[HM2Viking]

Originally Posted by Shamira Aizza

Minnesota is just about one of the most liberal states in the USA with an alleged higher comparative percentage of insured people...I wonder if there's a correlation between that and the need to unionize the hospitals in order to make them tolerable for nurses.

Interestingly, as the European Union was celebrating its 50th birthday this past week, the spotlight was on Germany, whose dynamic economy is enjoying an impressive recovery, with plummeting unemployment. The German Federal Republic incurred massive costs when it absorbed the former communist East Germany. Many blamed its slump on strong unions and high wages. But it turns out that this same social model produces the world's most productive workforce. Germany enjoys a large trade surplus despite an expensive currency, and much greater income equality. Unions as partners can be good not just for worker pay, but for the economy. In our country, unions have never been able to make that case by gentle persuasion. They make it in the old-fashioned way, organizing one worker and one legislator at a time.

http://www.prospect.org/web/page.ww?...rticleId=12613
I think that the relative incomes of American states with strong labor movements play out in health and safety outcomes for the citizenry.

[janfrn]

Originally Posted by RN4MERCY

(In case you missed it, this is a cross post from the Walter Reed thread...) <SNIP> I guess we'll have to agree to disagree about unions. As opposed to the "individual mandate/mantra--"every woman (or man) for themselves", I believe in the collective, progressive point of view, " we're all in this together."

It's always going to be a fight and someday, you're going to have to lock arms together in a righteous fight in the exclusive interest of, and for the safety of patients, be they civilians, or Veterans.

Well said.

[Shamira Aizza]

Originally Posted by RN4MERCY

(In case you missed it, this is a cross post from the Walter Reed thread...)

I guess we'll have to agree to disagree about unions. As opposed to the "individual mandate/mantra--"every woman (or man) for themselves", I believe in the collective, progressive point of view, " we're all in this together."

Before unions, people could be worked 10 or more hours a day, 6 days a week, in whatever kind of miserable conditions employers felt like offering. You have unions to thank for 40 hour workweeks, two days off per week, and living wages, retirement and insurance benefits. The ability, the right to bargain collectively, to meet your employer on equal terms, to enforce safe working conditions, pay and benefits over and above the minimum wage that the laws provide, to be respected as an equal, to be protected against arbitrary discrimination, all of these things are what unions are about.

Now, how about those hospital administrators vs. the direct care RNs who are really held accountable, ultimately, for what happens to the patient? (If you don't like it leave?) Mandatory overtime?, Merit pay or favoritism?, Staffing flexibility or admitting patients without adequate staffing and calling it "care", such as putting patients in the hallways or on monitors that no one is monitoring, and then billing for the "service"? Fraud or legalized neglect? Bottom line vs. genuine patient-focused care and nursing practice/patient advocacy protection? The bosses will tell you, "do the best you can" and then play "the blame game" when patients suffer complications and even death. Let's talk about fairness and justice!

Unionized direct care Registered Nurses in California, members of The California Nurses Association, called the question, collectively fought for and passed the first-in-the-nation minimum nurse to patient ratios. The law also requires hospitals to "staff up" (provide additional staffing of RNs, LVNs, NAs, Ward Clerks), based on acuity and scope of practice to meet the needs of the patient, as determined by the independent clinical judgement of the direct care registered nurses responsible for the patients. The ratio law protects patients from corporate greed/bottom line staffing schemes and improves working conditions to stop the hemorrhage of nurses from the profession.

The only reason the government does any of these things is because of union-led and supported legislation. Most of these laws – or at least their enforcement – are being undermined by "dirty money" (corporate cash exchanged for political gain)...political appointees and elected officials who look the other way as our individual rights and freedoms...free speech, freedom of association, and freedom to control our practice are encumbered or eroded to the point that they endanger patients by stifling our ability to advocate without fear of retaliation.

The reason they (Bush-its, Schwarzen-cronies, and Co.) are able to even attempt this is that unions are far weaker now than when these laws were passed – and the public is far less educated about the benefits of unions; and, the fact that most legal workplace protections wouldn’t be there without unions. And, in fact, if unions disappear, so will all of those legal protections, and many others that we just take for granted these days.

Responsibility is one thing, and it’s a good thing. No one would argue with that. But unions aren’t just about responsibility, they’re also about power – power in the good sense. The individual is no match for even a small company, much less a large corporation. Joining together in unions is the only way that individual workers can have a voice to defend pay, working conditions and benefits, whether legal or bargained. And unions, public interest groups, and government, (if the laws are enforced), are the only means to make sure that management lives up to its corporate and social responsibility not to sicken, injure, kill and exploit workers (or patients) and the community.

And when California's Gov. Schwarzenegger abused his discretionary power to suspend our ratios, the nurses and the community fought back, from a position of collective strength, united in a common cause for safe standards; we prevailed in court and the law won, the nurses won and our patients won! Just try that as an individual...and don't kid yourself.

It's always going to be a fight and someday, you're going to have to lock arms together in a righteous fight in the exclusive interest of, and for the safety of patients, be they civilians, or Veterans.

It's not so simple as "every man for himself."

When it comes to the workplace, people should be expected to show independent personal value instead of paying someone else to extort recognition from an employer. If folks don't want to work in specific conditions as professionals, then they should walk away and let someone do it who will.

Your description of what happens in some hospitals (which you blamed on management), is not necessarily abated by unions, and it's not necessarily a union problem. It's a reflection of a systemic problem with the union-type mindset works against itself to resolve while blaming everyone else for the problem. You want to socialize the system, which will result in more people using ED's for primary care while reducing available resources (because socialized systems ration care), and reducing staff two ways; reduced reimbursements will mean less money to pay the wages that unions demand. Hospitals won't be able to hire more people because the existing staff will have a union-negotiated wage; unions can't negotiate the number of people a hospital will hire, and they can't get water from an empty well.

And the last thing a union can criticize is corruption and dirty money; there is not a union in the history of man that hasn't been involved in illegal activities of some kind.

BTW, I'm offended by the terms "Bush-its" and "Schwarzen-cronies," but I have come to accept the fact that such flavor of labels are only infractions if they are uttered by a conservative. Moderation is not so objective as they'd like to say they are.

Your statement that "unions are the only way" is simply not true. Unions certainly can do their part to improve conditions for nurses, but they are not known for improving conditions for consumers, and to categorically say that unions are the "only way" fails to recognize non-union hospitals that have superior outcomes in patient care vs. union hospitals that are further down on the list.

[HM2Viking]

I would consider the source of the rankings. US News is only slightly to the left of the Weekly Standard. The problem with human social organizations is that they are run by humans who are subject to temptation. Making a categorical claim of "all unions are corrupt" is no more accurate than a claim that "all businesses are corrupt." The question becomes which organizational structure can be held to the highest standard of public accountability and transparency. Looking at the past 5 years I can think of rather dramatic cases of corporate corruption that resulted in real harm to the interests of the country.

Just a few examples:
Enron
Halliburton
KBR
World Com

Each of these companies have engaged in outright theft from their employees and us as taxpayers. Enron stole billions from its employees through destruction of their pension plans and price gouged california consumers. Professionalized management and clear work rules are the usual results of a unionized business environment. Your claims of rationed/reduced care and provider numbers under a universal care system are not really supported by the OECD data. On average the OECD countries have more physicians and nurses per capita. An RN in Norway makes almost exactly the same salary as an RN in MN. (Mn RNs are second in the country for average salary.) While the occasional venality of a business manager makes the news and tars the reputations of honest well run unions, on balance the presence of a strong labor movement tends to increase the average prosperity of any given state especially when you factor in the higher average wages, emphasis on good schools and a healthy populace. Investments of this type tend to result in a better educated and more productive workforce which directly benefits the business climate.

In health care the question becomes do you want a state economy where the average hospital is A-/B+ and is affordable/accessible for the population who are insured at a 92% coverage level at large or a state economy where you have one A level hospital and the rest are B-/C+ hospitals and the population is insured at a 85% level. The point of this is that social investments yield competitive business environments.

[Shamira Aizza]

Originally Posted by HM2Viking

I would consider the source of the rankings. US News is only slightly to the left of the Weekly Standard. The problem with human social organizations is that they are run by humans who are subject to temptation. Making a categorical claim of "all unions are corrupt" is no more accurate than a claim that "all businesses are corrupt." The question becomes which organizational structure can be held to the highest standard of public accountability and transparency. Looking at the past 5 years I can think of rather dramatic cases of corporate corruption that resulted in real harm to the interests of the country.

Just a few examples:
Enron
Halliburton
KBR
World Com

Each of these companies have engaged in outright theft from their employees and us as taxpayers. Enron stole billions from its employees through destruction of their pension plans and price gouged california consumers. Professionalized management and clear work rules are the usual results of a unionized business environment. Your claims of rationed/reduced care and provider numbers under a universal care system are not really supported by the OECD data. On average the OECD countries have more physicians and nurses per capita. An RN in Norway makes almost exactly the same salary as an RN in MN. (Mn RNs are second in the country for average salary.) While the occasional venality of a business manager makes the news and tars the reputations of honest well run unions, on balance the presence of a strong labor movement tends to increase the average prosperity of any given state especially when you factor in the higher average wages, emphasis on good schools and a healthy populace. Investments of this type tend to result in a better educated and more productive workforce which directly benefits the business climate.

In health care the question becomes do you want a state economy where the average hospital is A-/B+ and is affordable/accessible for the population who are insured at a 92% coverage level at large or a state economy where you have one A level hospital and the rest are B-/C+ hospitals and the population is insured at a 85% level. The point of this is that social investments yield competitive business environments.

1. If you can name a union, any union, it won't take long to find an instance of corruption involving that union. My statement is accurate.

2. Not sure of the point of comparing Norway to Minn. US nurses are largely the best paid nurses in the world, and it has nothing to do with unions. Regardless, the data most certainly does support the fact that socialized systems ration care, and it isn't tied to the numbers of physicians and nurses. It's tied to the policies of that country to provide for certain types of care. For example, socialized countries tend to refuse rescuscitation of preterm infants before a certain age, and deny transplants to people who are over a certain age. They place people on waiting lists for essential surgeries. You can have a 1:1 physician ratio, but it makes no difference if you won't pay for him to provide you any care.

The remainder of your claims are rhetoric...unless you can show some kind of reference that proves that unions result in good schools (and schools are one of the most unionized institutions in America and deteriorate even more every year) or result in a healthier populace. There is no data to support that.

[HM2Viking]

The education and health outcomes data for states with a history of a strong labor movement do compare favorably when compared to "Right to work" states.

I was not being an apologist for corruption in organizations I was making the point that while unions do have bad actors so do corporations. But when corporations engage in crime it tends to be much more damaging to the fabric of society. Bad actors whether they are CEO's or Union Presidents need to be held accountable for their misdeeds after they have abused the public trust.

Ultimately I think that we need to work together to reinforce and share a commitment to :

If the sense of community exists, both freedom and security exist as well. The community then takes on a life of its own, as people become free enough to share and secure enough to get along. The sense of connectedness and formation of social networks comprise what has become known as social capital.[4]
Social capital is defined by Robert D. Putnam as "the collective value of all social networks (who people know) and the inclinations that arise from these networks to do things for each other (norms of reciprocity)." Social capital in action can be seen in groups of varying formality, including neighbors keeping an eye on each others' homes.

http://en.wikipedia.org/wiki/Community

McMillan and Chavis (1986) identify four elements of "sense of community": 1) membership, 2) influence, 3) integration and fulfillment of needs, and 4) shared emotional connection.

http://en.wikipedia.org/wiki/Community

Community by definition includes individual awareness and appreciation for common interests and working together to meet the common good. Healthy communities are dedicated to building points of community networks for provision of the common good (public schools and health care are 2 prime examples)

[Shamira Aizza]

Wikipedia? Alrighty then.

We need corporations. Someone has to provide the services and products.

Unions do not exist without them, except in the government, and we cannot function as a sole gov't proprietorship.

The difference is that only some corporations are guilty of corruption, and they are dismantled. Unions are unanimously guilty of corruption, and they continue to operated without punishment.

Some of what you share is simple philosophy...it doesn't make it accurate or functional. Let's just allow..for the moment..your definition of community. I have no problem with the definition of the word "community," but I have a big problem with the attempted force-feeding of what you believe to be the "common good."

You think that some people should pay for everyone else's acute and routine care. I think that if I'm footing part of the bill, I should be allowed to tell them how to behave so that they don't engage in behaviors that result in their inability to pay even a $10 copay for medical care...that would be for the common good of everyone...both them and me.

[HM2Viking]

Originally Posted by Shamira Aizza

Wikipedia? Alrighty then.

We need corporations. Someone has to provide the services and products.

Unions do not exist without them, except in the government, and we cannot function as a sole gov't proprietorship.

The difference is that only some corporations are guilty of corruption, and they are dismantled. Unions are unanimously guilty of corruption, and they continue to operated without punishment.

Some of what you share is simple philosophy...it doesn't make it accurate or functional. Let's just allow..for the moment..your definition of community. I have no problem with the definition of the word "community," but I have a big problem with the attempted force-feeding of what you believe to be the "common good."

You think that some people should pay for everyone else's acute and routine care. I think that if I'm footing part of the bill, I should be allowed to tell them how to behave so that they don't engage in behaviors that result in their inability to pay even a $10 copay for medical care...that would be for the common good of everyone...both them and me.

Unanimously guilty of Corruption? Absolutely outrageous generalization. I did not equate all businesses as corrupt nor did I claim all Union leaders were virtuous what I did do was make a nuanced response. I said that where malfeasance was found that the malefactors need to be held accountable for their actions whether it was a CEO or a union leader.

The other point that I made was that a strong labor movement usually resulted in a stronger community across a variety of dimensions. I did some research on the issues surrounding what makes a state a healthy place to live. The correlation between quality of life in a state, health insurance and school performance is stunning.

Morgan Quitno Households School School
with Health Attendance Graduation
Insurance
MN 2 92 95 90
IA 3 91 96 91
WI 14 90 95 92
ND 12 88 96 92
SD 13 88 95 90
Mean 25 84 90 74

A strong commitment to public health and public education are part of a functional social contract. Union members typically advocate for social change to improve the overall quality of life for the community at large. To bring it around to the healthcare environment Nurses in MN struck to obtain safe staffing ratio languages for patient safety. CNA members fought the battle for a safe staffing ratio law. On a personal level I usually make the point that a functioning democracy and society requires that people have a civil conversation and work together to identify the needs of society and develop solutions together.


Source:
Morgan Quitno 2007 electronically retrieved on 4/6/2007 from http://www.morganquitno.com/sr07mlrnk.htm.
*-Cover the Uninsured electronically retrieved on 4/6/2007 from http://covertheuninsured.org/
http://education.state.mn.us/ReportCard2005/schoolDistrictInfo.do;jsessionid=GW7YSsVGhRZ5C5znz L2L2QqV3gGqnpQVhwn9YsLS60Qz71hRP21T!69398514?SCHOO L_NUM=000&DISTRICT_NUM=9999&DISTRICT_TYPE=99
http://www.dmps.k12.ia.us/facts/6Attendance04-05.pdf
http://desmoinesregister.com/apps/pbcs.dll/article?AID=/20070306/NEWS02/703060412/1004
http://dpi.state.wi.us/spr/xls/grdrtwis.xls
http://www.dpi.state.nd.us/dpi/reports/Profile/0506/ProfileDistrict/25014A.pdf
https://sis.ddncampus.net:8081/nclb/portal/portal.xsl?&extractID=8

[HM2Viking]

Morgan Quitno Rankings for the following states:

http://www.morganquitno.com/sr07mlrnk.htm

42

Alabama

20.86
39
-3

27

Florida

25.27
31
4

41

Georgia

21.09
38
-3

44

Tennessee

20.11
45
1

46

South Carolina

18.84
46
0

49

Louisiana

18.39
50

50

Mississippi

15.86
49
-1

Negative factors affecting QOL indices:

1Percent Change in Number of Crimes: 2004 to 2005 (Table 27)2Crime Rate (Table 28)3State Prisoner Incarceration Rate (Table 58)4Personal Bankruptcy Rate (Table 98)5Pupil-Teacher Ratio in Public Elementary and Secondary Schools (Table 120)6Rate of Public Libraries and Branches (Table 152)7Unemployment Rate (Table 175)8Percent of Nonfarm Employees in Government (Table 189)9Average Monthly Electric Bill for Residential Customers (Table 207)10Hazardous Waste Sites on the National Priority List per 10,000 Square Miles (Table 220)11State & Local Taxes as a Percent of Personal Income (Table 292)12Per Capita State and Local Government Debt Outstanding (Table 306)13Percent of Population Not Covered by Health Insurance (Table 369)14Births of Low Birthweight as a Percent of All Births (Table 379)15Teenage Birth Rate (Table 380)16Infant Mortality Rate (Table 386)17Age-Adjusted Death Rate by Suicide (Table 400)18Population per Square Mile (Table 434)19Poverty Rate (Table 493)20Percent of Female-Headed Families with Children Living in Poverty (Table 497)21State and Local Government Spending for Welfare Programs as a Percent of All Spending (Table 500)22Percent of Households Receiving Food Stamps (Table 528)23Deficient Bridges as a Percent of Total Bridges (Table 544)24Highway Fatality Rate (Table 547)25Fatalities in Alcohol-Related Crashes as a Percent of All Highway Fatalities (Table 553)

Positive factors affecting QOL indices

26Per Capita Gross State Product (Table 89)27Percent Change in Per Capita Gross State Product: 2001 to 2005 (Adjusted to Constant Dollars) (Table 90)28Per Capita Personal Income (Table 93)29Change in Per Capita Personal Income: 2004 to 2005 (Table 94)30Median Household Income (Table 96)31Public High School Graduation Rate (Table 128)32Percent of Population Graduated from High School (Table 129)33Expenditures for Education as a Percent of All State and Local Government Expenditures (Table 137)34Percent of Population With a Bachelor’s Degree or More (Table 150)35Books in Public Libraries Per Capita (Table 153)36Per Capita State Art Agencies’ Legislative Appropriations (Table 156)37Average Weekly Earnings of Production Workers on Manufacturing Payrolls (Table 165)38Job Growth: 2005 to 2006 (Table 180)39Normal Daily Mean Temperature (Table 232)40Percent of Days That Are Sunny (Table 233)41Homeownership Rate (Table 424)42Domestic Migration of Population: 2005 to 2006 (Table 472)43Marriage Rate (Table 478)44Percent of Eligible Population Reported Voting (Table 492)

The Morgan Quitno data are a pretty good overall measure of community health along social, physical and psychological dimensions.

[pickledpepperRN]

Registered Nurse Unions and Patient Outcomes.


...The significant finding in this study is that hospitals in California with RN unions have
5.7% (.84-the RN union coefficient from Model 4/14.8-statewide risk-adjusted AMI mortality rate average) lower mortality rates for AMI after accounting for patient age, gender, type of MI, chronic diseases, and several organizational characteristics.

This result includes controls for number of beds, AMI-related discharges, cardiac services, staff hours, and wages.
Although we have not necessarily identified a causal relationship, the approach in this study demonstrates
that there is a positive relationship between patient outcomes and RN unions. ...

http://www.jonajournal.com/pt/re/jon...856144!8091!-1

I bought this article but it is too big to attach.