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PubMed1985

Unionization in the hospital industry: how are wages affected?

With the enactment of the 1974 amendments to the National Labor Relations Act, employees in not-for-profit hospitals have more freedom to organize, form unions, and bargain collectively. As a result, union activity in the hospital field has greatly increased in the last 10 years. How does unionization affect hospital wages and ultimately healthcare costs? Studies indicate an approximately 8.8 percent wage increase in hospital occupations as a whole, resulting from collective bargaining in hospitals. If unionization can affect hospital wages to this extent, financial managers must be aware of the possible implications for their organizations.

Collective Bargaining↗
PubMed2002

Will physician unions improve health system performance?

In the public debate over the extension of collective bargaining rights to independent physicians, union proponents' primary argument has been that patients would benefit from allowing physicians to bargain collectively with health plans. This article examines the likely effects of physician unions on the U.S. health care system. Specifically considered are likely effects on economic efficiency, quality, access, and cost. Under none of these criteria are physician unions likely to improve health system performance, particularly when compared with available alternative strategies for dealing with problems identified by union proponents.

American Medical Association↗
PubMed1997

Physicians find power in unions.

A growing number of physicians are using organized labor to gain economic leverage. Hospital downsizing and autocratic managed-care plans have prompted more doctors to join the ranks of other professionals who carry union cards. While not a sweeping trend, interest in unions is growing--even among private-practice physicians who can't bargain collectively because of antitrust laws.

American Medical Association↗
PubMed1978

Unions and health care cost inflation.

Since the 1974 Taft-Hartley amendments gave nonproprietary hospital employees the right to organize and bargain collectively, the rate of growth of work stoppages has decelerated and the number of man days lost has been reduced. Wage rates, earnings differential, and fringe benefits have not been significantly improved by unionization. And little evidence supports the contention that unionization has contributed substantially to the inflation experienced in the health care industry.

Collective Bargaining↗
PubMed1993

The Family and Medical Leave Act of 1993--Wage and Hour Division, Department of Labor. Interim final rule; request for comments.

This document contains interim regulations implementing the Family and Medical Leave Act of 1993 called ("FMLA" or "the Act"). The Act is effective on August 5, 1993, six months from the date of its enactment. Where a collective bargaining agreement is in effect on August 5, 1993, the Act is effective when the collective bargaining agreement terminates or February 5, 1994, whichever is earlier. The purpose of these regulations is to set forth the requirements of Title I and Title IV of the Act. Title I applies to covered private employers and public agencies (except for most of the Federal Government, which is governed by Title II). Title IV of the Act primarily concerns the relationship between FMLA and other laws, as well as collective bargaining agreements and other employer plans and programs.

Employment↗
PubMed1982

Housestaff activism: the emergence of patient-care demands.

There have been two trends within the physician housestaff movement: increased acceptance of collective bargaining and unions, and a shift from narrower economic to broader political demands, including some involving patient care. Case studies of politically active housestaff associations in New York, Chicago, and Los Angeles are used to examine the emergence of "patient-care" demands and their compatibility with collective bargaining frameworks. As house-staff have become principal providers of care to indigent populations in public hospitals, and economic cutbacks have endangered service as well as the positions of physicians, patient-care demands arise and become infused with demands for participation and control in decision-making. Common factors in the politicization of housestaff have been the contribution of activists of the sixties as leaders, and the impact of fiscal crisis and economic retrenchment in the seventies. However, the emergence and resolution of these issues has differed depending upon legal, political, historical, and organizational variations. In general, patient-care issues are supported by housestaff when they dovetail with housestaff interests. However, physician interests can diverge from those of patients, as in the case of manpower redistribution. On the whole, wages and benefits have done better than educational or patient-care demands. Educational demands have met with counterattack, and patient care, limited by the traditional scope of collective bargaining, has had to evolve indirectly, and has been hurt by long-term economic trends. Finally, national housestaff organization is limited by the wide-ranging politics and ideas of diverse regional organizations which represent different types of training institutions and career orientations.

California↗
PubMed1991

Unionization: boon or bane?

Again, you only get a union if you deserve one, and you get the union you deserve. Collective bargaining in a professional milieu indicates an unhealthy environment, is incredibly cumbersome, and--perhaps most concerning--is phenomenally expensive, as measured in terms of fiscal resources, human resources, and energies. Moreover, time lost in collective bargaining reduces institutional flexibility and responsiveness. But more important, the collective bargaining process imposes an additional administrative layer and extra legal and contract implementation fees and adds mistrust into a professional setting that requires total trust along with professional competence. Thus, resources are diverted that could be better devoted to excellent patient care and professional salaries. The process of maintaining a union-free environment is well worth the effort. In the end, administration, nursing personnel, and, most important, patient care are positively impacted by an open, flexible environment. In short, within a healthy union-free environment, everyone wins!

Humans↗
PubMedDate not supplied

The ANA's Economic Security Program: the first 20 years.

This historical study is an analysis of the American Nurses Association's (ANA) Economic Security Program (ESP) from 1946 to 1966. Primary data sources include ANA Biennial Convention proceedings, ANA headquarters files, the ANA Collection at Mugar Memorial Library, and selected nursing journals. The findings indicate that although ANA took a bold step in initiating the ESP and collective bargaining, the ESP was minimally effective for several reason: nurses would not support collective bargaining, hospitals would not negotiate with nurses, ANA would not use coercive tactics, and hospitals were not included under existing labor laws. As a result, ANA resorted to an old tactic, education, to secure its economic goals.

American Nurses' Association↗
PubMed1991

Nurses and the new NLRB rules. Implications for healthcare management.

The inclusion of nurses as an allowable bargaining unit is one of the most significant aspects of the U.S. Supreme Court's decision to uphold the National Labor Relations Board's new collective bargaining unit rules. For a number of reasons, the decision makes it more likely that nurses at a given hospital will vote to form a union. Union nurses receive, on average, 6 percent higher salaries than do their nonunion counterparts. In addition, being able to organize into a smaller unit gives nurses a much stronger bargaining position. Finally, because of the new collective bargaining unit rules, labor leaders now find hospitals an attractive place to attempt to establish unions. In responding to the possibility that nurses might unionize, hospital managers should acknowledge that nurses often have legitimate grievances concerning pay and working conditions. They should also be aware that changes in the healthcare system during the 1980s often led managers and administrators to neglect focusing on nurses' satisfaction in favor of an emphasis on the bottom line. In the future, if managers can offer nurses the same rewards a union organizer offers and at the same time establish a cooperative, employee-oriented hospital atmosphere, nurses will benefit from the Supreme Court Ruling, whether or not they ultimately join a union.

Collective Bargaining↗