Moving beyond `labor vs. healthcare industry'
EFFORTS BY Senator Edward M. Kennedy and other top political leaders to press Boston's biggest hospitals to talk labor peace with a major union involve far more than urging reluctant healthcare executives to consider the union label. If the participants are willing to move beyond the typical (if not outdated) adversarial and unproductive model of the past, both hospital management and the union could signal not only a new era in labor-management relations, but a landmark step toward the overarching goal of making quality healthcare more available and affordable.
The question is whether both parties will have the foresight and leadership to serve as a model for the future -- or as a reminder of a trapped past that has failed employee and employer alike.
Healthcare executives in Boston have been wary of efforts by the union, 1199 SEIU, to organize the primarily non-union workforce at the city's world-renowned teaching hospitals. Businesses -- and many healthcare providers and analysts -- fear that unionization means higher wages, benefits, and restrictive work rules that will add to the already-soaring costs of delivering healthcare. Those costs, they fear, will end up being borne by companies, families, and individuals. But this predictable reaction reflects the win-lose mindset that has marked the tone of recent US labor relations. In Boston, an opportunity exists to change that tone, to prove that win-win is not only possible but is essential to achieve better and more affordable healthcare, while restoring the fast-fading American Dream for thousands of working families.
Unfortunately, the default strategy for both labor and management is to fight rather than work together. That's what labor and healthcare providers did this summer in squabbling with the Legislature over staffing ratios for nurses, an issue that should be worked out bilaterally and tailored to the needs of each work site and patient population, not through some one-size- fits-all legislated rule.
It need not be this way. For the past decade, Kaiser Permanente, the giant California-based HMO, and its unions have worked in partnership to negotiate labor agreements that use state-of-the-art, ``interest-based" problem-solving tools. The parties have worked together on a daily basis to solve budget problems, introduce new electronic medical record technologies, and enhance the quality of the healthcare services that they deliver. Patient and employee satisfaction -- not to mention Kaiser's productivity and profits -- have all risen in tandem. Similarly, SEIU and the Hospital League of New York have worked together for years on employee development, work-family balance, and child development initiatives.
Closer to home, Cape Cod Hospital and the SEIU this summer signed a partnership agreement that calls for using a problem-solving approach to negotiations. An important part of all these agreements involves handling new union organizing and recognition processes without the long, drawn-out legal battles or destructive conflicts that divert scarce healthcare dollars.
New forms of labor-management agreements in healthcare are about far more than avoiding short-term conflict. A service economy depends on the quality, skills, and motivation of those on the front lines with the public. Employees want to be treated with respect, but they also want a cooperative environment between management and the workforce. Countless studies demonstrate that employee morale and motivation, teamwork, and high-quality customer and patient service go together. We can't have a productive, innovative service economy with a disrespected, disgruntled workforce in a constant state of tension and conflict.
Which way will we go in Boston? Will we pursue the broken and nonproductive model of confrontation and distrust? Or will healthcare executives and unions learn from and apply proven best practices and begin building a new model of employee relations, one that simultaneously respects workers' rights and creates a platform for delivering healthcare that is high quality, innovative, and affordable for businesses and consumers alike?
If Boston chooses to travel on the smart highway, it will build on its international reputation for healthcare and become a model of new and better ways to produce and deliver it.
Thomas A. Kochan is a professor at MIT's Sloan School of Management, codirector of the MIT Workplace Center, and author of ``Restoring the American Dream: A Working Families' Agenda for America." 
