train 250,000 more healthcare workers,” and “deploy 10,000” of such workers in a “massive statewide public education and action campaign,” UHW is trying to create the impression that it is building a mass movement for improved health care.

But don’t expect to see these 10,000 UHW activists on the streets anytime soon. And while UHW’s ambitious campaign sounds like the start of an Occupy-style grassroots movement against wealthy hospitals, the “Let’s Get Healthy” campaign expressly states that the union will be “joining with healthcare providers” to improve healthcare.

It’s hard to see how UHW can “join” with hospital giants at the same time it is allegedly building a mass campaign to cut into their profits. But it is easy to see UHW dropping the initiatives as part of an overall “deal” with hospitals, and then claiming it has won a huge victory for consumers.

California’s future depends on voter approval of key initiatives on the November 2012 ballot to rebuild the state’s tax base and revenue stream. SEIU-UHW could be focusing on working with other unions on these broader goals, rather than squandering resources on what will be a failed attempt at union rebranding.

Randy Shaw is the author of Beyond the Fields: Cesar Chavez, the UFW and the Struggle for Justice in the 21st Century.

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