Unions and Health Care Don’t Mix

I entered the field of Health Care through Social Work and moved into Administration because of a desire to not only help patients, but to also protect Medical Professionals. Prior to the 1980’s it was possible to profitably run a medical office or facility. With the dawn of HMOs and other restrictive payment programs to Providers, it is now impossible to be profitable. Payments have been decreased so that now not only are the majority of Providers employees of large hospitals or groups, but Hospitals are also having difficulty making ends meet. As a result, policies are put into place that may seem draconian to some, but are done to ensure that the lights stay on.

In America there is the ability to protest against an employer if a group of employees feel that they are not being treated correctly. We have a system of Unions and Labor Laws to protect the employees. In recent years medical staff have jumped on the Union bandwagon, but the financial realities are not compatible.

On November 26, if negotiations between University of Chicago Medical Center and the National Nurses Organizing Committee/National Nurses United are not concluded the Nurses will strike. This strike will result in the closing of this Level 1 trauma center for adult and pediatric patients:

“In preparation for the strike, UCMC announced earlier this week that it is moving about 50 babies and 20 children in its neonatal and pediatric intensive care units to other facilities.”

“Negotiations between UCMC and National Nurses Organizing Committee/National Nurses United began earlier this year. Medical center leaders say incentive pay — and whether the hospital should end the pay for newly hired nurses — is a sticking point in negotiations, according to the Chicago Tribune. The union has continued to express concerns about staffing levels.”

Usually strikes impact a business’s finances because the workers make the widget that the business sells for profit, thus without the widget the business does not make money. In this case, however, Nurses are not money generators for medical facilities. Nursing Care is a net loss for hospitals. In the Medical Field, only Providers generate money. That is, the Doctors, Technicians, Therapists, etc. who provide a medically necessary service or procedure to a patient, and for which they can then bill the patient, usually through a Managed Care Organization, i.e. Insurance Company. Through this billing, funds are generated to pay for the person who performed the service or procedure. Funds are also generated to pay for the equipment used in the procedure.

Nurses do remarkable work, but their services are not billable for payment. Thus any salary paid to a nurse has to come from monies generated by Providers. Thus a strike will not affect the bottom line of a Hospital, it will only affect care that the Hospital can provide.

“The nurses said they plan to strike unless an agreement is reached.”