Strong 'Medicare for All' legislation is like bargaining a strong union contract

A recent Washington Post article highlighted how National Nurses United and other progressive groups influenced and shaped Rep. Pramila JayapalPramila JayapalHouse Democrats delete tweets attacking each other, pledge to unify House approves bill raising minimum wage to per hour Progressive House Democrats describe minimum wage hike as feminist issue in Teen Vogue column MORE’s (D-Wash.) new Medicare for All act into the strongest possible legislation. The Medicare for All Act of 2019 not only includes primary care, but also dental, vision and long- term care, at no cost to patients when they need to get treatment.  

While working people having a legislator’s ear was presented as a somewhat unique scenario, union workers and other everyday people should shape the policy that impacts their lives. Without working people at the table, policy becomes less about addressing what’s good for public health and safety, and more about appeasing corporate apologists who constantly champion “being realistic” over being safe, moral, or just.

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Union nurses know this dynamic well. Our corporate health care employers are always out to boost profits by cutting corners. They will overwhelm one nurse with countless patients to save on staffing. They will use techniques learned from the auto industry to stock supplies at bare-bones levels — as if healing a human being were the same as building a car.

In this environment, union nurses fight against unsafe practices with the power of our collective voice. We stand together, and come to the table with strong contract proposals that reflect what we actually need to protect our patients and ourselves. As a union, we improve our terms and conditions of work, and the quality of care for our patients, through a process called “collective bargaining.”

With our patients in mind, we bargain strong — from day one.

Why would we present management with watered-down demands, bargaining something less than what our patients and our colleagues actually deserved? For example, if the safe staffing level for the intensive care unit were one nurse to a maximum of two patients — but we anticipated management would push for four patients — would we give up and come to the table with a half-hearted proposal of three patients? That’s unacceptable.

Union nurses never bargain against ourselves, by lowering our expectations before we even get to the table. Human lives are at stake.   

Let’s zoom out of one individual, profit-based hospital and consider our entire profit-based health care system. To transform what’s wrong, and achieve conditions in which people are no longer suffering and dying, we cannot bargain against ourselves.
We have to come to the table with the strongest possible legislation — not a half measure.

We can’t start with health-care justice — only for some. We must demand what we actually need, because if human lives are at stake based on contract demands in any given hospital, imagine how many millions of lives are at stake with legislation governing the delivery of health care in this entire country? 
National Nurses United has been leading the way in standing up for the strongest possible legislation — and also in strengthening the movement to bring a massive, nationwide people’s union to the table, to fight for what is just and necessary, not just what the corporate world and corporate-backed legislators claim is “realistic.”

In early February, NNU sponsored Medicare for All “barnstorm” mass organizing meetings, across the United States. More than 150 events were held across the country, attended by 5,000 people and resulting in 1,500 scheduled canvasses. We’re going to keep growing our collective voice.

We commend Rep. Jayapal for listening to the special interest of the people.

Union nurses know the opposition, well-funded by wealthy corporate interests, will be attacking this bill at every turn. But we also know from standing up to management in our own hospitals that when we have something worth fighting for — when we come to the table strong — the people, united, can win.

Bonnie Castillo RN is executive director of National Nurses United, the largest union and professional association of registered nurses in the United States, with more than 150,000 members.