Recent news reports sometimes sound as if labor-management relations are headed down the tubes, especially in healthcare. Yet in some places an era of good feeling seems to be dawning-where you might not expect it.
A consortium of 10 Minnesota hospitals reached a major labor agreement in March with Service Employees International Union Local 113. The contract raises wages 3% in 1996, 3% in 1997 and 2% in 1998 for 5,000 service and maintenance workers in Minneapolis and St. Paul. It also increases vacation time, pension-fund payments and other minor benefits.
Average wages for workers under the contract are about $10 per hour.
Both the hospitals and the union attributed the successful outcome of the contract talks to "interest-based bargaining," a negotiating technique that replaces the traditional adversarial stance with a process of attaining mutual interests.
Local 113 and the Minnesota Hospital and Healthcare Partnership experimented with interest-based bargaining three years ago, but this is the first time they used it to work out the whole contract.
"The process is much better for the relationship between management and the union," said Marita Heller, senior vice president for human resources at MHHP.
What's surprising about the Minnesota situation is that such amicable relations are possible in one of the most heavily unionized parts of the country, which also has virtually the highest managed-care penetration. The Twin Cities have notoriously tight-fisted, sophisticated payers that have driven down premiums and lengths of stay. Hospitals have closed or merged, and HMOs have prospered, giving the region one of the most efficient markets in the country.
In other markets where HMOs have taken over and unions are strong, such as California, labor relations are tense, aggravated by workers' fear of job losses and hospitals' concerns about declines in reimbursements.
In Minneapolis, said Donna Chester, financial secretary for Local 113, "we've had a lot of restructuring and mergers. We've had one or two hospitals that closed. But we haven't seen a big loss of membership up to this point." That's partly because the union has been successful in organizing and because when hospitals closed it was able to place its members in other hospitals.
Furthermore, the hospital group has been working with Local 113 and a handful of other unions for 30 years. "It hasn't always gone this smoothly," Chester said, but "we've never had a strike with this group."
Heller said the hospitals stress the importance of good labor relations, not just through the contract bargaining group. "Within each of the hospitals, the union and management have worked together also. The leaders of these hospitals meet with leaders of labor at quarterly meetings. We have an annual conference to explore labor relations together."
Heller also said the unions understand that "in some cases we have to have reductions. They understand it's in their long-term professional interest to keep updated.
"We attempt to work out any workplace issues in a way that meets the needs of the employer and employee. We attempt to use data in decisionmaking, so we're all approaching (talks) with the same understanding of the problem."
Those are some of the cardinal precepts of interest-based bargaining, said Debra Kolodny, the SEIU's coordinator for workplace participation programs in Washington.
The SEIU doesn't have a position on interest-based bargaining, but it's in favor of anything that encourages worker participation. "We see it as `militant participation,"' Kolodny said. The union local must be clear on its goals and must trust the employer enough to collaborate in problem-solving rather than insist on the more adversarial win-lose approach.
"If the employer approaches it with integrity and plays by the rules, hey, great, it's another avenue we can take to get our goals met," she said.
In traditional bargaining, each side starts with a position and proposals, and they argue them out. In interest-based bargaining, each side goes to the table with a description of the problem it's trying to solve or the goals it wants to attain. On the employer side, those might be fairness, administrative ease or cost-effectiveness. On the union side, questions might include: Does it build the union? Does it increase employee work satisfaction? Does it improve wages or working conditions?
Participants at the bargaining table work through the issues using a problem-solving model. The basic idea behind interest-based bargaining originated in a book, Getting to Yes, by Harvard professors Roger Fisher and William Ury.
Chester of Local 113 said one reason the negotiations worked so well was the able direction from the mediator, Jeanne Frank.
Frank, a commissioner of the Federal Mediation and Conciliation Service, returned the compliment. "I'd like to clone the labor committee," she said. "The labor committee was so very good in actually practicing all the principles of interest-based bargaining. They practiced what I preached."
Frank said this style of negotiating has gained acceptance with numerous Minnesota healthcare organizations. "There is no need to rely on power, as there is in traditional negotiations. You use an objective way of measuring options that are possibilities," she said. Most importantly, the parties must have a trusting relationship in which they can believe that the information they are sharing is valid and accurate.
Once the contract is in place, the problem-solving approach can be used to address issues that arise in the course of events. "The byproduct can be that this process, if used day-to-day, can minimize the number of grievances filed, the number of arbitrations, before they escalate," Frank said.
The hospitals had worked with the unions all along on issues of care delivery and staffing, Frank said, so these were not bombs waiting to explode in the contract talks.
"I think their relationship is mature," she added. "This is not to say they still don't have grievances, but it seems like the people in positions of authority, whether on the labor side or the hospital side, have a commitment to working together because the adversarial approach was really not successful for either one."
The SEIU's Kolodny agreed in principle with that assessment. At hospitals where labor relations have declined to the point of trench warfare, the preconditions don't exist that would make interest-based bargaining possible. In those places, she said, "there are probably some very real differences in how management is dealing with the union. Many times it is inappropriate to approach management with a problem-solving approach."