WHEREAS:
This nation's failure to curb rising health care costs and to provide universal health coverage and access to care have been long standing deficiencies in our health care system; and
WHEREAS:
The call for a national solution to the access and cost crisis are fueling changes in the health care industry to address this failure; and
WHEREAS:
The health care industry is developing sophisticated networks and linkages to deliver care in the name of reform, but these systems are aimed at capturing more market share and increasing profits; and
WHEREAS:
Both the public and private sector are downsizing and laying off workers to cut costs, restructuring services to shift service delivery to other settings, developing managed care arrangements, entering into mergers, sales and acquisitions, or changing the facility governance; and
WHEREAS:
Restructuring efforts, such as the TENNCARE managed care program in Tennessee for Medicaid patients, and the change in governance proposed by the City of Austin for Brackenridge Hospital, affect patients and health care workers alike; and
WHEREAS:
Many of these changes in their design are specifically excluding or eliminating services in publicly-operated acute and psychiatric hospitals and developmental disabilities centers and are presenting uncertainties for hospital-based health care workers; and
WHEREAS:
In addition, several states are proposing or implementing Medicaid reforms that restructure the entire service delivery system for this population, further limiting access to hospital-based services; and
WHEREAS:
These market changes are to the detriment of the uninsured and the health care workers and safety net facilities that serve them; and
WHEREAS:
Despite these changes, shrinking budgets and the demand to keep pace with industry changes, public sector health care facilities are still expected to provide the lion's share of care to uninsured and underinsured individuals; and
WHEREAS:
All of these restructuring efforts, if inappropriately implemented, limit access to certain services, reduce lengths of stays despite acuity levels, fragment nursing care, reduce overall staffing, cause layoffs, and exploit lesser trained workers by requiring them to do more work for the same pay; and
WHEREAS:
Many efforts purporting to restructure jobs and facility services are designed by anti-union consultants who are paid hundreds of thousands of dollars to assist employers in downsizing rather than actually improving the quality of care; and
WHEREAS:
National health care reform also presents challenges in protecting workers against job loss and developing training, retraining and redeployment provisions; and
WHEREAS:
Councils and Locals everywhere have struggled with many different types of health care restructuring and have created innovative methods of reconfiguring both patient care and jobs to limit job loss while maximizing job security, upward mobility and quality care.
THEREFORE BE IT RESOLVED:
That AFSCME continue to highlight successful examples of health care industry restructuring developed by Councils and Locals across the country and continue to analyze the lessons of unsuccessful efforts; and
BE IT FURTHER RESOLVED:
That AFSCME and the International Health Advisory Committee continue to examine trends in the health care industry to alert Councils and Locals across the country to the opportunities and pitfalls of this restructuring; and
BE IT FURTHER RESOLVED:
That AFSCME continue to work with members and health care management at all levels to stress the importance of continuous, joint labor/management decision-making to improve the quality of care; and
BE IT FURTHER RESOLVED:
That AFSCME continue to closely monitor collective bargaining, legislative and political changes which might signal restructuring in health care services; and
BE IT FURTHER RESOLVED:
That AFSCME encourage affiliates to negotiate contract language that includes successorship clauses to address any merger, sale, acquisition or other changes in ownership of facilities and provisions to allow collective bargaining rights to follow work to new locations; and
BE IT FINALLY RESOLVED:
That AFSCME continue to work to ensure that any future national health insurance program protects the rights and interests of health care workers by providing for job security, joint decision-making and continuous improvement in patient care.
SUBMITTED BY:
James Butler, President and Delegate
AFSCME Local 420, Council 37
New York