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NEWS & LETTERS, June 2002
Workshop Talks columnKaiser Tele-sweatshops
by Htun Lin On May 17, the media exposed Kaiser HMO’s now
discontinued “pilot program” to reward employees with cash bonuses for
keeping as few patients as possible from accessing services from Kaiser health
professionals. Consumer advocates and nurses of the California Nurses
Association (CNA) expressed outrage, calling this a “morbidity bonus.” Workers in SEIU Local 250 were rewarded with 2-5% of
their pay for keeping at least half of incoming patient calls away from
registered nurses or other health professionals. They were to keep medical
appointments at between 15-35%. They were also told to average less than three
minutes and 45 seconds on the phone per patient. This program lasted for two
years from January 2000 to December 2001. In full Orwellian-speak, a Kaiser
spokesman said, “The whole purpose was designed to help serve members
better.” BY THE BOOK Today the press is reporting a lot of shock and dismay
from consumer advocates and CNA representatives. However, none of this current
press attention has gotten the view of the workers who are put in these horrible
positions. This was the focus of a report in NEWS & LETTERS back in December
1999 just when the Call-Centers were set up and before the bonus program even
went into effect. Or, as we reported then: “The patient’s first encounter with Kaiser health
care is a canned answer from a training manual. One Call-Center employee said,
‘If we don’t follow the manual to the letter, we’re punished. If we go by
the book and something goes wrong we’re still punished'." The real shock is that this effort to make money by
denying care came out of a “strategic partnership” initiated by AFL-CIO
President John Sweeney. Again, as we reported in 1999: “This is part of
Kaiser’s restructuring plan that the AFL-CIO enthusiastically embraced in
their ‘strategic partnership.’ Local 250 SEIU is really proud of having
these new union positions boosting their regular dues income. They are touting a
recent ‘understanding’ between Kaiser and the union that supposedly promises
no layoffs. “Many downsized employees end up in the new
Call-Centers, and many are now desperately scrambling to get out. As one
employee said, ‘I’ve never been in a sweatshop before, but this sure feels
like one. You have to get permission to go to the bathroom. Your bathroom breaks
are timed. They’re always monitoring your phone conversations to make sure you
adhere to the manual. They treat you like a computer which is not supposed to
think.’” WORKERS OPPOSED While state HMO investigators are now looking into this
scandal, we workers were opposed to this Call-Center scheme from its inception,
with or without the bonus, because we reject being treated like machines. We are
fundamentally opposed to the whole concept of managed care’s restructuring. When our own union officials embraced that
restructuring, they in essence adopted the same attitude that management has
toward us service workers. Consumer advocates also fall into this trap by
endorsing management’s separation between the professionals as the designated
mental workers and us service workers who are expendable. Marx’s vision was that a new human society would
eliminate the whole separation between mental and manual labor. Overcoming that
separation would mean that health care is an important end in itself, not a
corollary expense to capital’s expansion. Capital is happy to pay its workers bonuses to keep
patient-consumers away when the product is healthcare, human well-being. When
the product is a thing, the same army of telephone workers hired as automatons
to animate a computer script (as in telemarketers) are given incentives to
cajole consumers into purchasing that product whether they need it or not. Both
methods accomplish the same goal—to enhance capital’s bottom line and
self-expansion. FRAGMENTING CARE Capital puts itself in the middle between the patient
and the health care worker, fragmenting the natural human activity of caring for
another. Even the U.S. government under Bush has aggressively expanded their
role as HMO gatekeepers when it comes to Medicare. The government deliberately
underpays providers who increasingly are refusing to care for Medicare patients.
They are raiding this largest pool of health care resources in order to reward
the richest one percent with a permanent tax cut. Contrary to HMO consumer advocates, the government is not the solution to overcoming capitalist greed in the health care industry. Nothing will change until workers themselves have control. The problems faced by health care consumers will be solved only when we overcome labor’s alienation as reflected in the fundamental separation between mental and manual labor. |
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