When we look back years from now at health care's current transformation, in addition to feeling what I'm sure will be fondness for the good old days, I wonder if the agreement signed Monday night between hospital and union officials in California might stand out as significant.
I'm referring to the announcement that the SEIU-UHW health care union, California Hospital Association and member hospitals that choose to join have agreed to fund a $100 million committee to advocate largely on behalf of revamping the state's Medicaid program.
As I come close to finishing my 10th year on the health care beat, I can't recall such an agreement in which hospital and union officials decided to work so closely on a common goal and with that level of financial commitment.
In May of 2012, the two groups had signed a strategic agreement that had its hits and misses, and recently they have been feuding over two November 2014 ballot propositions.
But they sounded like real partners on a press call announcing the joint effort. "We are looking forward to not only working with each other, but working with all of the other stakeholders in health care," said C. Duane Dauner, president and CEO of the CHA. "The challenges in California are great and we can be a leader for the nation, and we certainly intend to bring California to the forefront in that regard,” Dauner said.
Dave Regan, president of SEIU-UHW, also sounded pleased to be partnering with a traditional foe. "What we've done here today also will hopefully serve as an example of what can be accomplished when people hang in there," and keep the conversation going, Regan said. "We have a joint commitment to making sure that whatever comes out of our relationship, first and foremost, must serve the common good in the state of California."
Medi-Cal does pose a problem. California, by Medicaid payments per enrollee, is ranked 49th out of 50 states, at $3,441. That's less than half of what some other states spend, such as New York and New Jersey.
In addition to jointly advocating for a revamping of California's Medi-Cal program, the two agreed to a code of conduct that calls for both to "engage in positive, factual communications that are designed to build and maintain a trust-based relationship rather than the confrontational relationship that characterizes the majority of employer-union relationships," a fact sheet notes.
The agreement, which is expected to affect at least 85,000 mostly service employees, will expire at the end of 2017.
In the meantime, California's health care labor climate will be watched closely to see if it works out for both parties. If it doesn't, California's hospital and union leaders, in a state known for innovation, may have to go back to the drawing board. If it does, the effects may be felt for years as others adopt the model.