NEWS & LETTERS, May-June 2010
Workshop Talks
Let health workers do their jobs right
by Htun Lin
The health reform law contains a few good provisions in regulating health insurance, like stopping by 2014 denial of coverage to those with pre-existing conditions. However, it is really a huge giveaway to the health insurance industry, mandating that everyone buy insurance from them.
It is a bill which big Pharma and HMO executives helped write. Our CEO at Kaiser, along with the heads of Blue Cross, Catholic Healthcare West and other big HMOs, were constantly jetting to Capitol Hill backrooms to shape the content of the bill. They expect windfall profits subsidized by our tax dollars.
Our CEO is very excited about all the new business our HMO will get. As the best in the industry in cost control and an already dominant position in California, Kaiser is poised to capture a large portion of the new market. Our unions, in a Labor Management Partnership (LMP) with Kaiser, are also rejoicing, because they expect their roster of dues-paying members to swell.
Bureaucrats in Washington and our unions are celebrating this political victory. They confuse expansion of health insurance with real healthcare delivery. We, who work daily in the frontlines of the HMO shop floor, know the difference all too well.
The reality is that HMOs have spent the last decade restructuring--divesting facilities, shuttering ERs, cutting staffing to the bone, de-skilling, eliminating beds, hiking co-pays and deductibles. All of these changes were deliberate to restrict access for those already insured, enhancing the bottom line.
The reform did not include workers' or patients' input. Those making the decisions are the same players who caused the crisis in the first place.
The overlords have an absolute fetish of hi-tech, information technology (I.T.), touted by both the White House and HMOs as the magic bullet that will solve America's health delivery problems.
President Obama singled out Kaiser as the model for the future of healthcare made more efficient by the wonders of I.T. We rank-and-file workers at Kaiser know that the top priority of computerization has been "revenue enhancement."
Whether the billion dollars spent on computerization has made healthcare delivery more efficient is highly questionable. Veteran nurses are worried that computerization has diminished critical thinking abilities in this new brand of care delivery.
New grads in nursing are trained to be so pre-occupied with entering computer data that the patient is often ignored. Nurse and patient alike are in a high-tech maze, lost to each other. I.T. separates the human aspect of care from its delivery.
I.T. is effectively the new foreman on the shop floor and instrument of discipline. Even management is under domination by the machine through the implementation of time studies conducted electronically.
The new healthcare reform law touts a large number of new regulations. But won't HMOs simply find new ways around them? All too often, we rank-and-file workers find computer data being used not to enhance healthcare but to justify non-care. One would think government regulation promotes efficient healthcare delivery. But think again. Regulators, too, inspect only the computer data, not actual care.
Nothing will change concretely, and no real reform can take place, until we return to the concrete struggles of rank-and-file workers. The California Nurses Association and thousands of other health workers succeeded in passing provisions containing landmark "quality-care" language in their contract over ten years ago.
Today's insurance reform, blessed by the insurance industry, is only a distorted echo of that original struggle. We workers must now continue our struggle for genuine healthcare reform. The only way we can do that is by returning to our roots in a ceaseless struggle to regain not only control of but the meaning of our labor. Let's finish the work we started.
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