| Sunday, April 24, 2005
Nurse ratchet |
Another interest group decides to play political
hardball, making increasing demands on taxpayers and using
ever more shrill rhetoric
One of the most regrettable realities of union domination
of any industry is that it turns otherwise honorable
professionals into the equivalent of political street-fighters
who focus on organizing and arm-twisting to divert more
resources and government benefits to "the cause," rather than
on creating a better product that meets the customers'
Keep that in mind as the governor is depicted as the spawn
of Satan in recent TV and radio ads by nurses, firefighters
and members of other unions who would like you to believe that
their only goal is to improve public health, safety and
Don't believe them. The governor has many flaws, but his
attempt to save the state budget from Gray Davis-like
malfeasance is not an attack on Californians, but an attempt
to keep the state budget from resembling the city budget of
San Diego, where excessive pay and pensions for union members
have pushed the once well-managed city to the brink of
bankruptcy. And he is trying to fix one of those crazy
California health care mandates that is making it impossible
for hospitals to meet the needs of patients.
One of the most aggressive challenges thrown at the
governor is from the California Nurses Association, a
60,000-member organization run by a $175,000-a-year labor
activist named Rose Ann DeMoro. She is not a nurse, and she
seemed proud in a recent newspaper profile of her aggressive,
Forget about the sight of kind, healing nurses. We're
talking tough-as-nails, Teamsters-style aggression here, in
pursuit of objectives that are self-serving, not
The union is hard left in its politics, and DeMoro rallies
nurses to dog the governor at his speaking engagements,
yelling and accusing him of sexism and virtually every other
evil. The Los Angeles Times described a DeMoro-sponsored rally
whereby nurses clogged streets and yelled this epithet at
Schwarzenegger contributors: "Corporate scum! Shame on
The alternative American Nurses Association believes that
the California Nurses Association is using its battle against
the governor as a means to expand its union-organizing
activities, rather than to secure real benefits for
Why do these vocal nurses despise the governor so?
The most obvious battle has been over state-mandated
nurse-to-patient ratios. The union-sponsored law, passed by
the Democratic Legislature and signed by Gov. Davis, mandates
an inflexible five patients for every nurse. That ratio cannot
change, even during slow hours and even during breaks, which
is why the governor tried to change the law.
The ratio law has become an administrative nightmare. There
aren't enough nurses to fill the slots mandated by the law,
and the law is one of the top reasons cited by several of the
hospital emergency rooms that have shut down in recent years,
especially in Los Angeles County.
Emergency rooms cannot afford to maintain such a high
staffing level. Under the ratio law, the only choice available
to hospitals is to hire more nurses or serve fewer patients.
Unions are about little more than driving up the price of
their members' labor, so it's easy to see what this policy is
about. Supporters of the ratios claim they are needed because
nurses are stretched dangerously thin, but their "solution"
only makes matters worse.
Unfortunately, the public suffers, as it finds fewer
hospitals to get treated or longer lines for care.
Government mandates cannot fix market problems. There
aren't enough nurses, so forcing hospitals to hire more of
what is not there only exacerbates the problem. That's why the
governor suspended the law, citing emergency conditions. A
judge issued an injunction overturning his decision.
Meanwhile, as Vicki Bradshaw, secretary of the California
Labor and Workforce Agency, explains, the state has 14,000
nursing vacancies statewide, and is producing about 10,000
too-few nurses a year to meet growing demand.
A key part of the problem is that California nursing
schools cannot handle the demand. There are 10,500 qualified
applicants a year for nursing school slots, but only 6,000
openings. Most nursing school applicants are accepted to
public colleges by a lottery system, in which a mediocre
student has the same shot as an exemplary one to get accepted.
So much for working hard and achieving good grades so that you
can pursue your chosen career dream.
Given this convoluted, inadequate and dysfunctional nursing
system, 45 percent of California's nurses come from outside
the state or from outside the country. Rather than focus on
fixing these real impediments to enlarging the pool of
qualified nurses, the nurses' union has chosen to battle the
governor and take to the streets.
CNA is angry, also, at the governor's now-abandoned plan to
reform all state pensions by requiring new government hires to
get defined contributions (a promised amount of contributions)
plans rather than budget-busting defined benefits (a promised
amount of paid benefits) that public sector employees now
(Only 8,000 of CNA's members are public employees, but the
union has identified the pension issue as an important line in
the sand for opposing Gov. Schwarzenegger.)
We all value the contributions of nurses, police, teachers
and so forth. But there are some important reasons the
governor is right on the nurse-ratio and pension issues and
the unions opposing him are wrong.
First, the government needs to live within its means, and
it cannot promise pay and benefit levels (or contributions to
health care facilities, public and private) beyond what can be
Second, the government cannot fix market problems by
mandates and regulations that make it more difficult for the
market to respond. With regard to health care, the goal should
be to loosen up restrictions and promote competition rather
than for legislators to micromanage operations of hospitals,
especially down to the level of mandating staffing levels.
Third, whenever unions exert their muscle, the public and
the economy take a beating.
That's true even in the private sector, where General
Motors is facing its biggest loss since 1992 largely because
of enormous pension costs as a result of union contracts. The
pension demands are so high that GM has been unable to focus
on developing new and better cars to sell to consumers and it
is shortchanging shareholders.
Unfortunately, the governor has taken the worst of all
approaches. He has riled the politically powerful unions, but
has backed away from reforms that would help Californians and
chip away at union power.
He delayed pension reform in response to police opposition
and the attorney general's shameless mischaracterization of
The governor is now negotiating away merit pay for public
school teachers in exchange for "combat pay" for teachers who
work in the toughest districts. Combat pay may be a good idea,
but it doesn't reform the bureaucratic, mediocrity-rewarding,
incompetence-protecting racket known as tenure, a key issue of
concern to the union.
And as he loses his fight with nurses over staffing ratios,
the CNA gets bolder and cockier even as staffing problems
become more critical at California hospitals.
Too bad there's no union representing the interests of the
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