When nurses go on strike against a health-care group over health care insurance, it’s pretty clear that the health care system in this country is, um, unique.
On Sunday, 4,800 Allina Health nurses marched off the job at five metro area hospitals after calling a seven-day strike. The fundamental issue: health care coverage.
The nurses want to maintain the health care plan they have, a plan nurses have at four of the five other major health care groups in the metro. (Fairview, North Memorial Methodist and Health East all provide the coverage Allina nurses are striking to maintain. Nurses at Children’s Hospital gave up a similar plan years ago.)
Allina claims that if the nurses move to the plan they offer to other Allina employees, the not-for-profit health care system would save $10 million a year, money it says could be used for improving patient care. The nurses’ union, the Minnesota Nurses Association, questions that number, which amounts to about $2,800 a year per nurse. Additionally, the nurses say, that even though they pay higher monthly premiums with the plan they’ve had for decades, the co-pays and deductibles are vastly superior to those offered in the Allina plans.
Those are the basics.
But what else do you need to know to understand the seven-day strike?
1. It’s not about the money
The nurses insist that this is an unfair labor practices strike, not an economic strike. There’s an important reason for the distinction. In an economic action — such as the dispute at American Crystal Sugar a few years ago — workers can be permanently replaced. In unfair labor practice strikes, workers can be replaced only on a temporary basis.
In this case, the union says Allina is using unfair labor tactics because it will not negotiate on any issues until the nurses accept the Allina health care plan. Allina claims that’s not true — that it offered the nurses a full contract package, including a wage boost. The company also said it addressed concerns nurses have about workplace safety. But Allina’s “offer” included what the nurses considered to be a poison pill: acceptance of the Allina health care plan.
“What can possibly be unfair about nurses accepting the same plan that every other Allina employee has?” said company spokesman David Kanihan.
He also said that the Allina plan offers three choices. Still, without nurses’ acceptance of a health insurance change, there is nothing on the table.
2. Both sides have theories as to what the strike is really about
Allina believes that the Minnesota Nurses Association has timed this strike to coincide with nurses’ union strikes in other parts of the country. Why do that? Because there is a limited pool of qualified temp workers to draw on to replace the striking nurses, which drives up Allina’s cost. The union claims that the 1,400 replacement nurses who have come to Allina facilities in the Twin Cities from all over the country are being paid $8,400 a week, plus travel expenses, lodging and meals. Allina nurses are paid, on average, $42 an hour. Allina will not say how much replacements are being paid.
Union leaders have theories of their own as to what’s driving the strike. The other major health care groups settled with their nurses quickly in February, and the words “health insurance” were not uttered in those negotiations. Allina, many local labor leaders believe, is a stalking horse for the other major health care groups. If it can get its nurses to give up on their health care plan, the other health groups will follow suit in future negotiations.
3. Yes, the seven-day strike strategy is unusual
Anybody who’s dealt with labor issues knows that strikes are a little like war. They’re easy to start, but damned hard to end. But this strike has a clearly defined end point, 7 a.m. Monday, June 27. (Allina is not obligated to bring all nurses back immediately.)
This may seem like a cushy way to strike. You miss only one paycheck, probably don’t miss out on any benefits, picket from 7 a.m. to 7 p.m. and then Monday go back to work. It should be noted that the nurses do not receive strike benefits, though there is an emergency fund to help nurses in particularly rough shape.
According to labor leaders, any union could declare a short-term strike. It’s just that, from a strategic point-of-view, end-certain strikes don’t make much sense in the private sector. Indeed, the one wedge that private sector unions have is hurting the bottom line of a company. If the company knows its teamsters or pressmen or butchers are going to only strike for seven days, or 10 days or even a month, they can ride it out with a combination of temp employees and supervisory staff doing the heavy lifting. On the other hand, a strike seemingly without end can force both sides to come to agreement.
Will a seven-day strike have an impact in this case? The nurses are highly skilled and key to the smooth-running of the hospitals. Additionally, they could announce next month that they’re going out for another week and they could continue to take those actions. (Nurses are required by law to give 10 days notice prior to walking out.) Still, once workers miss a check or two, striking becomes less and less palatable.
4. Allina really doesn’t like the way the nurses talk about the health care plan
Even Allina admits there are substantial differences between the health insurance the nurses have and the health insurance Allina is demanding the nurses take. But Allina bristles at what they believe are the “apples to oranges’’ comparisons nurses on the picket line are making in the media. In some cases, Allina says, the nurses are comparing their current plan to the “basic” Allina plan, which is a bottom-of-the-barrel plan offered to all Allina employees. Allina says only a few of its employees use the basic plan. According to Allina, most use the top-of-the-line Allina First plan, which Allina says is an excellent plan, offering considerable choices.
5. The health care plan isn’t the only issue
There are a few other issues in play, including staffing. The nurses want a staffing ratio established, meaning a certain number of nurses would have to be working depending on the number of hospital patients. Allina doesn’t like that idea, instead it wants more “flexibility.’’ Nurses also want more training, especially in dealing with issues of violence. Allina doesn’t seem to have an issue with that.
6. It’s something of a Minnesota-nice strike
There are bruised feelings on both sides but overall, this so far seems like a pretty civil dispute. With a few exceptions, the striking nurses are even not hassling the replacement nurses who are crossing picket lines. As Angela Becchetti, a rapid response nurse at Abbbott Northwestern and a member of the negotiating committee, says of the civility: “We care about the health of our patients.’’