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New Ground 110January - February, 2007ContentsNew Ground 110.1 - 01.25.2007
New Ground 110.2 - 02.06.2007
New Ground 110.3 - 02.20.2007
New Ground 110.4 - 03.08.2007
The Labor/Community Movement to Reform Resurrection West Suburban HospitalQuality Health Care for Allby Bill Barclay The problem of health care in the U.S. brings together many issues for progressives. First, it illuminates the conflict between the public provision of and access to an essential good-quality health care vs. the corporate desire to privatize and ration access to health services. Second, the health care workplace is often the intersection between the aspirations of workers for a voice in the organization of their daily work life and the pressure of profit-maximizing enterprises to control the organization and structure of work. Third, because of the racial distribution of low paying service sector jobs, the health sector is also frequently the locale where race and class meet, with African-American and Hispanic employees supervised by white mangers. These are the big picture frames. Each individual hospital and its surrounding community faces these issues in specific ways, as illustrated by the ongoing effort to reform West Suburban Medical Center (West Sub). West Sub is a unit of the Resurrection Health Care (RHC) chain, the second largest in the Chicago metropolitan area and is located on the border of Oak Park and Austin, drawing patients (customers) from both communities. Background:Resurrection Health Care Acquires West SubIn early 2004 West Sub, which had been an independent not-for-profit hospital was acquired by Resurrection Health Care (RHC). The acquisition occurred under the new "fast track" provisions enacted by the Illinois legislature and was well along the path to completion before many residents were even aware of the process. However, significant questions were raised by residents in both communities about the potential impact of the acquisition on the quality and availability of health care. In response to these concerns, the Illinois Health Facilities Board approved the acquisition only after an agreement between RHC and the Illinois Attorney General's office. The agreement required West Sub, as a unit of RHC to:
RHC's Impact on West Suburban HospitalDespite the agreement signed with the Attorney General's office, data compiled from the initial post-acquisition period indicates that the level of charity health care has been reduced below that provided prior to the acquisition. But this was only part of the impact of RHC's acquisition of West Sub. RHC has also implemented staff cutbacks that undermined the quality of health care provided. These include an increase in the patient/nurse ratio in units throughout the hospital (including labor & delivery, and medical/surgical floors) and a cutback in support staff (for example, the lactation consultant who helps new mothers with breastfeeding). During 2005-06 West Sub has been cited on multiple occasions by the Illinois Department of Public Health for problems including procedures for medicating patients for pain, preventing bed sores, and patients leaving the ER without receiving care. Since acquisition of West Sub, RHC has made no efforts to include Oak Park and Austin residents in their health care planning. Finally, because RHC shifted its accrediting agency from the Joint Commission on Accreditation of Health care Organizations (JCAHO) to the American Osteopathic Association's Health Care Facilities Accreditation Program (HEAP), the independent health care quality measurements that West Sub must meet have been lowered. JCAHO is the industry standard; HEAP is an outlier that, in contrast to JCAHO, does not make publicly available the results of its analysis of hospital quality performance and does not conduct unannounced survey visits. In this case the market has decided: HEAP accredits less than 10% Illinois hospitals but RHC wants the lower accountability and reduced transparency provided by HEAP. Thus we who rely on West Sub are subject to this corporate desire to place profits over health care. Staff at West Suburban responded to these changes by an increased interest in organizing for collective bargaining with RHC, working primarily with AFSCME Council 31 . RHC countered by hiring Sefarth Shaw and the ironically named Haymarket Group to counter employee organizing and community accountability efforts. Community Response:Oak Park/Austin Health AllianceThe decline in charity care, the attack on employees' rights to organize, the overall resistance to community input into health care planning and growing concerns bout the quality of health services provided has generated community opposition to RHC policies and methods. In mid-2005, the Oak Park Coalition for Truth and Justice (OPCTJ) joined with the South Austin Community Coalition (SACC) and AFSCME Council 31 to form the Oak Park/Austin Health Alliance (OPAHA) as a community/labor vehicle for countering West Sub's move towards a corporate approach to medical care. Since its inception, OPAHA has organized several community meetings to discuss West Sub and the crisis in health care. Out of these community meetings came a four-point program, OPAHA's Community Benefits Agreement:
In its organizing efforts OPAHA brings together the predominantly African-American community of Austin, the majority white community of Oak Park and the racially mixed work force at West Sub. OPAHA's work to date includes actions on several fronts.
In all of this there is one constant: a refusal of West Sub to meet with the only organization that represents key stakeholders the community and the work force. We now believe that it is time to increase the pressure on West Sub to behave as a member of the Oak Park/Austin community rather than as a predator seeking to extract the maximum of profit. We invite everyone to join us in this effort. Go to the web site devoted to changing RHC and decide how you can assist in this struggle to assure quality health care for all: www.reformresurrection.org Editor's Note: Bill Barclay is a member of Greater Oak Park DSA and the Oak Park Coalition for Truth and Justice. Also see New Ground 102, "Resurrecting West Suburban Hospital's Commitment to the Oak Park / Austin Community" for more information. The Empire Strikes Back!by Bob Roman As this issue of New Ground goes to the printer, the final meeting of the Adequate Health Care Task Force will be happening. As reported in New Ground 109, the Task Force will be recommending to the Illinois legislature a health insurance scheme that resembles the plan recently passed in Massachusetts. A minority report advocating a "single-payer" (that is to say state run) insurance plan will also be submitted. In New Ground 109, I speculated that the insurance industry would present its own minority report. And indeed, 5 members (all appointed by Republicans) of the Task Force are submitting such a dissent. This dissent is the opening shot in a campaign to prevent the legislature from doing much of anything on the issue of health care. Some of this involves whining about process: about how the Task Force went about its work, about how the interpretation of facts and assumptions made by the Task Force's consultant (Navigant) didn't fit with the libertarian dogma of the dissidents. You'll be hearing more of this as "unfair" is such an easy charge to toss at your opponents, especially if it's a half-truth. But the essence of the dissidents' complaint is: "the plan advanced by the Adequate Health Care Task Force will, if implemented, increase health care costs, reduce consumer choice of health care coverage, have a negative effect on the quality of health care provided to the citizens of Illinois and restrain job growth." Some of this, particularly "consumer choice" and "job growth", are symptoms of libertarian dogma. If this minority is ideological and self-serving, don't assume they are also, therefore, stupid. In fact, some of the criticisms they make of the majority report are dead on, and others are plausible enough to scare skittish legislators. Among the latter, one example is the charge that the system proposed by the majority report would violate the federal Employee Retirement Income Securities Act (ERISA) that regulates employee benefit plans. In order to achieve uniformity across the states, ERISA preempts state laws. Maryland's recent health care law aimed more or less at Wal-Mart was struck down by the courts using ERISA. Even if it does not apply in this case, proponents of the majority report had best get Attorney General Madigan on board as reassurance, at least. More to the point are the dissidents' complaints regarding the lack of cost containment measures and complaints (and questions) about just who is going to pay for this system. Employers will be expected to pay about $1.5 billion. Since this is money not necessarily going to the insurance industry, to any good libertarian it's obviously a burden and a waste. But there are also some 3 to 3.5 billion dollars in expenses (and more as those numbers do not include start up expenses) that are not funded by the majority report. Unfunded mandates have become common in the past quarter century and typical under the Blagojevich Administration, but they should make you very afraid. These dissidents can't simply say "no", not in the face of so much heart-breaking testimony collected by the Task Force. But they are mostly content with restating elements of the insurance industry's proposal to the Task Force. To be fair, this was not the worst proposal to the Task Force. It might cover up to 28% of the presently uninsured (some of the other proposals covered fewer), and if you have sufficient income so that you could save or invest, you might do well enough provided you're not especially sick. It represents an attempt to address the anguish of those denied access to health care (or bankrupted by it) while preserving the primacy of the financial industry. (Insurers are not in business to cover your butt against misadventure. They are in business to make money by investing your premium payments.) That the other Republican appointees to the Task Force did not join this dissent suggests these dissidents just don't get it. Health care is not just another commodity; it is a basic human right, not a reward for being the biggest rat in the race. CDSA Endorsementby Bob Roman At our January 9 membership meeting, we voted to endorse fellow DSA member Gary Schwab as a candidate for Trustee of the Village of Oak Park. Gary Schwab is running for a 4 year term as part of the Vision Community Action (VCA) slate in the April 17th consolidated election. The slate includes Annabel Abraham, James Balanoff, and incumbent Robert Milstein. The VCA platform embraces a Living Wage Ordinance for the Village. It calls upon the Village to sign contracts with all its unions by the end of 2007 and to accept arbitrated labor decicisions. The platform calls for the creation of a Labor Relations Commission to advise the Village Board on contested grievance and discipline actions, contract disputes and related issues. Gary Schwab is a 28 year resident of Oak Park. He holds a doctorate in Information Engineering from the University of Illinois in Chicago. He has served as a consultant and as information systems manager for public and private agencies. Gary's public service has included being a member of the Historical Society of Oak Park and River Forest. He has served as both chair and a member of the Community Design Commission, and as a member of the Community Development Citizen Advisory Committee. Gary has devoted many years to public service in the Village. Gary's remarkable grasp of history has made him a champion of historic preservation and economic development which respects Oak Park's unique and irreplaceable character and tradition of diversity. If you'd like to help, call Tom Ard at 708.386.0869 or Tom Broderick at 708.386.6007 or email milsteinr@gmail.com.
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