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As Covid Surges, Doctors Are Striking Against “Retail Health”

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We’re back with Sea­son Four of Work­ing Peo­ple! In this urgent episode, we talk with Dr. Amir Atabey­gi, a physi­cian at Mul­ti­Care Indi­go Urgent Care in Thurston Coun­ty, Wash­ing­ton. On Novem­ber 23, amid a ter­ri­fy­ing surge in COVID-19 cas­es around the coun­try, Dr. Atabey­gi joins his fel­low physi­cians, physi­cian assis­tants, and advanced reg­is­tered nurse prac­ti­tion­ers on the pick­et line as they strike for the basic safe­ty mea­sures their employ­er refus­es to pro­vide. We talk to Dr. Atabey­gi about what he and his cowork­ers face on the job, the rise of ?“retail health” com­pa­nies like Mul­ti­Care Health Sys­tems, and the grow­ing labor con­scious­ness of tra­di­tion­al­ly non-union­ized health­care workers.

This blog was originally published at In These Times on November 23, 2020. Reprinted with permission.

About the Author: Maximillian Alvarez is a writer and editor based in Baltimore and the host of Working People, “a podcast by, for, and about the working class today.” His work has been featured in venues like In These Times, The Nation, The Baffler, Current Affairs, and The New Republic.


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Pandemic on course to overwhelm U.S. health system before Biden takes office

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The United States’ surging coronavirus outbreak is on pace to hit nearly 1 million new cases a week by the end of the year — a scenario that could overwhelm health systems across much of the country and further complicatePresident-elect Joe Biden’s attempts to coordinate a response.

Biden, who is naming his own coronavirus task force Monday, has pledged to confront new shortages of protective gear for health workers and oversee distribution of masks, test kits and vaccines while beefing up contact tracing and reengaging with the World Health Organization. He will also push Congress to pass a massive Covid-19 relief package and pressure the governors who’ve refused to implement mask mandates for new public health measures as cases rise.

But all of those actions — a sharp departure from the Trump administration’s patchwork response that put the burden on states— will have to wait until Biden takes office. Congress, still feeling reverberations from the election, may opt to simply run out the clock on its legislative year. Meanwhile, the virus is smashing records for new cases and hospitalizations as cold weather drives gatherings indoors and people make travel plans for the approaching holidays.

If you want to have a better 2021, then maybe the rest of 2020 needs to be an investment in driving the virus down,” said Cyrus Shahpar, a former emergency response leader at the CDC who now leads the outbreak tracker Covid Exit Strategy. “Otherwise we’re looking at thousands and thousands of deaths this winter.”

The country’s health care system is already buckling under the load of the resurgent outbreak that’s approaching 10 million cases nationwide. The number of Americans hospitalized with Covid-19 has spiked to 56,000, up from 33,000 one month ago. In many areas of the country, shortages of ICU beds and staff are leaving patients piled up in emergency rooms. And nearly 1,100 people died on Saturday alone, according to the Covid Tracking Project.

“That’s three jetliners full of people crashing and dying,” said David Eisenman, director of the UCLA Center for Public Health and Disasters. “And we will do that every day and then it will get more and more.”

The University of Washington’s Institute for Health Metrics and Evaluation predicts 370,000 Americans will be dead by Inauguration Day, exactly one year after the first U.S. case of Covid-19 was reported. Nearly 238,000 have already died.

The task force Biden announces Monday will be staffed with public health experts and former government officials, many of whom ran agencies duringthe Obama and Clinton administrations — including former Surgeon General Vivek Murthy, former Food and Drug Administration Commissioner David Kessler, New York University’s Dr. Celine Gounder, Yale’s Dr. Marcella Nunez-Smith, former Obama White House aide Dr. Zeke Emanuel and former Chicago Health Commissioner Dr. Julie Morita, who is now an executive vice president at the Robert Wood Johnson Foundation.

Shahpar said that even before Biden takes control of government in January, he and his team can make a difference by breaking with Trump’s declarations that the virus is “going away,” communicating the severity of the virus’ spread and encouraging people to take precautions as winter approaches.

“There’s been a misalignment between the reality on the ground and what our leaders are telling us,” he said. “Hopefully now those things will come closer together.”

But Shahpar and other experts warn thateven if Biden and his task force start promoting public health measures now, it will take weeks to see a reduction in hospitalizations and deaths —even if states clamp down. And there is little indication that the country will drastically change its behavior in the near term.

Some governors in the Northeast, which was hit hard early in the pandemic, are imposing new restrictions. In the last week, Connecticut, Massachusetts and Rhode Island activated nightly stay-at-home orders and ordered businesses to close by 10 p.m. And Maine Democratic Gov. Janet Mills on Thursday ordered everyone to wear a mask in public, even if they can maintain social distance.

But in the Dakotas and other states where the virus is raging, governors are resisting calls from health experts to mandate masks and restrict gatherings. On Sunday morning, South Dakota Republican Gov. Kristi Noem incorrectly attributed her state’s huge surge in cases to an increase in testing and praised Trump’s approach of giving her the “flexibility to do the right thing.” The state has no mask mandate.

And unlike earlier waves in the spring and summer that were confined to a handful of states or regions, the case numbers are now surging everywhere.

In New Mexico, the number of people in the hospital has nearly doubled in just the last two weeks and state officials said Thursday that they expect to run out of general hospital beds in a matter of days.

“November is going to be really rough on all of us,” said Democratic Gov. Michelle Lujan Grisham — a contender to lead the Department of Health and Human Services in Biden’s administration. “There’s nothing we can do, nothing, that will change the trajectory. … It is too late to dramatically reduce the number of deaths. November is done.”

Minnesota officials said last week that ICU beds in the Twin Cities metro area were 98 percent full, and in El Paso, Texas, the county morgue bought another refrigerated trailer to deal with the swelling body count.

“We had patients stacking up in our ER,” Jeffrey Sather, the chief of staff at Trinity Health in North Dakota said during a news conference last week. “The normal process is we call around to the larger hospitals and ask them to accept our patients. We found no other hospitals that could care for our patients.”

An “ensemble” forecast used by the Centers for Disease Control and Prevention — based on the output of several independent models — projects that the country could see as many as 11,000 deaths and 960,000 cases per week by the end of the month. Researchers at Los Alamos National Laboratory suggest that the U.S. will record another 6 million infections and 45,000 deaths over the next six weeks, while a team at Cal Tech predicts roughly 1,000 people will die of Covid-19 every day this month — with more than 260,000 dead by Thanksgiving. The University of Washington model forecasts 259,000 Americans dead by Thanksgiving and 313,000 dead by Christmas.

Eisenman predicted that by January, the United States could see infection rates as high as those seen during the darkest days of the pandemic in Europe — 200,000 new cases per day.

“Going into Thanksgiving people are going to start to see family and get together indoors,” he said. “Then the cases will spread from that and then five weeks later we have another set of holidays and people will gather then and by January, we will be exploding with cases.”

This blog originally appeared at Politico on November 9, 2020. Reprinted with permission.

About the Author: Dan Goldberg is a health care reporter for POLITICO Pro covering health care politics and policy in the states. He previously covered New York State health care for POLITICO New York.


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Stiffing Corporate Lobbyists; Short-Time Work Salvation; Nurses on the Line

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It’s the permanent government—the corporate lobbyists who have friends in both parties. It is at the heart of why we don’t have Medicare for All, why the Pentagon is rolling in dough and why banks and Wall Street rip us off. Jeff Hauser, the executive director of the Revolving Door Project, talks about what the strategy looks like to limit the influence of the corporate elites in a possible Biden Administration.

The pandemic has ripped through the world, killing and sickening millions. But, if you look at the economic hits people have taken, the pandemic has exposed the complete and utter failure of the system in the U.S. to make sure people can hang on. Both Europe and the U.S. had to shut down their economies and both took hits in output—but why has the unemployment rate been so much lower in Europe in the first half of the year than the U.S.? Maria Figueroa, the Director of Labor and Policy Research at the Industrial and Labor Relations School at Cornell University, explains how “short time work” made the difference.

It’s fairly obvious that Trump has the blood of thousands of Americans on his hands for his absolute narcissistic bungling and incompetent handling of the pandemic. Tens of thousands of people, especially front-line workers like nurses, got sick at work because this administration let corporate shills, who don’t care about workers, run the Occupational Safety and Health Administration.

Which brings me to the Oregon Health and Science University, a massive sprawling operation which in 2019 had $3.2 billion in revenues. OHSU is taking a page from Jeff Bezos when it comes to stiffing nurses who are seeking a fair wage and leaving nurses at great risk by refusing to commit to fully providing for a safe workplace during the pandemic. We get the lowdown from Terri Niles, an ICU Nurse at OHSU and a vice president at the 2,900-member Local 52 of the Oregon Nurses Association.

(If you want my final election analysis and predictions for next week, check out my Working Life website and read it all there).

This blog originally appeared at Working Life on October 28, 2020. Reprinted with Permission.

About the Author: Jonathan Tasini is a political / organizing / economic strategist and the author/editor of Working Life.


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Nursing home workers strike over unfair labor practices

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Workers at the Four Seasons Rehabilitation and Nursing home on Monday walked off the job over what they called unfair labor practices during a pandemic. 

Essential workers at the home off Newburgh Road say they are working without a contract and without enough personal protective equipment to stay safe. They also want better staffing levels and higher wages.

Workers at Four Seasons Rehabilitation and Nursing walk off the job Monday morning, stating unfair labor practices, in Westland, Michigan on October 19, 2020.

After agreeing to hold off striking for 30 days in August, it’s now back on, they said. 

The home is part of a chain where workers represented by the SEIU Healthcare Michigan union are negotiating a contract. 

“Governor Whitmer said it best: ‘With COVID-19 cases in Michigan on the rise, we cannot allow our most vulnerable patients to lack vital care.’ But nursing home owners have refused to come to an agreement that would equip us to provide the care our residents deserve,” said Carolyn Cole, a worker at the home, in a statement released by the union.

“We’re going on strike because if our workplace isn’t up to standard, it’s the residents who suffer.”

The nursing homes involved in the effort include the  Charles Dunn chains. Calls to them were not returned Monday. 

Ciena Healthcare and Villa Healthcare facilities are not included in the strike and reached an agreement with union members last week, the facilities said on Monday. 

At 6 a.m., a group of workers gathered along Newburgh Road to march and chant. Workers inside the building walked off the job to join the picket line. A Facebook live video shows workers as they marched in the dark. 

U.S. Rep. Rashida Tlaib, D-Detroit, showed her support for the workers by making an appearance at the strike, tweeting: “The intimidation & racially-charged bullying is disgusting & must stop. Workers deserve a contract.”https://platform.twitter.com/embed/index.html?creatorScreenName=detroitnews&dnt=false&embedId=twitter-widget-0&frame=false&hideCard=false&hideThread=false&id=1318206599610159105&lang=en&origin=https%3A%2F%2Fwww.detroitnews.com%2Fstory%2Fnews%2Flocal%2Fwayne-county%2F2020%2F10%2F19%2Fnursing-home-workers-strike-over-unfair-labor-practices%2F3706738001%2F&siteScreenName=detroitnews&theme=light&widgetsVersion=ed20a2b%3A1601588405575&width=550px

Workers protested in shifts, planning to stay outside of the nursing home until 6 p.m. Monday. Workers say they will continue to strike until a deal is made. 

“We’re here until it starts snowing if he doesn’t give us a deal,” said Ken Haney, the executive vice president of SEIU. 

Haney said the union and Dunn were in negotiations until 10 p.m. Sunday, but talks ended when Dunn refused to give in to the workers’ demands. 

Some of those demands include better health care and more premium coverage, and increased wages for the certified nursing assistants, who say they’ve had to do more work during the pandemic. 

“We’ve all just been working all over the place and we’re just tired. He can’t keep staff because of the pay … but you’ll have me as a CNA doing a two- to three-person job, and it’s not right,” said Iyone Pruiett, a CNA at Four Seasons Nursing Home. 

Haney said Dunn is violating the union contract by direct bargaining and offering members an extra $1.25 a day to not strike. 

“He’s creating violations against the National Labor Relations Act, against the contract by implementing wages without negotiating with the unions, changing working conditions without negotiating with the unions,” Haney said. “We’re still willing to go to the table, but it has to be on the terms and conditions that these employees, these members are saying they want.”

As the pandemic hit Michigan earlier this year, workers inside some of the state’s hardest hit nursing homes rationed protective gear, went without COVID-19 tests and struggled to care for seniors who carried a deadly virus.

Mashala Pate with SEIU,  Service Employees International Union, on the sidewalk in front of the Four Seasons Rehabilitation and Nursing where workers have walked out stating unfair labor practices in Westland, Michigan on October 19, 2020.

About a third of the 21 nursing homes that Gov. Gretchen Whitmer’s administration selected to care for elderly individuals with COVID-19 at the pandemic’s peak appear not to meet new quality standards under a revamped policy.

On Sept. 30, Whitmer announced an executive order to establish “care and recovery centers” to replace her “regional hubs,” existing nursing homes across the state tapped to care for people with the virus who are discharged from hospitals or reside in facilities that can’t properly isolate them.

The Legislature and Whitmer are still working out details and trying to come to an agreement. Whitmer’s handling of nursing homes has been a topic of heated debate for months. About 32% of Michigan’s 6,781 COVID-19 deaths have been nursing home residents, according to state data.

A sign on the side door of Four Season Rehabilitation and Nursing where workers have walked off the job, stating unfair labor practices in Westland, Michigan on October 19, 2020.

In Detroit, where the COVID-19 virus has devastated communities of color and the majority of nursing home workers are Black women, workers aim to draw attention to racial justice disparities inherent to their fight.

“COVID-19 just reinforced what the Black women who work in nursing homes have always known — these homes put profits over people,” said Izella Hayes, a worker at Imperial Nursing Home in Dearborn Heights, in a statement.

“As long as owners continue to treat us like we’re expendable instead of the heroes we are, we’ll continue to stand up for what’s right: a living wage so we can afford to get healthcare just like we provide it, and proper safety protocols and guaranteed PPE throughout the pandemic.”

This blog originally appeared at The Detroit News on October 19, 2020. Reprinted with permission.

About the Author: Ariana Taylor is a breaking news reporter with The Detroit News.


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East Bay Health Care Workers Strike Forces County to Disband the Boss

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On day two of their five-day strike, Alameda Health System workers in California’s East Bay won a landmark victory. After years of stalling, the elected Board of Supervisors of Alameda County suddenly announced they would disband the unelected Board of Trustees that has long mismanaged this public safety-net health care system.

In 1998, Alameda County supervisors decided to hand off administration of the county health care system to an unelected board, with an aim to cut spending. While the system remained public, it ceased to be directly funded by the county or under its jurisdiction; instead the county loaned AHS money and forced it to pay back any debts. This was part of a wave of privatization and outsourcing of public services across the county and the country.

The Board of Trustees soon turned to union-busting and dangerous cuts to care and staffing. According to health care workers, the COVID-19 pandemic made a bad situation into a nightmare, as AHS management responded to the pandemic by denying workers adequate PPE or training, laying off essential staff, and retaliating against workers who spoke up.

Yet even a month ago, Alameda County supervisors were unwilling to take AHS back under their direct control. Current County Supervisor Wilma Chan was also on the board in 1998, and voted then to give up democratic control of the health system. Chan, who chairs the Board of Supervisors’ health committee, until yesterday had been a skilled opponent of the county resuming responsibility. What forced the politicians to act was a strike with deep rank-and-file participation.

“When you have over 3,000 employees in a health care system, marching out and saying something is wrong, somebody has to listen to that,” said Sheleka Carter, a community health outreach worker and AHS chapter secretary in Service Employees (SEIU) Local 1021. “How can you ignore it?”

TURNING POINT

The strike has forced politicians to take responsibility for the system, but the move is only the start of a fight to determine how AHS will be run. Details of how county government will manage the system and handle AHS debts to the county have yet to be hammered out. Nonetheless, for East Bay health care workers and patients, this victory marks a turning point.

“The privatization is stopped,” said Carter. “It brings the system to a place where now the community has a say in how they get care and how the system is run. Employees have a voice about the changes that need to be made.”

In a rally Thursday at county headquarters, workers made clear they plan to strike until they win a fair contract for patients and workers alike.

“If it takes five strikes, we will strike five times,” said Mawata Kamara, an emergency nurse at San Leandro Hospital and member of the California Nurses Association, whose members are also on strike at San Leandro and Alameda Hospitals. “We are ready!”

This blog originally appeared at Labor Notes on October 13, 2020. Reprinted with permission.

About the Author: Keith Brower Brown is a graduate student instructor and member of United Auto Workers Local 2865 at the University of California, Berkeley.


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Hospital Workers Fight Job Cuts at Duluth’s Biggest Employer

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Our health care employer announced hundreds of unnecessary layoffs this spring. Outraged at its poorly disguised greed, we didn’t just rely on negotiations. Instead, the members of our union voted unanimously to take the fight to the streets and into the community. We spent the summer fighting back—including holding our local’s first-ever pickets.

Essentia Health is far and away the largest employer in Duluth, Minnesota. Its sprawling main campus is a neighborhood unto itself, and its clinics and other facilities spread out across the region into almost every community of more than a few thousand people. Its very well-paid CEO and other top executives have overseen year after year of dramatic expansion; now they’re building a new state-of-the-art $900 million hospital. Business has certainly been good for Essentia Health.

But much of Essentia’s growth has come at the expense of its workers. For years we have been made to take on more and more work, while vacancies are left unfilled. This is sadly a common trend throughout health care. The COVID-19 pandemic has only thrown more fuel on the fire.

SMOKE AND SPIN

This spring, despite receiving $112 million from the government, Essentia announced its intentions to permanently eliminate 900 jobs. Its PR statements talked about how this was necessary because of the hard times that the pandemic was causing the company, and said that even the top executives and physicians would be taking pay cuts.

But it was all smoke and spin. The reality is that Essentia wasn’t even in the red; in fact, it took in more revenue this year than last year. At the same time as the chain was eliminating jobs, it was spending tens of millions of dollars to buy out a hospital in Moose Lake, Minnesota, and continuing full speed ahead with the construction of a new hospital in Duluth.

The top brass of Essentia cut their salaries—but we’re skeptical how long that will last. In the meantime, we’re sure they won’t have trouble getting by after receiving exorbitant sums like the $1.5 million in compensation paid to CEO David Herman in 2019.

FIRST PICKET EVER

United Steelworkers Local 9460 is the largest union at Essentia. Members voted unanimously to launch a fightback campaign across the chain across our 11 units in the chain.

Our campaign kicked off on June 1, with a car caravan protest and informational picket at Essentia’s main campus in Duluth. Several dozen cars and trucks filled with union members and supporters waved their way through Duluth’s streets and drove around the Essentia Health campus for hours, honking the whole time. At the same time dozens of workers held signs and gave our leaflets at all of the intersections around their campus.

The response from the community was overwhelming. Numerous motorists spontaneously joined the caravan, and almost every pedestrian we encountered indicated support—some even joined the informational picket. A number of other unions participated, including the Food and Commercial Workers (UFCW), the Minnesota Nurses Association, and the Service Employees (SEIU), as well as miners from the nearby Iron Range who are also part of the Steelworkers. The impressive pickets and union solidarity that had been built around MNA’s 2019 contract fight at Essentia helped lay the groundwork for our campaign.

This was the first picket of our own that Local 9460 had ever organized in our 20-year history, and it created a buzz in the community, the local labor movement, and the media. Next we mounted an aggressive information campaign, distributing hundreds of “No Layoffs at Essentia!” yard signs and posters throughout the communities where Essentia Health has facilities, and putting up billboards in Duluth, Ashland, Hayward, Spooner, and the Iron Range. The message of the billboards was “Essentia Health: Putting Wealth Before Health Like Nowhere Else”—a pointed mocking of Essentia’s official advertising slogan, which is “Like Nowhere Else!”

The yard signs, posters, and billboards generated a new wave of media coverage—and legal threats from Essentia. But the union refused to back down, and in the end the billboards stayed up and were seen by hundreds of thousands.

‘BRING OUR JOBS BACK!’

As the summer went on, we held more actions, including an informational picket in downtown Spooner, Wisconsin, where our members work at an Essentia outpatient clinic. We promoted the pickets with full-page ads in the local newspapers and a series of guest editorials.

In the face of this resistance, Essentia unfortunately did forge ahead with its layoffs. They started with non-union workers and managers, before moving on to the different worksites where Local 9460 represents almost 2,000 Essentia workers.

By the time the layoffs ended this fall, our union had lost about 300 members. This was considerably less than had been expected, but it still represented a huge loss. The cuts ranged from clinical assistants to janitors. Few job categories were spared.

Essentia, of course, will never admit that the fightback campaign reduced the number of union members laid off, but we are confident that it did. And we’re even more confident that it will cause the company to think twice from here on out, now that management has seen that our union can and will fight back.

The battle is far from over. We still have members without jobs, and those who are working are doing so woefully short-staffed. Local 9460 is preparing to enter contract negotiations with Essentia, and to launch a new community campaign around the theme, “Bring Our Jobs Back!” The struggle continues.

This article originally appeared at Labor Notes on September 28, 2020. Reprinted with permission.

About the Author: Adam Ritscher is vice president of United Steelworkers Local 9460.


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How America Continues to Fail the Health Care Workers Battling the Pandemic

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American Red Cross workers travel from one community to another conducting the blood drives that save countless lives in emergency departments and operating rooms.

But they struggle to perform that vital work while keeping themselves safe during the COVID-19 pandemic. Like many health care employers, the Red Cross fails to consistently follow social distancing and other coronavirus safety guidelines.

“Safety shouldn’t be only if it’s feasible,” observed United Steelworkers (USW) Local 254 President Darryl Ford, who represents hundreds of Red Cross workers in Georgia and Alabama. “It should be all the time.”

Eight months after COVID-19 hit America, the nation continues to fail the thousands of health care workers who put their lives on the line each day to help others survive the pandemic.

They still face chronic shortages of personal protective equipment (PPE) because the U.S. never fixed the broken supply chains that resulted in highly publicized scarcities of face masks, respirators and other crucial equipment last winter. Some employers refuse to take even common-sense measures to keep workers safe.

The Red Cross failed to provide face shields to protect Ford and his colleagues from blood spatter. And when a company that made the devices offered them for free, the Red Cross declined because of what it deemed the low quality.

“If it’s snowing outside and you don’t have a coat to give me, but you do have a sweater, give me the damn sweater,” fumed Ford, noting his members prefer some protection to none.

Employers’ shortsighted practices not only pose lethal risks to health care workers but ultimately will endanger the patients they serve, especially if a second wave of the virus strikes this winter.

Hospitals, nursing homes and other employers, for example, regularly work health care professionals to the bone despite the danger that understaffing poses both to workers and patients.

Across the country, tens of thousands of patients and workers died after contracting COVID-19 in nursing homes. And although employers had months to fill vacancies and resolve other problems affecting care during the pandemic, workers in these virus hotspots still face severe staffing shortages, lack of PPE or both.

“It’s challenging and it’s stressful,” explained Lynair Gardner, unit griever for USW Local 7898, which represents certified nursing assistants (CNAs), dietary and environmental services workers and other staff members at Prince George Healthcare Center in Georgetown, South Carolina. “But you’re there for people who can’t help themselves. Sometimes, you have to put that compassion first.”

CNAs at the facility took on extra responsibilities when the pandemic hit, such as distributing linens and cleaning up after meals to reduce residents’ contact with environmental services and dietary staff members.

Sometimes, Gardner said, she and her colleagues maintain such a grueling pace that they work through their scheduled breaks without even realizing it.

Instead of recognizing their sacrifices, however, the nursing home insists they work longer hours because of understaffing and give up the flexibility with shift scheduling they long had.

Gardner’s colleagues need to be protected from burnout. But they just as desperately want to be valued by a corporate employer that takes them for granted.

“Just show some respect,” Gardner said, “and treat the employees like you’re really thankful for us.”

Rather than fortify workers for the long fight against COVID-19 that remains ahead, employers flout coronavirus guidelines and retaliate against those who challenge safety lapses. And instead of using its power to safeguard the heroes on the front lines, the federal government helps facilities silence their voices.

Forced to share disposable gowns during the pandemic, three workers at a New York senior-living facility discussed the danger among themselves before one wrote a letter to management citing the infection risk that the requirement posed. The facility responded by firing them.

Donald Trump’s anti-worker National Labor Relations Board (NLRB)—acting through its general counsel, Peter Robb, who has pursued an agenda of undoing generations of cases favorable to workers—sided with the nursing home.

The NLRB dismissed the workers’ unfair labor practice charge after determining their efforts to safeguard their health failed to qualify as protected, concerted activity under federal labor law. The board strained to conclude there was no evidence of “group concern” in the workers’ actions. As a result of that case, health care workers across the country will be less likely to challenge safety risks even as the number of COVID-19 deaths continues to climb.

Since the pandemic began, the USW and other unions representing health care workers successfully forced many employers to adopt more stringent infection-control practices that protected staff and patients alike.

USW Local 9899 President Jackie Anklam pushed Ascension St. Mary’s Hospital in Saginaw, Michigan, to provide more respirators and gowns to workers caring for patients.

She also demanded better supplies for those cleaning the facility. When hospital managers tried to scale back the procedures for sanitizing rooms occupied by patients with infectious diseases, Anklam told them, “Then you go in there.”

Now, another NLRB case threatens that life-saving advocacy.

The agency dismissed another unfair labor practice charge after the general counsel’s office determined that a concrete company could refuse to bargain with union members over sick leave and hazard pay because the parties were in the middle of a contract.

To the NLRB, it didn’t matter that the pandemic had drastically changed working conditions, exposed workers to new risks requiring contract adjustments or created the need for their union to bargain about rights and benefits that couldn’t have been imagined months earlier. The decision potentially means employers in many industries, including health care, will refuse to bargain with workers on critical issues, such as COVID-19 safety practices, while contracts remain in place.

Anklam fears hospitals and nursing homes now will say, “It’s our way or no way,” when unions demand changes to protect staff and patients.

Already, far too many health care employers ignore workers’ concerns while exploiting their professionalism and compassion to keep them on the job.

Ford and his co-workers, for example, take great pride in collecting the blood that not only makes life-saving transfusions available virtually everywhere but also helps to advance research into public health dangers, like COVID-19.

He just wishes the wave of support Americans showed for health care workers at the beginning of the pandemic lasted as long as the health crisis itself and forced employers to make real, permanent changes in worksite safety.

Instead, health care workers perform ever more difficult jobs than they usually do—all without the proper equipment, support or attention they need to keep themselves and their patients safe. For too many Americans, health care workers are out of sight, out of mind.

“It’s back to business as usual,” Ford said.

This article was produced by the Independent Media Institute on September 8, 2020. Reprinted with permission.

About the Author: Tom Conway is the international president of the United Steelworkers Union (USW).


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Health providers’ scramble for staff and supplies reveals sharp disparities

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Doctors, nurses and caregivers at smaller and poorer hospitals and medical facilities across the country are still struggling to obtain the protective gear, personnel and resources they need to fight the coronavirus despite President Donald Trump’s repeated assertions that the problems are solved.

Health care workers at all types of facilities scrambled for scarce masks, gloves and other life-protecting gear at the beginning of the pandemic. The White House was letting states wage bidding wars against one another, rather than establish a central national manufacturing, supply and distribution chain.

But now, health care workers say a clear disparity has emerged and persisted. Larger and richer hospitals and practices outbid their smaller peers, sometimes for protective gear, sometimes to fill in staffing gaps. And some of those having the hardest time are precisely where the virus is spreading.

A POLITICO survey of health care workers elicited dozens of stories from the front lines across the country. Reporters did follow up interviews with about a dozen survey respondents, and also interviewed other health care practitioners and policy experts. Some spoke on the condition of anonymity because they feared retribution from employers, as some medical facilities have threatened to fire workers for airing complaints publicly.

Health care administrators say the smaller and poorer facilities are also being outbid in the labor market, as providers compete for a limited pool of trained nurses and specialists who can care for Covid-19 patients amid chronic staff shortages and pandemic-induced industry upheaval. Their descriptions illustrate the shortcomings of a federal response that was initially focused on major hospitals while scores of smaller providers fell through the cracks.

The resulting disparities, especially among long-term care providers who often continue to care for patients after they leave the hospital or whose patients don’t require hospitalization but are still infectious, puts an asterisk on Trump’s claim that “they’re very much stocked up, they’re in great shape,” as he put it at one of his recent briefings.

“There’s not a single building I work in that has adequate Covid-19 supplies,” said a nursing home worker in Colorado, who requested anonymity.

The challenges may persist. On Friday, the FDA included surgical gowns, gloves, masks, certain ventilators and various testing supplies on its list of medical devices in shortage, based on manufacturer reports. The agency has required companies to report potential supply disruptions since May under the CARES Act.

The shortages of personal protective gear, or PPE, has taken a toll. Without adequate protection against a contagious pathogen, thousands of health workers have fallen ill, and at least 922 have died, according to a 50-state tracking project by Kaiser Health News and the Guardian.

Congressional Democrats have repeatedly petitioned the administration for more comprehensive information about lingering shortages and have been frustrated by the lack of up-to-date projections. Just this week, House Ways and Means Chair Richard Neal (D-Mass.) complained that it has taken him months to get information on PPE from the administration — and then it’s out of date.

“They’ve fumbled at every turn,” Neal said in a statement.

GetUsPPE, the largest national organization distributing donated equipment, said it’s received a massive increase in requests for PPE over the past two months, as the virus walloped the Sun Belt states and spread throughout the country. But the group said there’s been a noticeable shift in who’s pleading for help. It’s no longer primarily hospitals, but smaller providers who can’t muster the same negotiating leverage.

“Those hospitals, at least speaking from experience, are figuring out the supply chains necessary to stock PPE,” said Ali Raja, the organization’s cofounder and vice chair of emergency medicine at Massachusetts General Hospital. “What we’re seeing now is a lot of requests from visiting nurse associations, rehab facilities – the kind of places that take care of patients after they leave the hospital but still have weeks or months of illness.”

Health care leaders said these shortages stem from a mismatch of resources, as well as the pandemic’s shifting nature. While Congress made available $175 billion in coronavirus relief payments to help hospitals, doctors, nursing homes and other care providers, much of the initial funding went to well-resourced hospital systems regardless of need, with more targeted funding rounds coming later.

“Unfortunately, at every level of government, there has not been a coordinated response,” said Mark Parkinson, president and CEO of the American Health Care Association (AHCA) and National Center for Assisted Living. “And there have been some public health mistakes that were made. Early on, everyone thought that every hospital in the country was going to be overrun with Covid. So the decision was made to put all the resources in the hospitals.”

That’s not to say PPE shortages are completely resolved in hospitals. Some front-line workers, even at well-resourced hospitals, say ongoing shortages have forced them to clean and reuse masks and gowns that were intended for single use.

“It’s an inappropriate use of PPE, it should be used one time on one patient,” said an ICU nurse in Henderson, Nev. who requested anonymity. “When we get sick because of inadequate PPE, it’s just adding to the problem of short staffing.”

Kevin Warren, president and CEO of the Texas Health Care Association, said that rising prices for PPE were putting financial strain on nursing homes and assisted living communities his group represents. He said that’s made it harder for some facilities to hire more nurses as they’re also struggling to compete with new bonus payments hospitals are offering to attract recruits.

“Given the cost of hero pay, and bonus payments and recruiting bonuses, they can’t compete in the market,” Warren said. “They can’t recruit someone away to work for them because they can’t compete in the labor market.”

At a recent Senate Finance Committee hearing, congressional Democrats argued that exorbitant prices for PPE were emblematic of the Trump administration’s failures.

Robert Wiehe, the chief supply chain and logistics officer for UC Health in Ohio, presented data at the hearing showing that his health system had paid up to ten times the normal price for masks and gowns due to shortages. After peaking in April and May, those prices began to decline but remained well above their pre-pandemic levels — particularly N95 masks, which still averaged more than double their normal price throughout June.

The Trump administration has pushed back, arguing it has mustered a massive supply of resources in response to an unprecedented pandemic.

“President Trump has led the greatest mobilization of the private sector since World War II to deliver critical supplies, including face masks, PPE, and ventilators, to the areas that need it most and saving countless lives,” White House deputy press secretary Judd Deere said.

According to the latest White House estimates, FEMA and HHS have distributed 203 million N95 masks, 855 million surgical masks, 36 million goggles and face shields, 364 million gowns, and 21 billion gloves.

Ways and Means’ Neal officially requested information from the administration on PPE distribution in early April. By the time he got it in early August, it was out of date.

“Given the length of time it took for them to even respond to my request, I had low expectations for the details and explanation the Trump administration would have for disbursing personal protective equipment. This really should be one of their highest priorities and unfortunately, it is another example of how ill-prepared they were to handle this pandemic,” he said.

In June, an internal FEMA document projected that PPE supply would just barely cover demand if various kinds of single-use equipment could be cleaned and reused. But that forecast assumed steadily declining case numbers, and has not been updated since, according to agency. Health officials and workers say that once another wave of cases crested in July, shortages of PPE and personnel resumed.

A health director for an assisted living community in Texas, who requested anonymity, said she had seen this grim financial calculus play out firsthand, calling it a “recipe for disaster.” Unlike hospitals and nursing homes, assisted living communities have not received any targeted financial aid through the federal provider relief fund.

When her workplace saw an influx of coronavirus patients in late June, she requested additional nursing staff from her parent company. She was told by a regional operations manager that they were not hiring additional staff because the company’s investors would not approve the spending. Since then, as the only registered nurse caring for a community of approximately 100 elderly residents, she said she has overseen more than 60 positive cases and 8 deaths.

Even for unskilled positions like home health aides — who are paid low wages for grueling jobs — labor shortages remain problematic. A home health worker in Ohio said her short-staffed employer saw a dramatic decline in job applications because “there’s fear attached to working in a health care environment.”

While hospitals have generally fared better, doctors and nurses say efforts were hampered by the massive staff furloughs that occurred during lockdown in the spring. With elective procedures paused, hospitals grappled with large revenue shortfalls and cut payrolls to cope.

In April and May, the health care industry reported more than 1.4 million job losses, including 161,600 hospital and 83,800 nursing home jobs, according to the Bureau of Labor Statistics. While hospitals rebounded in June with a gain of 6,000 jobs, nursing homes continued to suffer with an additional 18,300 job losses.

“You were just working with less than you started with,” said Carrie Kroll, vice president at the Texas Hospital Association. “First it was just trying to get people deployed. Now we’ve been much more focused on trying to figure out how that’s getting paid for, and there are only so many people to go around.”

An ICU nurse in Las Vegas said that staffing levels at her small hospital fell noticeably while elective procedures were paused, and did not fully rebound when they resumed. She described the harrowing experience of caring for multiple unstable patients in the dead of night without the ability to call for backup because of thin staffing.

“The feeling you have when no one shows up to help you, it’s like ice in your veins, you never forget it,” she said. She added that while other nearby hospitals had bolstered nursing staff with $1,000 hiring bonuses, her workplace has not.

Adequate nurse staffing was already a contentious issue before the pandemic — for years, nursing unions have pushed for policies that mandate a minimum ratio of nurses-to-patients. California was the only state to enact such a mandate, but hospitals in the state since March have been able to apply for temporary waivers excusing them from the requirement.

Jessica Vasquez, an ICU nurse at San Joaquin General Hospital, which recently obtained such a waiver, argued that exceeding the ratios would put patients at risk.

“You take out the ratios, you mess with safe ratios, there’s possibility that this can be life or death for some patients,” she said. “There’s no way a nurse can give her attention to so many patients.”

San Joaquin General Hospital CEO David Culberson confirmed that his hospital had received a waiver for coronavirus-related patient surges in the ICU, telemetry and emergency departments, but stressed that the hospital was “committed to providing as many nurses as possible to all its patients in order to provide optimal patient care and meet staffing ratios.” He noted that the hospital had hired additional full-time nurses in recent weeks and was offering nursing staff extra shifts and paid overtime to meet the demand.

Many hospitals that did have funds to hire nonetheless struggled to find staff with specialist training and experience dealing with a highly contagious respiratory disease.

“You have people going there that in many cases had literally no idea what they are doing,” said Sunny Jha, an anesthesiologist at the University of Southern California. “They’ve never worked in an ICU, they’ve never worked in a disaster field, they had never worked with Covid patients, and in some cases they had never worked period — this was their first job out of school.” 

This blog originally appeared at Politico on August 14, 2020. Reprinted with permission.

About the Author: Tucker Doherty is a health care reporter for POLITICO Pro.


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Thousands of health workers lose jobs in COVID crisis, while major hospital chains get richer

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Congress provided $100 billion in emergency funding to hospitals to respond to the coronavirus crisis in the CARES Act passed back in March. That was supposed to provide about $108,000 per hospital bed across the country, to help hospitals meet the resource gap they were experiencing and to ramp up infrastructure to meet the coming demand. The legislation gave wide discretion to the Secretary of Health and Human Services for the distribution of the funds, without imposing many constraints. That was a bit of a mistake, as an investigation from The New York Times demonstrates.

They’ve analyzed tax and securing filings from 60 large national hospital chains that received collectively more than $15 billion of that funding. They found that a lot of that money went into the pockets of CEOs while thousands of employees—health care and support workers—were furloughed, laid off, or had their pay cut. For example, HCA Healthcare, worth $36 billion and a chief executive was paid $26 million in 2019. HCA got $1 billion in emergency funding, but “employees at HCA repeatedly complained that the company was not providing adequate protective gear to nurses, medical technicians and cleaning staff,” and in May, “HCA executives warned that they would lay off thousands of nurses if they didn’t agree to wage freezes and other concessions.”

Of the 60 hospital chains the Times looked into, at least three dozen have laid off, furloughed, or cut the pay of their staff to “try to save money during the pandemic,” despite the fact that among them they’ve got tens of billions in cash reserves. The five highest-paid executives among these chains were paid a collective $874 million in the last year financial data was available. In interviews with more than a dozen workers at these hospitals, the Times found the it’s the front-line staff that’s been hurt the hardest—custodial and cafeteria workers, and nursing assistants. They also said that “pay cuts and furloughs made it even harder for members of the medical staff to do their jobs, forcing them to treat more patients in less time.”

The Mayo Clinic got $170 million in CARES funds, despite having something like eight months worth of funding in reserve. It has furloughed or cut hours for 23,000 employees, though one of the spokespeople who has not been furloughed tells the Times that Mayo executives have cut their own pay. Seven other chains—Trinity Health, Beaumont Health and the Henry Ford Health System in Michigan; SSM Health and Mercy in St. Louis; Fairview Health Services in Minneapolis; and Prisma Health in South Carolina—received a collection $1.5 billion and among them have let 30,000 employees go, either permanently or temporarily. Tenet Healthcare got $345 million in bailout money, and has furloughed 11,000. Stanford University’s health system got $100 million (it has 42.4 billion in reserve) and “is temporarily cutting the hours of nursing staff, nursing assistants, janitorial workers and others at its two hospitals.” The spokesman for the system says that those reductions are intended “to keep everyone employed and our staff at full wages with benefits intact.”

HCA, however, is the biggest villain here. The $1 billion—One. Billion.—it got in emergency grants is the largest. But in the past few months, the medical staff at 19 of its hospitals have filed Occupational Safety and Health Administration complaints over lack of personal protective equipment, including respirator masks and gowns. At least two HCA employees have died from coronavirus because they didn’t have adequate PPE. Celia Yap-Banago, a nurse in Kansas City died in April. She treated a patient without wearing PPE. At an HCA hospital in Riverside, California, Rosa Luna and her fellow janitorial staff clean rooms of coronavirus patients, and haven’t been provided proper masks. Rosa Luna died last month, at the same time that HCA executive were warning the unions representing hospital workers that “unless the unionized workers amended their contracts to incorporate wage freezes and the elimination of company contributions to workers’ retirement plans, among other concessions.”

Yes, all of these systems have lost money because pretty much everything but coronavirus care has stopped in the last few months; elective surgeries and procedures have been cancelled, non-coronavirus emergencies like car wrecks have plummeted with stay-at-home orders. But these huge hospital chains, which have received disproportionate amounts of CARES bailout funds, have billions in reserve collectively. They have CEOs bringing home millions in salary and bonuses. They can afford to keep their staff.

They need to be required to use some of the bailout money to retain and pay staff at current, if not enhanced, hazard rates. The bailout funds have already been highlighted as problematic because they were not meted out by coronavirus case numbers, but by a formula that allowed HHS to send the money out fast whether it went to hospitals that needed it most or not. A Kaiser Family Foundation analysis last month showed that the wealthiest hospitals, with the highest care of private insurance revenue, were getting the bulk of the emergency grants: “hospitals in the top 10% based on share of private insurance revenue received $44,321 per hospital bed, more than double the $20,710 per hospital bed for those in the bottom 10% of private insurance revenue.”

This blog originally appeared at The Daily Kos on June 8, 2020. Reprinted with permission.

About the Author: Joan McCarter is a Contributing Editor for the Daily Kos.


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Democrats in Congress Should Rethink a Health Insurance Deal That Would Be Terrible for Many Americans

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Congress must act decisively to ensure Americans get needed health care in the face of the novel coronavirus pandemic, both to promote public health and to reduce viral spread. But one Democratic proposal is a massive giveaway to private insurance companies with few redeeming qualities.

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This proposal would require the federal government to cover the full cost of COBRA, a continuation of employer-based coverage for people who have lost their jobs or who are furloughed. Because COBRA is for ex-workers, employers do not contribute to its cost. Instead, people on COBRA are typically required to pay their entire health insurance premium, which now averages around $20,000 a year for a family.

While the government would pay COBRA premiums, this proposal still requires workers to pay out-of-pocket costs that could add up to thousands of dollars.

This approach is inequitable, expensive, and not targeted to addressing the public’s health and safety. It should be set aside in favor of direct payments to doctors, hospitals, and other providers who deliver care to those in need.

Having the government cover COBRA premiums would lock in existing health inequalities. It would not help people who worked in jobs that did not provide health care coverage or who otherwise did not have access to employer-based insurance. And, if you had employer coverage and your employer offered you a low-cost HMO with limited access to care, for example, that’s all this proposal would pay for. But if you were a highly paid employee at a hedge fund and had excellent coverage that cost twice as much, this proposal would pay for your more expensive coverage.

This plan commits tens of billions of taxpayer dollars to private health insurers, regardless of the quality or price of the coverage they offer. That is not where our public resources should be going.

And, to repeat, this proposal does not cover the high out-of-pocket costs that come with most work-based coverage. To get care, people need to be able to afford the deductibles and copays. But, even pre-coronavirus, one in four Americans with insurance went without care because they couldn’t afford these costs. Forty percent of Americans didn’t have $400 in the bank for an emergency. Today, with no steady income, more people have fewer resources and will be forced to forgo care even with COBRA.

Furthermore, this proposal does not make budgetary sense. If enacted, Congress would be paying tens of billions of dollars more for people’s coverage than it would if the federal government paid directly for their health care through Medicare, as Senator Bernie Sanders and Representative Pramila Jayapal have proposed.

Why is Medicare less costly? Medicare’s administrative costs alone are more than 10 percent lower than private insurance. Medicare also reins in provider payment rates.

Paying providers directly through Medicare has additional advantages. It treats everyone equally, ensuring that all of us will get the care we need. People can see any doctor they choose. And, there are no financial barriers to care.

Moreover, covering care through Medicare provides real-time data on the scope of COVID-19 through a single electronic billing system, which is sorely lacking today. This data has helped other wealthy countries contain the spread of the virus and effectively deploy resources where they are needed.

The government picking up the tab for COBRA coverage should be seen for what it is: A handout to the health insurance industry. It rewards health insurers who offer inefficient, low-quality, high-cost health plans. And, it does far too little to ensure people get needed care, much less contain COVID-19.

Earlier in April, AHIP, the trade association for the corporate health insurers, made this same proposal in a letter to Congress. Surprise, surprise.

Some of the Democrats behind this proposal have financial ties to the health insurance industry. So, perhaps this legislation is payback for the hundreds of thousands of dollars in contributions to the Democratic Congressional Campaign Committee. If so, shame on these House Democrats.

Whatever the motivation, this is the wrong way to help our nation in a time of crisis. Help should go where it’s needed and where it will do the most good, not where it’s politically expedient.

This article was produced by Economy for All, a project of the Independent Media Institute. Reprinted with permission. 

About the Author: Diane Archer is a senior adviser to Social Security Works and founder and president of Just Care USA, an independent digital hub covering health and financial issues facing boomers and their families and promoting policy solutions. She is the past board chair of Consumer Reports and serves on the Brown University School of Public Health Advisory Board. Ms. Archer began her career in health advocacy in 1989 as founder and president of the Medicare Rights Center, a national organization dedicated to ensuring that older and disabled Americans get the health care they need. She served as director, Health Care for All Project, Institute for America’s Future, between 2005 and 2010.

About the Author: Richard “RJ” Eskow is senior adviser for health and economic justice at Social Security Works. He is also the host of The Zero Hour, a syndicated progressive radio and television program.


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