In July, a last minute contract reached by 1199 SEIU United Healthcare Workers East leadership and hospital executives in New York City averted a one-day strike that was to impact 70,000 health-care workers in over 100 hospitals and nursing homes. During the previous week, union members voted 95% in favor of the strike and 1,500 low-wage healthcare workers in Staten Island picketed for better benefits and working conditions.
The contract promises an annual raise of 3% in year 1 and 2, followed by 3.5% in year 3 and 4 of the deal. In addition, workers will receive full health insurance coverage but will reduce pension payments by employers. Several questions remain unanswered such as new hiring practices, the unclear future of outpatient clinics—especially in the newly merged health Contiuum Health Systems, overwork and short-staffing, the closure of units in various hospitals, and the overcrowding due to closed units and hospitals elsewhere; not to mention the ongoing working conditions in most city hospitals, which include concerns over safety and wellness related to shortstaffing, the inability to take breaks, and the division between workers in different paygrades. In short, the union is fighting a purely defensive battle, but still aren’t able to maintain the standards of workers, only to stave off a percentage of the attacks.
In addition, while there is a pay increase, it is not retroactive to pay for neglected cost of living increases in previous years. Furthermore, whole those who voted were overwhelmingly in agreement, many workers felt that yes, a strike was necessary, but not on the terms set by the union. Of our colleagues with whom we spoke, and other healthcare workers we surveyed who are 1199 members, many expressed extreme dissatisfaction. If the one-day strike had happened, no strike pay would have been offered. Furthermore, workers felt that they were being told to go on strike, not that they were deciding to strike. Finally, many workers were dismayed with the demands of the strike; while the potential rise in cost of health insurance matters, it is a relatively minor aspect of de-facto decreasing wages, overwork, and the potential at any time for a worker to lose her job. It is important to understand worker critiques of the strike not as a critique of taking action, but of the content of the demands, and the complete lack of democratic control. Workers feel like they get told when to come to work and when not to, and the master seems the same whether management or union leadership.
Another healthcare is possible
The overwhelming vote in favor of the strike is not surprising. Healthcare workers are upset and seeking new alternatives. Unlike the rest of the non-unionized private sector, healthcare unions are recruiting record numbers of workers. Since 2010, healthcare strikes have risen by 73% and numbers of days on strike have risen by 27%. Despite ambiguous claims by ‘expert’ academic and policy analysts claiming rising mortality following hospital strikes, such analysis ignores the motivating factors behind worker initiated strikes – such as unsafe working conditions, administrators’ use of inexperienced temporary workers, mandatory overtime and weekend shifts, lack of ancillary staff which delays vital diagnostic and treatment procedures, and higher volumes of patients in the face of staff shortages that have all been blamed for rising deaths and costs. Studies also neglect the critical role of strikes in protecting healthcare facilities in underserved communities that would otherwise be left with no access to immediate care.
Despite the increased mobilization of healthcare workers in unions, why is New York left with fewer hospitals? Why are our workplaces getting busier and more stressful? Why do we work so closely with another (the janitors, nurses, techs, doctors, social workers, aides) and yet are carved out into different unions that rarely talk or show solidarity for one another? And why is our relationship with the union more like a “grievance mill” filing for individual complaints rather than forums for collective reflection and larger-scale organizing?
More often, those we trust to be our representatives (such as hospital and union hierarchies, politicians, ‘expert’ academics) are unaware of immediate conditions in the units and clinics. We (healthcare workers) should open new forms of collectively practicing our visions for a better form of practicing care. We hope these suggestions may be of use:
- Find times and spaces inside and outside the hospital that can launch conversations that bring together all of our co-workers (i.e. nurses, aides, techs, janitors, doctors) to vent but also think of solutions that can make our workplaces safer and less stressful. For example, one lunch per week on the unit could be a relaxed space to hear one another’s concerns and consider immediate solutions. And for solutions that might benefit other units or require more resources and support, we can start having a monthly lunch with other units to explore larger-scale alternatives.
- We must identify ways to sustain our group meetings, be it in the form of regular lunches, committees, or gatherings outside work that link with other unit staff and present larger-scale concerns to hospital administration for immediate attention. And if ignored, mobilizing co-workers to find new strategies to press for a response.
- We must challenge our unions and locals to begin working in solidarity with other unions that represent other skilled professionals in our hospitals. Our work relies entirely on a team-based approach, so we must help one another, including our ‘temporary’ co-workers secure full-time jobs.
- We must not only avoid working over-time, but have protected time of at least several hours per week, in which we are free of clinical responsibilities to participate in quality improvement projects. These projects involve receiving training in health services research and finding solutions to improve the quality of care in our specific units and clinics. The work is rewarding and helps nurture real leadership and team-work skills.
- The protected time from clinical duties can also help us initiate projects that build stronger links with community groups to address locally pressing health issues, such as diabetes, asthma, alcoholism, or obesity. Many of our hospitals have lots of meeting space for support groups, educational and prevention projects, workshops, health fairs, and other forms of community support. Often sharing resources and skills with the community empowers residents to improve their health in a respectful and perhaps more effective form than if it were to be addressed in an ER or clinic. It also allows residents to see us, healthcare workers, as people that genuinely care for their well-being beyond acute or emergency care, and may support us if we were facing our own crisis, such as a closures or lay-offs.
NYSNA has been using the same slogan at Interfaith.
Today is the final day of emergency services for Long Island College Hospital. We have tried our best to stay on top of this developing story, but as in the case of Interfaith Hospital right down Atlantic Ave, the story changes almost daily, and different workers are told different things by the unions and management. Our recent piece on LICH in The Brooklyn Rail was an attempt to piece together this confusing story, and we welcome any comments or corrections.
Since the measures to close the hospital began, workers have mostly been kept out of the process and kept in the dark by management, their unions, and other politicians about what is going on. The only hope being offered is the legal route, which will decide the operator of the hospital, and determine how much of its prime real estate will go to the same greedy developers who are dropping luxury condos all over once-affordable Brooklyn neighborhoods (and speeding up the process of more working class hospitals closing down).
Last Fall Bill de Blasio graced LICH and Interfaith on a regular basis, staging high profile media spectacles in their defense, while running for mayor as the candidate who could save NYC hospitals. When he scored the Democratic Party nomination for mayor, however, he pulled the disappearing act that New Yorkers have come to expect from their politicians.
Upon learning that ER services would close today, we did something de Blasio and pals haven’t done since before the election: walked over there and talked to the workers.
“Some doctors say de Blasio is helping out behind the scenes, but I don’t believe it” one worker told us. Indeed, nobody we met believes that.
“Typical politician,” another told us. “This is all show anyway; this was all decided as soon as SUNY Downstate took over. It’s just a question of who will take over and how much of it will be condos.” She told us that it was the plan all along to sell, and SUNY was “waiting for the real estate prices to go up” while the livelihoods and lives of working class New Yorkers swing in the balance.
Like the northernmost LICH building, we learned that the parking garage across the street is a “floating zone”, meaning that a developer could renegotiate its zoning to build condos upwards of fifty stories. The parking garage, everyone agreed, is going down. But cars are easier to relocate than people on dialysis. “‘Dialysis patients are upset” one worker told us. “They’ve been coming here for years.”
Two different people told us that the deal with Brooklyn Health Partners (BHP), widely thought to be the inheritor of LICH until the deal fell through earlier this month, was never a serious possibility. “They never had the right licenses” one worker told us.
One thing is for sure — the option of LICH remaining a full service hospital is off the table. We heard repeated speculations that a minimal urgent care center will remain, as well as a diminished outpatient facility. This is consistent with the trend in NYC health care, away from full service hospitals and toward urgent care centers for working class New Yorkers and chic private clinics for the wealthy, which we began to document in Issue 1 of Vital Signs.
Now that the political route and the legal process have failed, what can we do to save LICH? And if we can’t save LICH, are we doomed to make the same mistake again? Will we keep relying on the hollow words of politicians, the bosses’ court system, and undemocratic unions? When are we going to stand up, as workers and community members, and fight for ourselves?
We think there’s no time like the present.
No more “calming down”. No more trusting politicians. No more waiting for the courts to decide against us. We need to take action. We need to take the first steps toward health care based not on profit, but on human needs. We need pickets and we need occupations.