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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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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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OSHA Complaints Show the Morbid Dangers Healthcare Workers Face During Covid

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During the darkest days of the Covid-19 pandemic, with thousands dying every day, America relied on a select few essential workers to keep society running, like postal workers, grocery workers and meat packers—all industries that have seen, together, hundreds of Covid-related deaths among workers. Chief among them are nurses, on the front lines of the pandemic, who have put their lives on the line to intubate disease victims and provide lifesaving medical care. Since the pandemic began, over 500 healthcare workers in the United States have died from the virus.

But these workers who we rely on so deeply—dubbed “warriors” by President Donald Trump and “heroes” by Senate Majority Leader Mitch McConnell—continue to work under hostile management and in dangerous workplaces that make the disease even more contagious and deadly.

That’s according to a dataset and interactive map recently released by Strikewave, a newsletter of original reporting and analysis for the U.S. labor movement. The data show at least 21,510 Covid-related Occupational Safety and Health Administration (OSHA) complaints since the start of the pandemic. It’s unknown exactly how many more complaints than usual have been filed, as OSHA complaints are relatively confidential. But it’s clear that they are surging.

Common in the complaints are allegations of managerial neglect, carelessness and abuse.

And while we may like to think that bad management is the exclusive territory of greedy corporations, the complaints show how healthcare workers, some of them working for nominally non-profit hospitals, have been failed by their employers even as they perform dangerous and essential work.

At Ascension Genesys Hospital in Grand Blanc, Michigan, a suburb of Flint, several OSHA complaints filed at the end of March alleged widespread shortages of personal protective equipment (PPE) and threats from management.

Carolyn Clemons, a registered nurse working in Genesys Hospital’s Covid-19 intensive care unit and member of Teamsters Local 332, said that in late March, when cases were skyrocketing, nurses who wore masks outside of patient rooms were threatened with disciplinary actions and firings. In hallways and offices, where nurses worked closely together, managers enforced a no-mask policy into April, according to Clemons. Ironically, some of the managers who threatened mask-wearing employees were the same who later tested positive for the coronavirus.

“There was not good communication,” Clemons said. “We felt a lack of respect for what we do.”

At the height of the pandemic, management kept stockpiles of PPE under lock and key in their offices while telling nurses to wear garbage bags instead, according to Kimberly Cox, a registered nurse and the Chief Steward of Teamsters 332. Even now, she says, much of that equipment remains unused.

Nurses at the hospital have tested positive. According to Cox, however, Genesys has so far refused to either provide on-site tests for nurses or inform employees of the number of positive or assumed cases among staff, despite repeated union requests. Nurses, some of them exhausted by persistent coughs and high fevers, were told to drive to the next hospital over.

There are complaints from hospitals across the Ascension health system.

One, filed on April 28 at Ascension St. Francis Hospital in Milwaukee, claimed management failed to implement social distancing practices “properly or effectively” and that workers were not informed when they were exposed to patients and coworkers with confirmed cases of Covid-19. At that point there were almost 3,000 Covid-19 cases in Milwaukee and more than 150 deaths.

There have been more than 15 such complaints against the health system, including the ones against Genesys and St. Francis, and there are likely more (detailed information about OSHA complaints is only available for “closed” cases, suggesting there could be several ongoing but confidential complaints). Additionally, Teamsters Local 332 has filed more than 100 grievances with the hospital.

Ascension, which operates as a non-profit out of St. Louis, Missouri, cut its CEO a $13.6 million paycheck in 2017, the last year on record. It also operates a venture capital fund, Ascension Ventures, which manages more than $800 million, and an investment advisory fund, Ascension Investment Management, which is responsible for $38.7 billion in corporate money.

The health system, which has been fined nearly $70 million for various regulatory violations over the past decade, received more than $400 million in federal funding in May. Genesys itself received more than $20 million. The funding, like all federal stimulus so far, comes with no stipulations regarding employee treatment.

Ascension Health did not respond to a request for comment.

These kinds of complaints can be seen across the industry. At publicly-traded HCA Healthcare, one of the wealthiest hospital chains in the country, complaints are, in some cases, nearly identical to those lodged against Ascension: N95 masks locked away by management, a total lack of protective equipment for housekeepers and food service workers, and prohibitions on mask-wearing. One complaint even alleged that nurses were directed to clean their masks with household cleaning wipes, return them to a bag, and then reuse those masks. In total, workers in the HCA network lodged at least 35 complaints, almost twice as many as Ascension received.

HCA paid its CEO more than $26 million in 2019 and has made more than $7 billion over the past two years. The chain received $1 billion in federal pandemic aid, also without stipulation. Weeks later, nurses at HCA claimed the company threatened them with mass firings unless they agreed to wage freezes.

These OSHA complaints are just a few of the thousands filed, all of which show how so-called essential workers have been treated as disposable. There are more than 3 million Covid-19 cases in the United States, but many essential workers are already losing meager hazard pay raises. As of April, at least 135,000 health care practitioners who work in hospitals had lost their jobs, including many nurses.

It’s a racial justice issue as well. In New York City, 75% percent of frontline workers are people of color. And Adia Harvey Wingfield, a sociologist studying Black healthcare workers, found that those workers are more likely to work at hospitals in the same impoverished Black communities that have been devastated by the coronavirus.

Both the pandemic and the protests sweeping the nation in the wake of the police killing of George Floyd carry the same lesson: our brutal status quo has long been untenable for many Americans, particularly the poor and non-white.

This blog originally appeared at In These Times on July 16, 2020. Reprinted with permission.

About the Author: Nick Vachon is an In These Times editorial intern.


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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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What Workers Have Already Won in the Face of Coronavirus

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The coronavirus pandemic has laid bare the stark reality of the United States: our inadequate, for-profit health care system, our precarious employment conditions, and the deep inequality that is foundational to our society. But it’s also shown us that when things get dire enough, the working class fights back. Over the last few weeks, in dealing with the outbreak of the coronavirus, people across the United States have organized at their workplaces, and also won major reforms in the housing sector. Workers’ consciousness about the cruelty of our profit-driven society—and about their own power—is being raised by the day, thanks to the failure of government leadership. While it’s likely that we will enter a recession or even depression soon, workers are still fighting for what they deserve—and that struggle must continue after the pandemic passes.

While many workers have lost hours or even been laid off in the last few weeks, others have made advances in various industries amid the crisis, including securing paid time off and health and safety guarantees. Teachers in New York City forced Mayor Bill De Blasio to close city schools under threat of a mass sick-out, workers shut down a Chrysler plant near Detroit over concerns about how the company was dealing with the virus, and workers at McDonald’s won 14 days of paid sick leave, albeit only at corporate stores which account for about 5% of the fast food giants’ restaurants.

In Philadelphia, city library workers moved a petition among themselves, patrons and the larger community to demand both the closure of public libraries and paid time off for all workers, even those who are not members of the union. The petition dropped in the morning on Monday, March 16, and by Tuesday evening, it had over 4,000 signatures, and the workers won their demands. Terra Oliveira, an after-school leader at the Philadelphia Free Library, told In These Times, “Our access to paid leave and our basic rights shouldn’t be something that we have to fight for every single time there’s a crisis.” Non-union library workers have been organizing with their union colleagues for about a year, building the infrastructure necessary to deal with our current crisis.

Similarly, the housing movement has long fought for moratoriums on evictions and utility shut-offs. Both have felt like far-off possibilities, the absolute peak of what we could win in a perfect storm of political will and power. But Tara Raghuveer, campaign director of the Homes Guarantee Plan at People’s Action, told In These Times that “the pandemic is showing us what has always been possible, and what that means is that it’s always been possible to end the practice of eviction.” Because of the seriousness of coronavirus, organizers and activists have won either moratoriums on evictions or utility shut-offs in cities and states across the country, including Philadelphia, San Jose, San Francisco, Los Angeles, and New York, Massachusetts, and Kentucky. The coronavirus crisis is revealing what was true before: It is unconscionable to abandon people who are houseless or without work.  “This has opened up tremendous space to ask for more and win more,” Raghuvver said.

The apparent ease with which these long fought for reforms were granted demonstrates that it is—and has always been—well within the power of the state and corporations to acquiesce to our demands. It also shows that it isn’t the benevolence of politicians and CEOs that has secured these victories, but worker organizing. If workers hadn’t been demanding paid sick time and eviction moratoriums for years, we never would have won them now. “Now that these demands have been won during this emergency crisis, there is so much more solidarity and communication among library workers that wasn’t there before. We will continue to fight,” said library worker Oliveira.

The state spends exorbitant amounts of money when it’s capital that’s feeling the pain, a fact illustrated by the dramatic financial actions being taken or considered to keep the economy afloat during the pandemic: a $1.5 trillion loan by the Federal Reserve to inject into capital markets; an $8 billion spending package to fight the coronavirus; and a nearly $1 trillion stimulus bill being considered at the time of this writing. These options obliterate the notion that money doesn’t exist to pay for programs like a Green New Deal, free college, free childcare, housing for all and various other social programs.

When it comes to spending to meet the needs of the millions of ordinary people who are hurting right now, politicians can’t muster the will. While the Democratic Party postures as recognizing and responding to this need in contrast to Trump, the proposals they’ve so far offered have been offensively mediocre and inadequate. H.R. 6201, trumpeted by Nancy Pelosi and House Democrats, offers paid sick leave benefits to only 20% of U.S. private sector workers—a figure that does not include informal economy workers. Former presidential candidate Kamala Harris also promoted a bill she had introduced that would give workers $500 each month—a pittance compared to the $2,000 per month cash payments to U.S. households floated by sen. Bernie Sanders.

We are heading into almost unprecedented economic territory—a potential 20% unemployment rate if our leaders don’t act now. More and more workers are facing the prospect of losing hours and even being laid off, as many major cities, municipalities and states impose shut downs for businesses except those classified as essential industries. Already, nearly one in five U.S. workers reports losing hours or work altogether since the onset of the coronavirus crisis earlier this month. We can expect that number to balloon in coming weeks and months as the public health crisis—and the ensuing economic crisis—continues to deepen. 

Some are trying using this crisis to fortify the tyrannical power employers have over workers’ lives. In Minnesota, Governor Tim Walz just suspended some collective bargaining rights for state employees, citing the need for “flexibility… during this peacetime emergency.” As workers unite to demand what we’ve always deserved, and the crisis deepens, some politicians and bosses will undoubtedly use this as an opportunity to ram through more neoliberal reforms that dismantle our rights and public institutions.

Conventional wisdom might suggest that in times of economic hardship, workers have the least power and leverage based on the scarcity of jobs and desperation for whatever we can get to provide for ourselves and our families. But strike activity and worker organizing is on the rise, the Bernie Sanders campaign program is raising political expectations, and workers are winning in the face of this pandemic. It’s reasonable to believe that when things “return to normal”—if that ever happens—politicians and bosses will attempt to take back all that we’ve won. They’ll try to strip paid sick leave from workers, and to reinstate evictions. But we mustn’t let them. Like Oliveira said, “It feels like only the beginning.” 

This article was originally published at InTheseTimes on March 17, 2020. Reprinted with permission.About the Author: Mindy Isser works in the labor movement and lives in Philadelphia.



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The Most Injurious Job in America

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Mike ElkWhile hospitals are better known for treating injuries than causing them, statistics show that for workers, hospitals can be a dangerous place. A new report put out by Public Citizen found that in 2010, healthcare workers (including hospital staff) reported 653,900 workplace injuries and illnesses. That’s approximately 152,000 more (a 432 percent higher rate) than the industry with the second highest number of injuries—manufacturing—even though the healthcare sector is only 134 percent larger than the manufacturing sector.

Part of the reason that healthcare workers’ injuries may have flown under the radar is because of the type of injury involved. Unlike manufacturing and construction, where injuries are more likely to result in death, healthcare workers mainly suffer non-lethal musculoskeletal disorders. The rate of musculoskeletal disorders among workers in the healthcare industry is seven times higher than among other workers—a trend that Suzy Harrington, director of the American Nurses Association’s Department for Health, Safety and Wellness, calls “alarming.” Although these conditions aren’t fatal, if untreated, they can lead to permanent disability.

The most common cause of musculoskeletal injuries for healthcare workers is lifting patients by hand instead of using a mechanical device. Yet while ten states, including Washington, California and Maryland, have dramatically reduced injuries by passing safe patient handling laws, which mandate that hospitals “furnish mechanical lifting and transfer devices,” no nationwide standard exists to protect healthcare workers.

Another major danger for healthcare workers is workplace violence. Workers in the healthcare sector suffer 45 percent of all incidents of workplace violence, and nursing home employees are especially affected, with seven times the average rate of injury from workplace violence. Violence in medical settings may arise from interactions with belligerent patients, who may be drunk, drugged or emotionally disturbed. Yet the Occupational Safety and Health Administration (OSHA) has never made a rule to require healthcare facilities to implement safeguards for their employees (such as metal detectors, security guards or even locked doors to isolate patients in guarded areas.) This is part of a larger problem: There are no federal OSHA rules requiring employers to ensure workplaces are safe from violence.

But workplace safety advocates say that OSHA’s particular lack of focus on the healthcare sector is symptomatic of the agency’s slow response to the shift to a service-based economy.

“OSHA has not been able to keep pace with the way the economy has shifted over the last 20 years,” says Keith Wrightson, worker safety and health advocate for progressive watchdog group Public Citizen. “The economy has shifted away from one that is industrially-based to one that is service-based. They are hardly any rules that directly affect the healthcare industry. We counted them out and there are only nine rules, but if you look at construction and manufacturing, there are literally hundreds—and rightly so, those industries are highly dangerous.”

OSHA, for its part, insists that it is very concerned about safety in the healthcare industry.

“Employers have the legal responsibility to provide workplaces free of recognized hazards.  They must take ownership over this issue, and our role is to see that they do,” says Assistant Secretary of Labor for OSHA David Michaels. “OSHA has a variety of tools at its disposal to hold employers accountable for safety and health, and we are committed to improving safety and health conditions for our nation’s healthcare workers. Under this administration, OSHA has done more than any previous administration to address the issues that persist in this industry.”

In response to questions from Public Citizen, OSHA elaborated on these efforts, explaining that it has instituted recent programs “to encourage employers in hospital and healthcare facilities to reduce hazards. For example, Assistant Secretary for OSHA David Michaels launched an OSHA initiative to work with hospitals and nursing homes to recognize the close link between patient safety and worker safety.”

However, when it came to passing concrete rules regulating the musculoskeletal injuries that plague the healthcare industry, OSHA ran up against a major stumbling block: Congress. In 2000, OSHA passed a rule aimed at reducing musculoskeletal injuries by making employers adopt measures shown to reduce ergonomic injuries. But in 2001, a Republican-led Congress repealed the rule. OSHA has since attempted to use the general duties clause under the Occupational Safety and Health Act to cite employers whose ergonomic conditions present a clear danger to workers, but that poses a trickier legal case to make than if there was were a specific rule, and in the past two fiscal years OSHA has only done so seven times, according to the report put out by Public Citizen.

In response to questions from Public Citizen about whether or not the agency intended to issue a another ergonomic rule, OSHA said, “At this time, OSHA is not pursuing a rule on safe patient handling for healthcare workers. We continue to be concerned about this serious issue and promote sensible solutions through the  NEP [National Emphasis Program] guidance and outreach activities. However, OSHA does not have resources to move forward on all rulemaking necessary to address all the pressing workplace health and safety hazards.”

Rules, however, are only the first step. For instance, while OSHA has rules in place to prevent healthcare workers from being accidentally stabbed, they still suffer an alarming 400,000 stab wounds a year from surgical instruments and needles. Public Citizen’s Wrightston says that such injury rates are unnecessarily high because OSHA, with its limited budget of only $565 million, has few resources—and what resources it does have are not focused nearly enough on healthcare workers, he says.

“OSHA has devoted relatively little effort to addressing the safety risks in healthcare compared to other highly afflicted industries,”  says Wrightson. “For example, health care workers outnumber construction workers more than 2 to 1, but OSHA conducts only about one-twentieth as many inspections of health care facilities as construction sites.”

Indeed, statistics show that OSHA conducted 52,179 inspections of the construction industry in 2010, which employs 9.1 million workers and saw 74,950 injuries that caused workers to take at least one day off work. In comparison, last year OSHA conducted only 2,540 inspections of the healthcare industry, though it employs more than twice as many workers and saw 176,380 such injuries.

Some of the differential is due to the higher mortality rate for construction injuries, which cause five times as many deaths on the job. However, according to the Public Citizen report, “Even if fatalities were the only factor considered, healthcare inspections would need to be increased by about a factor of four to bring them into parity with construction sector inspections.”

Another gap in OSHA coverage, advocates say, was built into the agency’s NEP iniative, which was created in 2011 to focus on nursing home occupational safety—but not hospitals. “We want the National Emphasis Program to focus on hospitals. OSHA could do this right now with the swipe of pen,” says Wrightson. “The reason that they have not concentrated on hospitals is due to industry lobbyists.”

OSHA did not answer Working In These Times’ inquiries about why the National Emphasis Program (NEP) has not been expanded to target hospitals, but did point to its educational programs on workplace safety for hospitals.

Advocates insist, however, that Congress and OSHA must go beyond education to better enforcement and rulemaking in order to prevent injuries in the healthcare workplace. At the end of the day, advocates say, those that suffer the most from injuries to healthcare workers are patients.

“[Musco-skeletal injuries are] a primary reason healthcare workers leave direct patient care,” says Harrington. “We can’t afford to lose healthcare workers to injury and still meet rising demands for healthcare services.”

Article originally posted on Working In These Times on July 22, 2013.  Reprinted with permission. 
About the Author: Mike Elk is an In These Times Staff Writer and a regular contributor to the labor blog Working In These Times.


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