America's largest union of healthcare workers wants to become the "partner" of public hospitals and health systems and to "remake public healthcare for the next century."
One of the ways it might do that is by advocating union purchasing cooperatives to buy healthcare services from unionized providers.
The olive branch was tendered by Andrew Stern, president of the 1.1 million-member Service Employees International Union. In a speech this month in Washington to the National Association of Public Hospitals and Health Systems, Stern said: "We want to help you identify new savings, new markets, new services, new ways to cover more people, and new ways to restructure your institutions, not just as hospitals but as total service delivery systems."
NAPH is a lobbying and action group formed by many of the nation's larger urban, government-owned hospitals.
Chris Burch, NAPH executive director, said the speech was received warmly. "It was a continuation of a dialogue we've been having with SEIU for the past year," she said. "If safety-net systems are to survive, we're going to have to work together, not just on the federal or the legislative level but locally."
In his speech and in a subsequent interview, Stern proclaimed the SEIU's readiness to jettison the combative shop-floor politics of yesteryear and look toward a joint effort to fight what it sees as the real enemy: corporate healthcare.
"We are totally dedicated to the survival of public health services for a population that has been shut out, priced out and, too often, kicked out of the growing profitmaking sector," Stern said, taking particular aim at Richard Scott, chairman and chief executive officer of Columbia/HCA Healthcare Corp.
To help out its friends-and employers-the SEIU is thinking about using pension fund money as a pool of investment capital. "One of the issues for public hospitals is access to capital," Stern said. "You can't go to the stock market, and you can't float bonds. There are legal and practical issues to access to capital." He said the SEIU is discussing its options with "people who understand the investment world . . . people who find venture capital."
The SEIU is working especially closely with the city of San Francisco. Mayor Willie Brown "is trying to expand coverage, using all the resources at his disposal," Stern said. "One thing they are looking at is creating clinics citywide. They want to create a system. It will cost millions to create those clinics. Where do they get that money from?"
The SEIU also is considering forming union and public-sector health purchasing alliances that would emphasize quality and not just low cost. If union members can choose union-made cars and union hotels, they ought to choose unionized healthcare providers, too, Stern said.