“America Makes a Lot of Money off the Sick”
The for-profit health care system in the US has created a crisis for patients and medical workers. That's why 2,000 health care workers are on strike in Ohio this week.
- Interview by
- Simon Nyi
On May 6, two thousand unionized nurses, technicians, and support staff at Mercy Health St. Vincent Medical Center in Toledo, Ohio began National Nurses’ Week by going on strike after nearly a year of contract negotiations. As of Friday, May 10, management had not presented union leadership with a proposal that meaningfully addressed members’ core concerns, according to UAW Local 2213 president Sue Pratt, and the strike remained ongoing.
Organized labor has deep roots in Toledo: during the Auto-Lite strike of 1934, a militant coalition of ten thousand workers from across the city successfully resisted a violent, five-day strikebreaking effort by management and the state at the cost of two lives and over two hundred injured. The strike spurred a wave of unionization in the industrial Midwest, and contributed to organized labor’s political ascendancy at the national level.
To this day, Northwest Ohio remains a labor stronghold in relative terms — of the nearly one thousand metropolitan areas where the Bureau of Labor Statistics tracks union density, Toledo ranked twenty-fifth overall in 2018. But it hasn’t been spared from the national decline in private-sector union membership: just 8.7 percent of private-sector workers in Toledo were union members in 2018, down from a twenty-first-century peak of 23 percent in 2001.
The Mercy St. Vincent strike has made it clear that Toledo’s private-sector unions aren’t done fighting yet. While it does not match the largest recent private-sector strikes in terms of sheer numbers, the scale of the strike is still remarkable by recent historical standards: on average, fewer than ten private-sector “major strikes” — defined by the Bureau of Labor Statistics as work stoppages involving more than one thousand workers — have occurred per year over the past decade.
In a city where 17 percent of all private-sector employees work in education and health services, the potential economic and political impact of the strike is even more significant. After its 2018 merger with the Maryland-based Bon Secours Health Systems, Mercy became one of the largest Catholic hospital networks in the country, with $8 billion in net operating revenue and $293 million in operating income.
The members of UAW Locals 2213 and 12 (which represents the hospital’s technicians and support staff) explain their struggle with unity and clarity of purpose. Their red signs on the picket line capture it succinctly: “Patients Over Profits.”
During the strike, local Democratic Socialists of America co-chair Simon Nyi interviewed two rank-and-file members of UAW Locals 2213 and 12 (which represents the hospital’s technicians and support staff) about what’s at stake. Dawn Thakur-Lyon is a UAW Local 2213 registered nurse, and Jessica Crowder is a UAW Local 12 phlebotomist.
We’re on strike for a couple of reasons. Health care costs are very high. The package that they want to give us is horrible; nobody can afford it — nobody who works. As a normal worker, we don’t make millions of dollars a year. They also work us short a lot, so it’s also staffing issues for patient care.
The mandatory on-call has just gotten worse and worse. A lot of the closed units have as much on-call as they work during the week. And with the health care, they weren’t saying what the out-of-pocket max would be. So potentially if you had a major surgery that was $200,000, and they’re saying it’s 75/25, you could owe $50,000, with no cap.
The hospital is constantly short-staffed. There’s a lot of “freezing” going on. Like, if you work a twelve-hour shift, they may not have enough people coming in, so you may be “frozen” [kept at the hospital]. They can only freeze you an additional four hours — you can only work sixteen hours, but you may have to come back the next morning. It’d be frozen until 11, 11:30 at night. If you got out by midnight and have to be back by seven the next morning —
— there’s not an eight-hour gap in between. There should be an eight-hour gap in between the shifts.
On your signs, the slogan is “patients before profits.” What does that mean to you?
They’re burning the staff out. Especially new nurses that get hired, a high percentage of them will leave because they’re overwhelmed. There’s not as many senior nurses around. For some units [on] the night shift, the most senior nurse might have two years’ experience, where it used to be twenty years. So I think there’s a lot of quick burnout, and they don’t really have anything to lose.
It affects the patient care overall. It really does. Your nurses are overworked. They’re tired. Your phlebotomy staff is overworked. They’re tired. Housekeeping is overworked, they’re tired. We’re all overworked, which can affect the patient’s care all the way from the bottom to the top. If you’re working every single one of your departments in the hospital only with the minimal staff that you can work them, you’re going to burn out everyone, from nursing to housekeeping to the dietary people, and then you’re going to have multiple call-offs because people are tired and exhausted. So it’s just one big mess.
One of the things that I’ve heard from a lot of people out here on the line is that it was a difficult decision to vote to go on strike because you all are concerned for the patients. And again, it’s right there in the slogan. How did the two of you weigh that decision?
It’s a safety issue. We’re doing this not only for us, but for the patients to get good care, because when the staff is not functioning at a high level, mistakes get made. I mean, we don’t want other personnel taking over. We want to be in there. We didn’t want to do this, but nothing changes. And the contract we were given would make things worse.
You have to take a stand. I’ve been here for fourteen years. I’ve seen everything. It’s changing. So do you continue to just close your eyes? I call it “blind eye syndrome.” Do you close your eyes and play blind eyes syndrome and just keep working so you can get a paycheck, and you don’t speak up for the patients? You don’t speak up for their care? You have to do something at some point.
Ten to fifteen years ago, for the same number of beds, we used to have three hundred to four hundred more nurses. Today with the same number of patients we have around nine hundred [nurses]. We used to have 1,200-plus nurses.
It’s the same amount of patients. The community is sicker. And back then we didn’t even really have call, but if we did, it was just for if our staff got sick.
It’s just pulling people, stretching them because you’re taking care of more and more patients and there’s just not enough staff.
What has changed in the time that you’ve been here in terms of management practices? I’ve heard from some people that things have changed since the merger with Bon Secours — do you think that has anything to do with it?
Yes, but things have been changing even before Bon Secours. Everything is getting stretched thinner and thinner. Even the supplies — you just have to do more with less. But this is the worst negotiation process we’ve ever had as far as length of time. And health care in general — they really do try to max you out with minimal resources including staff, supplies, everything.
What was the mood like on the floor among your coworkers during the negotiation process, and in the weeks and months leading up to the vote to authorize the strike, and to finally walk out? Was there a lot of fear or hesitation?
At first it was hopeful that we would come to a good contract, something that we could be behind. We’ve never voted a contract down before. So this was the first time. But of course, as things got closer, people were getting nervous not knowing how long this could last — financially worried.
Everyone felt like if we’re going to do this, we need a great response. We need to have as many people as possible go out and strike, or it’s not going to mean anything. There was a lot of solidarity that this wasn’t a good contract. People felt mobilized to really go out there and show their support because again, this is for patient safety too.
No one wanted to do this.
This was a very strong vote in favor of the strike, right? It was ninety to ten in the nurses’ bargaining unit. Tell me about the process about getting the support for that vote.
Since about two and a half or three years ago, our phlebotomy department has been under stress, period. They’ve brought in a whole different company to look at our whole process. They want to cut jobs, they want to cut costs. So we’ve been under stress prior to this.
You’re both from Toledo, right?
Yes. I’ve seen a lot of other unions out here, and also just people from the community. It’s a town with a strong union history, but it’s also a Rust Belt town. Manufacturing has been hit hard, and the unions have been hit hard with it, but it seems like there’s still union strength here.
We don’t have just union support. It’s Toledo.
I think it’s the fact that health care workers have a pretty good reputation. We’re not the greedy ones in all this. We want to do our jobs.
We take care of the people in the city! We just want to care for them. We know some of them personally.
We’ve seen a lot of people that we’ve taken care of coming down. Up and down the street.
The other night there was a photo circulating on social media of a guy who came out of the hospital to support the strikers with his IV pole still attached. Some of the nurses told me the scabs really shouldn’t have let him out like that, but I found it heartwarming.
That’s, what you have when you are the people who care for humans. You develop a relationship with the human, and they tend to kind of love you back. That’s why health care workers are so important. We’re caring for our community, we’re caring for our people. That’s why we have so much support.
It’s really insulting that the people that are replacing us make two to three times the wages that we make. They travel from strike to strike, and that’s how they make their living. If this is about money for [the hospital], which it sounds like it is, they are paying huge amounts of money for these people to come in.
If that’s the case, why are we even out here? Because if they can pay them that kind of money —
— they should be able to pay it to you.
So is this about trying to get ahead of the union? Because they’re paying a ton of money to these people — just what they’re making hourly, not including hotel, food, stipends we’ve been told they’re offering to their sister hospitals. What we were asking for was not that much. It’s far more costly for them to have the strike, to cancel surgeries and ship babies to other hospitals. So to me that’s not just about the money. That’s something else.
There’s more to it than what’s being said. We had a small meeting in our department with just us workers, and I said, “I bet you they’re trying to union bust.” I think that might be their main goal.
So how do you push back against that?
You just have to stay strong, and hope that our community support and union support can get the attention of higher ups — that this is more than money, this is about the patients and the people and the workers that have given their lives and livelihoods to this place.
The other big health care game in town is ProMedica, and they are not union. So what’s different at Mercy, that there’s such a strong union here?
The union’s been here I think twenty years, about as long as I’ve been here. People have a chance to grieve things that are unfair. They’ve helped a lot of people if they were unjustly fired. If there are issues, there’s a process and there’s some accountability.
So people see that the union is working for them, and they want to keep it strong.
The union is going to be there to support us if we need help with our bills, if we need help with our car notes, if we need help with rent payments, they’re there to help us. Our union has fed us 24/7, they’ve got heat out here for us to keep us warm. We’ve got good support all the way around.
We’re the only hospital in the Mercy system other than Saint Anne’s which has an infusion center or a cancer center that’s union. After the union got big here, there was a lot of pushback at the other hospitals.
I’ve heard that there were attempts to start a union at ProMedica a while ago, but it was quashed. But now, your strike has been inspiring for a lot of people — there were even some ProMedica workers out here on the line with you. Do you see this as something that could inspire other health care workers in the future?
It should. Our fear is that this is union-busting and could drag on for a long time because Bon Secours has deep pockets. Money can buy time for them, and that’s what’s going to be most difficult.
We’re seeing a lot of conversation nationally right now about the impact of the profit motive on people’s access to health care, and debate about whether we should even have a private, for-profit system. Do you see any relationship between what’s happening here at the hospital and those broader conversations?
America makes money off the sick. The way health care is run, in my opinion — it’s not being handled properly. No life is better than the other. Just because you have money doesn’t mean you should get better anything. We should all have the same health care across the board, whether we make ten dollars a week or we make millions of dollars a week.
Let’s start with the most obvious question. Why are you on strike?