AFL-CIO President John Sweeney made a one-day blitz across California last week, attacking Kaiser Permanente and sharpening the conflict between organized labor and what he called "the HMO that labor built."
In speeches in Los Angeles, Oakland and San Diego, Sweeney called on all union members to use their leverage to support Kaiser employees who are fighting job cuts, wage freezes and restructuring.
"Kaiser has decided to compete in t he healthcare marketplace by cutting costs at the expense of quality patient care, and by denying decent wages, benefits and working conditions to its employees," Sweeney said. "Now they seem to want to lead the race to the botto m of the HMO industry by putting patients into the hands of lower-skilled workers without adequate training by eliminating highly trained professionals, closing more hospitals altogether and contracting out vital services to the lo west bidders."
Kaiser has announced it will close some of its own hospitals and contract out inpatient care. Kaiser's Oakland hospital, which is scheduled to close, was one of Sweeney's speaking venues.
Kaiser said on the day of Swe eney's tour that it was "saddened to see the concept of quality of care being used as a Trojan horse." After noting that Kaiser is the largest provider of healthcare to union members and the largest employer of healthcare unionis ts, the HMO said the attack "should be seen for what it is-a thinly veiled attempt to apply pressure for favorable union contracts."
Kaiser highlighted the market pressures it faces and said it has reduced premiums for many labor- group payers. The AFL-CIO, it said, has chosen to launch "a destructive public relations campaign....intended to cause severe damage to our reputation and our economic position by frightening our members."
Sweeney's rhetoric al igns closely with that of Service Employees International Union Local 250 and the California Nurses Association, which are waging highly public campaigns to embarrass the HMO in Northern California.
Sweeney said Kaiser has stalled a nd used unfair tactics to avoid settling contracts with union locals.
The AFL-CIO's Industrial Union Department is going to help the various unions representing Kaiser employees to coordinate their bargaining efforts. Furthermore, l abor has developed a strategy to use its influence as a purchaser of healthcare for union workers to effect changes in provider relations with their unionized employees.
The AFL-CIO executive council authorized the IUD to create un ion purchasing alliances "to increase our leverage on prices and to hold health plans like Kaiser accountable on quality," Sweeney announced.
The battle lines between the AFL-CIO and Kaiser hardened in February after an attempt to find a new way of getting along at the highest level apparently failed. Kaiser Chairman David M. Lawrence, M.D., and Sweeney met to discuss a "labor-management partnership" that would have placed a moratorium on concessions and restructuring issues.
But in a letter to Sweeney dated Feb. 16, Lawrence indicated a willingness to set up partnerships at various levels but declined to halt restructuring or to declare a moratorium on wage and benefit concessions. Lawrence also insisted that the unions stop their pressure tactics, public relations campaigns and leaks to the media.
Sweeney called Lawrence's terms "unreasonable and unacceptable" in a letter dated Feb. 27.
To raise the ante fu rther, the unions apparently have a martyr. On his visit, Sweeney announced the creation of the "Pat Jackson Healthcare Action Center," funded by the SEIU and the AFL-CIO. The center will monitor quality of care and the tax-exemp t status of "giant healthcare organizations," Sweeney said.
Jackson, 68, was an SEIU organizer who died of a stroke after being treated and sent home from a Kaiser hospital, Sweeney said.
"I relate this story not to imply that Pat died because of poor patient care at Kaiser, but to raise the question of whether she might have lived had she been given superior patient care by Kaiser," he said.
Kaiser spokesman Dan Danzig responded: "It's sad they have used this unfortunate event for political and bargaining purposes, when, as Mr. Sweeney stated, this has nothing to do with the fine quality of care we provide in general and to Mrs. Jackson specifically."