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PubMedDate not supplied

Historical and political overview.

There are more than 10 million local government workers in the United States. Municipal workers are exposed to a wide variety of serious chemical, biological, physical, ergonomic, and safety hazards. Decisions made by legislative bodies and policy makers historically have had a severe impact on the health and safety of local government workers. In over half of the states, city workers are not covered by safety and health programs approved by the Occupational Safety and Health Administration. They also lack universal coverage under laws providing union recognition and the right to collectively bargain over working conditions. Collective action in the workplace and the political arena remains the most important vehicle for municipal workers to secure safe working conditions.

Accidents, Occupational↗
PubMed1979

Bargaining unit determination procedures in the public sector: a comparative evaluation.

A crucial first step in the formulation of a statutory framework for public sector collective bargaining is the selection of a procedure(s) for bargaining unit determination that will produce stable and workable employer-union relationships. In an attempt to provide empirically based policy guidance to legislators and administrative agency officials, this study presents an extensive examination and analysis of the experience of the several government jurisdictions that have previously made this decision. In the final section of the report, the authors explore the ramifications of their findings for any future state and/or federal collective bargaining legislation for public employees.

Collective Bargaining↗
PubMed1978

Regulating hospital labor costs: a case study in the politics of state rate commissions.

With the advent of various attempts to control hospital costs by direct state regulation, labor input costs have become a target of particular attention. This focus is due in part to the unique discretion administrators can exercise over labor factors, and in part to the large absolute part of hospital resources devoted to labor costs, conservatively estimated to be about 55 percent of total budget. This paper examines the impact of state efforts in prospectively setting rates on collective bargaining outcomes in the hospital sector. Specifically, bargaining in New York, Maryland and Connecticut is examined. The paper concludes that government attempts at controlling costs have, in all cases, required the regulatory bodies to consciously exert influence on the collective bargaining process. Further, while such attempts seem to be within the paradigm of multilateral bargaining, there are significant distinguishing features in the role hospital regulatory bodies play in the bargaining process. These variations from the multilateral paradigm may impede the long run ability of rate review efforts to control bargaining outcomes with respect to wages.

Collective Bargaining↗
PubMed1980

Contemporary perceptions of unionization in the medical profession: a study of attitudes of unionized and non-union physicians.

This study investigated current perceptions of a sample of unionized and non-unionized physicians toward the concept of collective bargaining. Specific areas for study were the issues that have motivated and might motivate physicians to unionize, as well as the individuals or institutions physicians perceive as the opponent in collective bargaining. The analysis showed that economic considerations and the imposition of external controls on the practice of medicine dominate the physicians' perceptions. Government and health insurance companies are perceived as the primary adversaries. Perceptual differences between unionized and non-unionized physicians were shown to be small.

Attitude of Health Personnel↗
PubMed1978

An imbalance of power: social workers in unions.

This paper presents and discusses four basic structural conditions that are likely to influence the ability of any group of workers to achieve their collective bargaining goals. When applied directly to social work practice, the primary finding is that a group of practitioners is unlikely to wield significant power in the face of employer resistance. Implications are analyzed and include assessment of both the form of union and type of collective bargaining goals that might most usefully be sought by the profession. Certain incompatibilities between professional values and group self-interest are seen as less substantive than is commonly perceived.

Collective Bargaining↗
PubMed1997

Finding common ground: how public health can work with organized labor to protect workers from environmental tobacco smoke. National Association for Public Health Policy.

Tobacco is not and does not have to be a high priority for all segments of organized labor, but public health advocates should continue to promote the issue and find segments which are open to collaborative efforts to protect workers' health. Even in those unions representing workers for whom smoking and ETS pose a lower health risk relative to other workplace toxins, smoking policy remains a strategic issue for at least two reasons. First, supporting efforts to control ETS exposure sure is an issue of service to non-smoking union members, and like-wise, bargaining for smoking cessation programs is a service to members who smoke. Second, it is in the union's interest to engage with management through collective bargaining to develop smoking policies, rather than to allow management to unilaterally propose and/or implement policies. To remain a strong voice in the worksite, labor needs to defend its unions and members from misdirected and overzealous actions. Within the context of the diversity of opinions from within labor and public health, this policy statement aims to identify our common ground and recommend ways to collaborate in protecting worker health. Specifically, we recommend that the public health community take the following actions: I) assist unions with smoking cessation services that meet the needs of labor, 2) support labor's efforts to negotiate smoking policies within the context of collective bargaining, 3) include labor in tobacco control coalitions, 4) advocate for regulatory initiatives that include ETS as part of an overall indoor air quality strategy, 5) focus attention on preventing smoking among children of union members, and 6) develop strategies with labor to benefit from savings that employers achieve under smoking restrictions or bans. Smoking and exposure to second-hand smoke represent a threat to the health of workers. Given that the public health and labor movements have a mutual interest in protecting worker health, it makes sense for these two groups to join together on tobacco control policy-making in the worksite.

Adult↗
PubMedDate not supplied

Unionization in hospitals: causes, effects, and prevention strategies.

Unionization pressure on hospitals has increased steadily since passage of the 1974 amendment to the National Labor Relations Act extending protection of organizing and collective bargaining to nonproprietary hospital facilities. This article analyzes the current state of knowledge on unionization in hospitals in regard to: future organizing pressures, the impact of collective bargaining on operations, the psychology of organizing, and the fundamental elements of a strategy for improving employee relations and avoiding organization.

Humans↗
PubMed1988

Re Protection of Women: E.C. Commission v. France, 25 October 1988.

The European Court of Justice held that French legislation allowing the continuation in collective agreements and employment contracts or trade usages of certain privileges for women and leaving it to collective bargaining to make changes was in breach of Sex Discrimination Directive 76/207. It ruled that the privileges, such as reduction in working hours for women aged 59, bringing forward the retirement age, time off for sick children, an extra day's holiday per year for each child, hours off on Mother's Day, and daily breaks for women working on computer equipment or as typists or switchboard operators, were much wider than the privileges relating to pregnancy and maternity authorized in Article 2(3) of the Directive. It also ruled that such privileges were not justified by the precise objective of Article 2(4) of eliminating de facto inequalities in working life and that changes in the agreements, contracts, and usages should not be left to collective bargaining.

Developed Countries↗
PubMed2006

Why don't courts treat hospitals like tanks for liquefied gases? Some reflections on health care antitrust enforcement.

In this article, I use the Federal Trade Commission and the Department of Justice 2004 report Improving Health Care: A Dose of Competition as an occasion to comment on two specific issues that have arisen in health care antitrust: the recent string of losses by the enforcement agencies in hospital merger cases and an antitrust exemption for physicians to bargain collectively with health insurers. One of the more salient facts about health care antitrust enforcement is the notable recent lack of success of the enforcement agencies in hospital merger cases. This may be due to judges and juries holding views of hospital markets as being different from markets for other goods and services. My conclusion is that hospitals are an industry with unique attributes, but nothing about the specifics of the health care industry suggests that the unregulated use of market power in this industry is socially beneficial. As a consequence, the antitrust laws should be enforced here as in any other industry. Countervailing power is an issue that has come to the fore in health care antitrust. Physicians have explicitly asked for legislative exemption from the antitrust laws in order to bargain collectively with insurance companies, as a means of counteracting insurers' monopsony power. It is not clear that health insurers possess significant monopsony power. Even if they do, bestowing monopoly power on physicians will not necessarily improve matters. Active antitrust enforcement in insurance markets is the correct response, not blanket exemptions for providers.

Antitrust Laws↗
PubMed1979

Unionism in the health care industry: an overview.

Block profiles the two unions that are the most active in organizing non-nurse health care employees: the National Hospital Union (NHU) and the Service Employees International Union (SEIU). The two international unions present a contrast in structure and ideology. The SEIU is a truly international, decentralized union, whereas NHU is a far more centralized affiliate. As an international union, SEIU characterizes, taxes, and disciplines locals. Its decentralized strategy has been to permit locals to do the bulk of the organizing and collective bargaining, while the national union merely coordinates and offers financial and technical support. Conversely, NHU is an affiliate of the retail, wholesale, and department store union, deriving authority from, paying tax to, and subject to discipline by the parent organization. Its centralized approach has been for national officers to determine when a district will be created and what its jurisdiction will be. The structural differences of the two unions can be traced to their respective histories. As an old-line AFL union, SEIU had an existing structure of independent local unions that operated in health care as they did in other industries. NHU, however, originated as a union of drug store employees and its structure evolved over time. Membership growth and geographic expansion elevated it beyond the status of a local into a division with its own districts. The unions also diverge in their ideology; SEIU takes a more traditional business union approach to collective bargaining and unionism, while NHU is oriented to social welfare, involving itself in more than the work aspect of members' lives. These differences again can be attributed to contrasting histories of the old-line SEIU and the more radical NHU. The authors emphasize that unions are not homogeneous entities but organizations that respond to a similar environment as a result of their respective structures and histories.

Health Workforce↗
PubMed1978

Sisters as union members: what do NLRB and courts say?

The NLRB and the appellate courts are more in conflict than in harmony over the inclusion of members of religious congregations in hospital collective bargaining units. The NLRB has bound several bases for exclusion; consequently, unless a hospital affiliated with a congregation is free of these conditions or is willing to assume the burdens of appellate litigation, members of a religious congregation in that hospital are unlikely to be included in a bargaining unit there.

Collective Bargaining↗
PubMed1995

A conversation about the work environment.

The author looks at work environment matters from the perspective of public policy-making and the policy instruments used to deal with workplace health and safety: standard setting; joint health and safety committees; compliance, enforcement, and prosecution; workers' compensation as an economic incentive; and collective bargaining. While regarding all as necessary, the author considers them as separately and collectively, fundamentally flawed and therefore insufficient, because liberal public policy-making itself is problematic. He proposes an alternative way of thinking about this subject from the perspective of the "politics of meaning."

Canada↗
PubMedDate not supplied

Pay inequity: it's still with us.

This article explores reasons for the continued existence of pay inequity. Throughout the past 3 decades, pay equity proponents have applied a number of remedies for inequity. For example, civil rights legislation has helped somewhat, but narrow interpretations hinder the usefulness of law. Labor market surveys do more to perpetuate inequity than to cure it. Collective bargaining offered by traditional unions benefits nursing to a lesser extent than nurses commonly believe. Job evaluation systems combine with multiple pay scales and inequitable pay formulas to perpetuate discrimination. Finally, there remains a danger that nurses' own lack of sophistication regarding pay equity issues may work against the interests of the profession on the pay equity scene. Nurses, therefore, need to keep abreast of current pay equity issues.

Collective Bargaining↗
PubMed1983

Structural determinants of union activity in hospitals.

This study uses national data from the American Hospital Association and the National Labor Relations Board in a multivariate framework to assess the impact of various structural factors on union activity in hospitals. The theoretical framework includes both management and union perspectives in evaluating (1) whether the hospital had a signed collective-bargaining contract in 1980; (2) whether a union election had been held; and (3) whether the union won the election. The results indicate that certain structural characteristics (hospital size, ownership, teaching status, and location) have had a significant impact on union activity in hospitals, while other characteristics (third-party reimbursement and area factors) have not. The results also show that prospective reimbursement has a positive impact on union activity.

American Hospital Association↗
PubMed1994

Knowledge can be power.

Despite the erosion of many employment rights during the past 15 years, there has been some improvement in the right to information about individual contracts of employment, or for the purposes of collective bargaining. Roger Kline considers how local representatives may obtain some of the information.

Collective Bargaining↗
PubMedDate not supplied

New management opportunities and the Kentucky River case.

Physicians and other health care workers seeking to unionize may face an uphill battle as a result of a recent decision by the U.S. Supreme Court that essentially defines nurses and physicians as supervisory personnel who can't engage in collective bargaining. Discover what led to the decision and how it affects health care.

Collective Bargaining↗
PubMed1987

Determining appropriate healthcare bargaining units: NLRB's historic rule making move.

On August 25, 1974 the Taft-Hartley Amendments (Public Law 93-360) took effect and mandated that voluntary not-for-profit hospitals enter into the process of collective bargaining. The belated entrance of these hospitals into the process stems from a change in the Taft-Hartley Act of 1947 where the law specifically exempted voluntary hospitals from the National Labor Relations Act (NLRA) of 1935. In deleting this exemption, Congress extended labor relations protection to employees of voluntary hospitals and all other healthcare institutions except those under government and public ownership. As far as most hospital chief executive officers were concerned, labor relations would never be the same again.

American Hospital Association↗