May, 11 2015, 09:00am EDT
U.S. Court of Appeals Issues Scathing Judgment Against Big Hospital Chain, Ordering CHS to Repay Union Costs for 'Willful' Failure to Bargain with RNs
The District of Columbia-based U.S. Court of Appeals issued a rare, scathing order to the nation's largest for-profit hospital chain, Tennessee-based Community Health Systems, requiring it to repay all of a union's costs incurred in efforts to bargain a contract for registered nurses at a San Diego hospital.
WASHINGTON
The District of Columbia-based U.S. Court of Appeals issued a rare, scathing order to the nation's largest for-profit hospital chain, Tennessee-based Community Health Systems, requiring it to repay all of a union's costs incurred in efforts to bargain a contract for registered nurses at a San Diego hospital.
Writing for the court May 8, Senior Judge Harry Edwards, the court's former Chief Judge, rejected CHS' Fallbrook Hospital's appeal of an April, 2014, National Labor Relations Board (NLRB) ruling that Fallbrook acted in an "obstinate and pugnacious" manner in unlawfully refusing to bargain with nurses represented by the California Nurses Association/National Nurses United.
The hospital's behavior was found to be so egregious, it was not only directed to negotiate in good faith, but also to repay what Judge Edwards termed "economic resources wasted by the Union in a futile pursuit of a collective bargaining agreement" as a result of CHS' "willful defiance of its statutory obligations."
CHS and Fallbrook showed their contempt for the court, says CNA, by taking the draconian step of closing the hospital. Instead of respecting the rights of the RNs and accepting their democratic choice to form a union, CHS and Fallbrook terminated all staff, and then appealed the decision ordering them to repay the RNs' bargaining costs.
Judge Edwards blasted CHS' arguments against paying negotiating costs as "not only meritless, it reflects real chutzpah," a Yiddish term which Edwards noted, in legal terms, is the equivalent of "a young man, convicted of murdering his parents, who argues for mercy on the ground that he is an orphan."
Ultimately, Judge Edwards noted, Fallbrook had "cherry-picked the record" to present its defenses. In fact, the NLRB's 2014 decision "rests on the Hospital's entire record of unfair labor practices which in this case is quite extensive. The Board found that the totality of Fallbrook's misconduct justified the remedy."
"CHS is probably the most arrogant, and lawless employer in the healthcare industry," said NNU co-president Karen Higgins, RN, today. "This welcome decision, along with a recent NLRB decision and jury verdict for a heroic Ohio CHS RN, Ann Wayt, illegally fired by another CHS hospital, are an indication of what RNs seeking to improve patient care standards in CHS hospitals have had to endure. NNU will never stop fighting for RNs' ability to advocate for their patients and their own rights."
In a striking parallel to the Fallbrook case, on April 30, the National Labor Relations Board affirmed a labor board law judge's decision ordering CHS' Affinity Medical Center to reimburse Wayt for expenses she incurred responding to Affinity's unlawful attempt to have the Ohio Board of Nursing revoke her RN license after she was fired by Affinity for supporting union organizing efforts by NNU's Ohio affiliate, National Nurses Organizing Committee-Ohio. Wayt subsequently won a $2 million court judgment against Affinity-CHS for its brazen defamatory attacks on her.
Further, the NLRB took the additional unusual step of ordering a top Affinity official to actually read aloud to assembled employees, in the presence of an NLRB official, the Board's order to cease and desist its multiple violations of labor law and the RNs' rights, including threats of physical violence and discipline against union supporters.
And, the Board issued a stern warning to the high-handed CHS lead attorney Donald Carmody, as well as other CHS lawyers, that they faced potential disciplinary proceedings if they continued submitting non-meritorious defenses to justify lawless CHS behavior in flagrant disregard of employee rights.
CHS has also been reprimanded for violations of federal labor law at other hospitals represented by NNU affiliates in California and West Virginia.
CHS' Barstow Community Hospital, in Barstow, Ca., has also petitioned the DC Court of Appeals for review of an NLRB decision mirroring the Fallbrook case that also ordered the hospital to repay nurses and the union for negotiating expenses in the face of similar willful refusal to bargain in good faith and other violations of labor law. The case is pending and may be set for argument in the fall.
Meanwhile, in Fallbrook, the Fallbrook Hospital District still owns the vacant building, while two nearby district hospitals have examined ways to restore an acute care facility to the rural northern San Diego County community. CNA still has other charges of violations of labor law pending against Fallbrook/CHS.
National Nurses United, with close to 185,000 members in every state, is the largest union and professional association of registered nurses in US history.
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Huge Administrative Waste Makes Clear For-Profit Insurance Is 'Actually Very Bad': Analysis
"It is totally fair for people to identify private insurers as the key bad actor in our current system," writes Matt Bruenig of the People's Policy Project. "The quicker we nationalize health insurance, the better."
Dec 10, 2024
Last week's murder of UnitedHealthcare CEO Brian Thompson brought to the surface a seething hatred of the nation's for-profit insurance system—anger rooted in the industry's profiteering, high costs, and mass care denials.
But that response has led some pundits to defend private insurance companies and claim that, in fact, healthcare providers such as hospitals and doctors are the real drivers of outlandish U.S. healthcare costs.
In an analysis published Tuesday, Matt Bruenig of the People's Policy Project argued that defenders of private insurers are relying on "factual misunderstandings and very questionable analysis" and that it is reasonable to conclude that the for-profit insurance system is "actually very bad."
"From a design perspective, the main problem with our private health insurance system is that it is extremely wasteful," Bruenig wrote, estimating based on existing research that excess administrative expenses amount to $528 billion per year—or 1.8% of U.S. gross domestic product.
"All healthcare systems require administration, which costs money, but a private multi-payer system requires massively more than other approaches, especially the single-payer system favored by the American left," Bruenig observed, emphasizing that excess administrative expenses of both the insurance companies and healthcare providers stem from "the multi-payer private health insurance system that we have."
He continued:
To get your head around why this is, think for a second about what happens to every $100 you give to a private insurance company. According to the most exhaustive study on this question in the U.S.—the CBO single-payer study from 2020—the first thing that happens is that $16 of those dollars are taken by the insurance company. From there, the insurer gives the remaining $84 to a hospital to reimburse them for services. That hospital then takesanother $15.96 (19% of its revenue) for administration, meaning that only $68.04 of the original $100 actually goes to providing care.
In a single-payer system, the path of that $100 looks a lot different. Rather than take $16 for insurance administration, the public insurer would only take $1.60. And rather than take $15.96 of the remaining money for hospital administration, the hospital would only take $11.80 (12% of its revenue), meaning that $86.60 of the original $100 actually goes to providing care.
High provider payments, which some analysts have suggested are the key culprit in exorbitant healthcare costs, are also attributable to the nation's for-profit insurance system, Bruenig argued.
"Medicaid and Medicare are able to negotiate much lower rates than private insurance, just as the public health insurer under a single-payer system would be able to. It is only within the private insurance segment of the system that providers have been able to jack up rates to such an extreme extent," he wrote. "Given all of this, I think it is totally fair for people to identify private insurers as the key bad actor in our current system. They are directly responsible for over half a trillion dollars of administrative waste and (at the very least) indirectly responsible for the provider rents that are bleeding Americans dry."
"The quicker we nationalize health insurance," he concluded, "the better."
Bruenig's analysis comports with research showing that a single-payer system such as the Medicare for All program proposed by Sen. Bernie Sanders (I-Vt.), Rep. Pramila Jayapal (D-Wash.), and other progressives in Congress could produce massive savings by eliminating bureaucratic costs associated with the private insurance system.
One study published in the Annals of Internal Medicine in January 2020 estimated that Medicare for All could save the U.S. more than $600 billion per year in healthcare-related administrative costs.
"The average American is paying more than $2,000 a year for useless bureaucracy," said Dr. David Himmelstein, lead author of the study, said at the time. "That money could be spent for care if we had a Medicare for All program."
Deep-seated anger at the systemic and harmful flaws of the for-profit U.S. insurance system could help explain why the percentage of the public that believes it's the federal government's responsibility to ensure all Americans have healthcare coverage is at its highest level in more than a decade, according to Gallup polling released Monday.
"There's a day of reckoning that is happening right now," former insurance industry executive Wendell Potter, president of the Center for Health and Democracy, said in an MSNBCappearance on Monday. "Whether we're talking about employers, patients, doctors—just about everybody despises health insurance companies in ways that I've never seen before."
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Extreme Weather Fueled by Climate Crisis Cost Insurers $600 Billion
"Unless we cut emissions sharply this decade, climate damages will grow exponentially and could overwhelm both insurers and economies," one expert warned.
Dec 10, 2024
A report out Tuesday shows that the fossil fuel-driven climate emergency accounts for an estimated $600 billion of global insured weather losses over a recent two-decade period, which a campaign targeting the insurance industry called "an immense climate price tag that insurers have long been passing on to policyholders."
Insure Our Future, the international campaign behind the eighth annual scorecard, is supported by advocacy groups including Ekō, Greenpeace, Mazaska Talks, Public Citizen, Rainforest Action Network, Reclaim Finance, the Sunrise Project, and Waterkeeper Alliance.
The report—titled, Within Our Power: Cut Emissions Today To Insure Tomorrow—"examines what 20 years of climate attribution science reveals about today's insurance crisis, explores the status of gross direct premiums from insuring fossil fuels and renewable energy activities, and analyzes the coal, oil, and gas policies of 30 leading primary insurers and reinsurers."
While climate-attributed losses from 2002 to 2022 worked out to around $30 billion annually, the financial burden was not evenly spread out over those 20 years. Instead, the report says, such losses "have recently accounted for a growing share of insured weather losses, showing how decarbonization is crucial to contain soaring insurance costs."
"The climate-attributed share of insured weather losses rose from 31% to 38% over the last decade on average, and their annual growth (6.5%) significantly outpaced thegrowth of the insured losses (4.9%)," the publication explains. "In 2022, $52 billion out of $132 billion was climate-attributed."
The other key findings are:
- Estimated climate-attributed losses for 28 top property and casualty insurers ($10.6 billion) approached the fossil fuel premiums they collected ($11.3 billion) in 2023—and for more than half the companies, they exceeded them;
- The renewable energy insurance market is still under 30% of the size of the fossil fuel insurance market in 2023, threatening to be a bottleneck for investments in the climate transition; and
- At the brink of 1.5°C, insurers are abandoning at-risk communities worldwide while enabling fossil fuel expansion that drives these risks higher—requiring immediate policy and regulatory action.
The report acknowledges that its findings arrive amid scientists' warnings that 2024 is on track to be the first full year to breach 1.5°C—the Paris agreement's target for temperature rise this century. The latest meeting for countries signed on to that treaty, held in Azerbaijan last month, concluded with what critics called a "big F U to climate justice."
Like activists and experts outraged by the conclusion of COP29, Ilan Noy, a professor focused on the economics of disasters and climate change at New Zealand's Victoria University of Wellington, stressed the importance of bolder global action in response to the Insure Our Future report.
"Insurers are fundamentally misunderstanding climate risk by failing to recognize how greenhouse gas emissions have driven up losses throughout this century," Noy said in a statement. "Unless we cut emissions sharply this decade, climate damages will grow exponentially and could overwhelm both insurers and economies."
🔎 The scandal: Fossil fuel underwriting is less than 2% of insurers’ premium income - pocket change. Yet this small slice enables massive fossil fuel expansion, pushing our planet toward irreversible tipping points. [3/8]
— Insure Our Future Global (@insureourfuture.bsky.social) December 10, 2024 at 4:13 AM
Laurie Laybourn, director of the U.K.-based Strategic Climate Risks Initiative, similarly suggested that the climate emergency poses an existential threat to the insurance industry while discussing Insure Our Future's report with Forbes' David Vetter.
"Because insurance impacts are mounting and because we don't have an insurance system built for the way that climate change is evolving, this dynamic is only going to get much worse," Laybourn said. "As we're already seeing, governments are having to step in to effectively ensure that insurance can still exist in certain places."
"In Florida, you have a situation where flood insurance is increasingly receding and the government is having to make decisions about how and what to cover," he noted. "It's the case as well in the U.K., where major flooding events led to the creation of Flood Re, a government-backed reinsurance agency to cover places that are effectively uninsurable through private markets."
Warning of a potential "doom loop" in which climate impacts cause instability that impedes adequately ambitious action, Laybourn added that "we need systems that are more resilient so that we can continue to remain focused on decarbonization, even as things get more unstable."
⏰ Time’s up for ‘voluntary’ action. While Generali overtook Allianz in our #Scorecard with stronger oil & gas restrictions, the industry is stalling on fossil fuels while accelerating its retreat from communities. [7/8]
— Insure Our Future Global (@insureourfuture.bsky.social) December 10, 2024 at 4:13 AM
The new report offers a roadmap to a more resilient insurance system. As the document points out, this is the first time Insure Our Future has included policy recommendations for lawmakers and regulators.
The publication urges insurance firms to immediately stop insuring new fossil fuel projects or any customers from the industry that have not published a transition plan for the 1.5°C goal. It also calls on insurers to set their own binding Paris-aligned targets and to divest from coal, gas, and oil companies.
The report further pushes insurers to align stewardship activities, trade associations membership, and public positions with a credible 1.5°C pathway; establish mechanisms to ensure clients fully respect human rights; and explore bringing fossil fuel companies to court "to make polluters rather than insurance customers pay."
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Top Progressives Urge DNC to Reject Super PACs, Uplift Working-Class Base
Congressional Progressive Caucus leaders are pressing the Democratic Party to offer "a clear alternative and inclusive vision for how we will make life better for the 90% who are struggling in this economy."
Dec 10, 2024
In the wake of U.S. federal elections resulting in Republican control of the White House and both chambers of Congress—in no small part due to Democrats' failure to win working-class votes—leading congressional progressives are pushing a plan to rebuild the Democratic Party by rejecting corporate cash and uplifting low- and middle-income Americans.
In a memo first shared with Punchbowl News, outgoing Congressional Progressive Caucus Chair Pramila Jayapal (D-Wash.), incoming Chair Greg Casar (D-Texas), and CPC members Rep. Maxwell Frost (D-Fla.) and Rep. Chris Deluzio (D-Pa.) urge the Democratic National Committee (DNC) to "rebuild our party from the ground up."
The lawmakers call on DNC leadership to "create an authentic Democratic brand that offers a clear alternative and inclusive vision for how we will make life better for the 90% who are struggling in this economy, take on the biggest corporations and wealthiest individuals who have rigged the system," and expose GOP President-elect Donald Trump's "corporate favoritism" to "create a clear contrast with Republicans."
Jayapal outlined what she called "four core principles" for the next DNC chair, who hasn't yet been elected:
- Reform, restructure, and rebrand the Democratic Party from the ground up and commit to a 50-state strategy that builds power through state parties;
- Embrace grassroots donors and reject special interest and dark money, including by reinstating the DNC's 2008 ban on corporate political action committee donations, and pushing to prohibit super PAC spending in state primaries;
- Rebuild Democrats' multiracial, working-class base by uplifting poor, low-, and middle-income voices and concerns; and
- Highlight recent electoral successes while working to build broad coalitions to win elections.
The progressives' memo urges the DNC to "invest in showing our commitment to real populism versus Trump's faux populism
through lifting up working-class voices and issue-based campaigns that take on corporate concentration and monopoly power at the expense of working people."
The principles enumerated in the memo resonated beyond the CPC. Responding to the proposed agenda in a social media post, U.S. Sen. Chris Murphy (D-Conn.) concurred: "The next DNC chair should absolutely refuse to take corporate PAC money. If we are the party of the working class—and we are—then let's raise $ like we mean it."
Casar, who before running for elected office worked as policy director for the Workers Defense Project—whose victories included rest and water breaks for outdoor laborers, anti-wage theft legislation, and living wage requirements—has repeatedly stressed the imperative "to re-emphasize core economic issues" that matter most to American workers.
"The core of the Republican Party is about helping Wall Street and billionaires. And I think we have to call out the game," Casar said last week during an interview with NBC News.
"The Democratic Party, at its best, can hold people or can have inside of its tent people across geography, across race, and across ideology," he added. "Because we're all in the same boat when it comes to making sure that you can retire with dignity, that your kids can go to school, that you can buy a house."
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