Diane Donoghue shakes her head fiercely. "How can you put your name on a hospital, Mercy Hospital, and not be involved in how the mission is applied?" she demands. Then she catches herself, pulls back, and announces she doesn't want to say anything "too rash."
"I have to work with these sisters," she adds.
Later that afternoon, in a panel of more than thirty religious leaders, labor-union organizers, and community activists, Donoghue lets her hair down a bit more: "Talk about mercy, dedication, compassion! That's what we say we're about! These principles are not being applied in a discrete and distinct way. And I know they can be."
The object of Donoghue's ire is the collossus Catholic Healthcare West (CHW, as it's known), a holding company of forty-six hospitals in California plus one each in Nevada and Arizona. One of the country's largest faith-based providers of health care, Catholic Healthcare West controls more hospitals than does any other entity in California.
For two years now, CHW has been the target of a "corporate campaign," or all-out public assault, by the largest union on the West Coast, the Service Employees International Union (SEIU), a powerful affiliate of the AFL-CIO. The SEIU is trying to organize new bargaining units at eight CHW hospitals (five in Sacramento and three in Los Angeles), and it claims that CHW is engaged in tactics that not only thwart the union but contravene Catholic doctrine.
CHW asserts that it is in "complete alignment with Catholic social teaching" and recognizes the right to unionize. It just doesn't recognize the right of an antagonistic labor union to intimidate and manipulate its employees, it states.
The dispute has careered from the boardrooms and cafeterias of CHW's hospitals into the public arena. Along the way, the SEUI has used every tactic in its arsenal to blacken CHW's reputation and force it to terms. As part of its approach, the union has tried to cast into relief what it means to be a Catholic organization- specifically, a Catholic employer - in the economic world. In doing so, it has highlighted, perhaps unintentionally, the added burdens experienced by religiously sponsored hospitals in the midst of the creeping secularization of health care. The union has allied itself with theologians and clergy from various denominations who insist that the social gospel be applied not only to the hospital chain's patients but to its workers.
An oddball lot of graybeard activists, hospital staff, retired priests, and youthful organizers gathered at the Biltmore Hotel on Pershing Square in Los Angeles on October 9 and 10, the weekend before the AFL-CIO convention in Los Angeles, to cement an alliance between organized labor and organized religion.
If the oracles of political thought in the United States seriously believe faith-based enterprises, instead of the government, must solve social problems, then the old (formerly New) left is going to give "compassionate conservatism" a run for its money.
That these philosophical children of Marx should be lecturing the Catholic sisters on how better to fulfill their commitment to Christ is the lesser of the ironies of this labor disagreement. The greater irony, perhaps, is that the church hierarchy, in the person of the archbishop of Los Angeles, should appear to be siding with the union rather than the sisters.
CHW, for its part, has taken a consistent and tough approach to the union's campaign, even stooping to the media-age equivalent of hand-to-hand combat: buying full-page ads in California newspapers to deny the union's assertions and challenge it to call a National Labor Relations Board election. The hospital chain has engaged notorious anti-union law firms and consultants, required employees to attend meetings to explain why the union isn't in their interest, and called on security guards to escort protesters-and clergy-out of its hospitals.
Through the bruising battle, the guarantors of the hospital chain's ethics and values, its nine congregations of sponsoring sisters, have remained in the background, quiet, unseen, and in the view of their accusers, unresponsive, unaccountable, and ethically inert. Among their most influential critics have been people like Diane Donoghue.
To look at her, you wouldn't know that Donoghue is a Catholic nun herself, one of the Sisters of Social Service, an order founded to implement the social teachings of the church. For ten years she has directed the Esperanza Community Housing Corporation, based at St. Vincent de Paul Church in South Central Los Angeles. She has made a career of being the voice for the voiceless, of creating economic possibility where none existed before.
In this struggle, Sister Diane has come down on the side of los angelenos: the working poor who labor as technicians, janitors, housekeepers, patient aides, and cafeteria servers in those other sisters' hospitals. "If you put your name on something, then own it!" she says. She underlines the "disconnect" she feels between Catholic Healthcare West as a hospital company and the nine congregations of sisters that sponsor it.
At the labor conference discussion on health care, Donoghue is surrounded by nuns who feel the same way. Sister Annette McDermott handles social concerns for the Diocese of Springfield, Massachusetts. Sister Mary Priniski works on organizing efforts among poultry workers in the deep South and on Catholic hospital campaigns. Sister Barbara Pfarr coordinates the religious employers project at the National Interfaith Committee for Worker Justice.
McDermott says the sisters in the hospital feel fear when they think of labor unions. "Jimmy Hoffa sticks out in their minds. And when unions think of us, they see a nun with a ruler. These stereotypes, they're dehumanizing."
Pfarr gets frustrated when she hears employers say, "Yes, workers have the right to organize," followed by "We don't think it's in the best interest of our institution." "Those two sentences don't go together," she says. "They cancel each other out. Yet I hear them all the time."
Pfarr goes back and forth from her home in Chicago to Los Angeles, trying to mediate the California dispute. "The problem is there are so few relationships between union folks and the religious sponsors. There is no trust, no one to go back to when problems arise," Pfarr says. "Some of the actual experiences are so painful, on both sides. And there's no best practice. So it's hard to get started."
As of early October, there was hope on the horizon. Both parties agreed to start meeting with a representative of the Federal Mediation and Conciliation Service to set ground rules on how to proceed. Those talks ended in mid-November with no agreement. Yet the union has agreed to back off some of its more offensive tactics, while CHW has dropped its two anti-union consulting groups.
McDermott wants the controversy to move beyond the legal stage and embrace the pastoral. The movement needs to put Catholic social teachings out front, she thinks, and to do that it needs to engage the bishops. The antis have found their champion, or at least a sympathetic listener, in the archbishop of Los Angeles, Roger Cardinal Mahony. Long a major player in California and an influential voice among U.S. Catholics, Mahony appeared at the labor conference to deliver a recapitulation of Catholic teachings on work and social life, beginning with Rerum Novarum, Pope Leo XII's pathbreaking encyclical acknowledging the social and human value of labor unions.
This encyclical is the ur-document of the layers of Catholic teaching on which the unionists base their argument. Leo wrote it in 1891, when Europe was being swept by industrialization, urbanization, and agitation for a more liberal regime. The pope's corporatist and paternalistic understanding of society and the masses' place in it led him to formulate a theory of "workers' associations"-organized around Catholic principles and respectful of the state-to represent the rights of the working class vis-à-vis their employers. Their principal goal, in Leo's view, was "moral and religious perfection" (Rerum Novarum, paragraph 77). Thus was the foundation of Christian Socialism laid in Europe.
A large body of Catholic teaching has flourished in the wake of Rerum Novarum, culminating in John Paul II's nuanced dissection of the role of work in the globalist era, Laborem Exercens. This ninetieth anniversary meditation on Leo's encyclical strove to delegitimize the communist state's claim to represent the interest of the working class at a time when Solidarity was ascendant in Poland.
In the United States, the words Christian and Socialist have never tripped off the tongue in tandem. True, the industrial proletariat in the U.S. was more Catholic and less native-born than the population as a whole, yet the labor movement was never known for its fealty to the church. The American labor tradition, in some regards, resembles more closely the malevolent unions that Leo warns the faithful against, those "under the control of secret leaders" that abjure Christianity and state power (Rerum Novarum, paragraph 74).
Like so much else in the intellectual and social history of the twentieth century, the current argument is a recapitulation and variation on motifs first introduced in the nineteenth century. The Catholic sisters feel they have a direct relationship with their employees. To invoke the language of Pope Leo, they are the padrone,or patron-boss, paternalistic bestowers of good things onto those who labor in their vineyards. They are not all that different from the kindly lord of the manor or owner of the factory. To those who hold this view, independent trade unions present every bit as much a psychological threat today as they did a century ago. Those who feel so threatened see the Marx-motivated rabble as wishing to interpose itself between the good patron and the good workers.
Of course to the workers, the Catholic sisters are not running the show. The hired lay manageres are. And the value system of those managers is that of modern American management theory. There is no social contract. Workers are expendable; the payroll must decrease as revenues decline. The business, not Catholic tradition, determines the tone. It is for this reason that union-sympathizing sisters such as Diane Donaghue and Barbara Pfarr are incensed by the refusal of the refusal of the CHW-sponsoring congregations to speak directly with the workers, insisting instead that communications go through proper (corporate) channels.
Turn-of-the-millennium Los Angeles is about as far as you can get from Risorgimento, Italy, or Communist Poland, yet the tradition of Catholic thought present in those places is still a living impulse. "Our church supports the rights of workers not only so that workers can have more, but more importantly, so that workers can be more human," Cardinal Mahony told the conference. "While our intentions are good, our record is not pure. Neither is the labor movement's. Each side is too ready to excuse the excesses of their side while they decry the activity of the other."
The archbishop is keenly aware that as this struggle in his diocese has assumed a national profile, each side has dug in deeper. While not necessarily pro-union, Mahony isn't anti-union either; he tries to move delicately in the territory between the two camps. He doesn't give press interviews on the matter, and he doesn't want the church to look like a cheerleader for the unions.
For cover, Mahony invokes the message of the most recent Catholic dialog on labor relations, "A Fair and Just Workplace: Principles and Practices for Catholic Health Care." This document, formulated between January 1998 and May 1999, seeks to lay ground rules for labor and management relations in Catholic enterprise. It was drawn up by a working group that included the Catholic Health Association, the Catholic Bishops' Conference, the Leadership Conference of Women Religious, the U.S. Catholic Conference Committee for Domestic Policy, the AFL-CIO, and the Service Employees International Union.
The effort began when Sister Mary Roch Rocklage, then president and chief executive officer of Sisters of Mercy Health System in St. Louis, asked that these issues be formally explored.
The working paper that resulted attempts to find common ground on four topics:
- The right of workers to choose if and how they will be represented in the workplace
- How Catholic teaching can guide both management and labor in their response to the choice of the workers
- What behaviors should be avoided by all sides
- The need for a new way for labor and management to relate to one another
The twelve-page report lists examples of good behavior and bad behavior by workers, unions, and management. "The core of Catholic teaching in this area," it states, "is that it is up to workers-not bishops, managers, union business agents, or management consultants-to exercise the right to decide through a fair and free process how they wish to be represented in the workplace."
That, says Bernita McTernan, is exactly what Catholic Healthcare West is trying to do. McTernan, a former Sister of Mercy, is now the senior vice president for mission services and human resources at the hospital chain. "We are 100 percent motivated to have a National Labor Relations Board election," she says briskly, taking a short time-out from an all-day management meeting in San Francisco. "We strongly favor that process for our employees. We feel it is their right to have that vote. We are in complete alignment with Catholic social teaching."
It is their right, of course, under U.S. labor law. However, those labor laws, written in the early years of this century, have been so often amended and unfavorably interpreted by the courts that the labor movement regards them as more hindrance than help. Today, evangelical unions such as the SEIU prefer to use the card-check process, which permits them to seek recognition from the employer as the workers' duly annointed representative without slogging through the cumbersome and expensive National Labor Relations Board (NLRB) election process.
The thrust of SEIU's corporate campaign against CHW was to put so much public pressure on the hospital chain that it would be forced to grant a card-check recognition. But CHW never budged. In December 1998, the union was forced to drop that tactic. Now, says McTernan, the union wants an NLRB election. "They just haven't called it. That's a puzzlement to us."
The union didn't want to call the election, says Mary Kay Henry, chief West Coast organizer for the SEIU, because it felt the hospital chain had created an atmosphere of intimidation in which workers would not feel free to vote their preferences. It also doesn't want to go through the endless appeals, hearings, and legal wrangling that can drag out the NLRB process to five years or more. It has asked CHW to forego such appeals and accept the election result at face value. "Catholic teaching tells them not to be overly litigious," Henry says. "They know they've been using the law for delay."
CHW doesn't intend to pursue elaborate appeals, McTernan says. "Sometimes employers can use stalling tactics. We are absolutely not going to do that." Still, she adds, there's a lot of detail in the NLRB process. "You can't say who's in the union without a lot of detail work." As a concession to the union, and in respect of the Fair and Just Principles document, CHW dismissed its management consultant firms, The Burke Group, of Malibu, and Management Science Associates, of Independence, Missouri. The union alleges these firms teach employers how to confound organizing drives and bully workers, which again would be a violation of Catholic teaching.
McTernan says CHW doesn't want to forego the NLRB process, because it guarantees the workers a confidential voice in whether they wish to be represented by the union. The system is "analyzing" the Fair and Just Workplace document. "We think Catholic social teaching as expressed there is fairly clear," she says. "Any statement is the ideal. We're all trying to reach the ideal." What they'd really like is for the SEIU just to file the election petition and get on with it.
Finally, the SEIU obliged in the Sacramento region in November. An election will be scheduled early in 2000. Union sources say it will file soon for an election in the Los Angeles hospitals.
The hospital company is somewhat exasperated by the union's attempt to lable it an "anti-union employer." About a quarter of CHW's workforce is already unionized, including substantial parts that belong to SEIU locals elsewhere in California. "We have eighteen or nineteen contracts in place right now," says Sister Bridget McCarthy, a CHW senior vice president in Northern California who assembled the original system core around Mercy Hospital in Sacramento thirteen years ago. She points to an NLRB election just held in the Bay Area. Workers at three CHW hospitals near San Francisco chose by a strong margin to join the SEIU. Now, says McCarthy, it is "management's responsibility to work collaboratively with those whom they have selected."
Judging from CHW's record in such matters, the rest should proceed smoothly. Rose Ann DeMoro, executive director of the California Nurses Association, one of the most radical and polarizing labor organizations on the West Coast, says, "We've organized 60 percent of their nurses. We fight them in the organizing campaign. We always beat 'em. Then they agree to a very fair contract."
The SEIU's pressure campaign has failed, DeMoro says, because it has "tried to organize CHW, not the workers. You'd be hard-pressed to find ten CHW employees who would talk to you about their union drive."
To fully comprehend the situation that the Catholic sponsors of CHW find themselves in, it helps to know that the system lost $310 million in fiscal 1999 on $3.5 billion of net patient revenue, an operating margin of -7.8 percent. The system has not broken even on operations since 1996. In three years, a cumulative $500 million has vaporized. In November, the Fitch IBCA credit rating agency downgraded $2.2 billion of CHW debt two notches, from A to BBB+. CHW's bonds are now near the bottom of what's considered investment-grade debt, and the credit agency sees a host of difficulties ahead for the organization. It's not expected to regain profitability anytime soon. Continued losses at 1999 levels, warns Fitch IBCA ominously, "will likely merit a further downgrade." Three more downgrades, and the bonds are "junk."
In September, CHW dumped its longtime CEO, Richard Kramer; Sister Phyllis Hughes, a housing activist and former hospital executive, is filling in as CEO until a replacement can be found. In the meantime, the system is drifting without clear strategic direction.
CHW notes on its Web site that it provided $177 million in community benefits and care of the poor in 1998. Presumably that's what the Catholic sisters got into this business for. But the credit markets don't award extra points for service to the poor. What Fitch IBCA notes in its rating report is that "increased union activity at several CHW hospitals in California may result in increased costs and reduced management flexibility." This is where the rubber meets the road.
Considered in the context of CHW's accelerating financial decline, its absence of leadership and the punishing commercial climate for health care operators in California, the complaints of labor advocates such as Diane Donoghue and Mary Kay Henry that the sisters have shown them disrespect by refusing to meet face-to-face to talk about workers' rights begin to seem misplaced.
This labor dispute, so vital to the church, the union, and the employees, is little more than a minor irritant in the midst of an unfolding catastrophe at CHW. (In the eight-page assessment from Fitch IBCA, the conflict merits one sentence.) The people who run CHW have some very large problems to solve. The existence of the nine congregations' entire health care ministry appears to hang in the balance, and the sensitivities of the labor leaders may not be at the top of their agenda.
In the meantime, in the Archdiocese of Los Angeles, the pulpit at Our Lady Queen of Angels Church was turned over to an SEIU executive on Labor Day Sunday. The executive told the congregation in Spanish that "the workers want to have a voice at work for just wages and benefits and better care for the (hospital's) patients" (Los Angeles Times, Sept. 6, 1999, p. B1). In Lynwood, not far from CHW's St. Francis Medical Center, the Reverend Jose Mejia told the parishioners at St. Emydius Church on the same day that "it is unjust to have to work two or three jobs to maintain a family." More recently, on November 18, Cardinal Mahony issued a statement calling the failure of the federally mediated talks "a lost opportunity to forge a new partnership between labor and Catholic health care management."
One can well imagine the feelings of the Catholic sisters as they confront this incursion by the church hierarchy into their pastoral realm: If the archbishop knows so much about running Catholic hospitals, then where's his turnaround plan? How many of his legions has he dispatched to Sacramento or Washington to procure higher Medicaid and Medicare reimbursements? Why hasn't he used the authority of his office to guarantee health insurance to the faithful or to make the HMOs pay their bills on time? The next time Fitch IBCA threatens to drop the bond rating, would he like to take the call?
While the cardinal recites Catholic social teaching, the world these women knew is crumbling around them. The institutions they built are failing by the only yardstick that seems to matter any more-the bottom line-and the armies of the secular night are gaining on all fronts.
Now these dwindling bands of women religious are under attack from the very institution to which they have dedicated their lives. And for what? For failing to respect the core values of the Catholic tradition. The irony must be breaking their hearts.
The sisters, of course, are much too discreet to utter such sentiments. Sister Bridget McCarthy, asked in a telephone interview how she felt about the cardinal's involvement in CHW's business affairs, cannot find words to respond. After a pause, she says weakly: "That's a tough question." After another long pause "to collect my thoughts," McCarthy answers finally that the bishop's role is to influence ethics and morals at the local level. "Management of the hospital and management decisions are a different issue," she adds. It is the bishop's responsibility to raise issues of church teaching with respect to labor, she says. "We believe we do provide a just work place. . . . I think you would find many Catholic sisters who are just as passionate" about that as the labor organizers are.
The sisters' position isn't made any more comfortable by the subtle intervention of the Catholic Health Association. The Reverend Michael Place, newly installed president of the St. Louis-based CHA and a former health care advisor to Joseph Cardinal Bernardin, is tactful but firm on the position of labor in the Catholic firmament. "I believe in the right to organize," Place says simply. "It is a fundamental human right." The question of unionization of the hospitals, painful as it may be, "is going to become more intense," he observes. "How can we change it from an adversarial position to one that balances all our values?"
Place was active in the working group that drafted the Just and Fair Workplace document. "People can use it if they find it useful. Or not," he says genially. "It is not required to be endorsed by any player."
Place is confident enough of his position not to worry about creating a little tension around this issue, as the social activists like to say. At the CHA annual meeting in New Orleans in 1998, he welcomed SEIU organizer Mary Kay Henry with a pointedly long handshake, sending the message, as one observer recalled, that demonization of the union would no longer be an acceptable response to the questions it raises.
Bishops, in Place's view, don't operate Catholic health care, but they have moral guidance over it. "They are the ultimate authority," he says. Place has seen that kind of authority in action. In 1995 Bernardin threatened to strip St. Elizabeth's Hospital in Chicago of its Catholic status if it persisted in joining a network based around the non-Catholic University of Chicago hospital system. Bernardin told the Catholic hospitals to stick together. That same year, the Sisters of Charity of St. Augustine Health System, based in Cleveland, was drummed out of the Catholic Health Association after it formed a joint venture with Columbia/HCA Healthcare Corp., the largest for-profit hospital company.
Given the subsequent and rapid fall from grace of Columbia/HCA and its ilk, it's almost surprising to remember that in 1995 and 1996, the ascendancy of the for-profits pushed the Catholics into a crisis of confidence. Reformulating a role for Catholic institutions was the challenge of the day. That role seems more evident now than four years ago. Yet the nagging argument of what it means to be a Catholic provider lives on.
Indeed, Sister Doris Gottemoeller, president of the Mercy Sisters of America and outgoing chairman of the Catholic Health Association, said in a speech last June that Catholic health ministry should become an instrument to achieve social justice.
"It is not surprising that there have been increased efforts by unions in recent years to organize health care workers," she noted. The response of Catholic hospitals has been "tentative and uncertain, perhaps even reactionary." It has stressed the opposition between the demands of health ministry and the employer's role in the labor market, rather than their potential to advance the common good, Gottemoeller said. She pleaded for some "breakthrough thinking."
Perhaps that breakthrough will come from the next chairman of the Catholic Health Association: Phyllis Hughes, Sister of Mercy and interim CEO of Catholic Healthcare West.
Oddly, one hears resonances of what could pass for breakthrough thinking from both the Sisters of Mercy and the Sisters of the Loyal Opposition. Take this comment, for example: "California is forty-sixth in Medicaid reimbursement. CHW is the largest chain of hospitals; SEIU is the largest union. Think of putting that kind of power on the same page, to work for the uninsured, to work for the living wage. That needs to be our five-year plan."
Or this comment: "If we could resolve these issues, think of all the places where we could work together. In San Francisco, we have a model program on training. There is the Balanced Budget Act. Access to health care. I feel there is common ground."
The first speaker is Sister Diane Donoghue; the second, corporate executive Bernita McTernan. The inability to use health ministry as an agent of social justice clearly pains all the parties the most.
Certain themes in the discussion come to be uttered again and again, in strange echoes of each other. Have the labor agitators simply appropriated an appealing rhetoric from the church? Or vice versa? Here, for example, is Sister Barbara Pfarr: "People don't understand the power imbalance. The enormous power that the employers have over workers . . . cancels out the right to organize." Pope Leo XIII wrote on the same theme, "If, compelled by necessity or moved by fear . . . a worker accepts a harder condition, which . . . he must accept because an employer . . . imposes it, he certainly submits to force, against which justice cries out in protest" (Rerum Novarum, paragraph 63).
This convergence extends even to John Sweeney, president of the AFL-CIO and former chief of the SEIU, who opened the Los Angeles conference by paying homage to "values as time-honored as the Scriptures. . . . Human beings are created in the image of God and are worthy of respect."
Perhaps these are more than rhetorical flourishes. The traditional Marxist "opiate-of-the-masses" strain in the hardcore labor movement has had to be suppressed in the presence of Catholic dignity, reports Mary Kay Henry, who, incidentally, introduces herself as a lapsed Catholic now searching for a parish to join. In this reversal-conflation, even-of historical roles, labor unions are standing on Catholic doctrine, while Catholic organizations are standing on the Taft-Hartley Act.
Did Pope Leo XIII imagine a world in which Catholic hospitals would be denounced from Catholic pulpits as unfaithful oppressors of their employees?
Did Eugene Debs ever dream that the AFL-CIO president would precede a Roman Catholic cardinal at a labor conference?
And did either of them imagine it would be possible to lose $310 million in one year doing the Lord's work?
