Monday, July 30, 2007

Pages from the Playbook

I have received lots of questions recently from hospital colleagues and others wondering about the status of the Service Employees International Union's apparent plans to organize the Boston teaching hospitals and BIDMC in particular. So, here's the latest, as seen from the corner of Longwood and Brookline Avenues.

Several months ago, I pointed out the type of approach employed by the SEIU when seeking to organize workers in hospitals elsewhere in the country. It consists of publicly denigrating the reputation of the targeted hospital, its senior management, and its board of trustees in an attempt to put pressure on the hospital to agree to certain concessions in the union certification process, i.e., either to agree to a "card check" form of organizing to replace elections or to agree to a so-called "neutrality agreement" during the elections to enhance the probability of winning a certification vote.

A key element of this tactic is to attack the hospital for not carrying out key aspects of its public service mission, aspects inherent in its non-profit status. In this way, trustees are meant to face embarrassing questions from their colleagues in the business world and the community on issues of general concern. "I hear your hospital is not taking care of poor people." "I hear your hospital discriminates against minorities."

Here's how it works in detail. Any hospital the size of BIDMC ($1 billion in revenues, hundreds of thousands of patients, millions of square feet of space) files tons of documents with federal, state, and local regulatory agencies. The union hires several dozen bright, committed young researchers and tells them to scour every line and item in all these reports. You look for inconsistencies, ambiguities, and patterns, and then you issue a public report stating that the hospital was incorrect in the handling of a certain matter or knowingly misrepresented some issue or other. You also ask for a review of the matter by a legislative committee.

The key is to pick a topic that garners a headline and public concern, like provision of care to poor people. It is also helpful to pick an arcane accounting issue that few understand, so that a cogent and concise rebuttal by the hospital is virtually impossible in the regular media.

(Meanwhile, SEIU will point to its membership and participation in various state bodies (like the Connector Authority board) as the rationale for raising these items. It will say that its concern has nothing to do with union organizing or this particular hospital but is only reflective of its interest in matters of public import.)

The next page in the playbook is an important intermediate step. You send letters to the homes of the hospital's board of trustees asserting that they are not carrying out their fiduciary responsibilities in properly supervising the management on the matters raised. Later -- if there is no response or if you don't find the answer fully responsive -- you publicly assert that the hospital's board is not sufficiently diligent about those responsibilities.

And now let's speculate about the next play that could be used to support that proposition: An expose might be released about specific poor people who arrived at the hospital's emergency room and did not get the care to which they were entitled, or who were later hounded by a third-party collection agency. Here would be a vivid (and media savvy -- although I truly hope that people are not used in that fashion) demonstration of the institution's insensitivity to the poor and also a portrayal of the board as ineffective in insuring that the management carries out its public service obligations.

And, what if the patient stories are exaggerated or untrue? Well, since a hospital is not allowed to discuss individual patient cases under HIPAA or state law or under the hospital's quality assurance peer review process, it would be left to give a general response that will not appear persuasive in the public eye.

And so it begins. We are only a few pages into the playbook so far. My colleagues wonder: Is the SEIU taking steps in preparation for a unionization drive at BIDMC, or is it sending a message to other hospitals in the city that it will attack anybody who has the nerve to speak out against its tactics, or both?

And please remember: No matter how this discussion is characterized, this is not about the right of workers to organize, a right we all support under the laws of the nation.

37 comments:

Anonymous said...

Well said! It is important to understand the story behind the story.

Anonymous said...

Paul;

I read somewhere a few months ago that you were the only hospital CEO in Boston to publicly criticize the union and therefore it seems your hospital has been targeted first. This was an interesting post and we will now all follow it in public.

Something apparently similar recently went on in California (see link below). I found out about it after the fact and therefore don't know if it's relevant but may be of interest:

http://www.chicoer.com/indepth/enloe/

See the header "Backgrounder" toward the lower right.

Lyss said...

Not certain how to contact you to compliment the Telemetry staff:
http://involuntaryslacker.blogspot.com/2007/07/what-is-telemetry.html

Elliott said...

So why not come out and say that you will support a card check organizing effort or will remain neutral? It's ridiculous for you to assert that this has nothing to do with the right of the union to organize in principle, but for you to oppose unionization in practice.

If, and when SEIU comes to BIDMC, I can assume management will not remain neutral. I also assume that there are valid reasons for your opposition. I expect that your anti-union educational efforts will not be fair and balanced (unless we are talking the Fox News definition). Why should the union not play by the same rules.

Paul Levy said...

Thank you, Lyss.

Anonymous said...

Paul,

Since the purpose of hospitals is to serve patients, it seems that the cogent question is: Do hospitals that have unions serve patients better overall than hospitals that don't? Is there any real data here (not just anecdotal events)?

In the auto industry, Toyota and Honda have no unions (including their many US-based factories), while GM, Ford, and Chrysler do. Since Toyota and Honda are gaining market share in the US and elsewhere while GM, Ford, and Chrysler are losing share, it seems clear that automakers without unions serve customers better. Consumer Reports assessments concur with market share results.

PJK

John said...

The union's sole objective is to win the the right to represent your employees. It has been my experience in years of dealing with collective bargining that the union has no concern about the well being of your patients, rather they concern themselves exclusively with promoting the objectives of their organization and membership. I commend you on your willingness to openly confront the hypocrisy of the techniques that they are willing to utilize.

Matt said...

This is an excellent post showcasing the different forms in which a hospital might be threatened.

The topic of unionization in hospitals kind of rubs me the wrong way. To quote your first posting that I just read:

"For me the underlying question is whether a union at BIDMC would enhance your ability to deliver the kind of patient care that is so important to all of us, to strengthen our research program, to improve our education programs, to strengthen our ability to serve the community, and to improve our employees' chances for personal and professional development and advancement."

This sums it all up for me, I feel the exact same way that you do given a need for a Union at any facility. It would seem to me if employee relations were to the point where a Union was needed, the CEO would have been gone long before. To often I hear of the short longevity of hospital CEO's due to the fact they have to keep the board happy, the doctors happy, and the employees. Then I bet there is some whole academia issue a teaching facility CEO has to deal with.

In my hospital, employee relations, and satisfaction seem to be such a core interest to our executive team.

Again though, Thank you for the detailed look at the challenges you face.

Anonymous said...

The initial cause for unions was to avoid worker exploitation and unsafe working environments. I don’t see this happening at BIDMC If a Hospital or business provides a good safe place to work with decent benefits and livable wages for all its employees than there is no need for union intervention. That being - said I do feel there are still places of business that could use a union…

Maybe the SEIU should be looking at Wal*Mart????

ERMurse said...

Hardball tactics, some might say terrorist tactics, are used by both sides when it comes to union organizing or preventing it. Your description of SEIU's tactics is very accurate. You can add trying to halt or hold hostage hospital expansion with numerous lawsuits to the list.

There is also another side to the story. I have also seen very well intentioned rank and file employees of all types trying to bring representation to a facility suddenly find themselves under investigation. Pure coincidence I'm sure. I have seen people who fit this description have their email and web surfing activity, charting, medication administration, and a variety of other activities combed over. When a policy violation or discrepancy is found the person is fired or disciplined. The net effect is intimidation of anyone who sticks their neck out trying to organize their co-workers or engage in patient advocacy.

Anonymous said...

Most employees do not want a union which is why the SEIU has chosen the tactic of avoiding a seceret NLRB supervised election. With "neutrality" there is no counterpoint to give the employees a real choice. This union is really about its leaderships' power ambitions hidden in the wrappings of populism.

Mike Fadel said...

Statement From Mike Fadel, Executive Vice President,
1199SEIU United Healthcare Workers East, 8/1/07

Paul Levy’s blog entry of 7/30/07 did something intellectually dishonest: He did not respond to the content of two serious pieces of research on BIDMC’s potentially inappropriate billings to the Uncompensated Care Pool and accounting of Charity Care and unusually high billing for Boston’s uninsured. Instead he used a tired rhetorical device of attacking the messenger.

The tactic of decrying critics of an institution’s policies as being somehow disloyal is something that we might expect from the Bush administration. It is not something that should be coming from the leader of one of Boston’s most important healthcare institutions. The act of demanding a community institution uphold its social mission and obligations is not something that warrants a broadside attack.

It is as offensive as it is inaccurate to say that the largest union of healthcare workers in the United States doesn’t actually care about the delivery of care.

We are proud and honored to be among the organizations leading the campaign to win access to quality affordable healthcare for everyone in Massachusetts, and to be in the leadership of the national fight to expand the State Children’s Health Insurance Program (SCHIP). We are also leading the efforts to save and expand Medicare and Medicaid, to ensure hospitals and nursing homes are staffed safely, and to create a Training Fund that ensures caregivers have access to the education and training they need to provide the best care possible. By being in the forefront of campaigns throughout the country to make healthcare a right for all, we have won funding that not only has provided access to care for patients, but that has also greatly benefited the healthcare institutions - like BIDMC - where care is delivered.

We have raised several concerns with BIDMC’s management and Board, which Paul Levy sidesteps in his blog entry, but which continue to warrant a detailed response. The concerns are outlined in reports that can be found at

http://www.1199seiu.org/media/news.cfm?nid=1394

We believe that our research shows the following:
• BIDMC appears to have the most expensive E.R. costs for uninsured patients covered by the Commonwealth’s Uncompensated Care Pool (UCP) fund;
• BIDMC’s charity care reporting to government agencies and to the public appears to be misleading and incomplete;
• BIDMC revised its stated un-reimbursed charity care figures down 30% in 2005 with no explanation;
• BIDMC billed Emergency Bad Debt at an abnormally high rate to the UCP in possible contradiction of UCP regulations.

Yes, hospital workers in every teaching hospital across the city, including but not limited to BIDMC, have begun organizing a citywide campaign to ensure their right to free and fair union elections.

But there is only one answer why, among all the Boston hospitals where organizing is taking place, BIDMC is the focus of the reports: It is because they are the outlier on the issues of high ER costs to the uninsured, problematic charity care reporting, and bad debt billing to the state.

These are serious issues deserving of serious review. Indeed, we believe they deserve more serious consideration than a back and forth on a blog. That being said, we did feel that Mr. Levy’s entry warranted a response in this forum.

Paul Levy said...

I have to admit that Mr. Fadel is very good at turning a phrase and, indeed, at offering responses to things I never said. I don't think I said that the union is disloyal. (By the way, how can you be disloyal if you are not even part of the organization in question? Disloyalty implies an underlying relationship that would ordinarily encompass loyalty.) Likewise, I don't think I said that the union doesn't care about delivery of health care. I said that it employs certain tactics as part of its organizing campaigns.

Odd, too, that he compares me to the Bush administration. Where on earth does that come from? Why is it persuasive on these matters? Is it some kind of attempt to portray me as -- ohmygosh! -- a Republic loyalist in largely Democractic Massachusetts? If I were (and I am not, by the way), would it matter in any way?

We do agree on one thing, apparently, that here are better forums than a blog like this to delve into technical accounting questions.

Anonymous said...

Dear Mr. Fadel;

I am a retired physician who lives considerably south of Boston and have never been to any of its hospitals. I read Mr. Levy's blog because many posts remind me of my own experiences during my practice. Unions are entirely outside my experience, as my hospital system was not unionized, although several in the metropolitan area were. So let me ask a simple question:

My understanding of traditional unionization in the U.S. is that it occurs as a consequence of "unfair" (e.g. low wages, poor working conditions, nasty/arbitrary management, wholesale layoffs, etc.) treatment of employees
by management. In fact, the hospitals in my area who were unionized had experienced exactly these or similar problems.

My question is, what is the relevance of all the points you have raised, to the reason you (should)want to unionize Boston hospitals? These are unrelated to the purpose of a union, despite all your undoubted good works.

To forestall a reply about how you were responding to Mr. Levy's statement that the union doesn't "care about patient care" - I interpreted his statement to mean that a union would want to drive up wages and benefits, drive down working hours,etc., and therefore weaken the hospital's staffing in an already difficult environment. While this may or may not be true, complaining about BIDMC's billing practices or charity care seems to do what you accuse him of - sidestep the real issue. Are workers being treated unfairly at BIDMC?

From an outside reader's perspective, you seem to be using exactly the tactics that he predicted.

patientme said...

These are deplorable tactics on the part of the union. I don't think that I want any organization that acts in this manner to be involved in any aspect of my healthcare. I have always been treated with compassion and respect as a patient at BIDMC - I suspect that would be hard to pull off if the staff there did not feel engaged and cared for in their place of work. And, by the way, if there is one aspect in which BIDMC is an outlier, it is in pushing the envelope on greater organizational transparency.

I agree entirely with the comments of the retired physician (anon 7.50) above. As I read Mr. Fadel's note, it seems to be full of verbal code language and subliminal messaging that seems to muddy the issues raised. The Bush administration - huh???

Barry Carol said...

One of the factors that account for the very high healthcare (and health insurance) costs in New York City (and the state overall) is excess hospital capacity, especially in NYC. An independent commission recently developed a plan to restructure the system which includes closing a number of hospitals and downsizing or reconfiguring others. One of the key opponents fighting this effort is SEIU 1199 and its political friends in Albany.

While the restructuring would save money, it also means that jobs would be lost including those of some SEIU 1199 members. The union's main priorities are to maximize the number of dues paying members and to maximize its members' pay and benefits. If the union cares about such issues as healthcare quality and costs or the economic competitiveness of New York City and the rest of the state, it is well down their priority list from the first two. The more members it has, the more dues it collects and the more political power it wields in Albany and NYC to further its interests at the expense of the rest of the public.

Paul Levy said...

Another thought on Mr. Fadel's comment. I was so taken by his writing skills and the need to respond to his choice of wording that I neglected to make a couple of substantive points. First, the accounting issues brought up by the SEIU in their reports are complicated. But please rest assured that all the calculations and figures prepared by BIDMC are subject to full review and audit by several governmental bodies, and we have always been ready and willing to discuss them at length with the appropriate oversight bodies in the legislative and executive branches. Second, please know, too, that our hospital's commitment to serving the poor and the underprivileged is unwavering and constant. That is a heritage of both the BI and the Deaconess that is extremely important and part of our ongoing practice.

Anonymous said...

Paul;

I am anon 7.50, and you speak to the issue I forgot to add - that is, all of the issues Mr. Fadel raises are subject to oversight by regulatory and/or governmental bodies. The IRS and Congress are even now looking into how much charity care is provided nationally by nonprofit hospitals, so this is high on the agenda already. It would seem the union should concentrate on its primary mission of ensuring fair and safe working conditions, rather than repeating work others are already doing.

Anonymous said...

I do not favor the tactics of the SEIU but I think the issues they, or others, raise about whether a hospital is doing "enough" to justify its tax exempt status is a valid point of discussion. Most large not-for-profit health systems and hospitals across the country can show little to differentiate themselves from the for-profit systems. Also in the past sloppy accounting of charity care have caused the numbers in many hospitals to be understated. In know in our state you saw a dramatic rise in the percent of charity care in 2005 and 2006 because this issue was being highlighted. Do some hospitals deserve to have their tax exempt status removed? I think the answer is yes. This is not an indictment of all tax exempt hospitals but we as an industry created our own dilemma to some degree.

Anonymous said...

Not weighing in for one side or the other - I'm pro-union, especially the SEIU, despite their shortcomings, and I also think that the BIDMC is a wonderful place to work, despite its shortcomings.

So just a sidenote: The SEIU's strategy of focusing on charity care, or lack thereof, has hard-hitting financial implications, in addition to the PR impact.

Over the last calendar year, Provena in Illinois paid 5 million in property taxes after the state revoked their tax-exempt status, finding they had not performed enough charity work.

At the time that Provena lost their tax exempt status, "a policy director at the Service Employees International Union (SEIU)—an active critic of hospital billing and charity care policies—predicted that the decision will prompt hospitals to expand their charity care programs, an action the SEIU has long endorsed. " (advisory.com, 10/13/06)

MI said...

It's a good point--unions began to deal with poor working conditions/wages/etc.

So to respond to those of you wondering if workers at BIDMC are happy:
In a country where health care (all!) workers are, year after year, required to pay more money out-of-pocket for health insurance; we are losing vacation and sick time; after years of dedicated service to our facilities, while the cost of living is increasing, our wages are being capped; why don't you ASK the BIDMC workers if they're happy with their wages/benefits/working conditions?

Ask them.

Ask them, off-site, without management around, without the use of "3rd party" consultants who set up surveys on computers AT WORK.

Just ask them.

I can guarantee you, that's what union staff will be doing before talk of any union election.

Anonymous said...

Because of the nature of my current position, I must respond to this article anonymously. However, I was present at a management level in a for-profit California hospital when the SEIU began its organizing efforts. They were simply the most ideological, scurrilous bunch of people I have ever had to deal with. Through virtual capitulation on the part of hospital senior management , SEIU prevailed. It has fostered a mentality among its members that is absolutely antithetical to the concept of professional patient care. It has wrecked the communal atmosphere of our local hospital and replaced it with an attitude typically found among mercenaries. What appalled me most was the complacency or naivete of our senior management when there was still time to expose SEIU for what it is and to wage a battle for the hearts and minds of our staff... a battle, by the way that could have been won. Now we have groups like the SEIU and CNA dictating the terms of healthcare in this state. The last thing that they are interested in is the welfare of the sick.

Paul Levy said...

To anon Aug 6, 11:44,
(I removed a commonly used, but unpleasant, word from your posting and have reposted the rest of your comment here. Sorry about the editing, but I am trying to avoid that kind of language in this blog.) This is the rest of what you said:

'Unions do not exist to defend "the little guy" merely instead insert their bloated structure into an already overbloated expensive system - allowing new cash cows to sip at the trough.

'Don't like working at BI? Get a job at one of the zillions of hospitals in the midwest that desperately need you.'

Anonymous said...

Wow. Mr. Fadel proves that a little knowledge is a dangerous thing. "Emergency Bad Debt" is what happens when a hospital can't get paid for taking care of people with emergency (not elective) catastrophic injuries or illness who arrive in their emergency departments. Worse, not all patients survive that situation. Is it shocking that a non-profit medical teaching facility founded as a charity doesn't (and in some cases can't) chase patients to the ends of the earth for payment? It is horrible for Mr. Fadel to reduce these the reality of these daily human tragedies into a distorted tale of dollars and cents. Bravo to you and your medical miracle workers in Boston. Perhaps Mr. Fadel would be satisfied if you bludgeoned severely ill patients with paperwork before attempting to save their lives in your Emergency Room.

Anonymous said...

as a registered nurse, I have never and would never wish to work in a hospital that was unionized. I don't trust them, find them to be totally self-serving, and not interested in the welfare of the people who are in the hospital to begin with, as pointed out by several of the excellent comments posted.

Anonymous said...

wow! good for you exposing the tactics the unions are allowed to use to gain membership. Well said and thank you!!!

Unions have no place in healthcare. Go back to the factories where you belong. The well being of me and my family is just to darn important to be played with in this fashion. With the $$ I spend on health insurance I expect the very best care - and I sure don't think a union is qualified to tell me about it.

Chris
NH

Anonymous said...

Dear mi;

I am the retired physician who posted the comment above to Mr. Fadel. I AM asking - are BIDMC workers treated fairly? Let them say so in this blog, from their home computers if need be!

But the next question inevitably is, would a union improve that situation without "side effects"
unpleasant to the worker as well as to management?

You must decide.

Anonymous said...

I followed Mr. Fadel's link and reviewed the SEIU report in full. Before I comment let me say a little about myself. I am a nurse. I have worked in healthcare for more than 20 years, in both staff and management roles in 3 of the 21 organizations listed in the report. This includes both community and tertiary hospitals, union and non-union, safety net and non-safety net. I am currently in a management role. I know operations well, hospital financing makes my head hurt a bit.
With that said, here are my concerns about the SEIU report. The report is based on "20 largest hospitals". This implies that they are comparable, they are not. You cannot compare the cost basis for community hospitals with academic medical centers, as this report does. You cannot compare the cost basis for emergency rooms providing adult level I trauma care (6 of the 20) with those that do not. You cannot compare the costs of hospitals with inpatient psychiatry (few) with those that do not. The list name ("20 largest hospitals")is actually misleading as it includes networks, not hospitals (ie., Southcoast, Hallmark, Northeast Hospital Corporation) all of which only become "large hospitals" by aggregating the beds in a number of small community hospitals. So, all in all, an apples and oranges mix, clearly constructed to tell a particular, inflamatory, story. It should be understood as such, and not as a valid comparison.

Anonymous said...

It appears that the unions have finished their work in the auto industry (nice job!) and are now switching to a less complex one, healthcare. Great choice!

Anonymous said...

The issue of having a union "represent" employees is indeed very complicated. The problems that usually makes staff want a union are not.

I work at BIDMC.

First, I very much intend to retire from BIDMC. I have worked as a nurse in several other hospitals and I find that BIDMC and I "fit".

Second, unions have both benefits and detractions and can be held to both sides of an opinion depending on one's view of the problem.

Third, union's are usually "invited" by employees for introductions and feeling out periods. If BIDMC's RN's are seeking out this type of representation might there be a problem at BIDMC?

I see the problem of the need for unions is the inaction of BIDMC management to solve little problems. Let me present two issues that are buring on the various floors at BIDMC.

Meal breaks: They don't exist as a nurse. To work 8-12 hours without a break is unsafe for the patient and the employee. I can honestly say in my past few shifts that I have not even had time to run to the rest room. Meal breaks are required by law, in addition to a 15 minute break. On my floor there is in excess of 13 hours of meal and break time in a 24 hour period for nursing staff. How does one go to break when you need to sign off to a colleague and they have 5-7 patients of their own and now they need to cover your patient assignment? They cannot. Increase staffing to allow for the breaks. You'll have a happier staff and in return happier patients.

Vacation: At BIDMC it is called ET time. It is the lumping together of vacation, sick and holiday time into a "bank" that the individual must manage. As a nurse at BIDMC, department dependent, you must work weekends. There is no exception to this rule. The usual rotation is once every three weekends, some are every other, and even fewer work every weekend.

The problem is that this requirement is met by an additional policy that you cannot use vacation time on weekends. Let's looks at this again. The RN must work weekends and in doing so accrues ET time. However, you cannot have weekends off using ET time.

So, how does one get weekend time off? The RN must self arrange swaps with other staff. This usually invovles working a different weekend for someone else and they then work for you at a later time. BIDMC uses these swaps to save millions of dollars in overtime each year. A HUGE benefit for BIDMC.

This in turn might cause an RN to work 60 or more hours in a week to get time off later. These hours are at straight time, to avoid the overtime payment, as it is a swap.

The other more critical event is the sick call. Staff whom do not get coverage call in sick. This then creates a staffing hole that goes unfilled or filled with an employee at over time. In the end this one sick call results in compensation of between time and one half to double time. Add that to the sick time pay and the cost of filling this 12 hour shift can almost equal 36 hours of pay. Where is the rationale in maintaining this policy?

How about giving your staff weekend time off? I agree that it cannot be a free for all, as everyone would take weekends off. It would seem reasonable to provide two weekends a year off, with the hospital left to cover. A system with the allowance of one summer/fall and a winter/spring weekend off would be fantastic. After that then revert to the current system that is widely held to be unfair and of questionable legal status.

Paul, fix the small stuff and your nurse's will not need a union.

Narsbars said...

You said, "An expose might be released about specific poor people who arrived at the hospital's emergency room and did not get the care to which they were entitled, or who were later hounded by a third-party collection agency."

You issued no denials, you showed almost no concern for the patient if it did happen and did not promise to make sure it would not happen.

You also said to paraphrase "asking for a fair atmosphere to hold elections in, is not something we will do"

You may be judged by your own comments. Your true concerns, certainly not the patients or your employees are so obvious I do not need to be a medical expert to diagnose greed and "control freak" syndrome.

Paul Levy said...

Dear nasbars,

I was predicting the use of that tactic by the union. I don't know of any such patients. If I ever heard of any such, we would certainly act to remedy the problems. But, by the way, HIPAA would preclude us from discussing the case publicly.

On your second point, it is hard for me to imagine how anything I have said amounts to not wanting or having fair elections. And, please remember, it is this union that has supported legislation to eliminate elections altogether.

On your third point, I expect to be judged by both my comments and my actions. I don't know if we have ever met, but your use of personal attacks is not worthy of this debate. It is particularly inappropriate if you chose to remain anonymous.

Narsbars said...

So, your comment is "it didn't happen and if it did happen, we can't discuss it". Clever.

There was no personal attack in my comments, only if you choose to see your own reflection in the description.

You obviously hate Unions and would not engage in discussions if you could avoid them.
The SEIU is not trying to do away with elections. The SEIU is trying to do away with employer intimidation of pro Union employees. What part of "If a majority" of employees sign cards don't you understand?

Will you personally agree to work for only TEN times the salary of your lowest paid employee and have the same benefit package?

Will you agree to have your benefits and pay set by a council of employees with no input from you?

Hospitals all over the country have denied input from their nurses re patient care. They have fought having an impartial arbitrator be a part of the process.

You impugn Union and your supporters say it all about dues.
Please post your salary and benefit package and then we can discuss the issue.

Paul Levy said...

I have posted my salary on this blog, and it is also public information in the From 990 filed with the state,and is written about in the Boston Globe every year.

Eve said...

It is clear that you know very little about union organizing.

Unions don't "target" a company without there already being a quorum of people at that company who want to be unionized. As anyone can see from reading the comments on this post, clearly there is a need for a union at Beth Israel. There are concerns that are not being addressed any other way, and unionizing is the only way workers can be heard and not feel their job is threatened.

The only compassionate, decent thing an employer can do when faced with a request from their employees to unionize is to recognize their union and bargain fairly.

As a Boston resident who is searching for a hospital to use for ongoing care, I will be watching closely to see how you respond to this situation. I will not support a hospital that engages in union-busting tactics and treats its workers unfairly.

Paul Levy said...

Eve,

There is a process under federal law that can be used for organizing here or at any other hospital in Boston. We support that process. That has never been at issue.

Eve said...

The current system of employment is inherently unjust for all employees. Without a union, it is fundamentally UNSAFE for any employee to talk about unionizing, or anything they are unhappy about, without being fired for no reason. Without a union, employers have the right to fire employees for no reason whatsoever.

So anything that can be done to give employees more access to unions, to make it easier for them to become unionized, is a good thing.

Unionization in health care is the ONLY thing that will save the disaster we call our health care system. Currently it is run by corporate interests and for the benefit of making a profit, not taking care of people. When we start taking care of the people who are actually doing the work on the front lines, when we start listening to them, then maybe we will have a functional health care system.