Big Deal

Only days after members of several allied unions walked picket lines outside of Kaiser Permanente medical centers across Northern California, AFL-CIO chieftains put the final ink on a landmark national agreement with the health care giant. Rank-and-file voting on the pact continues through the end of the month.

If approved by union membership, the deal would essentially give unions a seat at Kaiser's management table. The proposed partnership would create committees of union and management representatives; those committees would set policy on (among other things) patient care, marketing, and employment structure within Kaiser. As part of the deal, Kaiser has also agreed to recognize the organization of union locals at any of its facilities with a simple majority vote of workers, and without appealing election results to the National Labor Relations Board.

But Kaiser gets something out of the agreement, too.
As a national umbrella organization, the AFL-CIO has pledged to "use its influence to the greatest extent possible" to persuade all of the trust funds that provide benefits to union members to list Kaiser as a health care plan choice.

Union contracts would be separate from the partnership, and collective bargaining would determine which health plans are offered in those cases.

Even so, the proposed agreement is huge. In fact, if approved, it will create one of the biggest labor-management partnerships in the country.

Oakland-based Kaiser Permanente is the nation's largest health care system, a nearly 8-million-member health maintenance organization with its own hospitals and medical staff. The AFL-CIO is the nation's largest union, with 78 individual locals and 13 million members, more than 50,000 of whom work for Kaiser. The Service Employees International Union, which includes many health care workers, is the fastest-growing sector of the labor giant.

The union-Kaiser pact could more than triple the size of Kaiser's membership in a viciously competitive health care industry where market share means everything. The agreement is a potentially precedent-setting move for the union, as well, offering it the voice in health care restructuring it has sought while offering a way around the time-consuming NLRB process for organizing new locals. Management appeals can make approval of local elections a yearslong undertaking.

If the deal is approved by Kaiser union members, who are voting by mail during the month of May, the partnership will be the first of its kind in the national health care arena.

"[T]he proposed partnership gives Kaiser Permanente employees a real voice in the decisions affecting the future. And Kaiser has every incentive to make the new program work, because it commits the labor movement to endorsing Kaiser and helping them market to working families across the country," AFL-CIO President John Sweeney said in a letter urging union members to approve the deal.

But not everyone's celebrating. Many traditional supporters of labor wonder whether the AFL-CIO has not begun sleeping with the enemy.

The California Nurses Association reached a standoff in contract negotiations with Kaiser earlier this year; a massive one-day strike ensued. Service Employees International supported the strike, as did several other unions, bringing the walkout to 23,000 employees.

The nurses organization has refused to participate in the AFL-CIO partnership with Kaiser, calling the deal a "conflict of interest" that would undermine registered nurses in their role as patient advocates. The pact also would help an organization that, the nurses association believes, is reducing the quality of care provided to patients.

Some other union supporters aren't buying Sweeney's bridge-building strategy, either.

"They [Kaiser officials] are not altering their course one iota, and there's going to be a huge body count," says Tony Sustak, a union member and member of San Francisco Neighbor to Neighbor, a community activism group. "Rather than organize and fight, the AFL-CIO leadership is trying to run for cover with the Democratic party that wants everyone to play together.

 
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