By Mathew Keller, RN JD
Regulatory and Policy Nursing Specialist
Ask any Allina nurse. They all know why they are on strike. Health insurance, patient safety, workplace violence, and maintaining a voice in the workplace are all important aspects of this action. But what about Allina’s claims that the money it would save from cuts to nurses’ total compensation would be put to patient care?
As Allina puts it, the $10 million it proposes to take from nurses “means a whole lot to what service we’re able to provide,” according to Allina CEO Penny Wheeler. Unsurprisingly absent from that statement is why Allina needs this 10 million for patient care, why it needs to take it from its nurses, and why it can’t come from other sources.
As I mentioned in my previous blog, Allina Health’s Board of Directors is composed of investment bankers and non-healthcare company CEOs (even the CEO of Buffalo Wild Wings). Allina has made piles of money off of providing healthcare to the sickest amongst us.
In fact, according to Allina Health’s annual financial disclosures as well as its consolidated financials (prepared by an “independent auditor” who sits on Allina’s Board), Allina Health has posted a net income after expenses of $1.3 billion over the past 6 years, including a net income of $271 million after expenses at the height of the recession in 2009 when most of the country was pinching pennies to get by. Allina hasn’t yet said why $10 million for patient care can’t come from those $1.3 billion dollars of net income.
Likewise, the top 25 paid executives at Allina health could take a cut to the $23.9 million dollars they made in 2014 in order to make up the $10 million. Or, the $10 million Allina suddenly needs for patient care could come from the $108 million it’s investing in a for-profit healthcare data analysis company, Health Catalyst, which happens to have Allina CEO Penny Wheeler on its Board of Directors.
The Health Catalyst transaction, notably, isn’t about improving patient care—it’s about cutting costs. As nurses can tell you, cost cutting in hospitals tends to come from one source: cutting nursing care. Because nursing care is rolled into the “bed fee,” patients pay the same whether they received the 10 hours of nursing care they needed or the four hours Allina decided it would give them. This creates a perverse financial incentive for hospitals to cut costs through cutting the main reason patients are in a hospital and not in an outpatient setting. The reason? Nursing care.
At the end of the day, that’s what this is all about: squeezing every penny Allina can out of its nurses, its other employees, and most importantly, out of its patients. You will pay the same at Allina Health regardless of the outcome of these negotiations and regardless of whether or not Allina fleeces $10 million out of its nurses. As a commentary from Rand Corp. put it, “unfortunately, nearly every actor in our health care delivery system — hospitals, physicians, other health care providers, insurance companies and the manufacturers of drugs and devices — is currently focused on maximizing revenue growth.”
Indeed, we’ve seen that no matter how much money Allina makes, it doesn’t return it to its customers. From fiscal years (FY) 2013-2014, when Allina made $470.3 million dollars after expenses, the amount of charitable care it provided actually decreased by 18 percent, and, rest assured, everything from the cost of a band-aid to the cost of a a splenectomy went up too. The argument that Allina and other Minnesota healthcare systems provide enough of a community benefit to even be considered non-profit anymore is so weak at this point that many commenters, including, notably, a medical director at Allina, believe the whole system deserves much greater scrutiny. Likewise, any claims from Allina that skimming $10 million from the total compensation of its nurses will improve patient care deserve greater scrutiny as well.
Well written, well researched, and if this doesn’t open some eyes and turn some heads nothing will. I’m a retired nurse after 40+ years of service, while not in the Allina system, I was in another corporate hospital system of which I’ve seen the same practice. Take away from nurses, expect more from nurses and watch the patient care suffer. It’s time this stops. It’s not the nurses responsibility to fix the problems, the high salaries of the administration and all the fringe benefits they receive are more than any person is worth. Cut at the top and balance out healthcare. Healthcare is not supposed to be an industry , it’s meant to promote health, wellness and care to the weak, sick and feeble. Shame on Healthcare administrations and corporate management from allowing the healthcare providers and nurses as well as other staff from doing the jobs in an effective, safe and manageable manner and by expecting them to sacrifice benefits, salaries and their own health by working long stressful and strenuous hours to provide good patient care. I support Allina nurses in this strike for the good of the patient and to the nursing profession of which I have loved being a part of for most of my life. I would still be working if it weren’t for the unreasonable changes and expectations put on nurses causing stress and jeopardizing our own health. I can only hope and pray to continue to have good health so as not to have to be caught up in the nightmare of healthcare.
Plan and simple: the rich want to get richer while making the poor poorer. Greedy bastards.
This article has a concerning amount of content that reads more like propaganda instead of facts. The Health Catalyst transaction is a good example of that. Measurement & data analysis has a HUGE impact on patient care, and is the core of science based medicine. If we wish to truly improve public health, we have to make that investment.
The author also implies a lot of corporate greed & spending, yet from what I’ve seen & experienced first hand for the last decade: It’s quite the opposite; every department I’ve worked with usually operates as a responsible non-profit should.
If the core issue is about the healthcare plan, then let’s talk about that.
The healthcare Allina offers it’s employees is significantly better than market. I opted for the Allina First plan for my family, it is very good. I understand the current plan they’re on is better than the plan of the vast majority of their fellow employees,
I do agree with the downside of being somewhat locked into the Allina network for coverage on the core benefits. It’s something every new employee has to weigh out when planning their healthcare. Sometimes it’s worth paying the extra $$ a couple times a year to see the provider you prefer outside of the Allina network. We are creatures of habit afterall.
I imagine if I left Allina & went to work at Fairview, I’d mostly switch to new providers, but would still pay the premium on a select few.
It’d be great to have the flexibility to go wherever I want without an impact to my insurance, but unless our nation votes for candidates in government who support the transition to a single payer system, I don’t see how that would be affordable.
Your agenda is being ignored as you seek retaliation.
We would like the city, hospital administration, MNA members and potential patients to know that the environment at this hospital for AGENCY NURSES WORKING AT THE HOSPITAL is hostile. It is also dangerous to patients. Ancillary staff, HUC’s, nurse aids and nurses who are allied Health employees are being vengeful. The immediate care staff ignores phone calls, call lights, they ignore needs of patients, they purposely do these things and they are making an unsafe environment. Management is allowing these things to happen. They are retaliating on all levels. From Nurse Assistants to Charge Nurses and Directors. They constantly question the ability of nurses who are on contract to keep the hospital running. They do not perform bedside care, they dissapear from units, they do not help out as a they are being paid for and also as they should because the needs of OUR patients comes first. We fear as a whole for our licenses because of their actions. It is hard to work in this environment knowing that agency nurses are being fired without question for standing up for themselves and for their patients rights. As a MNA nurse that is striking one of their main concerns is unsafe care due to staffing. Why then do you go into hospital and interrupt patient care? Trespass? Why do you and ancillary staff conspire to make a situation worse inside the hospital? Why do you think it’s ok to ignore call lights? To ignore patients needs, not make rounds and not care for patients? The environment at these hospitals is very hard to work in. We are all working to keep the hospital afloat while you are seeking your needs as nurses. We are working to keep your hospital afloat. Did you think the hospitals doors would close completely? Do your needs as MNA nurses supersede the patients care and patients safety? Every day patients are being put at risk because of YOUR actions and inactions. Where did your plight go? When did you make it ok to do this and not care about the patients that are in the hospital every day. You are constantly communicating with ancillary staff and encouraging they not do their jobs. Encouraging them to make this job not only hard on us as nurses but unsafe for patients. If we express concerns or use our roles as RN’s to make it clear this is not ok- we are being fired. For legitimate complaints. For legitimate concerns. We report real actions of retaliation, we report unsafe environments and are being persecuted. Ancillary staff openly questions our roles, our experience. There are so many things happening and we fear for our licenses. The care of our patients come first. We all have permanent jobs in our respective home states and we all perform high quality care. We continue to be ethical and compassionate. Empathetic. You as striking nurses and their coworkers are going against your oaths and at least job titles. You are purposefully not doing your jobs. You are purposely ignoring needs of patients to make a point. We are working hard inside and our patients appreciate us. Please star tribune staff, ask the striking nurses why they have trespassed into hospital. Ask them why they can hold those signs up that tell of unsafe patient care but they encourage and also participate in making unsafe environments. Every day. We believe these nurses have put their agenda and needs above the needs and safety of the existing patients. We would like you to know that we are working hard without breaks, without help and in horrible environments to give you the best quality care. Despite the actions of staff and MNA striking nurses. Please dig deeper and help us. We are inside these hospitals doing our very best and our patients express they are happy with their care. They hug us. They say thank you. They trust us. They go home satisfied.
MNA why can your nurses trespass? Why are you allowing these things to happen? Why are the administrators allowing this to happen? Why are you retaliating on staff YOU sought to help you thru this difficult time?
To the last commenter: from the deepest of my heart, I sincerely apologize for any actions by MNA nurses which have limited your ability to provide safe patient care. If there are MNA nurses trespassing or otherwise hampering your ability to practice safely, I want to know about it IMMEDIATELY. I take this incredibly, incredibly seriously.
As far as nursing assistants and other staff… the word we have received is that NAs are working their tails off to keep the facility running. We have not heard of reports of ancillary staff not doing their job (quite the opposite, in fact), and we have most certainly NOT encouraged ancillary staff to not perform care to the utmost of their abilities. We truly, truly want the ancillary staff on the inside to be performing to the absolute best of their abilities because we know that at this point, they are the glue. If MNA had told, or even intimated, to ancillary staff that they should slack off and do as little as they could, I would personally resign my position on the spot. That is not what we stand for and that is not what we do.
Anonymous commenter– I wish I were able to get your contact info so we could talk. I hope you are able to take a look back at this and read my comment. If you do, please, please reach out to me as soon as you can– email@example.com, or (651) 202-0692. If you have specific examples of MNA nurses hindering care or evidence that anyone from MNA encouraged NA’s to not do their jobs, I want to know about it and I want to act on it IMMEDIATELY. Thank you.
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