Two-Day UC Strike Unlikely to Sway Bosses

A strike by nurses and other patient care workers at University of California (UC) hospitals and medical centers entered its second and final day Wednesday, despite efforts by the California Public Employment Relations Board (PERB) to block some employees from participating. UC officials said it would “threaten public health and safety,” the SF Appeal reported this week. The dispute involves over 12,500 employees, who are represented by the American Federation of State, County and Municipal Employees Union (AFSCME). Hundreds of members of the University Professional and Technical Employees Union threatened to join in a one-day sympathy strike on Wednesday.

According to AFSCME officials, the PERB injunction only barred around 120 employees from participating. Almost twenty-four of them had already been exempted from striking under the union’s “Patient Protection Task Force,” which allowed them to cross the picket line to help maintain emergency patient care.

UC officials predictably condemned the strike, saying it would cost them $20 million “to ensure patient safety” for two days, while completely ignoring how their own policies endanger patient safety every day of the year. Some of these policies include downsizing patient care staff, which reduces the ratio of nurses to patients. It has also resulted in a reduction in the Lift Teams used to shift immobilized patients in order to reduce bed sores and increase circulation. This is one of the more dangerous responsibilities of patient care workers because of the risk of lower back and other injuries and it becomes even more risky when there aren’t enough staff members to do it safely.

In an attempt to vilify the union and turn public sentiment against them, senior vice president for health sciences and services, Dr. John Stobo, said “It is completely inappropriate to threaten services to patients as a negotiating tactic—the health of our patients must not be held hostage.” Another official said that the staffing reductions were an inevitable consequence of revenue losses stemming from Obamacare (or the Affordable Health Care Act), which is reducing Medicare and Medical payments. Yet, according to one union member, the university’s hospitals have been making over $100 million in profits every year for the past 15 years (KPFA Morning News, 5/22/13), while administrative salaries have soared. In reality, the cuts have far more to do with maintaining high profits and administrative salaries and have been a far bigger threat to patient health and safety than a short, two-day strike.

While health care workers, like teachers and many other public sector workers, do provide essential health and safety services, this cannot be used to compel them to work under dangerous conditions that threaten their own health and safety. Wage workers have little freedom in the long term (one must work for wages in this society in order to feed one’s family)—hence the term Wage Slave. However, they do (at least in theory) have the right to withhold their labor in order to fight for better, safer working conditions, unlike chattel slaves, who could be beaten or killed for such impudence. According to Dr. Stobo, however, hospital workers do not even have this right because of their role in maintaining patient health and safety. (Similar arguments have been made to ban teachers’ strikes). Yet, if we take this argument to its logical conclusion (i.e., that patient health and safety trump all us), health care should be provided free of charge to everyone, since profit- and insurance-based healthcare result in thousands of preventable and premature deaths each year. Likewise, hospitals should be required to provide all necessary services to maintain both patients’ and workers’ health and safety, and not be permitted to reduce these services either to maintain profits or administrators’ bloated salaries.

UC and AFSCME have failed to come to an agreement on several contractual issues, including staffing ratios and the demand that workers pay more toward their pension plans. Unfortunately, a limited two-day strike is unlikely to cause enough pain to compel the bosses to concede to the workers. To make matters worse, many employees crossed the picket lines, including AFSCME members. The Los Angeles Times reported that 601 AFSCME members crossed the picket line at UCSF Medical Center and UCSF Benioff Children’s Hospital, out of 1,095 scheduled to work, a solidarity rate of less than 50%.

Doctor Visits Drop 20%—Life Expectancy for the Poor Drops 5%

Image from Flickr, by Metro Centric

Pretty much everyone I talk to at work or in my neighborhood has been raving about how wonderful Obamacare is going to be. Granted, most of these people are liberals (I do live in San Francisco, after all). And they are correct that Obamacare will offer some advantages over the status quo, particularly for women’s reproductive health, as I described in a recent post. It will also no doubt provide coverage for many who currently lack it.

Overall, however, it is primarily just a huge giveaway to the big insurance companies. By requiring that everyone purchase coverage, it will increase the insurers’ customer base and, therefore, their profits. It does little to reign in skyrocketing costs and profiteering. There will continue to be millions of Americans who still cannot afford coverage even with the subsidies or who refuse to purchase the mandated coverage for other reasons. Those who already receive coverage through their employers will continue to see greater and greater out of pocket expenses each year, which will further erode their take home pay and living standards. And, worst of all, we continue to see thousands of excess deaths each year because people are still not receiving adequate preventative and long term care for chronic and infectious diseases.

One of the problems with Obamacare is that it does not adequately address the skyrocketing costs, which are a product of the profit-driven basis of our healthcare system. The most expedient way to remove the profit-motive and reign in costs is to create a single payer plan in which health care costs are collectivized through progressive taxation and provided to everyone through the government free of charge whenever needed.

Since that option was never allowed onto the table in the first place, the powers that be have come up with an alternative that keeps profits high and quality of service low: Increase copayments and decrease services in exchange for lower premiums. The rationale is that lower premiums increase the chances that people will be able to afford a plan and thus have coverage for emergencies. But higher copayments discourages people from using their plans except for real emergencies, thus undermining personal, as well as public, health. For example, when copayments are high, people are less likely to go in for preventative care and physicals, and more likely to suffer through undiagnosed symptoms in hopes they’ll go away on their own, all the while infecting their colleagues and schoolmates. This also leads to more emergency room visits, when symptoms that could have been easily treated with medication, had they been promptly diagnosed, escalate into acute or life threatening conditions.

Between 2001 and 2010, the number of doctor visits for Americans between the ages of 18 and 64 declined by almost 20%, according to the U.S. Census Bureau. This was due a combination of factors, including increased copayments for those with healthcare coverage and an increasing number of people who lost coverage through unemployment or unaffordable increases in private policy premiums. A recent study in the journal Health Affairs found that life expectancy for the poorest Americans fell dramatically between 1990 and 2008. Life expectancy fell from 78 to 74 years for white women without a high school diploma, and from 70.5 to 67.5 years for men in this group. This decline in life expectancy was likely due, at least in part, to the declining access to, and quality of, healthcare.

Obamacare may result in more Americans having healthcare coverage, but it will not result in greater access or quality. Many employers will simply stop covering employees, forcing them to purchase plans on the open market which will end up being more expensive and provide poorer coverage. According to the WSWS, up to 20 million Americans could lose employer-provided coverage by 2019. Those who retain employer coverage will continue to see increased copayments and out of pocket contributions to their premiums, as overall costs continue to outpace inflation. This will translate into fewer doctor visits and increased preventable deaths.

Meanwhile, the majority of Americans will see a continued decline in their standard of living, as healthcare costs continue to eat away at their net income. This could further erode overall health and longevity as people spend less on healthy foods, fitness, preventative care and leisure to compensate for their dwindling incomes.

Most New Jobs Low Pay, Despite Unions & College Degrees

Huck/Konopacki Labor Cartoons

Studies indicate that those with college educations are more likely to have jobs and earn more money in those jobs than those who lack a degree. Similarly, union workers tend to earn more than workers in similar jobs who lack union contracts. Yet the majority of jobs lost over the past few years were in the middle range of wages, while most of those added during the recovery have been at the lower end of the income range, according to a new report from the National Employment Law Project, suggesting that neither degrees nor unions provide the same security they did a generation ago.

The report examined 366 different jobs covered by the Labor Department, dividing them into three groups based on average wages. The middle group, which included jobs in manufacturing, construction and information, with wages ranging from $13.84 to $21.13 per hour, accounted for 60% of the job losses between 2008 and 2010, the New York Times reported. These same fields made up only 22% of the job growth, and higher-wage jobs, with wages ranging from $21.14 to $54.55 per hour, made up only 20% of the job growth. The bulk of the job growth during the recovery (58%) has been in the lowest wage occupations (e.g., retail sales and food preparation), with hourly wages ranging from $7.69 to $13.83.

Since 2001, lower-wage job growth has been 8.7%, while mid-wage jobs have declined by 7.3%. According to Lawrence Mishel, president of the Economic Policy Institute, worker productivity in the U.S. has risen by 80% over the past 40 years, while wages have declined by 11%. This has been a boon to the bosses, who have been able to extract even greater profits from their workers. Greater productivity means more widgets per hour per employee. This would benefit capitalists even without cutting wages. However, they have also downsized, getting fewer employees to produce the same or more widgets, without raising wages, resulting in a downward spiral of both working and living conditions for the majority of American workers.

Over the past 40 years, union membership has declined by 50%. This is part of the problem. Union workers do tend to earn more than their nonunionized counterparts, while regions with high union membership also tend to have higher wages for other workers in the area, even the nonunionized workers. Rising health care costs have taken a cut out of workers’ compensation packages (at least from those who are lucky enough to get health benefits). Outsourcing is another cause of both declining union membership and wages, as workers find themselves accepting lower wages just to keep a local job.

Yet it is not accurate to blame these problems entirely on the capitalist class, though its members are certainly the driving force and sole beneficiaries. The mainstream union leadership has all but given up unions’ two main sources of power—organizing and striking—in exchange for the safer, easier and more comfortable tactics of lobbying and hobnobbing with the bosses and politicians, thus hastening the demise of unions and losses for workers.

The unions have also taken the strategically stupid tactic of valuing job protection/creation over compensation and working conditions, thus contributing to the downward spiral of wages. This was perhaps best exemplified by their Detroit compromise/sellout, in which the UAW accepted a two-tiered wage and benefits package giving new workers salaries that were half what autoworkers had traditionally been earning, all in exchange for an agreement by autoworkers to lay off fewer workers.

While being jobless certainly sucks, having a job that kills or injures or keeps one living in poverty is not much better. Unfortunately, most Americans accept that jobs are the only solution to the problem of feeding and housing ourselves. Thus, when Romney or Obama promise more jobs, people cheer, ignoring the quality of job, whether it is low wage, high stress, degrading to the soul or the environment.

Yet if worker productivity has really increased by 80%, then why not let the workers work 80% less for the same wages or increase their wages by 80%, thus lower the wealth gap or the number of unemployed workers? Certainly not a revolutionary idea (the bosses would still own the means of production and the employees would still be at the mercy of the bosses to keep them on the job and pay them), but one that would be justifiable considering they are the ones whose productivity has increased.

This kind of thinking is alien to both the bosses of the workplaces and the unions. Workers are seen by bosses as a means to an end: pay them $5 for a product or service that can be sold for $20 and pocket the profits. Increased productivity means only one thing to them: they get to pocket even more of the profits.

Bosses and employees truly have no common ground. The bosses have the power to hire and fire, set wages and working conditions, speed up, layoff, shut down and outsource. Employees are dependent on bosses, both to offer jobs in the first place and to pay wages, since the only thing they have to sell is their time and their bodies and minds, and this is the only way they have to put food on the table. So if the boss wants to keep all of the rewards of increased worker productivity, the workers can either accept it and hopefully keep their jobs and current income, or risk being replaced by striking for more.

The union bosses actually have interests more in line with the workplace bosses. Laid off workers do not pay dues, thus cutting into the pool available for the wages and benefits of the union leaders. A strike is risky for the union bosses, not only because the pool of dues paying members could decline, but because the union itself could be cut out of the picture. If they lose the right to collectively bargain, the union leaders could end up unemployed themselves. Thus, protecting jobs and collective bargaining (through lobbying and campaign contributions) become far more important than protecting working conditions and compensation for the workers (through organizing and job actions). The former keeps the union leaders materially comfortable, while the latter is just a lot of work and risk for someone else’s benefit.