Malinda Markowitz
Co-president, California Nurses Association

Has therapeutic healing and recovery become a vanishing mission among California hospitals? Are California hospitals operating as big corporations more devoted to piling up cash than to assuring the delivery of care?

A look at how California’s private, not-for-profit hospitals are meeting their responsibilities for providing charity care and community benefit programs suggests many have lost their way.

In 2010 alone, not-for-profit hospitals pocketed $1.8 billion dollars in government subsidies through their tax breaks and other benefits above what they returned to patients in charity care, as documented in a California Nurses Association report based on public data.

Nearly half that total was recorded by just two of California’s biggest hospital chains, Kaiser Permanente and Sutter Health, which also happened to account for almost half of the 100 not-for-profit hospital executives who received pay packages of more than $1 million a year.

While many hospitals are no doubt good corporate citizens, these numbers undermine credibility for the hospital industry as a whole, especially when some apparently count marketing, cost-cutting and other dubious practices as their community benefit program.

Instead of opposing a common sense bill like AB 975, just as they have fought nearly every reform aimed at strengthening patient protections in California, hospital lobbyists should welcome this legislation as a way to restore public confidence that they are being genuinely transparent, accountable and acting in good faith in the delivery of charity care and community benefit.

California’s nurses salute Assembly members Bob Wieckowski and Rob Bonta for introducing AB 975. The bill is supported by California Nurses Association and an array of other labor and consumer groups, as well as elected leaders who believe we need common standards and a level playing field with equal expectations for all not-for-profit hospitals that reap the rewards of their tax exempt status.

Regrettably, implementation of the Affordable Care Act will not end the health care crisis. We continue to see patients skipping needed medical treatment, cutting prescription pills in half, unable to pay exorbitant hospital bills and facing huge out-of-pocket costs for insurance they can barely use.

Until we can achieve more far-reaching health reform, it is more important than ever for hospitals to compete in providing appropriate and equitable levels of charity care and community benefit, and not in who can most resemble Lehman Brothers or Goldman Sachs

Read more

SEIU-UHW’s Dave Regan’s sordid scorecard: ‘We are proud of it and would do it again’ says Regan of his attack on ratios

When the usual corporate suspects lined up before the Assembly Health Committee last week to oppose a CNA-sponsored bill to require some non-profit hospital giants to stop treating their tax exempt status like a Cayman Islands tax shelter, they had a special friend in tow.

That was SEIU-UHW rubbing shoulders, again, with the California Hospital Association, CHA (chief lobbyist for the state’s biggest hospitals), Kaiser Permanente, Sutter, Cedars-Sinai Medical Center, and the California Chamber of Commerce (main state advocate for Wall Street).

SEIU-UHW,  which only a year ago was collecting signatures on a similar initiative to hold non-profit hospital corporations accountable for meeting their charity care obligation, now was telling the committee it was worried about the “uniquely uncertain landscape” created by the Affordable Care Act.

So were SEIU-UHW and its president Dave Regan being dishonest last year when pushing their initiative, at a time when the problems with the ACA were already quite clear? Did they just suffer a sudden loss of conscience?

Was that initiative, which conveniently exempted Regan’s top partner, Kaiser, a fraud, quickly dumped when Regan signed a secret deal with CHA?

Or are Regan and company now just making up new pretexts for marching in lockstep with their hospital industry mates?

For more on the charity care bill, read here http://www.nationalnursesunited.org/press/entry/bill-to-hold-hospitals-accountable-on-charity-care-passes-first-california-/

And here http://www.mercurynews.com/breaking-news/ci_22971313/two-bay-area-lawmakers-seek-hold-tax-exempt

Why Kaiser RNs are supporting NUHW-CNA

As thousands of Kaiser health care workers this week begin receiving ballots on whether to dump Regan’s SEIU-UHW and vote to join the CNA-affiliated NUHW,  it’s worth revisiting the sordid record of Regan and his top managers the past two years.

Regan’s attack on RN ratios

Most infamously, Regan last spring agreed to a request from CHA CEO Duane Dauner to lobby California legislators to introduce a bill last year to fulfill the CHA’s decade long goal to overturn the state’s landmark ratio law.

As part of the scheme, Regan was to urge the California Labor Federation, umbrella organization of California unions, to go along with that proposal.  Regan fell on his face, failing to win the support of a single legislator or other union.

Read more here http://www.bizjournals.com/sacramento/blog/kathy-robertson/2012/06/unions-health-care-nurse-ratio.html?page=all

And here

http://www.nationalnursesunited.org/news/entry/cna-wages-war-against-uhw-in-california-claiming-attempt-to-suspend-staffin/

Has Regan had second thoughts about his proposal to sabotage a law that is saving the lives of thousands of California patients, some of whom are even Regan’s own members?

Not at all. “We are proud of it and would do it again,” said Regan in a radio interview last week.  http://www.kpfa.org/archive/id/90399 

Regan’s promotion of ‘Wellness’ schemes to erode health benefits

Regan has teamed with CHA and other hospital employers to promote “wellness” programs supposedly intended to encourage healthy personal habits to reduce overall healthcare costs. The public CHA-SEIU-UHW joint wellness initiative for California is what Regan publicly received in return for abandoning his charity care initiative.

The employers’ real goal, of course, is slashing what they pay for worker health coverage, and forcing workers to pay far more out of pocket for not meeting arbitrary “wellness” goals, even if they have chronic or genetic health conditions that have nothing to do with “life style” choices.

Recent evidence documents that the “cost controls” come from, you guessed it, cost shifting from the employer or insurer to the employee.

The plans, which more hospitals are seeking to make mandatory, also involve substantial invasion of personal privacy. 

Read more here http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/04/corporate-wellness-programs-not-quite-the-cost-savers/ 

And here http://www.labornotes.org/print/4146

Regan’s concessionary contracts

RNs across California who work side by side with SEIU-UHW members are probably already aware of the sweeping concessions Regan and his coterie have signed with hospital managers.

Here’s a list just for Kaiser:

• $1.8 billion in retiree health benefit cuts
• Closed door talks to dump defined benefit guaranteed pensions for 401 (k) plans subject to shaky market swings.
• Higher out of pocket health coverage costs tied to “wellness” goals 
• 1,000 announced layoffs of UHW-SEIU members
• Subcontracting union jobs 
• A 9 cent per hour labor-management “partnership” tax to Kaiser paid by every UHW-SEIU member
• Marketing Kaiser’s business plan goals, including silence when Kaiser cuts mental health and other patient services

And in other hospital systems, SEIU-UHW has agreed to wage freezes, deep cuts in health and pension plans, requiring members to go through a bidding process following seismic rebuilds, and public testimony in support of employers’ corporate initiatives.

Shilling for hospital employers—that’s the Regan legacy, and why so many Kaiser workers are voting this week to replace him.