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Message from the President

The Wrong Diagnosis, The Wrong Solution

Whether you are a nurse, a medical researcher, a lab tech or social worker, or any other health care worker you know this: without the correct diagnosis, you can’t cure or solve the real problem.

Yet, misdiagnosing the cause of our state and national economy’s ills is precisely what we are doing. On the national level, the opponents of national health care reform – in any form – simply choose to ignore the direct relationship between spiraling cots of health care, business and personal bankruptcies and the spiraling profits of the insurance companies. No economy can continue to grow and create new jobs while millions of dollars are diverted to insurance companies and millions of Americans go without health coverage. Small businesses cannot remain competitive when they provide health care to their employees, and their competitors do not. We simply cannot afford to allow private insurers to keep 15-20% of our healthcare dollars in profits and administrative costs while the cost of coverage skyrockets.

Here in NJ, in the midst of this terrible recession, when our new Governor stands up and says that New Jersey doesn’t have a revenue problem – we have a spending problem, he is also misdiagnosing the problem. And the solutions he poses will cause serious harm to our members and the public we serve at hospitals, nursing homes and universities across NJ.

For example, this year, NJ’s income from sales tax fell by 5% - and income from business taxes fell by 8%. That’s a revenue problem. Allowing a millionaires’ tax that brought in nearly $1billion a year to lapse is a revenue problem. Allowing a corporate tax surcharge of 4% to lapse is a revenue problem. We should fix our revenue problems first – and it doesn’t mean adding taxes, it just means not allowing existing taxes on the wealthy and corporations to lapse. Once we do that, we will have a different budget gap, and therefore a different set of solutions to offer.

Treating the symptom and not the underlying problem is a recipe for disaster, and as healthcare workers, we know that. Cutting back the funding for vital programs like family care won’t solve a revenue problem, it will only leave more than 15,000 children and families without health care coverage, placing more pressure on our hospitals – whose funding is also being cut. The wrong diagnosis, the wrong solution.

In the same document, Governor Christie announced the end of funding for other vital health programs. These ‘freezes’ or elimination of funds for the current year, many affecting HPAE hospitals and UMDNJ, include:

• $12.5 million in charity care to our hospitals–money that is now matched by the federal government –meaning $25 million in budget cuts to NJ hospitals.
• $ 1million in bioterrorism preparedness
• $ 5million in spinal cord research
• $ 5million in autism research
• $ 5million in cancer care research
• $ 3million in brain injury research
• $ 10million in health care subsidy funds
• $ 2million in AIDS grants
• $367,000 to University Behavioral Health

Governor Christie also believes our colleagues providing public services are the problem, either because of their health benefits or their retirement security. Our new Governor‘s answer is to eliminate the state’s meager projected $100 million contribution to the pension fund; eliminate paid health coverage and the defined benefit retirement for part-time workers – defined as less than 35 hours. Without exception, every single worker in the state pension system has continued to make his/her annual contribution to the fund. Yet every year since 1994, our state has used gimmicks instead to justify not paying into the fund. Unfortunately, the trend continues and many of our NJ Legislators are proposing legislation to enact these so-called reforms.

Governor Christie has also announced a freeze in the implementation of regulations, claiming they are a hindrance to business growth. These include regulations that would enforce our health and safety laws, like the Safe Patient Handling law, or the Violence Prevention Act. Again, assuming that regulations are the problem leads to the wrong solution. Safer workplaces, we know, improve healthcare worker retention, reduce injuries and associated costs, and make things safer for our patients too.

If you want to have enough money in our state Treasury to invest in our communities, put people back to work, provide quality health care and share any necessary sacrifices - there is one set of solutions. Extend the millionaires’ tax and the business surcharge. Invest and repair our crumbling roads, bridges, schools and hospitals. Sit down with the public worker unions – like HPAE’s own local at UMDNJ --and negotiate solutions that share not only the sacrifice but the rewards.

This year, HPAE will move forward, not backward, in our fight for quality health care, and for the rights of our members to decent wages, benefits and safe working conditions. We will continue to ask that our hospitals be held accountable to our communities; that a standard be set for safe staffing; and that funding to our hospitals and healthcare institutions be provided at a level that enables us to provide the care our communities need and deserve.

Join in that effort. HPAE members will be testifying on important legislation and budget items in the coming months. Go to www.hpae.org/political/ or see your COPE representative in your local.

Ann Twomey
HPAE President

Clarion Newsletter

HPAE In Haiti

Englewood Hospital nurses return after 17 day trip to Haiti
January 29, 2010
The Bergen Record

ENGLEWOOD — Two nurses from Englewood Hospital and Medical Center returned Friday from Haiti, where they spent an emotionally intense 17 days treating hundreds wounded in a massive earthquake.

Read More

The following Guest Commentary is by Charley Richardson, Director of the Project on Technology, Work Reorganization and Continuous Bargaining of the Labor Extension Program at UMass Lowell. For over 20 years, Charley has been working with unions in all sectors of the economy, providing training, education and strategic support on issues of changing technology and work restructuring. Charley is consulting with HPAE on health information technology issues and will be leading a workshop on the subject at the October 1st Professional Issues Conference. Charley welcomes your feedback and questions.

Electronic Medical Records and other Health Information Technologies: Challenges and Opportunities for Healthcare Workers and Unions

A freight train is barreling down the tracks. They’ve just turbo-charged the locomotive and it is accelerating in your direction.

Electronic Medical Records (EMR) and other Health Information Technologies (HIT), pushed for years by large stakeholders ranging from IT vendors such as Intel, GE and Microsoft, to insurance companies such as Blue Cross Blue Shield, to large health care purchasers such as AT&T and UPS, are receiving a boost in the form of $17 billion worth of incentives in the federal stimulus package for hospitals and other providers to implement HIT. Those who fail to adopt EMR’s by 2015 will suffer penalties in the form of lower Medicare/Medicaid reimbursements.

HIT is coming our way, which is for certain. Electronic Medical Records, more than simply the digitalization of information currently stored on paper, are the digital backbone for a series of transformations that are on the horizon, including telemedicine, robotics, work restructuring and outsourcing – a true Health Information Technology revolution. Electronic Medical Records and other HIT such as automated pharmacy systems, time and attendance systems, location monitoring devices and telemedicine will have a huge impact on health care workers and their unions.

So what should health care workers and their unions do? How can unions and the health care workers they represent have a voice in the technology decisions that are so critical to their futures and the future of health care?

As a start, we need to understand all of the new technologies that are being introduced or are on the horizon and recognize both the positive and negative impacts that HIT can have on health care workers and patients.

Computerized physician ordering systems and medication bar codes can, if properly designed and implemented, help to reduce errors, telemedicine can provide specialist expertise to remote or hard-to-reach patients, and EMRs can facilitate interdisciplinary consultation and communication and provide ready access to critical patient information.

At the same time, we’ve already seen that as HIT is implemented:

Jobs can be eliminated.
Job duties and work processes change.
New skills are required, while “old” skills may be de-valued.
Workers’ location, movements, and “productivity” can be monitored electronically.
Work may be moved to remote locations.
Poor software design can make it harder for caregivers to access the information they need, when and how they need it.
Health and safety problems, including stress and repetitive strain injuries arise.
Time spent interacting with patients and their families at the bedside is replaced with time in front of the computer screen, and the quality of caregiver-patient interaction and the quality of patient care can suffer.

Because of the profound impact the HIT revolution will have on patient care, working conditions and labor-management relations, there needs to be a knowledgeable, informed, strategic and strong union voice at all the tables where discussions and decision-making about HIT are taking place. But this won’t happen simply because it is right.

The time to take action is now. When it comes to EMR’s and HIT, the reality is that: It is always too late, because we should have been acting on this long ago, and it is never too late, because we can still affect the future and delaying action would be disastrous.

While some employers have held vendor fairs to solicit individual worker input into the selection of HIT hardware or software, our challenge is to insert a collective union voice into all HIT discussions. Specific steps that need to be taken include:

The time is now to demand a real seat at the table (at all of the tables) where HIT discussion and decision-making is taking place. The time is now to develop internal capacity and activity. The time is now to develop a clear union agenda on HIT and a strategy for getting a worker/union voice heard.

Message From the President

President Obama’s Chief of Staff, Rahm Emanuel recently said, “Never let a crisis go to waste”. Just like the economy, our hospitals and health care system are in crisis, and if we let opposition forces scare us into keeping things as they are, we are in danger of losing the opportunity for real reform.

From a quality patient care perspective, our members know what works and what has failed. Every single day is a struggle to provide safe patient care. Spending time with patients and families to provide compassionate care is becoming rare. The “system” allows hospitals to cut needed services in favor of more profitable elective or duplicative services. The “system” allows board members and for-profit owners to steer health care delivery to services that will benefit them more than the community. The “system” allows for hospitals to put nurses and health care workers on the street rather than provide safe staffing levels or respect the rights of its staff. The “system” allows urban hospitals to close in while shifting resources to hospitals who are fiscally more independent.

A health care system must be based on the health care needs of all of our communities. This requires accountability and transparency over how every health care dollar is spent. We need laws that make sure that hospital board members remain independent and focused on the hospital’s mission - so that money isn’t wasted on sweetheart contracts, or in fighting the rights of healthcare workers to organize.

While some worry that national health care reform will take away our choice over health care decisions, or will put the government in charge instead of medical providers – I have to ask – what choices do we have now and who is really in charge? Too often, physicians are forced to base their medical decisions on their patients’ insurance coverage. Insurance companies determine the access patients have -- to doctors, hospitals and treatment. That’s not the choice we want to preserve. Insurance companies are the controlling force in our current health care system, with one exception – Medicare, a government-run program that is more effective, efficient and is working better than any other health care system in our country.

Further, we see the unhealthy competition among our hospitals, declining reimbursements and the stranglehold of insurance companies that threaten the existence of many of the hospitals where we work and live. We know that decisions are not in the hands of nurses, or physicians, or health care providers who are trying to care for their patients. When we see patients who can no longer afford insurance – or who have insurance that won’t cover the care they need – how can we not speak up for real reform?

We don’t get to vote on this. It’s now up to our federal legislators. Fortunately, we elected a President who is standing strong for reform. In NJ, our Senators and most of our Congressmen are standing for reform. There is something we can do – we can be at the Town Hall meetings of our Congressmen to help them explain why we need reform.

There is a right wing effort organized to oppose this funded by insurance dollars. We need to fight for health reform from the bottom up, too. That means continuing our contract campaigns to improve patient care and working conditions, as well as advocating for state-wide standards for safe staffing, for hospital accountability and the rights of health care workers – public and private – to organize and bargain collectively. In 2009, in NJ, the Governor and Assembly are up for re-election, and for the first time, we will be electing a Lieutenant Governor. These elections give us an important opportunity to elect candidates who will stand up on these issues.

Governor Jon Corzine has wisely chosen State Senator Loretta Weinberg as his running mate. Loretta Weinberg has walked countless picket lines with our members, and been the lead sponsor on almost every important piece of health care legislation in New Jersey. From the ‘baby bill’ to the ban on mandatory overtime, to violence prevention, safe lift programs, staffing disclosure and hospital accountability, family care and patients rights. It’s not every day we get to elect someone who has been there for every fight affecting our members and quality health care. Under Jon Corzine’s leadership and Cabinet, HPAE has had allies in the fight for quality health care, participating and winning many of the policies Loretta Weinberg sponsored in the NJ State Senate. We can’t afford to go backwards in NJ. In the crisis facing us in health care, we can’t afford to lose this opportunity, both in our state and across the country, to shape the future of health care.

Ann Twomey
President

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