Unions make inroads in healthcare

In April, unionized nurses at the Quincy Medical Center in Massachusetts ended a one-day strike over looming job losses, only to see 30 of those in their ranks laid off the next day.

A month later, in Worcester, Mass., the UMass Memorial Medical Center and the union representing 1,100 nurses reached a contract agreement that narrowly avoided a strike there, guaranteeing maximum patient-to-nurse ratios.

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Three thousand miles away, two major healthcare worker unions recently joined forces, arguing that they could better fight concessions sought by hospitals and healthcare companies in California.

The past year has been volatile in health care for workers and employers alike, and experts expect more of the same. Sometimes the victors are employees, sometimes employers. But more often than not, they are the unions.

Several factors make health care a particularly attractive battlefield for unions this year. Among them: the pending Affordable Care Act; recent actions by the National Labor Relations Board; a wave of mergers and acquisitions among healthcare facilities; and the growing frustration among America’s nurses and physicians, according to labor relations experts.

Most importantly, with a new National Labor Relations Board in place, unions feel they finally have an edge.

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As James G. Trivisonno, president of IRI Consultants, noted in the introduction to the 40th Semi-annual Labor Activity in Health Care Report, “The past several months have seen a flurry of activity from the National Labor Relations Board (NLRB); with a series of high-profile decisions issued in the last few months of 2012. These decisions … have a potentially major impact on healthcare employers in union and non-union settings … In many cases, the Board has acted to give unions and employees far more latitude and preference in disputes with employers.”

Beyond the regulatory battles, there are other reasons why health care is so attractive to unions, Trivisonno said in a recent interview: “Health care is one of the only industries that is adding jobs. Health care is one of the largest employers in any market. And it is an industry in turmoil. It is a really good target.”

According to the IRI report, industry-wide, labor unions saw a decline in membership in 2012 of approximately 400,000. More telling, union membership in the U.S. workforce fell to 11.3 percent, its lowest rate in 97 years.

However, in 2012, unions won 72 percent of representation elections in health care versus 61 percent in non-healthcare industries, Trivisonno noted.

“Healthcare unions will continue to achieve strong positive results from organizing nurses, technicians, and other healthcare workers since healthcare reform is placing greater pressures on hospitals and health systems,” Trivisonno said. “Employee concerns about the implications of flat or low wage increases, rising employee contributions for benefits, the introduction of wellness programs, workplace changes, and greater merger/acquisition deal activity could lead employees to be more prone to the promises of union organizers.”

G. Roger King, a labor relations expert with Jones Day blamed the merger-and-acquisition frenzy for much of that. “The pressure will continue. We’ll see a lot more of that activity,” he cautioned.

King agreed that unions are taking advantage of a more-friendly NLRB environment, and that isn’t going to change soon either.

Especially ripe pickings for the unions are nurses, said John Lord Jr., a partner in the Labor & Employment Practice at Foley & Lardner LLP. While Lord has clients in a wide range of industries, many are in the healthcare space, and he is a member of the firm’s Health Care Industry Team.

Unions focus on the nurse-to-patient ratio and not so much on mandatory overtime hours. “The unions talk about and focus on patient safety issues. That’s a way to get in,” he said.

Many physicians and nurses are frustrated in general, many of whom see the industry in chaos, working conditions in decline and expectations on the rise. Across the board, healthcare workers are looking for the Rx to their situation.

“Union membership has been on the decline for a few years,” Lord said. “The unions are looking at who would be good recruits. They see health care as a good target industry. And it is working.”

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