Subject: A Healthcare RX: Long-Term Problems Require More Than Short-Term Solutions: LRI Ink

November 20, 2023

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Happy Thanksgiving From LRI!

It's a short week for Ink staff in Broken Arrow, but we wanted to take a minute to wish all of you in the United States a very happy and safe Thanksgiving. We will be back next week with our usual full Ink newsletter.

The Workfront: Developing Labor Trends

Legit Grounds for a Strike?

Did you know that Starbucks has only three union contracts in all of North America? Those agreements are all in place in Canada, in provinces where collective bargaining operates under different rules than in the United States.  There are no contracts anywhere in the United States, and it’s unlikely that we will see one soon.


U.S. labor laws contain no provisions for mandating that an employer grant a collective bargaining agreement, which makes getting a first agreement very problematic for unions like Starbucks Workers United, which claims that "thousands" of workers at 500 Starbucks locations went on strike across the country yesterday in the second annual so-called #RedCupRebellion, demanding that Starbucks negotiate agreements more than 360 unionized stores. The very fact that this is the second annual #RedCupRebellion illustrates clearly how hard it will be for SBWU to get any type of agreement in these U.S. locations. One thing is sure: this tussle isn’t ending anytime soon, staying more heated than your morning latte.


Previewing the AI Ghost in the Machine

AI jitters among workers are plentiful and, in 2023, are being increasingly seized upon by opportunistic unions in an array of industries, including Hollywood. There, the WGA recently ended a 118-day strike with a contract outlining AI protections for writers and studios. SAG-AFTRA also finally concluded their 148-day strike, which means that Deadpool 3 and Stranger Things can now resume production, but what else?


Why it matters: The AI issue is urgent in the entertainment industry, according to Axios, which has created digital replicas of actors. But with the tech moving so fast, all of us will likely face disruptions soon enough, economists said at a Brookings panel this week. This makes AI a likely hot issue for unions to bring up during collective bargaining in many industries and even more likely to be used as a potential organizing issue where employees may fear being replaced by technology.


Worker Centers Flexing Muscles Again?

As more traditional labor unions like the Teamsters and the UAW have been dominating headlines in 2023, the once trendy labor organizations known as worker centers have taken a bit of a back seat, but that may be changing.

In 2021, hundreds of staff members at First Avenue, a Minneapolis music venue, began discussions about forming a union due to frustrations with wages, schedules, parking availability, and lack of a voice in the workplace. 


Unsure of how to get started, they reached out to the local workers center Restaurant Opportunities Center of Minnesota (ROC-MN).  Earlier this month, workers from seven First Avenue locations delivered a demand for recognition of their desire to be represented by UNITE HERE Local 17. A day later, management voluntarily recognized the union. According to reports, the unionization effort was successful based on the collaboration between the worker center and UNITE-HERE.


Worker Justice in Corporate Agendas: The Interfaith Center on Corporate Responsibility (ICCR) highlighted that worker justice has become a top agenda item for investors in 2023. A total of 37 shareholder proposals focusing on worker health and safety, paid sick leave, wage equity, freedom of association, and workplace sexual harassment were set to be voted on at annual general meetings.


Social Justice Campaigns: Some of the original worker centers, such as the Restaurant Opportunities Center (ROC) United and the Coalition of Immokalee Workers, have been active as well. ROC issued a report on workplace heat and a Restaurant Workers Bill of Rights, while the CIW has been working the retail grocery industry with corporate campaign tactics, including shareholder initiatives.


Allies on the Picket Line: a bevy ofsocial justice groups, labor unions like the AFL-CIO, UAW, and SEIU, along with workers centers joined Starbucks baristas on the picket line during the #RedCup Rebellion as you can see in the image below.  Look for this rebound in worker-center support for labor unions to increase in 2024.

A Healthcare RX: Long-Term Problems Require More Than Short-Term Solutions

It’s time for a checkup on the Kaiser Permanente saga, which means that some staggering numbers are coming your way. In August, we updated you on the consortium’s brief remission and returning strife following a 10-week California mental healthcare strike and a Hawaii sister strike that lasted 172 days. Kaiser also averted a strike by 21,000 nurses with 22% raises. 

 

The constant push and pull must be dizzying for Kaiser workers. They face burnout issues over the staffing crisis, and patients likewise endure lengthy appointment wait times. Kaiser feels all of this pain acutely, and third-party interference comes from the Coalition of Kaiser Permanente Unions, which pushed these recent developments: 


  • Kaiser experienced “the largest healthcare worker strike in U.S. history” when 75,000 workers, or 40% of all staffers, walked out for three days in November. This included nurses, pharmacists, housekeepers, lab techs, and more who ended up with a contract for 21% raises over four years. Separately, a Washington-focused strike landed those Kaiser workers up to 25% wage increases.

  • Kaiser ended up on the hook for a $200 million settlement with the California Department of Managed Health Care. This adds up to a $150 million investment in behavioral health and a $50 million fine.

 As a consortium, Kaiser manages healthcare facilities and is the U.S.’s third-largest health insurance provider. As such, it can be viewed as a healthcare-industry snapshot and provides some perspective.

 

Why Kaiser can’t dig out: Ongoing staffing shortages, mandatory ratios, and strikes are all forcing Kaiser and other healthcare providers to choose emergency stop-gaps in the form of temporary workers, who are not a magic-bullet solution and arguably even compound the staffing problem. Those ratios are favored by unions (and legislators who are lobbied by unions) and can be a short-term tactic that creates long-term harm.

 

A self-perpetuating cycle: Healthcare facilities that hire traveling temp workers pay them a premium that effectively doubles labor costs for those positions. This can breed resentment from permanent workers, which can cause even more burnout, turnover, and a never-ending, revolving door of staffers. This also means that far less money can be applied to longer-term, more holistic solutions. 

 

The burnout cycle also extends to medical education programs reporting faculty shortages, leading them to take on fewer students, which does not bode well for easing the staffing crisis. Add that to reports that up to 50% of healthcare workers aim to leave the profession by 2025. 

 

What comes next? None of the above ills can be solved by ratios alone if an industry is coming up short on overall workers. To that effect, Bloomberg recently quoted Daniel DeBehnke, a VP of Premier Inc. healthcare consulting firm, who suggests “opening up more visas for healthcare professionals, investing in universities to expand their medical programs, or getting creative on a corporate level to free up funds.”

 

All of this is much easier proposed than done. Sooner or later, however, the healthcare industry will find the wiggle room to move past the illusory solution of ratios and focus on more comprehensive solutions – for the benefit of patients, workers, and hospitals. 

 

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About Labor Relations Institute

LRI exists to help our clients thrive and become extraordinary workplaces. We improve the lives of working people by strengthening relationships with their leaders and each other. For over 41 years, LRI has led the labor and employee relations industry, driven by our core values and our proven process, the LRI Way.

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