The Union-Kaiser Deal
By an overwhelming 9 to 1 margin, members of 24 local unions representing 50,000 Kaiser Permanente employees have endorsed a "Quality Care/Quality Jobs" labor-management partnership with the nation's largest health care chain. The six-page agreement, signed by locals from five AFL-CIO internationals in the health care field, deserves close scrutiny. Let's start with the goodies:Kaiser pledges that "there will be no loss of employment to any employee because of participation in a Partnership program at the worksite." Kaiser promises to use attrition and other means to prevent the displacement of employees. This is an important concession at a time when most HMOs, including Kaiser, have been cutting costs by downsizing their staffs and reducing health care services to patients.While Kaiser's past relationship with unions has not always been amicable, the company now agrees that its employees "should exercise free choice and decide for themselves whether or not they wish to be represented by a labor union." Kaiser is willing to recognize any union that can show by card check that it represents a majority of employees in a bargaining unit.Even more surprisingly generous, Kaiser "will encourage subcontractors, vendors, mergers and alliance partners to adopt the same policy regarding union representation of their employees."For unions that are hungry to organize new members, Kaiser's willingness to accept card-check certification and a pledge of neutrality offer the possibility of unionizing thousands of workers.So what's the catch? What does Kaiser want in return? It's spelled out in clear language in the joint agreement:"The AFL-CIO, acting in the interest of and in support of the Partnership, will use its influence to the greatest extent possible to assure that union health and welfare trusts and Taft-Hartley trusts operating in or providing benefits to union members in areas served by Kaiser Permanente include Kaiser Foundation Health Plans as a unionized health care option available to their members."It is understandable that Kaiser employees would be delighted with this clause, but what about the tens of thousands of other workers, union and non-union, in the health care field? Will non-union workers at other HMOs be receptive to an organizing campaign when they learn about the deal with Kaiser?Why should the AFL-CIO take on the role of official salesperson for Kaiser, trying to wean away affiliated unions from contractual arrangements they have made or plan to make with other health care organizations?There are other problems. Government inspectors with the Health Care Financing Administration have found numerous potentially life-threatening deficiencies at Kaiser hospitals in two California cities, Oakland and Richmond. Kaiser was ordered to correct all of the problems outlined in the 104-page HCFI report by July 1 or risk losing millions of dollars in Medicare funding. Despite the hype, there is not the slightest evidence that quality care will improve under the partnership agreement.How will the AFL-CIO react to company violations in the future, as it tries to do its selling job for Kaiser? Will it downplay or ignore such violations or unjustified price increases or reductions in patient care?And what about collective bargaining with Kaiser? Last April, 7,500 California nurses staged a one-day strike at Kaiser's 45 hospitals and clinics in protest against the company's demand for a wage freeze, pay cuts and benefit reductions. The California Nurses Association has been working without a contract since January 30. In the past three years, Kaiser has cut 15 percent of the nursing positions. Is this the kind of company that the AFL-CIO should promote as a monopoly within the labor movement?To be sure, the partnership agreement provides layers of committees in which the unions will have equal representation with the management. But there is no question as to who makes the final decision if there is no consensus. The agreement states unequivocally:"On non-mandatory and non-contractual subjects, management reserves the sole responsibility and right for the final decision."What the agreement boils down to is that the AFL-CIO will be a decidedly junior partner, whose major responsibility will be to market Kaiser HMOs. Surely, such a radical departure from traditional policy ought not to be decided by the unionized Kaiser employees alone.