Personally, I don’t think the situation we face in our economy is helped by the incessant union bashing I hear from many, including the business community. Our economy, more than 70 percent of which is consumer spending, would only benefit from workers having better pay and benefits, and perhaps a bit more disposable income. This is the real purpose of labor unions, which have seen a marked decline in private-sector membership for decades now. It could be especially beneficial in service and other industries like health care where labor can’t be outsourced to foreign markets and competition for the jobs among the best and brightest benefits us all.
This brings us to the situation at Woonsocket’s Landmark Medical Center, which has been in receivership, a form of court-ordered bankruptcy, for over four years now. Landmark’s situation is a symptom of a larger trend in health care, which has been undergoing rather disorderly reform. Landmark isn’t the only hospital in receivership in Rhode Island, as it was joined some time ago by Westerly Hospital. Just two, but in a state with less than 10 general acute-care facilities, an alarming percentage. There are other hospitals that are technically insolvent or facing very troubling fiscal situations as well. The state of the economy and especially unemployment haven’t helped at all. Our hospitals are staggered by their role as safety net to the uninsured. In addition, there is also a larger trend away from inpatient acute care for a wide variety of conditions. So, uncompensated care is markedly up while overall utilization is distinctly down. Fewer customers with more of them unable to pay is not a healthy direction for any business.
What we are seeing is the consolidation one would expect under such business conditions. Health care reform should help alleviate the coverage problem, but isn’t expected to reverse utilization trends. Despite the aging population, it appears we are looking to a future with fewer hospitals, although they may be larger as economies of scale can improve efficiency, and the mobility of the modern population has reduced the necessity of a facility in every village and town. Health care jobs probably won’t decline, but they certainly may move around a bit, and this aspect of reform evidently has health care unions a bit befuddled.
At Landmark what we see is the union seemingly embracing a for-profit firm from out of state who promises to preserve the jobs there. Well at least some of them, as the company now being considered as a suitor for Landmark, unlike our own nonprofit hospital systems, is hardly considered union-friendly. In fact Prime Healthcare has complained loudly that its checkered public image has resulted from a broad campaign against it by a leading health care union. One would wonder why? I won’t bore you with a litany of Prime Healthcare’s problems here. You can easily Google them and spend hours on the “issues” they face in their home state of California and elsewhere where they operate hospitals. So why does it seem that unions here are supporting them?