Healthcare workers unions celebrated the defeat of California's Proposition 226 last week. The referendum would have forced unions to get permission from each member to spend money on lobbying or political activity. The proposition failed with 46% of the vote.
Kathy Sackman, president of the United Nurses Associations of California, said if 226 had passed, her nurses would not have been able to testify on nursing legislation, regulation or patient-care bills. "It was a slam-dunk for us that we couldn't have this pass," Sackman says.
Likewise, the California Nurses Association energized its members to spread the word that they would no longer be able to advocate for patient safety and healthcare reform if the measure passed. Only the voice of the organized healthcare industry would be heard, the CNA says. It sent out precinct walkers and set up phone banks.
The Service Employees International Union also made phone calls, work-site visits and neighborhood walks. "We involved our whole union in this the last couple months," says Sal Rosselli, SEIU Local 250 president.
And it may have worked. The two counties with the strongest votes against the proposition, San Francisco and Alameda, also have the largest Local 250 membership.
St. Louis confidential. With all the controversy about charity care and tax status, it would seem that openness would be a priority for most not-for-profits. But Unity Health, a large integrated system based in St. Louis, isn't having any of that. The tax-exempt organization won't even reveal who sits on its board.
Asked by a reporter for names and phone numbers of board members, Unity representatives confirmed it is against policy to give out any board member information.
Compare that stand with the information publicly traded companies are required to issue about their boards of directors. A proxy statement includes directors' names, ages and outside business affiliations and a list of the committees with which they are involved.
Anecdotal evidence. Politicians like to try to put a human face on the issues of the day, and the "Patient Bill of Rights" is no exception. In a pair of speeches earlier this month, both President Clinton and Vice President Al Gore promoted the measure by citing the case of Ricka Powers, who they said was denied HMO coverage for breast cancer treatment.
But that example is drawing criticism from several sources.
Speaking to the National Congress on Medicare+Choice in Washington last week, Rep. William Thomas (R-Calif.), chairman of the House Ways and Means health subcommittee, criticized the Clinton administration for taking an anecdote and "arguing as though it occurs every day in every community across America."
Thomas also wondered aloud why Clinton and Gore cited the same example.
"If there are so many good (anecdotes about how bad HMOs are) . . . why did Vice President Gore have to use the same one (Clinton did) a week later?" Thomas asked.
HealthPartners, the HMO in question, also took umbrage at the Clinton and Gore story.
"You owe HealthPartners a public apology for the disparaging statements you made about our organization," wrote George Halvorson, the HMO's president and chief executive officer, in a letter to Clinton.
Halvorson went on to tout HealthPartners' various prevention programs and contradicted aspects of Powers' story. He says HealthPartners offered her access to a specialist and paid for chemotherapy.
The White House would not comment on the letter or Thomas' criticisms.
In the red. A small contingent of reporters gathered at New York's Flushing Hospital Medical Center June 3 to be briefed on the hospital's Chapter 11 bankruptcy filing. As executives announced the proposed reorganization, fire consumed a conference room on another floor of the hospital.
Firefighters determined an alcohol-based accelerant was used to set the blaze. It has been deemed suspicious and remains under police investigation. A $26,000 reward for information on the identification of the parties responsible is being offered by the hospital, members of the board, medical staff members and the police department's crime prevention program.
It would be easy to presume that the fire was started by someone who opposes the hospital's proposed reorganization, which may result in layoffs. But hospital management isn't pointing fingers.
"It's unfortunate that it happened on the day that the filing took place," says Brian Salisbury, a hospital spokesman. "It could just be somebody who likes to set fires."
As a precaution, hospital staff moved some patients to other areas to avoid any discomfort caused by the smoke. The hospital also stepped up security at all facility access points.
"There's got to be a special place in hell for people who start fires in hospitals," Salisbury says. "You've got to be a coward, and you've got to be really sick."
Next, the hurricane shirt. In what passes for the marking of history in America these days, "I survived the Tennessee Twisters of 1998" T-shirts have been sent to the 2,750 attendees of the VHA hospital alliance annual leadership conference held this spring at the Opryland Hotel Convention Center in Nashville.
On the afternoon of April 16, a tornado ripped through downtown Nashville, shutting down the VHA meeting temporarily. "While the weather was out of our control, our group was admirably calm and cooperative," writes VHA exec Bruce Brennan in a thank-you letter accompanying the extra-large T-shirt. "Please accept this `survival T-shirt' as a token of our appreciation." Next year the meeting will be held in Orlando, Fla., another spot prone to rough weather, not to mention the unrelenting commercial onslaught of nearby Disney World.
Outliers suggests that VHA tuck T-shirts into the obligatory souvenir meeting tote bag that read: "I survived the `It's A Small World After All' theme song in 1999."