The Oregon Nurses Association (ONA) has gone on indefinite strike against the Providence Healthcare system, an ultimate move in a years-long dispute that is partially, but not primarily over equitable compensation for a class of workers widely recognized as the backbone of any hospital operation. Originally founded and run by a religious order, Providence as relatively recently corporatized, being taken over my money-market and hedge fund types eager to ‘cash in’ on the lucrative healthcare market, restructuring Providence’s operations on more traditional neoliberal lines—austerity, precarity, and privatization. Providence management, willing to invest in its long-term vision is paying scab nurses up to $100 an hour—well beyond ONA’s current economic demands, at least in terms of employee compensation.
Many of ONA’s primary demands do, however, affect the bottom line of hospital operations—the baseline need for adequate staffing. Understaffing is partially a function of a shortage of trained professionals—ironically, teaching nursing pays so much less than being a nurse, that there is a back-end educational crisis in which the system is failing to produce the workforce required to meet demand.
One would think this would make nurses more valuable in the labor market. However, healthcare in the US is not a ‘free market’ system—dominated by profiteering, healthcare in this country is controlled not by demand, and not by providers, by a vast intermediary “healthcare management” system comprised of insurance companies and other entities whose primary ‘value addition’ to the system lies in their ability to extract vast profit not least by denying services to theoretically ‘covered’ individuals, that is, people who have paid for medical insurance who are then denied coverage for life-saving claims.
Furthermore, Oregon is a vast and, in many places, sparsely-populated state. The bulk of Oregon’s population lives in the Portland metropolitan area, arguably stretching south along the I-5 corridor south, through the state capitol Salem to Eugene, the seat of the state’s university system. Then there’s the ‘rest’ of Oregon, southern and eastern, vast stretches where a ‘big city’ might have 50-100,000 residents and many towns and villages have residential numbers in the hundreds. Services can be hard to physically access, requiring drives of hundreds of miles, and there is little profit incentive for capitalist healthcare to provide more proximate infrastructure to the rural parts of the state.
Delivering more services with fewer staff is a Profitability 101 strategy, but unlike say package or entertainment delivery, healthcare still requires a high degree of one-on-one human interaction at all stages of its services. A profit-wringer’s alternative, then, is to vastly understaff the services being delivered, and call it good enough. Leaving aside ONA’s demands around pay equity and adequate cost-of-living adjustments, this is the real crisis underneath it. The situation is so bad that the Oregon labor movement did an end run around the bargaining process, and got the state legislature to pass hospital staff/patient ratio laws requiring that patients be provided adequate care through adequate hospital staffing. Providence, among others, has been deeply resistant to complying with these laws.
Additionally, the recent corporatization of Providence in particular has brought with it a new management that wants to more or less wipe the board (represented by collective bargaining gains over time) and ‘start fresh,’ something like when management fires everyone and makes them re-apply for their old jobs under new terms and conditions. Providence and the ONA have been bargaining for a next contract for years. Management has not bargained in good faith, meeting infrequently with ONA’s bargaining team, and offering little-to-no movement in proposals when they do. By all appearances, management seems to be in ‘last offer’ mode without actually saying so, because of course if they said so, labor law would move the process along, imposing an arbitration process that might be fairer than what management has in mind, even if arbitration threatens significant losses for the nurses, thus labor’s overall reluctance to turn the fate of a collective bargaining agreement (CBA) over to the tender mercies of arbitration.
Last summer, Providence nurses led a three-day walkout of Providence hospitals across the state, which turned into a lockout when management refused to let nurses return to work, the week before they’d contracted with scab agencies. The current strike is open-ended, indefinite, and has seen nurses picketing for going on a month now, sometimes in severe winter weather, with no end in immediate sight.
Donations to the ONA Strike Fund can be made at:
https://www.gofundme.com/f/support-the-providence-strike-fund
Even very small donations are meaningful expressions of solidarity, and add up.
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