The head of the nation's largest healthcare workers union is calling for "a new framework" that permits more flexibility from both labor unions and healthcare employers.
"We're looking for a new social contract with the healthcare industry," Andrew Stern, president of the Service Employees International Union, told MODERN HEALTHCARE*last week. "We need a new framework that breaks our tradition."
Stern, who was elected to his post in April, was in Chicago as an at-large delegate to the Democratic National Convention.
Shortly after Labor Day, Stern said, the 1.1 million-member SEIU wants to initiate discussions with employers, policymakers, foundations and public-health advocacy organizations about knocking down some of the barriers to flexibility in the healthcare labor market.
The industry's transformation places such heavy demands on workers and employers to adapt, Stern said, that it doesn't make sense to continue to think in the old paradigms.
It's time for all players to find a new modus operandi, Stern said. "How do (employers) get out of the mold of the anti-union view that unions are a hindrance? How do (unions) get out of the role that the status quo is OK?
"Our problem in the labor movement is the healthcare system is changing, and it should change," Stern said.
But labor unions are perceived as obstacles to change, and that's a losing position. "We can't stand in the way of progress," he said. "The healthcare industry is not shrinking; it is realigning."
The labor movement must find opportunities to adapt with that realignment instead of allowing its members to fall victim to it, he said. As examples of those changes, Stern cited home health and ambulatory care replacing inpatient care.
"Patients prefer to be taken care of in their home as technology changes," he said. At the same time, home health nurses should be able to organize on the same basis as hospital nurses. Otherwise, Stern said, "if I'm a hospital-based nurse, and I lose my job when I go out the door, I'm going to fight like hell to keep that job and that door open."
The issue for the union is "how do we get our jobs into areas that are expanding? We're trying more and more to do that," he said.
Stern said consolidation of hospitals into networks and systems offers an opportunity for a different kind of job security: "security in the system, not security simply in your facility." Restrictive and limiting contractual terms need to be winnowed down on both sides.
Cross-training of personnel should not be inherently objectionable to union workers, Stern said. "We're not stuck on these rigidities," but workers should be trained properly and compensated for their added skills, he said.
Some of the harder questions will include redefining the bargaining unit and the employer. Eventually, that may require taking another look at provisions in the National Labor Relations Act, Stern said.