What's the deal with unions?

pickledpepperRN · May 16, 2003

I work registry at a couple Tenet hospitals now. Many critical care nurses want a CNA election with the labor board rather than take what Tenet told them they are getting. Most would rather not have any union. They have become friends over many years and would rather put up with the hassel of working for the best union (or at least a choice) than quit.

For the person just applying. There is a shortage. Unless there is only one hospital in town you don't have to accept the offer.

PS: a union is only as successful as its members make it.

Jodie Snyder

The Arizona Republic

May. 16, 2003 12:00 AM

Five Valley hospitals have made the list of the nation's 100 operating rooms with the highest markups, with one charging 10 times more than cost, says a report issued Thursday by an influential nurses union.

Tempe St. Luke's was tops in the country, charging 1,020 percent over its operating-room costs, according to an analysis of 1999 and 2000 federal cost reports conducted by the California Nurses Association.

The national average was 220 percent over cost.

In late 1999, Tenet Healthcare Corp. sold Tempe St. Luke's, St. Luke's Medical Center and Mesa General Hospital to Iasis Healthcare Corp.

It's not surprising that Tenet, which is being investigated on suspicion of performing unnecessary heart operations, would have high-charge ORs, said Chuck Idelson of the association.

Iasis didn't raise rates for three years after it bought the Valley hospitals, spokesman Tom Reavis said.

Iasis believes its charges are now in line with those of other hospitals.

Rainey Daye Holloway, spokeswoman for Maryvale Hospital Medical Center, said the hospital's high ranking may be because it handles complex cases.

Officials of John C. Lincoln Health Network were not available.

There are no simple reasons for Arizona having four hospitals in the top 20, said Jim Haynes, chief financial officer for the Arizona Hospital and Healthcare Association.

"I wish there was an easy answer for this, but there isn't."

Hospitals' surgery charges blasted

Modesto Bee

By KEN CARLSON

BEE STAFF WRITER

Published: May 16, 2003, 06:03:23 AM PDT

Doctors Medical Center of Modesto and Doctors Hospital of Manteca had the second- and third-highest markup rates in the nation on surgery charges, a union-commissioned study says.

The California Nurses Association released the study amid intense labor organizing activity at the Modesto hospital and other facilities owned by Santa Barbara-based Tenet Healthcare Corp.

The study includes a national top-100 list. Five hospitals in the top 10, and 25 in the top 100, are Tenet facilities.

Tenet officials suggested that the association is angry because the company recently aligned with two other unions.

Tenet officials also point to a link between the union and the Institute for Health and Socio-Economic Policy, which performed the study. Don DeMoro, the institute's executive director, is the husband of Rose Ann DeMoro, executive director of the California Nurses Association.

"We're not going to dignify the report with a response," Tenet spokesman Steve Campanini said.

The association said the study was not intended to single out Tenet.

"There are other hospital chains on the list," spokesman Charles Idelson said. "Anyone who follows the CNA knows we are an equal-opportunity critic. We have the same concerns with every one of these 100 hospitals."

Since late last year, the institute has released a series of studies into hospital pricing and has received national attention for its work.

The latest study examines information about charges and costs that hospitals submit to the federal government.

Don DeMoro said the data are reliable because it is illegal to falsify the reports. He said the information speaks for itself.

"(The research) holds up," he said. "If it isn't correct, we don't put it out."

According to the study, surgery charges at Doctors Medical Center and Doctors Hospital were 974 percent and 940 percent more than costs, respectively.

Two Stockton hospitals also made the top 100: Sutter Health-owned Dameron Hospital, with a 536 percent cost-to-charge ratio, ranked 91st; and St. Joseph's Medical Center, with a 526 percent markup, ranked 96th. St. Joseph's is part of the Catholic Healthcare West system.

On average, hospitals across the country have a 220 percent markup on their surgery charges, the study says.

According to the study, for-profit and large hospital chains had the highest markups. Sixty-one of the top 100 are for-profit hospitals and 44 are owned by the nation's two largest investor-owned systems, Tenet and HCA-The Healthcare Company.

"Surgery is a very lucrative element within the hospital industry," Don DeMoro said, adding that the markups cause overall health care inflation.

Previous CNA studies show that Tenet's California hospitals charged the highest drug markups in the state and that its billings for workers compensation cases were well above the state median.

Doctors Medical Center had some of the highest charges in the statewide comparisons and also was blasted in a California Public Employees Retirement System report in February. Cal-PERS found that its health plans had paid DMC five times more than what CalPERS paid other hospitals in the state for heart surgeries.

Federal regulators are investigating whether Tenet overcharged the government for expensive Medicare cases called "outliers." And the state Assembly has ordered an audit of the company's billings.

Earlier this month, Tenet announced a labor alliance with the Service Employees International Union and the American Federation of State, County and Municipal Employees, and said employees who join either will receive 29 percent raises over four years.

The California Nurses Association filed a complaint this week with the National Labor Relations Board, saying the alliance is illegal and that employees should be granted the raises regardless of whether they join the unions.

Bee staff writer Ken Carlson can be reached at 578-2321 or [email protected].

Genista, BSN, RN · May 16, 2003

I think you need to look at each union & facility individually. As for me, I worked a non union hospital where the staff meetings were basically a talking head manager monologue. Staff had little to no input. Pay was a joke. Breaks didn't exist. There was no support. There was no bargaining. "Take it or leave it," was the philosophy & guess what, I left. They had high turnover at that place. You reap what you sow, I guess.

I went over to another hospital with a strong nurses union. I didn't go there for the union necessarily, but...the working conditions were reputed to be pretty darn nice. I think the union is a big part of that. We have educated union professionals to represent us in bargaining. We need them, because frankly,many of the upper management are like a bunch of sharks in a tank. They would have nurses working for free if they could. At my union job, we have meetings where our opinion is heard and counts. We vote on issues that are important to US. My pay has jumped dramatically. Our contract had "no mandatory overtime" written into it. Any extra shifts worked are voluntary, and we get bonus incentive pay to work them. My ETO earnings are generous.

I went to some of our union meetings the last time we were bargaining for a new contract, and you should have heard the greedy and insulting propositions on the part of hospital management. They were trying to take drastic amounts of benefits away from RNs who worked 20+ years at that place. It was disgusting. Thank goodness we came together as a team, and had our union reps who are knowlegable to back us up. All we wanted was a fair and competative package, which is all anyone ever seems to want. Yet in some instances, you can be treated like a lowly slave unless you have some union backing.

I don't think it's fair to lump unions as all good or all bad. Take it into consideration.My experience with unions has been positive by far. And I gladly pay the $25/month for the top notch pay, benefits, and experience the union has helped us to get. Anytime a staff nurse has a grievance, the union is there to back us up.

My union rocks!