CostRx: Workers join healthcare fray

WASHINGTON, Feb. 28 (UPI) -- With momentum for healthcare reform intensifying, the Service Employees' Industrial Union -- one of the largest U.S. unions with more than 1 million members -- is launching a national union just for healthcare. UPI interviewed Executive Vice President Mary Kay Baker, a 27-year veteran of the labor movement, who will be one of the leaders of the new healthcare union.

Earlier this year, the union -- comprised of service workers including healthcare workers, janitors and retail workers -- announced an unlikely coalition with retail giant Wal-Mart to push for healthcare coverage for all Americans that drew fire from other labor groups because of Wal-Mart's less-than-friendly relationship with unions.

Nonetheless, for the first time in years, the union's membership said they feel "incredibly hopeful" that healthcare reform can be achieved -- without sacrificing principles, Baker said.

Q. In terms of organizing workers, what are some of the goals of establishing the new union? And what are the advantages of it being a separate entity from SEIU as a whole?

A. We think creating an identity nationally for all of our healthcare members across the country is going to make it possible for our existing members to drive change in their hospitals, nursing homes and homecare facilities.

But also, for non-union healthcare workers across the country (will have) an organization they can belong to that will deal with the two burning desires they have: to improve quality patient care and to win healthcare for everyone in the country.

We don't think we can accomplish that if we remain a state-based organization. Our locals are doing a lot of really good work for our members, but we need to unite 9 million that don't yet have an organized voice.

Q. What are some of the concerns about healthcare quality your members are raising, and how do you plan to address some of those concerns?

A. The biggest quality concern that people have is staffing and the amount of time they can spend. They feel like they always have to triage every minute of every day, deciding what's most important. It doesn't allow them to do the kind of patient education, or infection control that they find necessary.

Hand washing, as you know, is a big deal, it helps prevent a lot of hospital-based infections. But it's difficult in hospitals and nursing homes because of staffing issues. So, that's an example of how staffing is at the core of a lot of quality concerns.

The second thing is that our members in New York and California feel like their organizations have allowed them to have a lot more say in decisions about resources and how things run in their hospitals. We want to make that a part of every healthcare worker's experience so the intelligence they have can be unlocked to help change care in the (United States).

Q. Another stated goal is healthcare coverage for all Americans. How will that work and what actions do you plan?

A. Our union is trying to accomplish two goals. One is to reform the system so that everybody has access to quality coverage at an affordable price, and the other is that all frontline providers have a voice in how the system will change.

The way we're going to accomplish those two goals is by operating on three fronts. One is on quality, which is, we want our frontline caregivers to participate in shaping how quality care is delivered.

Two is that we're going to unite employers. Our employers, and employers across the country will be making demands with us.

Three is that we're going to work on advocacy at every level. We are working on comprehensive state reform, and we're trying to push a federal agenda.

What we think is required right now is creating a drumbeat for change and that the change has to be comprehensive not incremental. Once we create the political will in this country, we will arrive at an American solution that takes the best practices of other countries and state experiments to arrive at a solution that's best for our country.

Q. SEIU just announced an agreement with Wal-Mart that surprised many people. Some unions have had an adversarial relationship with Wal-Mart. How do you reconcile that tension with cooperation with employers?

A. Our members think that, unless we get U.S. employers at the barricades with us demanding change, we're going to be in the situation we've been in for the past 60 years. We tried in the 1940s, we tried in the 1960s and 1970s, and 1993 and 1994, and we've never created a critical mass of political will.

So we think it's possible to join hands with Wal-Mart in demanding coverage for everyone, but also hold Wal-Mart accountable on their current business practices that are hurting workers. The agreement with Wal-Mart to fight for universal coverage doesn't mean that we have gagged ourselves on holding them accountable on other things.

We believe we need to have a relationship with anyone who's willing to demand healthcare change. We have relationships like that with employers all over the country.

With employers where we represent workers, we can have an agreement to have the bargaining process be an internal struggle and not be public about it. But because Wal-Mart is not a unionized company, our agreement with them is through a public campaign.

Q. In addition to employers, who are some of the other groups to whom you are reaching out?

A. We work with 50 organizations on a national basis in the civil rights community, health advocacy community, faith-based community and women's rights groups. Our state-based organizations and local unions also have coalitions and partnerships in their states.

So there's some of the old healthcare coalitions that have existed for decades, but what we're trying to do is forge a new coalition that has unlikely partners because we think that's the only way to accomplish this change in our generation.

We don't want to just be rhetorical -- we want to make it happen.

Q. Some people have pointed to high healthcare costs as one of the main causes of the high number of uninsured people. Is there a tension between union organizing increasing healthcare costs and expanding coverage to more people?

A. That's false. Our global sense is that we need to fight to get the people who are currently financing this system to maintain their commitment even if the system changes. So one of our key principles is individuals, businesses and governments all have to bear responsibility for financing healthcare as we move forward, and I do think that there's a lot of very creative things our unions have done in cooperation with employers to maintain costs.

Our administrative costs in our New York healthcare benefit fund, for example, are much lower than traditional administrative costs for third-party insurers. The Medicare program has only a 3 percent administrative cost.

I think there are ways that unions have demonstrated ability to contain costs, but because we are such a small segment of the population we need to figure out a way in any new American system to do much more systematic cost control.

Q. What other solutions are you advocating?

A. We've made a conscious decision in this campaign not to get sunk in designing a solution before we have the political will organized that says, "Whatever the details we have to have a comprehensive change."

We have principles we've gotten people united around, but when you examine the failure of our country to act in all the successive attempts, it's because the political will was never strong enough to survive all the pushes and pulls that come when you start designing the solutions.

Massachusetts squared is the way to think about it, where forces that fought each other before came together because they all didn't like the status quo. People there were finally willing to say, 'We don't like the status quo, we have to change it. In spite of our differences, let's push through.'

Q. When it comes to campaigning for universal healthcare coverage, why is a union the right organization for the job?

A. There's no organization better positioned because we can represent the interests of low-wage workers, median-wage workers and high-wage workers, all of whom are either getting impacted because they're uninsured, or because they're underinsured or because even as a fully insured person, they don't have access to care because of how fractured the system is.

Even in our best benefit situations, our members are getting jerked around inside a healthcare system that doesn't serve patients. We can listen to the spectrum of the American experience, and think about what's best for everyone, as opposed to any individual special interest.

We don't think of ourselves as doing it alone, we think of ourselves as being a catalyst for change.