From the new January-February 2014 issue of News & Letters:
by Htun Lin
On Jan. 6, RNs from the California Nurses Association (CNA) picketed a new state-of-the-art facility at Kaiser Oakland to protest increasing restrictions on access to care while decreasing frontline care staff. The opening was timed to coincide with the implementation of the Affordable Care Act (ACA).
Management issued a statement: “The nurses’ union has indicated that their picketing involves claims about patient safety and access to care…despite their claim, it is not about quality and safety. It is about the need to adjust staffing related to the overall number of patients in our hospitals. Our hospital census has been declining for some time.”
The statement goes on to say: “At the same time, we are experiencing a shift in care delivery to other appropriate settings, such as medical offices, by phone, and even online…”
Emergency Room (ER) nurses are seeing the opposite: longer and longer patient wait times, as the ER is increasingly congested everyday. Many of those on the picket line were ER nurses, who face this concrete reality, not the dishonesty behind the claim of “decreased hospital census.”
We workers know that the real cause for a “lower hospital census” is restrictions in access imposed by management. The hospital census has been artificially kept low because of ongoing deliberate cuts in staffing. The result is that patients are warehoused daily in the ER.
One only has to look at the general decline in the overall health quality indicators to understand the nurses’ deep concerns over the care they are prevented from providing. The greatest threat to quality care and patient safety is the increasing spread of antibiotic-resistant bacteria which, management claims, is because hospital workers fail to wash their hands and take other precautions. Period. End of story.
What is the rest of the story?
As any nurse will tell you, the ever increasing workload has been so overwhelming, and speed-up so severe, that all their tasks are performed with compromises they have no control over. There is no end to the hurried, harried, and harassed work pace.
Staff is monitored by computer software surveillance. Every problem that arises due to short staffing is not resolved by replacing missing staff, but by adding more technology—to harass or monitor staff even more. In short, all this expensive high-tech investment is not a means to health. It is a way to get rid of workers.
To corporate America, who see only the bottom line, labor is only a cost. They hike premiums while reducing service and staff, using ACA as an excuse to get rid of workers in the name of “affordability.”
The ACA is expected to add 30 million new health plan members to our already severely congested healthcare system. We are on the cusp of a potentially massive healthcare disaster in what the Centers for Disease Control calls the “post-antibiotic era” of the spread of antibiotic-resistant bacteria, and the baby-boom generation is aging. Yet HMOs are hell-bent on their plans to perform further cuts in the healthcare delivery force.
“Affordability” to them means sacrificing the health and well-being of both patients and workers. By picketing, we are saying we cannot afford this kind of deformed healthcare disguised as reform. The industry misuses the letter of the law in the ACA to eliminate staff that is very needed to care for the millions of patients seeking care through the ACA.
HMO executives are playing Russian roulette with society’s collective health. More money is poured into buildings and high-tech, while the workers to tend those machines are increasingly absent. Healthcare restructuring brings to life what Karl Marx called capitalism: the increase of dead labor over living labor.
Capitalists have declared that affordable care means that labor time in healthcare must be drastically reduced. This is big business jargon to say that workers are using too much healthcare. Healthcare benefits that workers struggled hard to win are now declared “Cadillac” plans and taxed as a luxury.
On Jan 6, we healthcare workers picketed our brand new facility. We had picketed the old facility at the onset of healthcare restructuring 17 years ago. Our message, then as now, is: We are fighting for quality healthcare. We are not only fighting for our patients’ lives, but for our own.