by Peggy Wang (APA, MTA/NEA – personal capacity)
Below is an interview with a healthcare provider and labor activist at Mass General Hospital in Boston, Massachusetts. A union drive organizing the “House Staff”, Residents (doctors in training) and Fellows (medical specialists in training), is taking place across the Mass General Brigham (MGB) health corporation. The union drive is now headed for a vote on whether or not the House Staff workers want to be represented by the Service Employees International Union—Committee for Interns and Residents (SEIU-CIR). This union organizes and represents house staff in hospitals across the United States. The name of the interviewed worker is not given due to possible anti-union retaliation by management.
What are the major issues behind the campaign for unionization of the residents and fellows of MGB House Staff United?
Harmful working conditions impact residents and fellows training to become attending physicians. Physician trainees struggle with unsustainable schedules (worsened by understaffing and burnout), unlivable wages atop hundreds of thousands in student debt, and inadequate time, resources, and equipment for training and treating patients. These concerns have driven them to organize not only for themselves—their interests as workers and physician trainees—but also for the patients they treat every day.
A big issue is adequate compensation and benefits. This includes a push for higher wages that would at least be appropriate for the cost of living in Boston (including housing and moving stipends, higher employer retirement contributions, and subsidized child care). The union calls for on-the-job improvements including food access and exercise equipment. Most residents work over 60 hours a week, leaving little time for families, food prep, exercise, and other personal needs.
The union effort also demands proper workplace resources such as fully stocked materials and equipment necessary for patient treatment, to avoid delays in care, and to minimize risks to staff. Workers want changes to hospital operations such as accommodations for house staff with disabilities and illnesses (including pregnant and parenting house staff); guaranteed time and funding for necessary training, licensing, and preparation for post-residency employment; and protected time for personal health needs, with fair compensation for colleagues who provide shift coverage. Together, these demands help ensure healthcare workers are in good condition and have the necessary means and experience to provide the best possible patient care.
One point the house staff union has made very clear is their stance on solidarity with co-workers. They want a living wage, adequate benefits, and humane working conditions for all MGB employees. Given that many MGB locations do not have any unionized workers at all, MGB House Staff United, with its presence across all of MGB, has the potential to lead the charge in organizing for union rights, better working conditions, and good compensation for all staff.
How do you feel about the unionization effort as a worker at the hospital whose job is not included in the current union campaign?
MGB staff, in general, face low wages, unpaid overtime, and high stress. Healthcare is demanding, difficult work. Even if this union doesn’t directly represent us, it will represent our co-workers, helping them to secure more rights and motivating the rest of the hospital’s employees to unionize, which will help all of us.
On that note, while this is an excellent start, we need the hospital to be full of unionized workers. SEIU-CIR may only represent the house staff, but other workers should also unionize. The goal should be for all MGB workers to be organized, wall-to-wall, under one union. If workers unionize with multiple unions, we need to ensure that a situation like what happened at the 2021 St. Vincent nurses’ strike never happens again: Teamsters and UFCW continued to work in the hospital struck by the Massachusetts Nurses Association (MNA) for almost a year. All unions should act together in negotiations and actions.
I think it’s super important that workers not be alone in this and any other fights against the hospital corporations, which profit from paying workers as little as possible while working them to the bone. The Chief Executive Officer (CEO) of MGB makes over $4 million per year, more than any other healthcare CEO in Massachusetts. Meanwhile, those working with patients struggle with understaffing, burnout, and inflation cutting into wages.
Many of the demands health workers are pushing for with this unionization effort directly impact patient safety. Safe staffing levels, measures for staff health, and humane working conditions are all crucial to ensuring quality care. Patients should rally behind the MGB house staff’s unionization campaign to help bring it to public attention, and patient advocacy organizations should be brought into the struggle to put even more pressure on MGB management. Workers and patients alike benefit from union rights.
What role do you think unions can play in the fight against for-profit healthcare?
For-profit healthcare is harmful to patients, workers, and society as a whole. Most healthcare spending does not go to worker wages, facilities and equipment, or medical advances. Instead, spending goes to high salaries for upper management and profit-taking shareholders. Healthcare workers have seen inflation and the cost of education rise much faster than their wages. On top of this, understaffing puts more pressure on existing staff, causing more workers to leave. Addressing understaffing, part of which involves reducing the cost of healthcare education to allow more people to become healthcare workers, is crucial.
In this context, universal healthcare is something myself and my co-workers just about unanimously support. Contrary to what some may think, health workers face the same struggles with getting health insurance coverage, accessing covered healthcare providers, and paying co-pays and other fees when we get care. This can put us into medical debt as easily as other workers. Also, like most workers in the U.S. with health insurance, our health coverage is tied to the corporation we work for, heightening the fear of job loss.
Universal healthcare, free at the point of care, funded by increasing taxes on the rich and big corporations, would be a huge step forward. Ultimately, only a national health system, completely publicly owned and with democratic workers’ control, can guarantee adequate staffing for patient needs, good wages, and high-quality patient care.
So I think health worker unions can have a big role in fighting for universal healthcare and the eventual nationalization of all healthcare facilities. In fact, I think a lot of us would agree that nationalization of all healthcare facilities would do a lot to improve patient safety, quality of care, and workers’ rights if, of course, we’re all unionized and have control over how the system is run. The two corporate political parties, the Republicans and Democrats, have no interest in pushing for free healthcare for all. They continuously defended the profits and mergers of large healthcare corporations and insurance companies and criminally mishandled the COVID pandemic.
This leads right to another point–frankly, myself and my co-workers couldn’t care less about the Democratic politicians’ support of the MGB house staff unionization effort–we care about our co-workers, what they are doing, and what we can do on the ground and in the workplace to help support them–not the empty words of a wealthy politician. We would argue that it is a waste of time and money to lobby Democrats or Republicans as a way of winning union drives and campaigns–time and money that could go into demonstrations, campaigning for public support, and building a strike fund (should the need for a strike arise).
For example, Democratic Governor Maura Healey was endorsed by the MNA in her recent election but has a record of fighting alongside corporate healthcare companies and removing access to healthcare facilities for working people. As Attorney General of the state of Massachusetts, she approved the Beth Israel Lahey merger in 2018. She stood on the sidelines as Beth Israel Lahey union-busted the midwives at its North Shore Birth Center. The corporation chose to close the facility down, thereby cutting off reproductive care, in order to block pay increases won in the first contract.
Ultimately, as we go about forming our unions and pushing for contracts with measures that improve patient safety and workers’ rights, we really have to push our unions to break ties with the Democrats and the Republicans. As we saw with the rail workers’ contract struggle, neither corporate political party actually supports workers. We need to reclaim union funds used to support these corporate parties and put our dues money into building an anti-corporate workers’ party run by and for working people. That is the only way to win universal healthcare, nationalize the healthcare industry, and, ultimately, have workers’ control of the healthcare system.
Independent Socialist Group 