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On June 19, thousands of workers and supporters massed on the walkway of the Golden Gate Bridge. Wearing the trademark purple of the Service Employees International Union, they sang chants and sported T-shirt slogans demanding that every American have access to quality health care. On June 22, the final day of the union's annual convention in San Francisco, John Kerry gave a keynote speech at the Moscone Center echoing the convention's theme slogan: "Healthcare for All." He lamented the lack of quality health care for workers and denounced a recent Supreme Court decision limiting the lawsuits that patients are able to file against HMOs that deny them medical care.
On that same day, SEIU lobbyist Allen Davenport continued making the rounds of the politically connected in Sacramento, promoting the union's campaign to limit the right of disabled and elderly patients to sue nursing homes when they are neglected, maimed, sexually abused, or killed.
That's right: Just as the SEIU's highly public health-care-for-all sloganeering is gaining national resonance, the organization's lobbyists are visiting offices and conference rooms in Sacramento, hoping to limit the medical legal rights of the most helpless and infirm of Californians. The SEIU has entered a compact with the owners of California's for-profit nursing homes, and it involves an apparent, coldblooded trade-off: In the pact, alluded to on an industry/SEIU "alliance" Web site and described in greater detail by elder advocates who oppose the deal, the SEIU has agreed to help the nursing home industry obtain its long-sought holy grail of limiting lawsuits that hinge on allegations of mistreatment of patients. Among the benefits the SEIU would receive by dint of the pact is better access to nursing home workers who might be organized into the SEIU's ranks.
The compact that SEIU lobbyists are touting to legislators and others includes a warm-and-fuzzy package of health care reforms, such as higher wages and staffing levels and higher government payments to nursing homes that care for low-income Medi-Cal patients. But the real action, the deal's sweet spot, involves so-called "tort reform" for nursing homes. To this end the union is currently lobbying politicians and interest groups to sign onto a legislation package that would make it harder to sue the deadliest members of California's poorly regulated nursing home industry. If everything goes according to the SEIU/nursing home industry plan, some of the pact's "reforms" aimed at limiting patient lawsuits might be quietly slipped into the massive, 2004 state budget bill.
Nursing home patient advocates -- who've long supported the SEIU on issues such as pay, benefits, and staffing levels for nursing home orderlies -- consider the deal an act of betrayal.
"We're outraged," says Lupe de la Cruz, California advocacy director for AARP, an organization formerly known as the American Association of Retired Persons. "Our basic line is that we care about the people in the beds. The erosion of their rights, so the SEIU can get a sweeter deal on negotiations ... it's not [the SEIU's] to negotiate away."
Many nursing home residents aren't terribly old, yet they suffer severe disabilities. And disabled advocates are likewise astonished by the industry/labor pact. Deborah Doctor, with the group Protection and Advocacy Inc., says that as recently as this year she had been fighting alongside the SEIU against cuts in the California health care budget.
"Before I put out anything to my constituency, I verified this information with the SEIU's lobbyist, to make sure I wasn't dealing with rumors, partly because I was disbelieving. I was thinking, 'This can't be,'" says Doctor, who was told the union would indeed carry water for the nursing home industry and lobby to limit elder-abuse lawsuits. "I would say the SEIU's alliance with the for-profit nursing home industry is unholy. They have no more right to negotiate away our rights than we would to negotiate away their collective bargaining rights."
Pat McGinnis, executive director of California Advocates for Nursing Home Reform, recalls standing on SEIU nursing home picket lines when corporate owners fired workers and shut down less profitable homes.
SEIU members "are people we've worked together [with] on so many issues that would further residents' rights. They think they'll be guaranteed all this extra money for staffing and wages. We know they're getting access for unionizing at these facilities, too. It's all tied together," says McGinnis. "It just breaks your heart."
I asked Bay Area SEIU Local 250 President Sal Rosselli whether it was really true that this deal would allow organizers greater access to nursing homes.
"Yes, by agreement," Rosselli said. "Traditionally, there has been an adversarial relationship between SEIU and general health care providers. We've been changing those relationships to accomplish common goals."
When asked about the SEIU lobbying toward the nursing home industry's goal of limiting patient lawsuits, Rosselli suggested that somehow the money the most abusive nursing homes would save on lawsuits would go to patients and union members. But does the lobbying mean the union is swapping the possibility to expand its membership in nursing homes in exchange for "reforms" that would limit injured patients' right to sue? "That's not a legitimate way to describe it whatsoever. The problems in the nursing home industry are multifaceted. We make decisions based on what's needed to reform nursing homes. It's a complicated question. There are problems in the system. There is a system where dollars don't go to actual health care," Rosselli explained. "So it's legitimate that the whole system be looked at, from our point of view."