Saturday, November 7, 2009

Union Behavior Might Be Obstacles in Transforming American Healthcare

Some interesting articles in USA Today regarding union positions about the H1N1 vaccine which suggest that transforming American medicine so that it is higher quality, improved access, and even more affordable will be extremely difficult if not impossible.

Some hospitals, healthcare organizations, and the state of New York attempted to have staff required to get the seasonal and H1N1 vaccines. Even though, Infectious Diseases Society of America recommended all healthcare workers get flu shots, the Service Employees International Union (SEIU) opposed this and won.

Although patients are lining up demanding flu shots, doctors and the Centers for Disease Control want those at risk, SEIU indicates that the issue is education, rather than attaining compliance by fiat. To be completely fair, too many doctors don't get vaccinated either which is equally as disturbing. In healthcare, we make too many exceptions rather than require that the right thing gets done at all times.

While I was troubled by the behavior of SEIU, I can understand while disagree with their opposition to mandatory vaccination. It seems more of a political decision rather than scientific.

Yet, later that week SEIU was again in the news. This time upset about the distribution of flu vaccine to companies that have employed in-house doctors and clinics. Specifically, the union had a problem with companies like Goldman Sachs which received vaccinations from the City of New York in a equitable system where only those at highest risk (chronic illnesses or pregnancy) were to be immunized and the original distribution was reserved for pediatricians and obstetricians who requested vaccine. Sadly only about half of the pediatricians in New York City wanted it. As a result, the city moved on to give vaccines to those doctors caring for adults, which included the physicians working at Goldman Sachs as well as the Federal Reserve Bank, Columbia hospital, and Time. From the article:

"Wall Street banks have already taken so much from us. They've taken trillions of our tax dollars. They've taken away people's homes who are struggling to pay the bills," union official John VanDeventer wrote on the Service Employees International Union website. "But they should not be allowed to take away our health and well-being."

The union has about 2 million members, including health care workers.

Um, so wait. Healthcare workers are considered a high-risk group as defined by CDC. Naturally healthcare workers should be among the first in line to get the vaccine. If you had agreed to a mandatory vaccination program for those in the union who are healthcare workers, wouldn't that mean those in your union therefore are vaccinated and kept healthy? Getting the vaccine, which is in short supply wouldn't be a take away, but a benefit!

Having mandatory vaccinations in really only a small issue in a much larger problem. How can employers and unions get together and transform American healthcare?

To be clear, I'm not opposed to unions. One of the most successful organizations ever is Southwest Airlines, which to the surprise of many who don't know, is among the most unionized airline in the country.

I'm troubled because companies like General Motors failed because unions and employers were unable to see eye to eye. As a result, it failed because it was unable to compete with foreign competitors. Unlike the auto business, there foreign national healthcare organizations wishing to take over the US marketplace.

What it does mean, however, that making healthcare better and cheaper won't happen. Result? Government takeover or increasingly more Americans uninsured, worsening healthcare quality, and increased costs.

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