What I Learned in a Decade Fighting for the Labor Movement
The following is a book excerpt taken from several chapters of Raising Expectations (and Raising Hell): My Decade Fighting for the Labor Movement by Jane McAlevey with Bob Ostertag published by Verso Books. You can order the book here.
It is hard to convey how odd it was for me to move to Las Vegas. I didn’t own a TV and never had. I’d never put so much as a nickel in a slot machine (and that’s still true). Sheep farming in New Zealand is my idea of entertainment. Moving to a place built on glitz and glamour, a fake city whose skyline is a collection of replicas of real cities I actually like, had been nowhere on my life’s radar screen. But there were lots of good reasons why a union that wanted to organize the hospital industry would make Las Vegas a priority, and Larry Fox had them figured out. And though the details are complicated and a little arcane, they are worth explaining because they offer some insight into what goes into an intelligent strategy to organize workers on a large scale.
To start with, some of the key national and regional hospital chains SEIU had targeted for unionization ran hospitals in Las Vegas. What’s more, these hospitals really mattered to the national companies, because they made truckloads of money for their parent corporations. You have to understand the system of hospital billing and insurance companies to appreciate this. When you injure yourself at home and you have health insurance, you go to a health care facility that’s “inside” your insurance company’s network, and the insurance company can work how everything is billed to its own advantage. But when you drive to Las Vegas from Los Angeles (and 300,000 people do that every weekend), or fly in for a weekend from somewhere in the Midwest, your local hospital doesn’t come with you. Vegas hospitals are delighted to see you walk in the door, because you are an “out-of-network” charge that they can structure to their own advantage and then collect from your health insurance company. Las Vegas has 44 million tourists coming and going each year, and whenever one has a heart attack after drinking too much and losing their house at the roulette table that’s another juicy patient for a Las Vegas hospital. If you are interested in organizing a campaign to unionize a whole national chain, send some organizers to one of their hospitals in Vegas and you will definitely get their attention.
If you are a national union and you want to organize an entire industrial sector, if you are smart you don’t start with the weak, underperforming shops, even though those are the ones where workers are most likely to be underpaid and pissed off. No, you start with the high-performing, income-generating outfits. You assume you are going to win the organizing drive (this leaves out the vast majority of union organizing), and when you do, you want to end up sitting across the table from an employer who actually has some money to pay for a good contract. Now, this presumes you care about winning a high quality contract (even more unions fall out of the mix). But you care about this, because you want the workers at all the hospitals in the market to see what is possible to win with a union. Finally, this presumes that your national union is actually going to stay focused on the local campaign and keep putting resources into it long enough to win a good first contract—and now we have left out virtually all of the unions. Amazingly, when Larry Fox was the head of national health-care organizing, the SEIU actually behaved in this intelligent manner.