Health Screenings Provide Health and Financial Benefits to Businesses

Corporate health screenings are a growing trend for companies seeking ways to reduce expenditures and provide a better quality of health for employees. By encouraging and maintaining the wellness of workers, the possibility of preventing potential health problems increases, which can result in lowering medicals costs associated with treating a condition in its advanced stage. Implementing preventive health care programs that include regular health screenings, immunizations and education is the first line of defense against health problems and rising health expenditures for businesses.

Chronic illnesses and health conditions can decrease employee productivity and increase absenteeism and presenteeism, which greatly impacts a company’s bottom line. In fact, The Human Resources Policy Association puts the annual cost of reduced productivity for businesses between $87 and $127 billion. Diabetes, high blood pressure, heart disease, high cholesterol and complications from obesity are listed by The Center for Disease Control as illnesses most commonly uncovered during health screenings. If undetected and left untreated, problems resulting from these conditions can disrupt every aspect of an employee’s life, including productivity in the workplace.

“Preventive health care is an efficient and effective method of identifying and treating possible health conditions before they have the opportunity to develop or worsen,” says Dr. Jeffrey Greiff, founder of Flu Busters, a third-party provider of on-site preventive health care for businesses. “When a potential health condition is diagnosed in its early stages, it can be easily remedied and can prevent more serious conditions, resulting in a much healthier patient over time.”

An Employer Health Benefits Survey found from 2002 to 2007, health insurance premiums for businesses increased approximately five times faster than inflation and four times faster than wage growth. As health insurance premiums continue to increase throughout the 2008 – 2009 fiscal year, analysts believe health care costs are a threat to the financial success of American businesses. Businesses are discovering the economic benefits of preventing and identifying employee health problems before they become serious ailments by offering annual on-site health screenings that improve and protect employees’ current and future state of health.

A common deterrent for employees against receiving health screenings and immunization by a primary care physician is that the medical services can interrupt an employee’s busy day resulting in wasted time and energy. Third-party health care providers are gaining popularity in the business world due to their ability to provide on-site services to companies of any size. So, how does it work?

Health screenings are available to companies of all sizes and can be provided on-site by a team of experienced health professionals. Prior to a health screening, information sheets are provided to make recommendations on what screenings would be most beneficial for an employee based on individual circumstances, such as, age, sex and family history. The actual screening takes only minutes and employees receive most screening results within minutes of the actual screening. A post-screening consultation with a registered health professional, as well as an online customized wellness program is offered to address any existing or potential health issues that may have been uncovered in the screening. From the initial screening to the post-screening consultation phase, the screening participants are actively assisted in developing solutions that will enable them to lead healthier, more productive and fulfilling lives.

Even through economic hardships, businesses can still provide employees with quality health care by focusing on prevention. Routine health screenings and immunizations can identify and prevent illnesses, resulting in healthier employees, lower insurance premiums, increased productivity and decreased absenteeism. Businesses that establish a comprehensive wellness plan are investing in their employees, and ultimately, the company’s success.

Public Health Insurance – An Essential Lifesaver For the American Health System

There is much debate about the type of insurance proposals that will be required in the new health system currently being negotiated in Congress. President Obama has just come out in support of a public health plan, which is opposed by private insurers who say that they could not compete with a public health plan that didn’t have to make a profit. Supporters of the public plan proposal correctly say that it would give people more choices and create more competition. Opponents argue that private health plans would go out of business, leaving only an entirely government-run health care system.

Of course all sides are exaggerating and taking up extreme positions. They will all in time compromise and hopefully reach some form of agreement. The sad part is that at present they don’t seem to be thinking of the person at the center of all this – the patient. It is widely acknowledged that health care costs far too much in this country, while at the same time at least 47 million Americans are uninsured. So, from a patients perspective, if you do have health insurance, you are paying way too much for it, and getting poor value, and if you don’t have it, then you just continue to suffer. What a dreadful choice. What an indictment of America.

The goals of overhauling the health care system are to lower costs and extend care to the uninsured. Obama wants a bill on his desk in October at the latest. Where can Congress begin to compromise, and why is it that Republicans in particular, believe that public health plans are likely to be so dreadful. What is the evidence for this belief beyond their own philosophical ideas. They regularly bring up the supposed ogre of “socialized medicine” whenever public plans are discussed, but there is no evidence whatsoever that countries with more federal control over their health systems, especially in Europe, have worse health outcomes that the USA. In fact the contrary is true, health outcomes are much better overall, and cost a lot less money per capita of population.

As a physician who has lived and worked in the USA, Australia and Britain, and who has an interest in how health services are organized, I think America could move forward in a relatively simple way as long as we always keep the patient at the center of any health system we plan. It is essential that we do not design a health system primarily to protect profit levels for some or all of the various constituents, whether they be providers, health insurers or pharmaceutical companies. We have the opportunity of picking the best parts of other health systems from around the world and including these in the eventual plan to reform American health care, and we should learn from other countries.

What should we do?

Firstly we need a public-private partnership philosophy. Australia is a good example where this works excellently. That means public and private, not just private. American core business and social philosophies are based on capitalist principals so any new approach to health care must combine the need for profits in certain sectors of the health system, with the need to develop a number of core public health services that may be less likely to ever achieve a profit. Funding for care has to involve choice and should be provided in many instances through payment for annual or episodic whole of person care, rather than on individual piece rates as at present. These capitated payment systems work well for Kaiser Permanente, and in Britain. The primary gain from this approach is that it tends to force more resources into the prevention of illness and wellness promotion, rather than into the treatment of illnesses that have already commenced.

The public component of the health care system, seemingly strongly supported by President Obama, would include universal basic health insurance as well as catastrophic care insurance. We know that this type of system works well in America and is widely accepted and popular, because we have the very successful example of Medicare for seniors. Effectively broadening the base of Medicare for other populations would prevent many of the bankruptcies caused by healthcare costs, and would cover many of the current uninsured. Public insurance would then be likely to pay for many emergency and geographically isolated health services, as well as public health services, pre and postnatal and early child care as well as care of some special populations who cannot afford private health insurance such as the unemployed, and certain impoverished or geographically isolated groups. Medicare for seniors would of course continue. These are areas where there will be less competition from private insurers who have typically kept away from them, but of course any private health insurers would be able to enter these markets and compete if they wished.

The private component would be funded with the aid of broader tax incentives or similar financial tools to encourage most people (or companies) to take out private insurance. The aim should be that at least 80-90% of the population should have private insurance, whether it be comprehensive insurance, or top-up insurance to support core government provided insurance. It is important to reach this level of insurance to ensure that we all are financially responsible for at least a reasonable proportion of our health care costs. Here the Republicans are right as it is important that we do not see health care as something that is provided for free. The private sector should offer a full range of services from birth to death, but the industry should be more carefully regulated so that they would, for instance, be prevented from excluding patients on the grounds of pre-existing conditions. They should also have the ability to charge extra for certain “non-essential” services such as cosmetic surgery.

These ideas are taken from what I consider to be the best parts of the American, Australian and British health systems. No country has a perfect health system, and no country ever will. America can afford to choose the best from other countries as it debates how to improve its health care system. Lets hope that Congress can be creative, look outwardly, and not get bogged down in political dogma.

Health Savings Accounts Should Be Available to All Americans

All Americans should have the right to save for current and future healthcare expenses with pre-tax dollars. Health Savings Accounts provide some Americans with precisely that opportunity, but it is too limited in its scope to benefit the majority of the US. I love the concept of Health Savings Accounts (HSA), if you’re not familiar with them they are savings accounts in which money can be put away for future medical expenses on a pre-tax basis. In order to be eligible for an HSA you must be covered under a qualifying high deductible health insurance plan (HDHP). These are health insurance policies that typically cost less because they require their holders pay a high deductible (typically greater than $1000 annually). Unfortunately, the eligibility requirement to participate in a health savings account precludes the majority of the population from receiving a privilege that should be as basic as saving for one’s own retirement.

In a recent response from my Congressman, he suggested I consider using a sister product, the Flexible Spending Account (FSA). Although beneficial, the benefits of an FSA fall short of the benefits in an HSA; primarily because the balance of unused money in an FSA expires annually where an HSA rolls over from year to year. This is a monumental difference. With an HSA I have a means to cover current and future medical expenses which can accumulate to a retirement vehicle which becomes available for any purpose at age 65.  The rollover benefit becomes an even greater benefit when you consider the funds in Health Savings Account are eligible to pay the premiums on Cobra. Contributing to an HSA provides financial resources to use should one lose their job. Americans can use their HSA to pay the necessary 102% of their health premiums through COBRA or they may roll the money into a less expensive high deductible health plan (HDHP) with the resources to meet the high deductible.

Let’s look at a couple of case studies.

Dick and Jane

Dick and Jane are engaged. Jane has been submitting $2600 into and HSA for the past five years. During that time she has only consumed $1600 in health care costs that means Jane has been able to build up a health nest egg of $11,400. After they are married Dick begins carrying Jane as a dependent on his health care plan which does not qualify as a high deductible health care plan. Under current laws, Jane would be forced to discontinue contributing to her HSA, but it if all Americans were eligible for this savings incentive she wouldn’t have that problem. Instead they could increase their contribution $5,150. After a year, Dick may lose his job, but the family has been able to save $16,550. Their healthcare nest egg provides Dick and Jane with additional options. They may select to continue their current coverage through COBRA or they can select an alternate health care option. If COBRA were to cost $400 a month they can utilize their HSA funds. With these funds they would have the means of paying for coverage for 41 months. They could also choose to purchase independent health coverage. Their $16,550 nest egg minimizes their risk on a high deductible healthcare plan. They could conceivable absorb a $10,000 deductible and reduce their monthly payment to about $200, or half the cost of their cobra payment.

Scott and Laura

In the scenario of Scott and Laura, Scott is a severe asthmatic. His condition leads to a hospital stay about once a year costing about $3000. He must also have continuing medication at a monthly cost of $112. Scott and Laura are both on her employer’s group health plan. They pay $112/month with a $500 deductible and a 20% coinsurance. Their annual healthcare responsibility is approximately $2610 with insurance or approximately $4340 without insurance. Their insurance saves them approximately $1700 annually from paying full price on their medical care. Their FSA saves them about 20% (their tax bracket) on their prescription charges. Because Scott and Laura will lose the money in the FSA if they don’t spend it by the end of the year, they only save the cost of Scott’s prescriptions. Now, if Laura loses her job their healthcare future becomes much less secure because Laura’s plan was not HSA eligible, they do not any residual savings from their health care expenses nor were they granted guaranteed tax savings from their medical expenses. If they keep the medical insurance they clearly need through COBRA they now need to pay $400/month. These annual premiums total $4000 alone meaning that Scott and Laura only save about $340 a year by having health insurance. This does not include the cost of any of the co pays. Keeping the insurance could increase their medical expenses to about $6000 a year or $550/month at a time when the family income has been reduced. Scott and Laura have a very difficult choice to make in regards to their healthcare. Should they continue with coverage or should they let the family health insurance lapse?

Had they been able to contribute to an HSA, their scenario may have looked a little different. Scott and Laura would still have the same policy but chose to contribute the maximum allowable to their HSA. From the $5150 they withdrew $2610 for healthcare expenses leaving $2540 to accumulate over for the next year. Over the course of 5 years they have accumulated $12700 in the HSA. If Laura loses her job their options look much more promising. They can more easily absorb costs of COBRA and provide for the costs of their existing coverage for their entire 18 month term of eligibility. By making wise decisions in time of plenty, Scott and Laura would be able to prevent financial devastation or public dependence in the future and still provide the means to maintain their health needs. All health consumers should have the option to participate in an HSA and receive the corresponding tax benefits. The opportunity to participate in an HSA should not be tied to a high deductible health insurance plan. As it is written an HDHP with an HSA discriminates against most Americans, namely, consumers whose employers don’t offer a qualified high deductible healthcare plan and those who may have regular health needs which require a more generous health plan including young families who may need maternity or well child care.

Ironically, those ineligible to participate are doubly discriminated against. Not only do they lose the opportunity to financially prepare for the future healthcare needs, but it actually results in having higher healthcare costs. Here’s how:

1. High deductible health care plans often attract the healthiest segment of society, and when you remove the healthy consumers from the general insurance pool, rates rise to cover the lost revenue and higher payout per consumer.

2. Non participants must pay deductibles and uncovered health care from post tax dollars or they must try to forecast their annual health expenses through a flexible spending account (FSA). If they underestimate, they are again paying for expenses with post-tax dollars and if they overestimate they lose the unspent balance.

3. Individuals who have continuing healthcare needs are at the mercy of their employer for continued coverage. The loss of employment often means the loss of health care and can bring great personal risk and financial hardship.

By eliminating the requirement that an individual have a HDHP plan, you open the door for many more participants. These are people who need to hedge against risk in their health and financial well-being. When you allow people to pay their insurance premiums with their HSA, you grant them a means of planning for their health future, without discriminating based on their health care needs. Nationally, you increase the savings rate, sending more money into banks, and driving down your uninsured among the unemployed. Fewer people are dependent on government healthcare subsidies because they were able to plan during times of plenty. You open a door for increased retirement savings and, by giving people access to their funds when healthcare is needed, you limit some of the draw on government resources because they don’t end up on state sponsored plans.

Student Health Insurance is Meant to Be Affordable

Student health insurance is meant to be affordable. Health insurance coverage is vitally important while a student is in college!

Insurance health coverage is mandatory for all eligible college students . During the time you are registered at the University, you are required to enroll in the U-SHIP Basic or Prescription Advantage coverage , or waive enrollment by providing evidence that you have health insurance coverage that is comparable.

Student health insurance is billed annually at the beginning of the academic year and appears on your first statement for tuition and fees.   Student Health Services is an ambulatory clinic only, and does not provide major hospitalization or treatment outside of the clinic. Student health insurance coverage is only one of the options available to provide for your medical needs and protect you in the case of an emergency until you graduate. In addition to the student health coverage plan offered by your school, you may be able to remain on your parents’ group health plan. Students enrolling (or already enrolled) must request the graduation extension which will expire one year from the student?s graduation date. Please keep in mind that there can be no break in coverage from the original plan and the extension. Students wishing to be enrolled by the College in the Student Insurance Plan should verify the charge on your student account.

Students who provide proof of continuous enrollment in an alternative U.S.-based health insurance plan with comparable benefits are able to waive out of the SHIP coverage each semester. Students enrolled in SHIP are eligible to purchase coverage for their spouse and/or for any dependent children under the age of 19 who reside with the student.

Students with limited out of area coverage or otherwise inadequate coverage are urged to carefully review their options before waiving the SHC sponsored insurance plan. Deadlines to waive the insurance are prior to the first 14 days of the semester. Students will still be free to choose alternative insurance so long as their plan’s coverage meets or exceeds the minimum requirements listed at the bottom of this page. In order to use alternate insurance, students must complete and submit the Student Health Insurance Waiver form no later than the 20th day of classes each semester.

Health coverage for students is generally considered to have the advantages of a large group plan without the usual high cost large group insurance requires. Student health insurance is a way to ensure you can get medical care when you need it, at a price that is affordable. Health insurance for students is typically less expensive than a traditional individual health care plan and is tailored to the needs of the typical college student. Student health coverage is also required for all commuter international students, student-athletes, and Nursing and Physical Therapy students. Marymount University allows F-1 International Visa students as well as Nursing and Physical Therapy program students to opt out of the University’s health insurance plan by showing proof of existing coverage and completing a waiver form.

Student health coverage is generally considered to have the advantages of a large group plan without the usual high cost large group insurance requires. Student health insurance is a way to ensure you can get medical care when you need it, at a price that is affordable. Health coverage for students is typically less expensive than a traditional individual health care plan and is tailored to the needs of the typical college student. Student health coverage is also required for all commuter international students, student-athletes, and Nursing and Physical Therapy students.

7 Reasons Why You Should Start a Health Network Marketing Business

More and more people are looking into starting a home based business. The unstable economy, low job satisfaction and the high cost of living are some of the many factors driving people to explore ways to create additional income. Even network marketing doesn’t seem to have the stigma it used to as people are starting MLM businesses more than ever.

If this describes you then I congratulate your entrepreneurial spirit! I admire people who seek ways to improve their lives and those of their families. I also encourage you to do your due diligence before leaping into just any MLM company if that’s what you’re considering. I’ve been in many network marketing companies and I learned what to look for (and what to avoid) in MLM companies through painful trial and error.

There are a huge variety of multi-level marketing companies out there offering almost any product or service you can imagine including travel services, legal services, nutritional and health products, weight loss products and many more. But I personally recommend you seriously consider starting a health network marketing business rather than any other. And I have seven really good reasons which you’ll never forget because they form the word healthy.

Here we go!

Huge market. When you start your health network marketing business you’ll automatically have the largest market possible–everyone! Everyone either wants to improve their health or maintain their good health. You won’t find anyone who will say, “Nah, I’m not interested in being healthy.”

With some other network marketing companies, however, the market can be very limited. Not everyone needs a cell phone plan or dental insurance or legal services, for instance. These aren’t bad companies but their markets are obviously smaller than that of health MLMs.

Everyone wants more money. The primary appeal of network marketing is the potential for additional income. This is another place where health network marketing outshines other forms of network marketing. With other types of MLMs, getting people excited in the products or services can be a “tough sell” which means making money is harder. Many health and nutrition MLMs, on the other hand, offer products that create visible and dramatic results with their customers, creating instant excitement. If you’ve had dramatic results with your own health products, even better! Sales are easy when people are excited and want to get the same results you had.

Before and after photos are common sales tools in health MLMs, usually showing improvement with skin problems or significant weight loss. These photos are visual evidence that customers are getting great results. Great results create an emotional attachment between the customer and the products. This translates into more repeat sales, better customer retention, increased word of mouth advertising and referrals for you.

This is in contrast with other network marketing companies which may have great products or services but are less likely to create dramatic physical results, emotional attachment from their customers and repeat sales. I’ve been in other types of MLMs myself and I can tell you from personal experience that the income potential in a health network marketing company is significantly higher.

Alternative health industry is booming. Health network marketing products generally fall into the alternative health category versus more traditional forms of Western medicine such as surgeries and pharmaceutical drugs. This is a good thing because there’s a growing trend of people preferring alternative health options such as high-density nutritional products; vitamins, antioxidants and other supplements; natural weight loss solutions; etc.

Think of the “buy organic” trend and the popularity of Whole Foods and other similar stores. When it comes to picking a good business, it’s like picking a good stock: “The trend is your friend.” Ask yourself if the other network marketing companies you may be looking at are part of a booming trend like alternative health or if they just have run-of-the-mill products and services that could have been offered 20 years ago.

Lowers your grocery costs. Many health network marketing companies offer a wide variety of nutritional products including meal replacements, vitamins, protein bars and energy drinks–all of which can replace equivalent products that you and your customers probably already buy at the grocery store.

If you’re a distributor, you’re getting your company’s products at wholesale prices which in many cases will be about the same price or lower than what you’d pay at a regular store. Not to mention your products are probably much better for you! Plus, if you factor in the advantage of deducting you autoshipped products from your taxes (check with your CPA) your food costs are even lower.

Take advantage of massive income potential. With health network marketing companies, your chances of getting large initial and ongoing purchases are very good as customers stock up on their favorite products for themselves and their families. This means higher commissions for you–and more business volume from your team members.

With other types of MLMs, though, it’s much harder to get large orders on a regular basis. For instance, it’s not likely that a customer will order several hundred dollars worth of household cleaning supplies or greeting cards on a monthly basis. But this is common practice for many customers with families in health network marketing companies. That’s why there’s so much more potential for huge income in a health network marketing business.

Health professionals are seeking additional income streams. With the uncertainty in the economy, the questionable future of health care (at least in the US) and rising costs of running a health practice, health professionals are looking into health network marketing businesses like never before. Normally, health professionals need to get past one or more “hurdles” before they’ll join a health MLM, though.

These hurdles include believing that alternative health products must be inferior to Western medicine counterparts and the concern that selling products to their patients may be “unethical”. Once they see proof that alternative health products can benefit their patients, many health professionals will take a serious look at the products and company behind them. Then, once they see that sales of these health products can create a significant income stream, even surpassing their income as a health professional (like the millionaire chiropractor I know), stepping over their earlier hurdles becomes much easier.

Of course, the benefits of having a health professional on your team can be huge. Few people have more authority or bigger personal networks than health professionals. I’ll write another article about attracting health professionals to your business soon.

You get to help others transform their lives. The best reason of all for starting a health network marketing business, though, is you are able to impact people’s health and improve their lives like no other type of network marketing company. I’ve personally helped people lose hundreds of pounds total, improve their energy and probably extend their lives through my business. I get incredible personal satisfaction knowing how much I’m helping people lose weight and improve their health.

In other network marketing companies, you can certainly help people save money with helpful products and services. They’ll probably be grateful to you for introducing it to them. But if these aren’t health products, are you really transforming their lives? You can only really do that with a health network marketing business offering highly effective products.

And those are the 7 healthy reasons why you should start a health network marketing business!

Don’t Get Me Wrong

I know it sounds like I’m bashing other types of network marketing companies and saying a health network marketing business is the only type of MLM you should consider if you want to be successful. I’m not bashing other types of companies, though. There are lots of great companies out there.

But I’ve been in this industry for many years and I’ve seen other companies from the inside. And it’s my strong and obviously biased opinion that if you want to improve your chances for outrageous success in network marketing, a health network marketing business is the way to go for the 7 HEALTHY reasons above.

Union Organizing in the Health Care Industry – New Unions and Alliances Among Rivals

Though our nation’s economy has recently lost millions of jobs, the health care industry has continued to add them. Not surprisingly, unions are eager to sign up health care workers. In the last 10 years, the rate of union wins in the health care industry has grown faster than the national average. Unions are uniting to lobby for labor-friendly legislation to promote increased union membership in the health care sector.

In addition to traditional organizing, health care union organizers are using more radical corporate campaigns that target hospital donors, shareholders, community groups, and even patients. The unions push these target groups to put pressure on hospital owners to allow unions to organize their employees. Many critics have argued that some of these agreements with employers have greatly limited workers’ power and emphasized the union’s cooperation with management.

The following article provides an overview of the major unions involved in the health care industry, as well as strategies to ensure your organization is prepared and remains successful.

Service Employees International Union
The Service Employees International Union (SEIU) began in 1921 primarily as a janitor’s union and branched out to include government, security, and health care workers. By 2000, it was the largest, fastest-growing union in the United States, with much of that growth stemming from a series of strategic mergers with smaller unions. In June 2005, the SEIU and six other unions left the American Federation of Labor and Congress of Industrial Organizations (AFL-CIO) to form the Change to Win coalition. Citing the need for a renewed effort to organize workers, Change to Win purports to be focused on achieving fair wages, health care benefits, and secure retirement for all employees. The coalition also encourages workers to unionize on an industry-wide basis, consolidating smaller unions within larger unions.

SEIU Healthcare
In 2007, the SEIU announced plans to launch a new health care union to serve approximately one million members, such as nurses and service workers at hospitals and nursing homes. SEIU Healthcare combined financial and personnel resources from the 38 local SEIU Healthcare unions. Of the SEIU’s 1.9 million members, 900,000 work in health care. In September 2008, the SEIU reported it would begin several high-profile projects to bring business leaders, health care providers, community organizations, and elected officials together to work on the nation’s health care system. SEIU leaders were part of a May meeting held by President Obama to discuss a health care overhaul. More recently, SEIU members attended town hall meetings to speak out in support of the proposed health care reform. In August, the SEIU was part of a group-largely funded by the pharmaceutical industry’s lobby-that launched $12 million in television advertisements to support Obama’s health care proposal. This group, the Americans for Stable Quality Care, could spend tens of millions more this fall.

SEIU and NUHW
The SEIU attempted to consolidate three local units representing home health care workers into one unit last December, taking authority away from the local units. The SEIU accused the local unit officials of financial misconduct, and in response, the leaders of the local units criticized the SEIU’s practice of centralizing power at its Washington headquarters and making corrupt deals with employers. In January, a 150,000-member SEIU local unit in Oakland was put under trusteeship by the SEIU, and the local officials of that unit were dismissed. The ousted officials formed a new union, the National Union of Healthcare Workers (NUHW).

The NUHW announced the first workers had cast votes in favor of representation by the new union in March. A majority of 350 union-represented workers at four nursing homes in northern California managed by North American Health Care wanted to end their labor relationship with SEIU and join the NUHW. The day after this announcement, the SEIU filed unfair labor practice charges against the four nursing homes, charging that administrators of the facilities had illegally withdrawn union recognition and colluded with a competing labor union. In that same month, a National Labor Relations Board regional director ruled against the NUHW, saying that the contract between the SEIU and the hospital chain prevented the effort by a new labor union to represent 14,000 Catholic Healthcare West workers. Despite the ruling, the founding convention to formally launch the NUHW took place in April 2009. According to the NUHW, approximately 91,000 California health care workers have signed petitions filed at the labor board, stating they would like be members of the new union.

The NUHW also claims that, in response to these decertification drives, the SEIU has resorted to harassment and intimidation and tactics similar to union prevention. The SEIU argues that the new group has unfairly restrained and coerced workers, as well as complained to the National Labor Relations Board. A decisive battle between the two unions will come in 2010, when the SEIU-UHW contract with Kaiser Permanente expires and the opportunity for decertification elections reopens. Kaiser, the largest health care provider in California, has 50,000 workers that could potentially become members of NUHW.

California Nurses Association/National Nurses Organizing Committee
The California Nurses Association (CNA) began as a state chapter of the American Nurses Association (ANA) in 1903. The ANA has a federated structure: Nurses do not typically join the organization directly, but instead join their respective state organization, which has membership in the ANA. After several years of believing the ANA was not providing them adequate financial support to increase collective bargaining activity in California, the CNA broke ties with the ANA in 1995 and formed its own union, becoming the first state organization to secede from the ANA. Since its break from the ANA, the CNA has acquired a reputation as one of the most aggressive labor unions in the country. In 2004, the CNA began establishing itself in other states under the name National Nurses Organizing Committee (NNOC). The CNA voted to seek affiliation in the AFL-CIO in 2007. CNA membership has doubled over the last seven years and represents 80,000 members from all 50 states.

UAN-NNOC
In February, CNA/NNOC, United American Nurses (UAN), and the Massachusetts Nurses Association (MNA) announced the formation of another new union: the United American Nurses-National Nurses Organizing Committee (UAN-NNOC). With a combined membership of more than 150,000 affiliates in 19 states, it is the largest nursing union in the history of the United States.

National Federation of Nurses
The National Federation of Nurses (NFN) was officially launched in April at an event in Portland, Oregon. The NFN represents more than 70,000 nurses in six state nurses’ associations, including New York, New Jersey, Ohio, Montana, Oregon, and Washington. Based on a federated model (much like the ANA), the NFN recognizes the independence of each member organization. Membership is open to state nurses’ associations and other labor organizations that represent RNs. The NFN is tied to the ANA, which outlines standards for nursing practices, but has historically opposed nurse unionism and includes managers in its leadership. Since nurse union leaders expect many of the 15 unions with nurse memberships to flood hospitals with authorization cards if the Employee Free Choice Act (EFCA) passes, they want to establish their own national union to ensure nurses are organized by nurses.

SEIU and CNA: From Violent Disputes to Cooperative Agreements
The SEIU signed a neutrality agreement in March 2008 with an Ohio Catholic hospital to organize 8,000 workers. The day before voting was scheduled to begin, members of the CNA distributed leaflets to discourage workers from joining the SEIU. After the workers received the leaflets attacking SEIU and its arrangement with management for an election, SEIU called off the vote. Then at an April 2008 conference in Detroit, SEIU staff and members protested at a banquet of CNA members, resulting in violence. The two unions have also launched raids and counter-raids across the country, and both have sent mailings to thousands of nurses (including nurses in other unions, as well as nurses whose unions are currently trying to organize) attacking each other.

After more than a year of fighting, the SEIU and CNA signed a cooperation agreement in March. They will work together to bring union representation to all non-union RNs and other health care employees, as well as improve patient care standards. The unions have also agreed to refrain from raiding each other’s members and will work together toward common goals, including lobbying for congressional passage of the EFCA. SEIU and CNA will coordinate campaigns at the largest health care systems and launch an intensive national organizing campaign. Catholic hospital chains will likely be among the first targets.

In June, the U.S. Conference of Catholic Bishops and the nation’s largest unions (including the SEIU and the AFL-CIO) signed an agreement describing how union organizing will be conducted at Catholic health care facilities. (The document is similar to the one Catholic Healthcare Partners and Community Mercy Health Partners created last year with the SEIU before the CNA protest canceled the vote.) This agreement is significant because Catholic health care providers represent the largest employers and providers of services in many communities. The agreement provides seven guidelines for management at Catholic health care facilities and unions, making it easier organize health care workers at these facilities.

What This Means for Your Organization
Many experts agree that expanded unionization, along with the passage of the EFCA, will negatively impact our health care system. Both health care providers and industry analysts fear that unionization could mean higher costs and more restrictive work rules, adding to the soaring cost of delivering health care. Hospital and health care facilities need to be aware of these issues and how they can educate their supervisors and workers about the threat of unionization.

Communication with your employees is a critical first step. Many issues are involved in the possible unionization of a health care facility (economic factors, working conditions, quality of patient care, employee satisfaction, etc.). To prepare for possible union activity, identify issues that are relevant to your facility and address those needs publicly. Train leadership and include information about your union-free policy in the employee hiring and orientation procedures. Assess your wage and benefit structure, and be sure to promote what you offer.

You can use brochures, meetings, video, webinars, e-mail, Web sites, or eLearning tools to reach your employees. The most effective efforts include an employee feedback system that encourages two-way communication.