NEWS & LETTERS, February - March 2009
Workshop Talks
Acting human not cost-effective
by Htun Lin
Vanessa O'Connell reported in the Wall Street Journal ("Stores Count Seconds to Trim Labor Costs," Nov. 13, 2008) that "Taylorism," used by capitalists in manufacturing to speed up production by breaking down each one's work into mindless repeatable tasks, is now big in service industry jobs, especially chain stores. Ironically, the story focused on stores in Detroit, home of the U.S. auto industry that is now threatened with bankruptcy.
Henry Ford's assembly line was the epitome of Taylorism early in the twentieth century. Stores are now conducting Taylor's time-and-motion studies, using computer software for surveillance on their employees. The effort is to shave every last second from retail labor to squeeze out every last penny of profit. Those who do not perform within the guidelines are given "alternatives," demotion or even termination.
While workers feel like it is their duty to be customer-service minded, the new down-to-the-second time-study intimidation has left many of us with no choice but to be anti-social. Retail workers who used to enjoy taking extra time to help elderly customers now see them as customers from hell, taking too long and negatively impacting a worker's time-study stats.
We have the same problem at the HMO where I work. It is standard practice to redline health-insurance customers, rejecting those who already have an illness or a family history of illness. Since elderly patients take more care than the average patient, and make us look bad on the boss's time-study ledger, many of us shave time off our ledgers either by avoiding being assigned to very old and very sick patients, or by putting pressure on them to hurry--or sometimes even commit fraud.
Some Certified Nurses' Aides feel forced to doctor their patient-care documents--making up vital statistics without having seen the patient. They enlist the RN supervisor to get permission to tie up demented patients just to cut the time it takes to deal with them. There are really ugly fights with co-workers about who is going to take the next older and sicker patient.
Falsifying forms is done, I feel, with a nod and a wink from management. I've reported some of these falsifications. My bosses didn't do anything. I think they figure if it helps their bottom line and keeps their departmental budget in line, then why not turn a gaze away from employees doing these fraudulent things.
HEALTHCARE ON PAPER
People are judged by what is on the ledger, not by what actually gets done. As long as no one is caught, the boss will be promoted because they are under budget. That a few patients might be harmed here and there does not come into the calculations until they get caught. Then they put on a big show for the state authorities.
That's what happened a month ago when the California State Dept. of Health and Medicare regulators did a surprise inspection, on a tip from an anonymous caller, probably a worker or a patient. The surprise inspection uncovered a myriad of violations on the part of management. Violations included delays in patient care and poor documentation. Medicare regulators had threatened to pull federal funding.
Now top administrators are scrambling for cover. They called all managers and supervisors to a mandatory emergency meeting to try to get everyone "within federal guidelines," and to abide by state regulations. All managers are lecturing their workers daily on the top priority of preserving Medicare funding.
HMO GOAL: HEALTH OF BOTTOM LINE
Some of us noticed how they forgot to add that the point of any remedy ought to be to improve patient care, not just to preserve funding. Other workers dismissed the whole charade as a dog and pony show, knowing that a few heads might roll, but every incentive in our alienating workplace is to let things slip again once the inspectors leave.
Denying healthcare is no longer restricted to insurance adjusters. It is the way healthcare is practiced on those who have insurance. It is capitalism, and its drive to self-expand, that forces everyone who works under it to behave according to the dictates of its anti-human values.
HMO practice, based on the objectivity of labor time under capitalism, separates us healthcare workers from our patients and fellow workers. Rather than regulations, we need a new concept of labor that will confront this false objectivity head-on.
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