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The Hospital Workers: “The Best Contract Anywhere”?


Unions exist to negotiate contracts, to set out the terms under which workers will supply their services until the next negotiations. They are not designed to free Joan Bird, de-pollute the environment, elect John Lindsay, or end the war. Gestures made in these directions are peripheral, undertaken by the leadership of Local 1199, Drug and Hospital Union in New York—as well as by other unions—because the leaders can see as well as anyone else the connection between the security of their members and the state of the world, and because they feel responsible for directing leftover energies and resources to useful ends.

The heart of the union, however, is contract negotiations. The contract justifies the very existence of the union, justifies the building of buildings, the payment of salaries; it justifies the officers and is the excuse for, if not the source of, their power; it also justifies the dues the workers pay to support the structure. A good contract is what holds the union together, giving the blacks and whites, the Puerto Rican porters and the Jewish technicians a common interest. Most important, the contract is the spring of all real gain: it is the source of additional money, of dental insurance, of pensions, of vacations. You have only to be around a union at contract expiration time to feel what an emotional, as well as a political and practical, watershed it is.

During contract negotiation time all the chickens in a union’s barnyard come home to roost. The union’s history and character come together and are revealed as having a functional, not an arbitrary, source. This was certainly true of 1199. Patterns that seemed abstractly “authoritarian,” rooted in power hunger, egotism, or sectarian conceptions of structure, seemed, while the contract was at stake, to make perfect sense. Factionalism or opposition to the leadership, however idealistically inspired, seems when it occurs at this stage to border on treachery: Will not disruption risk the unity needed to face down the bosses? As a result the settlement might be unfavorable, a matter not just of loss of credibility for the leadership and the union, but of overwhelming practical consequence to the members: the workers won’t get what in fact they desperately need. They won’t get it this time, and the power of the union will be compromised in the future. Immediate interests are at stake.

These things are so because of the adversary nature of collective bargaining in America. Capitalism rewards workers not according to need but according to the power of their organizations to threaten or disrupt. There are lights, cameras, smoke-filled rooms, clustering reporters, political machinations, all-night waits, exhaustion. The leaders need endurance, oratorical skill, and technical understanding. They must be equally at home in the bureaucratic regions of the managers and in the field commanding their own troops. During 1199’s talks with the hospitals the problems of negotiation were very much exaggerated because of the way hospital services are financed: the dependence of hospitals on state and federal funds made them irresponsible negotiating partners. They never would or could say what resources were in fact available, or how far they might go in meeting the union’s demands. Moreover, the tension and infrequency of contact during collective bargaining made it impossible for both sides to discuss real issues or grievances, real ways in which working conditions might be reformed.

Collective bargaining is a grueling, insane, time-consuming experience, full of truth and full of lies. It can also be exhilarating. As an instrument of achieving real progress, this proud invention of the American class struggle seemed to me absurd. But it is the world in which unions live, and in which they must prove themselves or fail.

There were essentially three elements in the 1970 talks between Local 1199 and the League of Voluntary Hospitals. The first was what was happening within the union: the formation of demands, the mobilization of support, the development of tactics. The second was the talks themselves: the interplay between workers and management, the dickering over what it was possible to achieve. The third was the hospitals’ side: the strategy that the hospital leadership had adopted and its relation to New York State politics, and specifically to Governor Rockefeller. People in the union sometimes felt, as one of them said, that the negotiations were being manipulated “by forces greater than Leon Davis.” I don’t know to what extent that is true; perhaps no one does. But certainly the demands on the union officials to provide mass leadership—to inspire, then control their troops—were inseparable from the demands on them for tactical judgment and political skill in dealing with the managers. It was the tension between these demands that defined the entire process.

Within the union, preparations were carefully arranged to reach a climax on July 1. Beginning in March, meetings were held in every hospital, with the Guild and Hospital Divisions meeting separately. The workers were asked what they wanted—a rare occurrence—and at least in the places I visited, there was a spontaneous outpouring of present grievances and visionary hopes for the future. For example, from the basement of a chronic disease hospital in the Bronx: Why can’t we take our holidays when we want them? Make the bosses stop calling to check on us when we’re home sick. Let’s get paid for unused sick leave at the end of the year. We should get paid every week, not every two weeks. Why does my husband at another hospital make more money than I do when we do the same work? We need a locker room with a shower. They’ve taken away the chairs where we take our breaks. Make the hospitals pay for cleaning uniforms. We need: dental care, $100 take home pay after taxes, $50 a week raises; free meals; hour-long lunch breaks; more respect from the supervisors; differential pay for night and weekend work…and so on.

The organizer, the staff member chairing the meeting, takes it all down. We’ll see, we’ll see. The problem of negotiations exists from the beginning: to determine where there is real need and strong feeling, to mobilize support, without making false promises. The organizer then supervises the election of a worker to sit on the negotiating committee. It is clear from the start who the representative will be. It will be the active union delegate, the worker who has already proved his or her reliability to the organizer and the leadership. “I think you should elect Mrs. P. She was on the committee two years ago and she did a great job.” Mrs. P. is elected. It was apparent that the process was roughly the same in every hospital because the composition of the negotiating committee was like a who’s who of the 1199 rank and file. Dissension was unlikely to afflict its ranks.

The final demands, sifted by the leadership and the committee from these outpourings, seem now, months later, to be somewhat limp or trivial. Yet each one had a concrete meaning for thousands of workers. Each one would have made their lives just a little better: a greater accumulation of sick leave, differentials for weekend work, differentials for Licensed Practical Nurses who act as RNs, longer vacations after shorter periods of employment, payment of laundry costs for uniforms, dental care under the benefit plan. The demands reflected a certain amount of internal pork barreling: LPN differentials, for instance, or a demand to end inequities in reimbursement to social workers were clearly aimed at satisfying the more highly skilled workers in the division of the union known as the Guild. For itself, the union demanded that workers’ savings at the Credit Union and contributions to the union’s Brotherhood Fund be deducted by the hospitals from the payroll. Then there was Martin Luther King’s birthday as a holiday: a little soul, something for everyone.

Money, however, was the critical demand. During the negotiations of 1968 the problem had been simpler: the $100 minimum was plain, dramatic, a good magnet for community support. No one could argue that human beings supporting families should make less than $100 a week. Now the money question was more complicated. The union feared that people would argue—and at one point the hospital managers actually did, incredibly in view of their $75,000-a-year salaries—that the workers were no longer so poor. They would point to industries such as retailing where New York workers are still making only $80 or $90 a week.

The committee therefore decided to tie its coattails to the Bureau of Labor Statistics, which in the early summer of 1970 reported that the minimum needed to maintain a family of four in New York City was $139.71 per week, or $7,265. (Try it.) the union accepted this figure, though many of its members are supporting far larger families, and demanded a $140 minimum: a 30 percent increase across the board or a $40 increase, whichever would be higher. It also demanded a cost-of-living escalator clause.

One union demand was more than ameliorative and its fate is significant. This was a demand that appeared on the list simply as “Establishment of Career Ladders Within Each Hospital.” I believe this was meant to be an extension of a union-management program which was begun under the 1968 contract. Known as the Training and Upgrading Fund, it trains workers in lower job categories to be technicians or clerical workers. The program is extremely expensive to administer, because under it the hospitals must not only finance the worker’s training, but also pay him or her a salary during training and, in addition, pay another employee filling the job the trainee has left. Because of its cost, the program has remained very small and will not become a major factor in changing conditions for a significant number of workers.

The new “Career Ladders” proposal, as I understood it, would have—or more accurately could have—been more effective. It was designed to establish an automatic upgrading procedure open to all the workers in the hospitals: a maid would be trained as an aide, an aide as an LPN, a file clerk as a typist, a typist as a technician, a kitchen aide as a dietician, etc. The proposal might have abolished the worst and most notorious characteristic of hospital jobs: that they are dead ends. It was hardly a revolutionary proposal, unless increasing people’s capacities and giving them more mobility are revolutionary. It did not, for example, change the distribution of power between workers and management. But it was a reform which would have made a difference, and that is why the union’s inability to work it out is important.

That was how the Career Ladders proposal seemed to me; yet I sometimes felt that I was the only person around who had noticed it at all. It appeared on the list (by what process I do not know), but was never mentioned again. It was never central to the negotiations. No one mourned its passing. The reason for its extinction is not that the leaders of 1199 do not want to improve the lot of hospital workers; they do. But given the structure of collective bargaining—particularly the two-week period in this case in which there was no contact whatever between the antagonists—there was no possible time for the discussion, planning, and argument that would have been needed to consider and implement such a huge administrative program. The negotiations stayed deadlocked on money and were barely able to deal with anything beyond that.

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