NEWS & LETTERS, October - November 2009
Workshop Talks
Job cuts guarantee needless deaths
by Htun Lin
Healthcare rationing? Death panels? We've been constantly subjected to these scary phrases from the right-wing propagandists, warning us that with President Obama's healthcare reform, government bureaucrats will pull the plug on grandma. Demagogues from that end of the political spectrum have been trying to reduce Medicare spending since its inception and refused to increase Medicaid a few years ago, even when that meant a lot of grandmas and disabled were thrown out of nursing homes in states facing budget crises.
The truth is that, long before we had heard of Obama, we already had healthcare rationing by HMOs and insurance industry death panels. We have heard horror stories about insurance industry bureaucrats whose decisions often deny lifesaving remedies. In addition, an estimated 18,000, young and old, working and unemployed, die each year from treatable ailments because they don't have access to affordable healthcare.
What has not gotten any play in the news are the further casualties and deaths from speed-up of healthcare workers. Our own unions have been allied with management's cost-control directives. They say we should be glad to have a job, we should help the company downsize, help them outsource our jobs, and that our well-being is dependent on the bottom line of the corporation.
Speed-up has caused an overall decline in the quality of healthcare in this country. That is the business-as-usual "death panel" already practiced by HMOs and nursing home chains. Preventable death and injuries from accidents arise from HMO cost-cutting measures and divestments, resulting in hospital bed eliminations, reductions in clinic services and ER closures.
Kaiser HMO's immediate reaction to impending healthcare reform was to announce more layoffs, including nearly one third of Oakland's housekeepers. Nearly all housekeepers told me they had no faith that SEIU will really fight these layoffs.
As one Black housekeeper put it, "They say they want to improve performance and reduce the time it takes to get rooms ready. But tell me how they're going to do this by laying one third of us off? You know what's going to happen? They're going to make the rest of us work three times faster."
Cost-control ideologues fail to view the whole healthcare issue as one of safety, not just finance. Every day yet another safety measure is eliminated in the hospital. Built-in redundancies were originally created to prevent accidents, much in the same way airlines use redundancies in their planes to prevent accidents.
For HMO managers, it's all about emulating manufacturing's "just-in-time" delivery, as if healthcare were just another product like shoes and tires. Our former CEO, Dr. David Lawrence, once said, in a moment of candor, "If [the HMO industry] were in the airline business, we would have been shut down a long time ago."
Every day our nursing supervisors are ordered by budget directors to send nursing staff home in the middle of their shifts if the patient total goes down. Nurses are called back to work "just in time" only in the last hour, and only if the patient census goes up. They make sure there is no buffer for the emergency situations that arise. Nurses are constantly overworked and missing their lunches and breaks. With labor costs under such tight controls, the HMO has reported handsome quarterly profits. These profits didn't stop our HMO from announcing a new round of layoffs.
Safety and prevention are the essence of healthcare in rebuilding the health infrastructure. Dealing with the imminent threat of catastrophic epidemics, like SARS and antibiotic-resistant TB, require treatment for all humans, immigrant or not, because such illnesses know no nationality.
For a moment President Obama, in his speech to Congress, turned the question of healthcare away from the tug of war over costs, which healthcare workers experience every day. Obama cited a letter from Sen. Edward M. Kennedy to be read after his death. He wrote that healthcare was "above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country."
From the point of view of those who are struggling to provide quality care, speaking about healthcare as a moral issue, something we "ought" to do, is inadequate. It is about reclaiming the very meaning of our labor. Must our labor be only a means to life under the regimen of capitalism, or can it be directly about enhancing the well-being of ourselves and others?
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