Nurses union claim strike is for the good of the patients

...and if you believe that one I have some oceanfront property in Montana for sale.

In Maine this week unionized nurses went on strike claiming that the ratio of nurses to patients is too high, and more nurses should be hired to bring the ratio down. I can understand why a union would want to use strikes to increase their membership levels (and membership dues), but what bothers me is that they are claiming their sole motivation is for the good of the patients.

It reminds me of when unions lobby for higher minimum wages. They frame it as a charitable act for non-members, when in fact its really in their own interest.

The real story is summed up in a 1988 paper by Matthew Kibbe:

As would be expected, labor unions are the main political force behind minimum-wage legislation. Although unions already hold privileged positions in labor markets, minimum wages further increase their gains by raising employers' labor costs. As long as union members earn wages above the minimum rate, their positions are made more secure by the government policy that eliminates those who might undercut the union wage. People willing to work for less than the government's minimum are not allowed into the labor market at all. Indeed, union leader Edward T. Hanley stated in a catering industry employees' publication, 'The purpose of the minimum wage is to . . . provide a floor from which we can upgrade your compensation through collective bargaining.'

So the obvious reason a hospital would not want to hire more nurses is that it's expensive to do so. Nationally, registered nurses command a median wage of $31.99. That adds up to $63,750 a year an hour plus benefits. That's a pretty expensive position to increase.

A friend of a friend was one of the striking nurses and said the following:

It is unsafe for nurses to be working past their 12 hour shift, but many nurses consistently work 16 hour shifts because we are so short staffed. Patients don't always get their medications on time because each nurse commonly has 5-7 patients, which is too many for one person to be able to take care of.

In addition, she said there are numerous studies that show a lower nurse-to-patient ratio results in better outcomes for patients. I completely believe her, but I think it misses a larger point.

It costs money to increase the number of nurses, and that will mean higher health care costs, which will in turn raise the cost of health insurance. But don't hold your breath expecting the union to take responsibility for those increased costs: it will be blamed on the insurance industry.

Increasing the ratio of nurses to patients will probably have even better outcomes if two nurses look after on duty for each patient, but the importance of a cost-benefit analysis becomes even more apparent at that level. More nurses means better patient outcomes, but it is also prone to diminishing returns. There must be some optimal point for the nurse to patient ratio.

And I have no idea what ratio is optimal.

But I have to be skeptical when the people who to push or pull those figures will profit if we take their advice.

When the American automobile CEO's went to Washington DC to ask for a bailout, they didn't frame it as something good for their company. They said it was good for the American public. We knew they were a biased source, and we knew it was foolish to believe them.

I don't know how many nurses we should have at a given hospital, but I do know that the union is hiding behind the patients. I've never heard of a nurses union of asking to reduce the number of nurses when there are too many on duty, and I don't see them offering to lower the wages of nurses so hospitals can afford to hire more. I would rather hear it from someone who doesn't stand to gain from the action they advocate.