If you hadn’t noticed, the next round of unionization will come in the big service industries. This is going to build over time, but health care services will be the biggest push because (with the obvious caveat about overseas surgeries) it’s hard to move health care jobs off-shore, and it’s hard to replace labor with technology in those jobs (though lots of people will be trying!). So if you’re a hospital chain how do you handle the fact that the SEIU is targeting your industry? You basically have two choices. Enter into a partnership agreement with the unions and hand over a small slice of the vast profits you are making as an organization to your workers. Or tough it out, continue to make as much as you can, and let the unions eat cake.
In Northern California we have both examples. Sutter is deciding to essentially risk its non-profit status by being not only the consistently most expensive provider chain, but having a nasty fight with the SEIU at its most profitable hospital, Cal Pacific. And of course the unions are highlighting the amount of money they’re making and helping get the Department of Justice to investigate.
Kaiser Permanente on the other hand has a big deal with its unions in which everyone gets a decent pay rise (at a time when KP is making bank, one might add) and about which the unions are deliriously happy. Here’s what the union rep said.
"This is the best (union) contract in the country," said Sal Rosselli, longtime president of SEIU’s Oakland-based United Healthcare Workers West and its predecessor, Local 250. "It’s the best contract we’ve ever reached with a hospital system." Praising Kaiser for including workers in every stage of planning, Rosselli called it "the opposite extreme" from Sutter Health, which runs California Pacific Medical Center in San Francisco, now in the third week of a bitter UHW strike. "Kaiser is serious about being the health-care provider of choice," he said, "and to do that it needs to be the health-care employer of choice."
Given that there is a huge connection between employee satisfaction and patient/member satisfaction, Kaiser might be on to something. Either way, at its current rosy spot in the revenue cycle, it’s a little odd that Sutter is drawing such a strong line in the sand. Perhaps someone wiser than me can explain why.