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.
To go on from here, I need to explain a little about hospitals. Most health-care markets are served by a combination of five common types of hospitals: faith-based, academic medical centers, publicly owned, nonprofit, and for-profit. Actually, some states don’t allow for-profit hospitals health care, and that’s a good thing. My home state of New York, like most of the Northeast, does not permit publicly traded hospitals to operate at all. Many politicians and journalists I have met, and certainly most workers, don’t even know that there are states that entirely ban the kinds of hospitals that dominate Las Vegas. This is one reason there are so many good hospitals in New York and Boston: It is actually illegal in those cities to set up a hospital or health care company whose core purpose is making money rather than healing patients. Have you ever heard anyone with cancer say, “I am jumping on a plane to Vegas to get some quality care?” I didn’t think so.
The for-profit hospitals deliver the worst care in the country, hands down, and sue me for this sentence so I can depose all your records in court and have some real fun. This is not to say that the other types necessarily deliver high-quality care. Plenty of them don’t. But the worst patient care is consistently found in for-profit operations. Like all corporations whose purpose is to make money, the for-profits want the least regulation possible. That means no environmental groups or laws, no community organizations to account to or laws that mandate health care for the poor, and above all else, no unions.
For-profit hospitals didn’t even exist in this country until a regulatory structure that favored them was set up during the Reagan administration. And once for-profit hospital corporations had crawled out from under a rock, they headed straight for Las Vegas, and undid a lot of Nevada’s health care laws. The Las Vegas hospital market is now unique, in that it is actually dominated by national for-profit hospital chains.
Not coincidentally, Nevada is what is called a right-to-work state. The labor laws in Nevada are totally different from those in what are commonly called union security states. In a union security state, once the workers in a shop vote to form a union by a simple majority of the votes cast, every worker in that shop has to join and pay dues. In a right-to-work state, though a majority of workers vote to form a union, each individual worker can decide at any time to join or to leave it, which has all sorts of implications for how one goes about organizing and sustaining a strong union, which I will get into later. When you look at a map of the right-to-work states, you are also looking at a map of the “red” states in presidential politics, the states with the worst schools and the most poverty, teen pregnancies, and other community ills.
The Gloves Come Off
To the Universal Health Services corporation, Las Vegas was like a freak oil well that never ran dry. In 2005, their Vegas hospitals generated 20 percent of corporate revenue, though they constituted a tiny fraction of UHS facilities around the country. From 2001 to 2005, the UHS hospitals in Vegas generated profits of $105 million, nearly as much as all the other Vegas-area hospitals’ profits combined. And that was just the figure they reported. There was another $85 million that they hid through an accounting maneuver called home office allocations: a corporation bills itself in one location and pays itself in another, so it can siphon money out of one region and stash it back home. Add that money back in, and the UHS hospitals in Las Vegas sent profits of $190 million out of the Nevada desert and off to King of Prussia, PA. UHS’s second most profitable regional operation was in New Orleans. Like Vegas, New Orleans was full of tourists (and thus of lucrative out-of-network health insurance billing), known for corruption, and located in a right-to-work state. This was the sort of business model one could expect from a cutthroat for-profit hospital corporation.
“Nothing less than depraved indifference,” was how Dr. Paul Verrette described the evacuation of Chalmette Medical Center, the UHS hospital in St. Bernard Parish during Hurricane Katrina. Verrette was medical director of St. Bernard’s emergency preparedness office. The Chalmette staff was left alone as power failed, water rose, and patients died. As nurse Charlene Gonzalez told the national press, “They left me to die and now nobody’s even called to say, ‘Thank you.’ ” Then, just a few weeks after the flood, UHS sent a message to its 2,800 hospital workers in New Orleans that everyone definitely heard: With the hospitals out of commission, their pay and medical benefits would be cut off in two weeks.
The CEO who signed off on these decisions was Alan Miller whose own pay had made him a multi millionaire. Miller was a personal friend of, and large donor to, President George W. Bush, and was closely aligned with him on issues like taxes, government regulation and unions. Presumably, Miller was not at all pleased when his employees at Desert Springs and Valley hospitals won contracts that set standards for pay, working conditions and patient care far above the prevailing Las Vegas norm. He hadn’t located four facilities out in a right-to-work desert to get pushed around by some upstart SEIU local, and now he decided to pull out all the stops.
In late March the management at Desert Springs hospital had begun sending workers to mandatory captive audience meetings. In a clear sign that UHS was targeting the whole union, nurses were required to attend even though the decertification petition was only for the technical workers. A nurse would literally be in the middle of a procedure with a patient and her manager would show up and say, “Stop what you are doing and get downstairs and report to meeting room A.” If she was one of the tougher ones, she’d say, “When I am finished,” which would win her about one minute, and then the manager would be back, threatening, “You will be fired for gross insubordination if you refuse to take this assignment. You must go down to the conference room, now.”
Brent Yessin probably thought he was playing good offense by forcing the nurses to attend the meetings, but he may have had second thoughts when he discovered just how staunchly pro-union they were. Before the first captive meetings, we brainstormed with worker leaders some creative ways to wreck the meetings. They would go to the meetings wearing their union buttons and immediately raise their hands and start asking all sorts of disruptive questions. They would clap at inappropriate times, pretend to fall asleep and snore as a group, and constantly interrupt to ask if they could go back to their patients.
For their next series of forced two-hour meetings, the Yessin team produced a scary video about SEIU Nevada. We dispatched organizers to buy hundreds of microwave popcorn packets and distribute them to all the workers as fast as they could. The break rooms at the hospital were all equipped with microwaves, and for the entire week workers walked into the screenings ready for the horror flick with popcorn in hand. In organizer shoptalk this is called cutting the tension.
By the end of April the average worker in that hospital had been through ten hours of mandatory captive audience meetings. Then management replaced the meetings with mandatory one-on-ones, working every intimidation angle they could. Evidently it had dawned on them that when you put workers who are organized and united together in the same room, even as a captive audience, the result is not exactly union-busting. Maybe their message would be more convincing in an isolation cell, er, a private office.
By this point access to the hospital by any union organizers had been severely curtailed. Our organizers had to notify management whenever they were coming. They would be given special badges on arrival and were restricted to three-hour visits, clocked by security. After a few weeks of this we knew we had to shake up the dynamic. We called the national union and requested one of SEIU’s giant purple recreational vehicles, and Sal Rosselli’s California local sent one. If the boss was going to essentially kick us out of the hospital, we were going to set up a new satellite office right outside the front door, with staff living in it round the clock ready to talk to workers from each shift as they took their breaks or came and left work.
That RV was emblematic of the overall tension cutting strategy that Yessin’s campaign required 24/7. Yessin had no legal right to limit our hospital access in the manner they were, but instead of trying to fight him through a legal challenge that would disappear into some mysterious government cubicle in the sky for a judgment from on high, we seized the opportunity to build more community, to build enough worker power that the restriction of our organizer’s access became irrelevant. Nothing raised the spirit of the workers quite like the day the big purple RV pulled up directly across from the hospital, covered with banners and balloons. We moved our entire operation out of the union hall and into the RV. And, partly because we needed to talk to every worker and to be able to react quickly to changes in the situation, and partly because some thug might vandalize the RV in a New York minute, so some of the staff moved in, too.
We brainstormed with the worker leaders on how to get their more timid coworkers out to our new headquarters. Just approaching the RV was an act of bravery, as Yessin had put it under surveillance. There were always at least three security guards there; they made a show of taking photos of every worker who crossed the street from the hospital to the RV. Our leaders thought that food might do the trick. The hospital cafeteria served hospital food. It seems like every hospital cafeteria is run by the same grumpy British guy with no taste buds. We stocked the RV with energy snack bars, quality candy, fruit, and drinks. At lunch and dinner we would cater in good local food and also held Mexican and Chinese nights.
That RV became the place to be. It developed its own microculture. The staff had lawn chairs spread out around it. The workers would walk up to the security men and do little skits for them, posing for their photos. “Wait, I need my lipstick, oh, and I want Sally with me, no wait, let me get some more people in the shot!” This was all great fun and serious organizing. Nevertheless, Morgan and I knew that although just about every Desert Springs nurse was visiting the RV, we weren’t hitting our goals with the technical workers who had the upcoming decert vote.
- The CEO, the Union Buster and the Gunrunner
As a result of my brief harrowing visit to Desert Springs hospital, we now had a picture of Brent Yessin, literally and figuratively. The platoon of union busters under his command, however, remained hidden. All the new security personnel were out in plain view, and of course we already knew the two union busting negotiators from California, Rick Albert and Larry Arnold. But as for Yessin’s lieutenants, the suits who were really running the operation, all we had were their first names. Worker reports on the mandatory captive audience meetings at Desert Springs noted at least five full-time people on his core team—and this is in addition to the countless security guards watching every move the workers made. Yessin’s gang included a couple of well-dressed women, former nurses they claimed, who were the “good cops,” sent to talk nicely to the nurses and techs; a guy named Byron, who said he was a behavioral psychologist; and Jose. Jose was clearly the “bad cop.” At the captive audience meetings he would get right in everyone’s face, asking over and over (completely illegally), “Are you going to do the right thing and stand with your unit manager and your patients and keep your job, or betray your patients and employer?” This was 2006, just before the dawn of the age of cell phone cameras, and photographing everyone everywhere anytime was not the bizarre social norm it would so soon become. We decided it was high time to unmask these goons.
The plan was to send one of our organizers, Morgan Levi, to crash a mandatory captive. Of course she would be kicked out, but, we hoped, not before she had eyeballed and photographed the union-buster general command. Morgan was totally up for this sort of thing—she wasn’t a body builder for nothing. Our core new leadership—Morgan, Jessica, and Maryanne—was cut from the same mold of tough-as-nails women:. This had become so normal at our local it was easy to forget that most union locals in this country are run by men. And it really worked for one that represented so many nurses, a profession that draws tough—and smart and socially conscious—women.
We had to pick the right captive meeting, one in which all the workers attending were solidly with the union; we didn’t want to alienate anyone. The big day came. Surrounded by a group of nurses, Morgan navigated undetected through the back halls of the hospital to the conference room behind the cafeteria where the meeting was under way. The nurses opened the doors and in walked the well-known star union organizer. The hospital CEO Sam Kaufman was personally addressing some techs, and at the sight of Morgan he stood up and began to belch orders about this being a private meeting. You could always count on Sam losing his cool, and making him do it was fun. The process of getting Morgan thrown out began almost instantly, but she got the photos we wanted, plus a good look at the whole setup of the suits in the room.
Beyond Yessin himself, this Jose character was clearly a real problem, as he was actually beginning to scare the workers. Choosing Morgan to crash that meeting was real serendipity because she discovered, much to her surprise, that she knew this man. His full name was Jose Salgado. He had joined one of SEIU’s organizer-training programs three years earlier, in another state, and it had been Morgan herself who had fired him, after less than a week. Now either this guy was here because he had a crazy thing for getting back at Morgan, which seemed unlikely, or he had gone as a spy to get the SEIU organizer training manual, or maybe being fired had pissed him off and instead of going postal, he’d done the next best thing and gone rabidly anti-union. Whatever the reason, he was working for Yessin, and if he hadn’t lost his notes and manual, they now had some sense of our playbook—though ours in Nevada was a bit different from Washington’s.
Luck further had it that Morgan’s father was a private investigator, and she asked him to do some PI-level background research on both Yessin and Salgado. The dirt he turned up on Salgado was a mother lode. Jose had been convicted of running guns. Lots of guns, the sort that could arm a drug gang. We could never have made up something like this guy’s arrest record. So that was the sort of operation Brent Yessin ran, infiltrating unions with convicted gunrunners. Here were all our fresh-out-of-college idealistic twentysomething organizers, plus nurses themselves who had become our organizers, illegally banned from a hospital where they admitted a convicted gunrunner, who had clearly been brought in to scare the workers. Blowing this jerk out of the water was going to be a pleasure.
We called the national communications team in DC to get advice on how best to break this news. My mistake: I forgot this would trigger a review by the SEIU legal department, which told us that we couldn’t use the information because we couldn’t say where we had obtained it. I was mentally kicking myself: I should have known better than to call D.C. Now that they had discussed it with me, I would be directly disobeying legal counsel if I broke the story. I could have acted first and talked to our lawyers second. I already had a reputation among them for this sort of thing, and I readily admit it was well founded. Lawyers, not surprisingly, get very caught up in the law. But the laws regulating unions in the country are pathetic, and the amount of attention that unions pay to them is one reason (among many) that the labor movement in this country is dying. It was legalized to death.
Don’t get me wrong here. The SEIU does have some excellent lawyers who are devoted to the labor movement. If some day I actually wind up in legal trouble I would be delighted to have a lawyer as good as them. The problem is that lawyers wake up each day and think about how labor leaders can get their work done inside a legal framework that is deadly to unions. I woke up every day and thought about how to disrupt that system. I respected and appreciated them—I just didn’t listen to them as often as they wanted.
Knowing when to listen to lawyers and when to ignore them is a key for an organizer. My own rule of thumb is this: If something I want to do might get me in trouble, I do it; if it might get the workers or staff in trouble, I don’t. Really good labor lawyers help people like me with militant impulses understand when to cut the crap. The very best also know that sometimes, ignoring them is part of the organizer’s job. When an action needs to be taken right away or the union will lose, you take it and resolve the legal issue later. We were fighting a decertification effort with enormous stakes. If we lost, UHS could kick the legs out from under a plan that had taken thousands of hours to assemble. If we won, we could create unprecedented standards for workers and patients in a right-to-work state, and a presidential swing state to boot. What drives me absolutely crazy is how so often over the recent history of the movement, labor leaders have followed the letter of the law when confronting the boss while throwing the book out the window when confronting each other.
After hanging up with our legal department, I called D Taylor over at the casino workers’ union. D said, “Get a copy of the complete arrest record with the gun list over to my office right away.” I had no doubt that very soon all of Las Vegas would know who Universal Health Services had brought into town.
We ran a sticker-up at Desert Springs hospital with a big round sticker like a shooting-range target, and across it the words “NO WAY JOSE!” The workers had never had so much fun with a sticker. In a matter of hours Jose’s power over them was in the hospital’s toxic refuse bins. People would shout at him in the halls. “Hey! It’s the gun runner; don’t shoot me!” Very quickly Jose vanished from Las Vegas.
Yes, there was a legal issue to resolve—after the election. The hospital filed a racial discrimination suit against me, claiming that “No way Jose” was a racial slur. And they distributed a flyer declaring that I personally had “maligned an innocent Hispanic man with a racial slur by using a common phrase with Jose in it and linking a Hispanic man to guns to attack his integrity.” Just as we had with the boss’s letters, we made hundreds of copies of these charges for all the workers. Now even the lawyers in D.C. were laughing on the phone with me.
The decert vote among the techs at Desert Springs was now just a few days away. The walls of the RV were covered with charts and assessments, papers strewn everywhere, food scattered all over. I would stop in to clean the place up at night and remind our young organizers that the much older techs and nurses didn’t live like twentysomethings. But the RV was fantastic. The hospital management had tried many times to get the cops to tow it away on one pretext or another, but they weren’t interested. We had supported the police union when they had been blindsided with awful arbitration, and we were currently campaigning together for the same County Commission candidates. And anyway, cops don’t like convicted felons in general, and gunrunners in particular. Neither do politicians, news editors, or pretty much anyone.
In public, Morgan and Jessica and I were brimming with confidence about the decert vote but privately we were in panic mode. We had scored a major victory running Salgado out of the hospital, but it was still a tough campaign. Hell, we had been banned from the hospital for just about the entire fight, while the workers were locked up inside with Yessin’s gang. UHS had run the most expensive A-level boss fight any of us had ever seen. By now we’d moved every good organizer we had to this campaign. In the final days, we house-called every single tech worker, and more than once.
I am not sure whether Morgan, Jessica or I slept at all during the last three days. Our get-out-the-vote operation was tight. We had individual plans for each worker we were certain would vote union. If we could get every one of them to the polls, we would win. The boss’s campaign at that point was just to get the workers to shut down, stay home, stay away, not vote. The voting was at the hospital, and on any given day half the workers are not on shift. That afternoon our organizers and worker leaders chased down workers in shopping malls, casinos, wherever the people who answered their door at home told us they might be.
When the polls closed, we headed to the official NLRB counting room inside the hospital. Yessin was there, smiling. Rick Albert was there from Foley and Lardner, smiling. Some of the rad techs who had been promised big raises for destroying their own union were there, and so was the CEO himself. It was clear that they thought they had won. You don’t send all the big guys to a vote count if you think you are going to lose. Shit.
The count began. Vote counts are seriously high drama. Everything slows to a crawl. The NLRB officials have to read all sorts of laws out loud. Then there is a whole protocol for the unsealing of the ballot boxes. No one makes a sound. When the paper ballots finally come out, the NLRB agents carefully unfold each one, iron out the crease at the fold, and place it face down on the table. After all the ballots have been prepared, they pick them up one by one and call out “yes” or “no.” Everyone in the room knows the magic number that means they have won, and a running tally is kept. In this case, the boss needed a yes vote: Did workers want to decertify the union?
The first few ballots came. “Yes. Yes. Yes.”
What? We were keeping poker faces but inside I felt ready to crack. And then it started.
“No. No. No. No. No. Yes. No. Yes. No. No. No. No.”
At the exact “no” we needed to win, we exploded. Yessin and the CEO dashed out of the room. The final tally showed the workers voted by nearly 3 to 1 to keep their union. I am pretty sure I got drunk that night in the bar across the street. We all did. It was a repeat of the contract victory from 2004, with everyone phoning everyone else, ordinarily well styled women arriving at the bar with no makeup, hair in rollers, spouses in tow, and everyone ready to party. I was so tired I couldn’t move, but still happy. Never had we seen such ferocious intimidation. We had a great time trying to imagine what Brent Yessin was saying on the phone to UHS CEO Alan Miller back in his corporate palace in King of Prussia, Pennsylvania, about the millions that had been spent on his losing effort to drive out the union.
 Nicholas Riccardi and Ellen Barry, “Hospital Staff Endures Storm, Faces Layoffs,” Los Angeles Times, September 20, 2005.