WORKSHOP TALKS: Veteran Affairs care is for data

From the July-August 2014 issue of News & Letters

by Htun Lin

The media has been abuzz with news of the Veterans Administration (VA) scandal over concealing lengthy delays in providing access to healthcare. VA bureaucrats admitted that they cooked the books to hide that many patients had to wait years to be seen by a doctor. Some of these patients died before they were ever seen. Some VA workers confessed that the fake data was what their higher-ups wanted to see.

There was much pompous indignation displayed by Congress, which ultimately succeeded in forcing General Shinseki, the VA’s top man, to resign. Congress, however, doesn’t want to confront problems in the system which surfaced in the VA scandal. Congress is part of the problem. The right wing promoted axing VA spending, just as they voted against extended unemployment benefits, in the name of cutting the federal budget.

Healthcare reform took cost-control ideology to a whole new level. The Affordable Care Act (ACA) has been transformed into its opposite by the HMO industry which sacrifices the lives of patients and workers alike for the sake of fiduciary health.

Where I work, at the nation’s largest HMO, we healthcare workers are not shocked to see what has happened at the VA. We too have seen our own corporate bureaucrats provide data which their higher-ups want to see. Endless cadres of corporate overseers, monitors and marketing consultants have been hired to keep track of computer data generated by healthcare workers, poring and obsessing over it daily. Data production takes priority over concrete patient care itself in the new healthcare assembly line.

Corporate has concluded from the data that there are too many nurses, whom our HMO plans to cut. Patient wait times are longer than ever. Management scapegoats nurses by imposing unrealistic deadlines which nurses can’t meet due to chronic short staffing. Nurses face perpetual speed-up. The threat of disciplinary action motivates them to cook the data.

Management also saw fit to reduce mental healthcare staff and resources at a time when patients had to wait months for access. Clinic receptionists have witnessed patients canceling themselves on the day of their procedures, once they are hit with co-pays and deductibles as high as several thousand dollars.

Management has transformed the concept of accountability to apply to abstract financial objectives rather than to the concrete labor of providing healthcare. Many of us healthcare service workers know how a Labor-Management Partnership (LMP) between SEIU and Kaiser HMO has been instrumental in getting the union on board to be accountable for company financial objectives.

The LMP is in full marketing mode to compete for new ACA enrollments. At the same time, unions have collaborated with management in cooking up a new attendance policy to help cut staffing by hounding workers out of their jobs.

The California Nurses Association (CNA) has a solid record of refusing to participate in the LMP. Nurses have been at the front lines of the fight against attacks on healthcare access. They protested at the grand opening of a new state-of-the-art facility even as the HMO cut staff and increasingly shifted the costs of care to patients themselves, while preaching “making affordability a priority.”

But lately nurses who have been active in the struggle, like rank-and-file SEIU workers, have been expressing increasing frustration with their own union bureaucracy. One nurse said, “Officially, CNA is not part of the LMP. But they are starting to act like they are. Maybe they’re feeling the pressure to conform. CNA reps now often don’t return our calls, taking us for granted just like SEIU reps.”

Another nurse said, “Let’s not forget, CNA’s newest advisor is Sal Rosselli, a former SEIU official who helped bring in the LMP.” Rosselli is now head of NUHW (National Union of Health Workers), which challenged SEIU, the company union, but lost in a representation election.

In this debate about various union bureaucracies, it really doesn’t matter anymore which union is better than another. What’s happened at the VA is nothing new. In this kind of ideological climate, when money is more important than human lives, you can’t expect any bureaucracy, ANY, to be pure. They all eventually surrender to the dominant ideology. We can no longer rely on support from them. The only support we have left is each other.

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