Tom Kochan, Robert McKersie, Adrienne Eaton, and Paul Adler. Healing Together: The Labor-Management Partnership at Kaiser Permanente. Ithaca, NY: Cornell ILR Press, 2009.
During his uncontested campaign for AFL-CIO president this year, Rich Trumka offered the olive branch to corporate America — despite the latter’s demonstrated lack of enthusiasm for reinstating organized labor as its junior partner. “Here’s the deal,” he told a Reuters’ reporter. “For employers who want to work with us and want to work with workers, we’ll be the best friend they ever had.” In another interview, Trumka called for “a new compact,” in which “collective bargaining is part of the solution” to the nation’s economic woes and union members’ contributions to society are more highly valued. Amid unrelenting business opposition to the pro-collective bargaining Employee Free Choice Act (EFCA), any plan to renew the social compact model that governed labor relations in the post-World War II era has had few takers on the management side.
One notable exception is Kaiser Permanente (KP), the giant California-based hospital chain and health maintenance organization. Kaiser was founded as a pioneering pre-paid medical plan. It was embraced by California unions to such a degree that it became known as “the HMO that labor built.” By 2007, Kaiser employed 96,000 union members, out of a nationwide workforce of 130,000, making it one of most heavily unionized “not-for-profit” health care providers. After a series of strikes (not always successful) between the late 1970s and early 1990s, twenty-seven different Kaiser labor organizations formed a coordinating council with help from the AFL-CIO in 1995.
As described in Healing Together, their goal was to “exchange information about particular local struggles” and begin “developing a joint strategy and structure” for more effective bargaining and strike activity. At the time KP was losing $250 million a year and facing pressure “to better match the cost structures of competing HMOs.” So labor and management ended up trying to create a less adversarial relationship that would, as a by-product, expand worker influence in the administration of Kaiser and improve its delivery of care. The resulting “partnership” — which according to the authors has produced more than “a decade of labor peace” — was not “the product of an ideological conversion to labor-management cooperation.” Rather, it evolved “out of a pragmatic judgment” that the parties “would have more to lose separately and jointly by going further down the road of escalating conflict.”
Advocates of this approach point to subsequent gains for workers in job security, pension coverage, and standardized wage rates, plus opportunities to participate in decision-making about issues beyond the scope of normal contract bargaining, a process which required strong, union involvement. Critics, such as the California Nurses Association (CNA), which represents thousands of Kaiser nurses, contend that “jointness” in health care can lead to compromising of patient care standards.
The four labor relations experts who produced this book were hired, in 2001, as paid consultants to the Kaiser-financed trust fund set up to administer the “Labor-Management Partnership” (LMP), which the CNA has boycotted. Several are well-known advocates of greater labor-management cooperation. So, notwithstanding their claim to “independence as outside researchers,” they would appear to have a vested interest in proclaiming the LMP to be a great success. The authors believe it “has implications for two of the greatest challenges facing the nation today: how to improve, if not fix, a broken health care system” and how to revive a system of collective bargaining “that has collapsed.”
The AFL-CIO likewise remains quite bullish about this experiment. At a Washington, D.C. forum in July, now-retired AFL-CIO leader John Sweeney applauded Kaiser for its LMP-assisted “improvements in patient outcomes, reductions in medical errors, better preventative care, cost savings, and a better, more satisfying work environment for everyone involved.” In particular, Sweeney cited the “significant work” of “unit-based teams” (or UBTs) in “bringing doctors, nurses, technicians, pharmacists, and other caregivers together on behalf of patients.”
Unfortunately, neither Sweeney’s upbeat view nor Healing Together — because of the timing of its publication — address the latest developments at Kaiser: a bitter shop-floor struggle in which management has sided with the Service Employees International Union (SEIU) against the latter’s own rebellious California members. That conflict began last winter when the LMP’s largest local union participant, 150,000-member United Healthcare Workers (UHW), was put under trusteeship by SEIU President Andy Stern, following a major challenge to his leadership by UHW officers and rank-and-filers.
Although supportive of the Kaiser partnership and a key player in building it, UHW had, in 2007-8, resisted pressure from Stern to make continuing contract concessions to California nursing home operators. These deals were supposed to expand union organizing opportunities but, as documented by UHW, deprived workers of important job rights, prevented them from functioning as patient advocates, and failed to produce significant gains in either wages or dues paying membership. Stern responded to this dissent by trying to dismember UHW and transfer 65,000 of its long term care workers to a new statewide local, with leaders appointed by him, who would be more partnership-friendly. When the affected UHW members balked at this plan, Stern removed all of UHW’s democratically-elected leaders and replaced them with his own appointees, triggering a grassroots revolt.
Soon after UHW’s treasury and offices were seized, a majority of the 48,000 UHW-represented employees at Kaiser petitioned to leave SEIU and join the National Union of Healthcare Workers (NUHW), a rival union created by former UHW-president Sal Rosselli and other ousted activists. Unfortunately, the National Labor Relations Board is not a great protector of “employee free choice” among already unionized workers seeking to change unions. The Board upheld SEIU’s legal claim that no representation vote should be held at Kaiser until next year, when the current five-year contract expires. Until then, NUHW must survive on voluntary contributions from its workplace supporters, plus re-sign KP workers on new election petitions or cards.
Since last January, more than 700 UHW stewards have quit in disgust or been removed by SEIU after they refused to sign the “loyalty oath” required by Stern’s trustees. Kaiser has eagerly exploited the International union’s dismantling of the shop floor organization created by UHW for the purposes of strong contract enforcement and defending workers’ rights. At Kaiser today, rank-and-file confidence in the value of partnering and management’s commitment to that process is very low, in bargaining units controlled by SEIU. Kaiser’s “unit-based teams” — the basic building blocks of worker participation much lauded by the authors — are in complete disarray, SEIU opponents report.
“I’ve never seen this many terminations without just cause,” says Lisa Tomasian, who works at Kaiser’s Santa Clara Medical Center. “Many of us are facing discipline on trumped-up charges by managers who we used to hold accountable as shop stewards.” According to Tomasian, the “open bargaining” championed by UHW has been replaced by secret meetings between management and SEIU staffers from out-of-state. The latter “agreed to huge cuts in our pension,” Tomasian charges. “SEIU brought four stewards to meet with Kaiser after the deal was made. They were told to just listen and ask no questions. SEIU appointees claimed that, by including these four people, democracy was served. Meanwhile, our lump sum payout will get smaller and smaller until it’s gone as an option altogether in 2012.”
In August, with no membership participation in bargaining, International union reps then undermined past job security protections by giving Kaiser the green light to eliminate as many as 1,350 jobs. KP claimed the downsizing was necessary because of recession-related “enrollment losses and declining margins.” As NUHW noted Sept. 25, even larger lay-offs were threatened five years ago when KP introduced a new system of electronic record-keeping. Yet, under the old leadership of UHW, “a large committee of elected rank-and-file members met with Kaiser management to implement the contract’s employment security provisions” and insure that “workers would be redeployed throughout the company without any lay-offs.” This time, with no worker-input or bargaining table resistance to management’s plans, “SEIU leaders’ top-down concessionary style” led to the signing of “a massive layoff deal at the same time Kaiser posted $1.1 billion profits during the first six months of 2009.”
“Kaiser is truly in bed with SEIU,” says former UHW leader Ralph Cornejo, now an organizer for NUHW. “Relationships that our stewards had built with the administration ended from one day to the next, when the trusteeship was imposed last January. Kaiser is feeling like they can do just about anything now, and get away with it. Many members feel the union is irrelevant. The other unions know that partnership is doomed if this continues.”
In Healing Together, Kaiser is nevertheless lauded for its exemplary pre-trusteeship agreement on union recognition. KP’s pledge of non-interference with new organizing has led to a success rate of 80 percent, in 29 recruitment campaigns involving 7,400 workers. Overall, between 1997 and 2006, LMP unions grew from about 55,000 to 86,000 members, via card check recognition, bargaining unit accretion, and additional hiring. Yet, when workers opted to join a labor organization outside the partnership, managers behaved very differently: they reacted like any other anti-union bosses. In 2004, for example, several hundred workers at a Kaiser call center in Alameda, California chose to organize with help from the Communications Workers of America. KP refused to recognize their “card majority” and bought additional time for “Vote No” campaigning in a hotly contested NLRB election that was a case study in why workers need the Employee Free Choice Act. After CWA won, KP management continued to spend heavily on “union avoidance,” while engaging in bad faith bargaining for more than a year. Without benefit of first contract arbitration (of the sort proposed by EFCA) and lacking enough support to strike, the union was decertified by a narrow margin, due to worker frustration and demoralization.
KP’s union-busting behavior — which no LMP participant protested at the time — prefigured what is now widespread management hostility toward workers allied with NUHW rather than Kaiser’s much preferred partner, SEIU. As 17-year Kaiser worker Richard Schofield from West Covina, Ca., wrote in a recent letter of protest, after being removed as an elected shop floor leader: “Requiring stewards to ‘bow down’ and sign a pledge of allegiance to SEIU-UHW is in direct conflict with all that we accomplished through partnership activities. Where is the collaborative spirit that the LMP was founded on? Does anyone really think that directing stewards to sign such a document will not contaminate the more democratic environment that has been created?”
For Schofield and many other longtime KP union members, next year’s representation contest between NUHW and SEIU-UHW can’t come soon enough. “You don’t need a weather man to see which way the wind is blowing,” he says. “SEIU is on the wrong side of this storm” because, “without trust and honesty, there will never be a relationship between leadership and rank and file. The eventual outcome is always with the majority no matter how long and hard the fight.”
Steve Early spent 27 years as a Boston-based staffer for the Communications Workers of America and was involved in telecom organizing, bargaining, and strike activity. He is the author of Embedded With Organized Labor: Journalistic Reflections on the Class War at Home, published this summer by Monthly Review Press. The article above appeared, in different form, in Dollars & Sense, Sept/Oct, 2009 and as a chapter in Real World Labor: A Reader in Economics, Politics, and Policy (August, 2009) available at www.dollarsandsense.org. Early can be reached at <Lsupport@aol.com>.