This month's announcement by the American Medical Assn. supporting collective bargaining for physicians made headlines and caused a lot of talk-show lip flap. But the drive to organize doctors was underway well before the AMA's sanction. In May, 800 physicians employed by Los Angeles County voted to unionize, and estimates indicate as many as 15% of the nation's 300,000 salaried doctors carry union cards. The majority of union physicians are affiliated with the Service Employees International Union, a group best known for its innovative and often highly confrontational Justice for Janitors campaign.
Starting in 1985, the SEIU staged public demonstrations around large office buildings in major U.S. cities, demanding better wages and benefits for workers who cleaned and maintained those buildings. At times they blocked traffic; in Washington, Justice for Janitors staged a series of bridge closures that clogged traffic up and down the Potomac. While controversial, these tactics helped win labor agreements with real-estate-management firms in cities throughout the country.
The union then focused its attention on the health-care industry, which employs more than 12 million. Early this year, in what was the largest union organizing victory in decades, 74,000 Los Angeles County home-care workers voted to join the SEIU. These workers, many of whom earn $5.75 an hour, feed and bathe the county's elderly and disabled. They would seem to have little in common with highly educated and highly paid physicians, but each group is caught up in the changes created by the nation's move toward managed medical care. The idea of a union that organizes health-care workers to take on giant medical organizations has wide appeal among all levels of health-care employees, and it motivated the L.A. County doctors who joined the American Federation of State, County and Municipal Employees. It's also the chief goal of the Service Employees International Union.
Leading the charge is 48-year-old Andrew L. Stern. As the union's organizing director, he orchestrated the Justice for Janitors campaign and the decade-long struggle to unionize L.A. County home-care providers. Since becoming president three years ago, he has seen his union, already the largest in California, become the nation's fastest-growing labor group. He has also earned respect for his efforts to root out union corruption, placing several locals into receivership and forcing the ouster of the union's flamboyant New York local president, Gus Bevona. His forward thinking and embrace of innovative tactics has made him an often-mentioned successor to current AFL-CIO president John J. Sweeney, who led the SEIU for 15 years.
Stern is a New Jersey native who was a social worker when he joined the union in 1973. He sees himself as part of a new generation of labor leaders who are determined to rethink, retool and revitalize the labor movement. In a conversation from his Washington office, he talked about the challenges of organizing workers in today's service economy, the ways the labor movement can become more relevant to workers and his personal philosophy as a labor leader.
Question: What's the difference between organizing traditional industrial workers and the service workers that your union represents?
Answer: I think everyone's aware that there are more and more workers in the service sector. Much of that growth has been centered within the health-care industry, which now ranks just below government as the largest employer in the country. Historically, this is not an area that has been unionized, and only about 10% of health-care providers are members of unions. But now we're seeing a new wave of organizing in the sector, with everyone from doctors to home-care workers becoming interested in unionizing. This is spurred on by the changes in the way medicine is practiced in this country. Much of the drive to organize is being fueled by nurses and doctors who are concerned about patient-care issues. What we are seeing now is that changes in the way health care is being delivered are powering today's labor movement much as changes in the industrial sector fueled organizing in the factories of the 1930s.
Q: But unlike factory workers, home-health-care workers are spread out all over. How do you organize such a dispersed work force?
A: In Los Angeles, we organized 74,000 workers who actually worked in 74,000 different places. In the service sector, work is spread out across the community, and that requires an entirely different model for organizing workers. Simply finding and communicating with workers, or even just finding out who their employer is, can provide the kind of challenge that you don't see in a traditional factory setting. It requires building strong alliances within existing community organizations such as churches and advocacy groups, existing organizations who know the work force and who may have helped place them in their jobs. It means developing a highly sophisticated communications system that includes a huge phone-bank operation. It means holding meetings within the community rather than at the workplace. So it's much more difficult than just handing out a leaflet at a factory gate.
Q: You also represent workers across a wide spectrum of income levels. On the one hand, you have home-care workers who are at the bottom of the pay scale. On the other, you have physicians with six-figure incomes. How does that all mesh into a single labor force?
A: All these workers actually have a number of things in common. First, they are all looking for a way to make their voice heard. Home workers, because of their economic situation, are much more inclined to look for support around wages and benefits and being able to raise a family and get a good education for their children. Doctors are much more interested that their voice be heard at the bedside around quality patient care and issues involving the practice of medicine. But in each case, though their voice may be speaking about different needs, they are unified in their desire to be heard. In fact, having such different types of workers organized within our union brings us a lot of strength.
Q: While many people might easily accept the idea of a union for building-service workers or home-health-care providers, the idea of a doctor with a union card is foreign and even abhorrent to many. Why should someone choose a physician in a union, and how will union affiliation improve doctors' ability to practice medicine?
A: Doctors are joining unions because they are concerned about being able to continue to provide capable, quality care to their patients. Doctors don't like being told that they have only 10 minutes per patient. They don't like so-called managed-care organizations telling them what procedures they can perform or what tests they can authorize. I would think that people would want to go to a doctor who is fighting for their interest and not to one who is just trying to achieve the objectives of a managed-care organization.
Q: But there are some serious problems with unions in the public mind. There is a general perception that many unions suffer from internal corruption. There is also a feeling, even among union members, that union leaders are often nonresponsive. How are you and other union leaders addressing these perceptions?
A: The union movement had a period when it represented one in every three American workers, and it was enormously successful. Then the world changed and for a long time the labor movement didn't. Our industries changed, and we became part of a global community and economy. I think the labor movement was very slow to respond. Like many corporations, it didn't respond, and because of that we suffered, and our members suffered. But now I think we're seeing a generational change in the leadership of unions, with new people bringing fresh ideas to the movement.
As to the issue of corruption, as in any organization, there is a tremendous need for financial integrity within union leadership. I think when leaders forget they are a voice for their members and that their position is a privilege and not a right, there are all kinds of negative connotations. I believe that the labor movement, just [like] any institution moving into the 21st century, is going to have to constantly think about how to stay vibrant and ahead of the times. We live in a lightning-fast world, and we can't have a lumbering, slow-moving labor movement.
Q: Another problem with the labor movement is competition between unions for workers, and this intra-union squabbling has often come at the expense of workers. How do you see unions improving the way they work with each other to eliminate these turf battles?
A: I think we are now at an enormously important time in history, when many industries are consolidating and where unions, if they are going to change our members lives, need to have expertise and focus. We're not going to be successful trying to organize hotel workers. Our expertise is in health care. I hope we are coming to understand that unions need to support each other and not compete across industries for workers.
Q: In terms of tactics, what do you see as the most effective tools labor unions can use to achieve their goals with employers? How will labor flex its muscles in the coming century?
A: First of all, whether it's confrontation or a strike or a labor-management council, the goal is the same: We need to improve the lives of our members. We have lots of resources for doing that. For instance, we can use our pension funds to invest in projects that will create good union jobs. We can use our strength in the electoral process to make sure that employers pay workers a living wage. We can block bridges and create confrontation, and we can work in labor-management partnerships. Different situations require different tactics. For instance, it was very difficult for janitors to be heard by the real-estate community. The tactics we used, such as blocking bridges in Washington, D.C., certainly got our message out to the right people. But that has its limits, and in the end it took a lot more persuasion than confrontation to settle that very difficult dispute. I think you will see labor use everything from the most sophisticated capital strategies to the most militant activities, such as the civil disobedience we've seen at LAX in support of a living wage for workers there. We're going to do everything in our power to make sure that our members are heard.
Q: Unions have had some success appealing directly to the public to support a living wage for traditionally low-paying service jobs, such as home-health-care workers. How do you convince people that increasing wages for such jobs is good for the entire community?
A: Henry Ford knew people had to be able to buy his cars. We live in a time of enormous wealth in this country, but it is very unevenly distributed, and too much has trickled up, rather than trickled down. We should as a society commit to the idea that people who work should at least be paid a wage which keeps them out of poverty and allows them to feed, house and educate their children. They don't use up scarce public resources and benefits. They pay taxes that help support our schools. In the end, raising pay scales to provide a minimum living standard can only benefit our communities.
Q: What role will your union play in the upcoming political season? What are some of your concerns, and what are you looking for in a presidential candidate?
A: Our members have established forums to evaluate the candidates on Medicare and Social Security, universal health care, rights of workers to organize and the role of the public sector in society. We've asked all the candidates, Republican and Democrat, to tell us where they stand on these issues. When we decide on a candidate, our support will be a huge factor. For instance, in 1998 in California, we mobilized more than 10,000 volunteers. In L.A. County, we have a network of people who have been very successful in going out and raising support for candidates who back our pro-working family agenda, and I think we are going to be even more successful in 2000.
Q: One emerging and largely nonunion work force is the knowledge workers, people involved in industries such as communications, software and Internet development. Do you see them as a prime target for organization, and what other groups will labor target?
A: Yes, I think the convergence of cable, telephone and the like will create a need for organization in the communications industry. I also think you are going to see a big push in organizing two other groups who are enormously important, and those are the people who take care of our parents and the people who take care of our kids. Child care and child educators, along with nursing-home and home-care providers, will be the focus of a lot of effort within the labor movement.
Q: There has also been a good deal of controversy and some proposed legislation regarding the designation of workers as "contract employees." Some accuse companies, such as Microsoft, of using this designation to avoid having to pay benefits and certain taxes. What's your union doing about this issue?
A: We find that often these designations are simply being used by employers to deny so-called contract workers the benefits that comparable workers enjoy. While we are very supportive of employers who offer part-time work or job sharing to accommodate the needs of their employees, we think it's a grave problem when hugely successful companies such as Microsoft concoct schemes that simply take away wages and benefits.
Q: You began your working career as a social worker. How did you get from there to being a labor leader?
A: I went to my first union meeting because they were serving free pizza. They had an election for an assistant shop steward, and I was convinced to volunteer. I soon found that while in social work I could help change lives one at a time, I was able to imagine changing hundreds of thousands of lives by working in the labor movement. So I worked my way up to being a staff member and was an organizing director for 13 years and finally president.
Q: What talents do you think you have that make you successful?
A: I try to always remember what it means to be a worker. I think of the power we have when speaking with one voice and the futility of trying to go it alone. I keep that in my heart, no matter whether I'm sitting in a room with the president of the United States or sitting in the room with one of my union members. I try to have the courage to speak the truth to the people in power about what life is like for a home-health-care worker or a janitor or a physician who's trying to provide quality services. Keeping at the forefront who I am and who I represent has helped me a lot. *
"Changes in the way health care is being delivered are powering today's labor movement much as changes in the industrial sector fueled organizing in the factories of the 1930s."
"Doctors don't like being told that they have only 10 minutes per patient. They don't like so-called managed-care organizations telling them what procedures they can perform or what tests they can authorize."