In the June 9 commentary ("Nurses, it's time to talk," p. 42), Tom Debley says Kaiser wants to put on its "work clothes" to settle a dispute between the HMO behemoth he represents and the California Nurses Association. This is another instance in which the emperor has no clothes.
Registered nurses are not alone in noticing the free-fall in care standards. Kaiser was nearly chased out of Texas by the state attorney general over denial of emergency-care claims and other abuses. In California, federal officials have threatened a cutoff of Medicare funds for a string of egregious deficiencies at two Kaiser hospitals.
Kaiser is systematically displacing and driving out registered nurses. A Kaiser senior vice president said in March that it's the corporation's "strategic plan" to cut staff "at the highest skill level-MDs and RNs." For those who remain, conditions are at times so intolerable that Kaiser recently had to pay bonuses of $200 per shift to retain RNs in maternal child services at its Oakland hospital.
Debley's analogy with the railroad industry is specious. The CNA is hardly bartering solely to save jobs in a dying industry. Healthcare is one-seventh of the U.S. economy and one of the most profitable industries in the nation.
A better comparison would be agribusiness. Large conglomerates are buying up hospitals, selectively shutting down less profitable facilities and reducing services to control the market. At least in agriculture, we've had a legacy of subsidies for small farmers and food stamps for the poor. With this vital resource, the corporate giants just appropriate the healthcare product while providing little in return.
Kaiser's campaign amounts to little more than planting flowers around Three Mile Island. What the company needs to do is bargain so that the RNs can help them problem-solve with a genuine voice on patient-care issues.
Rose Ann DeMoro
California Nurses Association