The fight for affordable health care and the struggle of health care workers for decent wages and union representation come together at Yale New Haven Hospital (YNHH).
When a top-ranked hospital is exposed as engaging in aggressive debt collections and home foreclosures, it spotlights both the crisis in coverage and the corporatization of medicine. At the same hospital, the drive by 1,800 workers to join the union exemplifies the problems of health care workers who at YNHH, as at many hospitals, form one of the largest concentrations of workers in the area.
In recent years, YNHH has resorted to aggressive tactics to collect on hospital bills owed by poor patients with no health insurance. A study released by the Connecticut Center for a New Economy (CCNE) discovered hundreds of liens against patients’ homes and numerous foreclosures.
The story received national attention in March, when the Wall Street Journal profiled Quinton White. White, 77, had been paying on his wife’s medical bill for twenty years, but, with added interest and legal fees, he now owed $39,000 – more than twice the original debt. CCNE reported many other cases of low-income workers, lacking health insurance, whose medical emergencies exposed them to crippling debt, high interest rates, wage garnishment, foreclosures, harassment from collection agencies, and “bank executions” (where money is seized directly from the patient’s bank account). Victims include workers at YNHH and Yale University School of Medicine.
Adding to the community’s outrage is the existence of $37 million in “free bed” funds, donated with the express purpose of providing free medical care to the poor. Victims of the hospital’s aggressive debt collections say they were never told they could apply for the funds, and Connecticut’s Attorney General is suing the hospital for misusing the donations.
The hospital’s 150 dietary workers have long been members of Health Care Workers’ District 1199, Service Employees International Union (1199/SEIU). They have been working without a contract for over two years, while 1,800 housekeeping and patient care workers are seeking union recognition from YNHH. Over 1,100 workers have signed public statements calling on the hospital to agree to recognize the union when a majority of workers sign union cards. Management has refused this and similar proposals, insisting that it will only recognize an election by the National Labor Relations Board (NLRB). The NLRB process often takes years, and provides employers opportunity for coercion and intimidation.
CCNE’s Hospital Debt Justice Project and 1199/SEIU’s organizing drive at YNHH are closely intertwined. For more than three years, CCNE has worked with 1199/SEIU and the service, clerical and graduate teaching unions at Yale University. YNHH and the university are legally separate, but have overlapping Boards and share buildings, and their employees work side by side.
CCNE and the Yale unions have developed a broad movement for justice for the workers, and for a social contract between the university and hospital and the city of New Haven and its communities. Neighborhood meetings throughout the city have brought together workers, clergy and community activists to discuss the impact of the two Yale institutions both as employers and corporate citizens. A thousand community supporters rallied in support of the unions during a one-week strike this March.
Following a packed May 1 town meeting on YNHH’s uncharitable care, the hospital announced it was closing 170 accounts more than five years old, and was reviewing the remaining 9,900 collection accounts. The first debt cancelled was that of Quentin White. However, the hospital still refuses to meet with representatives of the clergy and the debtors to discuss the coalition’s demands to cancel all prior debt and for public accountability.
The fights for health care and workers’ rights cannot be won only on a local level. Grassroots movements in New Haven and around the country lay the basis for a growing movement for national health care, for workers’ rights, and to change the current pro-corporate, anti-worker policies coming from Washington and many state capitals. The most important part of this struggle will be to oust the ultra-right from Congress and the White House in 2004.
The growing number of uninsured – 40 million and rising – is becoming a top issue as the 2004 elections approach. At the same time, the Bush administration is engaged in a full-scale attack on unions, creating an atmosphere difficult for organizing.
Yale University cites the national economy as an excuse for offering its workers minimal raises. Both the university and the hospital rely on Bush appointees to the NLRB and the courts to block union organizing.
The anti-union stance adopted by YNHH’s corporate-minded Board is in direct contradiction to efforts to provide more national resources for health care. Allowing workers to freely choose union representation, and cooperating with labor and community movements to win a national program of health care for all, would be more in keeping with the hospital’s stated mission. A strong and united movement by workers and communities is the best way to persuade the hospital to such a position.
Arthur Perlo lives and works in New Haven, Conn. He can be reached at email@example.com