Seachange Bulletin #122November 6, 2003Seachange Bulletin ArchivesEmail the editorSeachange Bulletin #122: IOM Call for Safe Staffing, Labor News Canton - Adding to mounting evidence that inadequate RN staffing in hospitals threatens patient safety, a report from the Institute of Medicine of the National Academies released today said, "The environment of nurses, the largest segment of the nation’s health care work force, needs to be substantially transformed to better protect patients from health care errors." The report calls for changes in how nurse staffing levels are established and for mandatory limits on nurses’ work hours as part of a comprehensive plan to reduce problems that threaten patients. In a statement, the blue ribbon panel said, "Despite the growing body of evidence that better nurse staff levels result in safer patient care, nurses in some health care facilities may be overburdened. For instance, some hospital nurses may be assigned up to 12 patients per shift." "There is a clear relationship between staffing levels and patient safety," said Donald M. Steinwachs of Johns Hopkins’s Bloomberg School of Public Health and chair of the Institute of Medicine committee. "This is what MNA long has been arguing," said Karen Higgins, president of the Massachusetts Nurses Association, which is promoting safe RN staffing legislation (H.1282) that would address many of the problems identified in the report. "I couldn’t have put it more clearly myself. Fatigue and overwork, brought on by understaffing, are causing errors in patient care." ... In addition to legislative support, the bill has garnered strong support from 64 health care and consumer advocacy groups that have joined forces with Bay State RNs to form the Coalition to Protect Massachusetts Patients, which will push for the urgently needed measure to safeguard hospital patients. Information about the Coalition and the safe staffing legislation can be found at <http://www.protectmasspatients.org>. Institute of Medicine Study Affirms Need for Safe RN Staffing as California Nears Implementation of Model Law California Nurses Association, November 4, 2003 <http://www.calnurses.org/cna/press/110403.html> The California Nurses Association today welcomed a new study released today by the Institute of Medicine, "Keeping Patients Safe: Transforming the Work Environment of Nurses," which, said CNA, reaffirms steps taken in California to protect patients, such as the landmark law, sponsored by the California Nurses Association, that requires all hospitals to be staffing with minimum numbers of RNs as of January 1, 2004. The IOM report states that better working conditions, including safe staffing and restrictions on forced overtime, are critical to patient safety. At a time when up to 98,000 patients die in hospitals every year as a result of medical errors, according to a 1998 report, the new IOM study cited research showing that nurses intercept 86% of medication errors. IOM officials called for improved conditions for nurses, and said state regulators should ban nursing staff from working more than 12 hours per day and 60 hours per week. "California has already taken a major step forward to saving patients' lives, enhancing the work environment for RNs, and reducing the tragedy of medical errors, with the RN staffing ratio law," said CNA President Deborah Burger, RN. ... Fed report: Nursing staff levels dangerously low Michael Lasalandra, Boston Herald, November 5, 2003 <http://www2.bostonherald.com/news/local_regional/nurs11052003.htm> Echoing what nurses in Massachusetts have been saying for years, a federal advisory report says hospitals and nursing homes nationwide are severely understaffed, threatening patient safety and contributing to errors that kill tens of thousands of hospitalized Americans each year. "We found strong evidence that linked staffing levels to patient safety," said Donald M. Steinwachs of Johns Hopkins University, who chaired the Institute of Medicine panel that prepared the report. The report by the panel that advises the federal government on medical matters concluded many nurses are overburdened, with some being assigned to care for as many as 12 patients per shift. The Massachusetts Nurses Association hailed the report, saying it validates their efforts to pass legislation mandating staffing ratios. "This is exactly what we're proposing," said Julie Pinkham, executive director. The MNA bill calls for no more than four patients per nurse on medical/surgical units. ... Medical panel seeks better working conditions for nurses Improvements would reduce errors, report says Maggie Fox, Reuters, November 5, 2003 <http://www.boston.com/dailyglobe2/309/nation/Medical_panel_seeks_better_worki ng_conditions_for_nurses+.shtml> Washington - Tired and grumpy nurses forget to wash their hands, give the wrong drugs to patients, and waste hours on paperwork, a panel of experts said in a report calling for shorter hours and better working conditions for the profession. The changes, including 12-hour limit on their workday, would reduce medical errors and make conditions better for nurses and patients alike, an Institute of Medicine panel said yesterday. ''We need to move ahead urgently with these recommendations,'' Donald Steinwachs, chair of the committee that wrote the report, told a news conference. ''The benefits go beyond saving lives,'' he added, saying that changes would make nurses less likely to quit or change jobs and would save money spent treating patients hurt by costly mistakes. Steinwachs is chairman of the department of health policy and management at Johns Hopkins University School of Public Health in Baltimore. ''No one or two actions by themselves can keep patients safe,'' Steinwachs added. ''Rather, creating work environments that reduce errors and increase patient safety will require fundamental changes in how nurses work, how they are deployed, and how the very culture of the organization understands and acts on safety.'' Karen Higgins, president of the Massachusetts Nurses Association, which is promoting safe registered nurse staffing legislation, said: ''I couldn't have put it more clearly myself. Fatigue and overwork, brought on by understaffing, are causing errors in patient care.'' ... Report Cites Danger in Long Nurses' Hours Robert Pear, The New York Times, November 5, 2003 <http://www.nytimes.com/2003/11/05/national/05NURS.html?ex=1069009675&ei=1&en= 18ca13de73f65cab> Washington - Many hospitals and nursing homes are endangering patients by allowing or requiring nurses to work more than 12 hours a day, the National Academy of Sciences said on Tuesday. Such long hours cause fatigue, reduce productivity and increase the risk that the nurses will make mistakes that harm patients, the academy said in a new report commissioned by the federal government. Donald M. Steinwachs, chairman of the health policy department at Johns Hopkins University, said fatigue was a "major cause of mistakes and errors" in hospitals and nursing homes. ... Public Support for Safe RN Staffing Legislation Grows Legislators’ Position on the Issue a Determining Factor for Voters at the Ballot Box Massachusetts Nurses Association, November 4, 2003 <http://www.massnurses.org/News/2003/11/ratios.htm> Canton - In the wake of the release last week of a report by the Department of Public Health (DPH) showing a 76 percent increase in the number of injuries and complaints by patients in Massachusetts hospitals, a strong majority of Massachusetts residents link the decline in quality of care to the issue of understaffing of registered nurses and inadequate RN-to-patient ratios, according to a recent omnibus statewide survey conducted by Opinion Dynamics Corporation (ODC) of Cambridge, Massachusetts. Most telling in the survey is the significant impact that the issue could have on voters at the ballot box. When asked if a candidate’s position on safe RN staffing legislation (House 1282) would have an impact on their vote at the ballot box, an overwhelming 60 percent of respondents said they would be "more likely" to vote for a candidate that supports the legislation. Forty-five percent of respondents say that they would be "much more likely" to support a candidate that favored the safe RN staffing legislation. The results of the October 2003 survey indicate that the public’s awareness and concern for patient safety and quality care rose significantly. Sixty percent of respondents say that they "agree strongly" that patients are suffering because they have to share their nurse with too many other patients as a result of inappropriate cost cutting. This is a jump from 49 percent last year. ... Safe Staffing Legislation Update Kate Anderson, Associate Director, Department of Government Affairs Massachusetts Nurses Association, November 4, 2003 First and foremost, a resounding thank you for everyone’s efforts towards passage of Safe Staffing legislation. Your phone calls, letters, and emails are making a significant impact towards moving our bill forward. While the Health Care Committee held an ‘Executive Session’ (a meeting in which bills are given a disposition) this morning, our Safe Staffing bill was not included. Please do not be alarmed or discouraged by this - the Committee will be meeting in Executive Session again before the holiday recess. To be successful in the legislative process you must have patience, persistence and perseverance. It takes multiple efforts to move a bill forward. To that end we ask that you contact your legislators with the following messages: If you have already called your state senator and state representative please call back with the following message: * I am a constituent and a registered nurse. I called before in support of H. 1282, the Safe RN Staffing bill. I am calling today to ask why the bill didn’t get a favorable vote out of the Health Care Committee at today’s (Wednesday) hearing? * The bill is co-sponsored by more than 100 legislators and 14 members of the health care committee. This bill is important to protect patient safety. * I would appreciate it if Rep./Senator __________________ would contact his/her colleagues on the Health Care Committee and urge them to release this bill with a favorable report. (If you have NOT called your state senator or state representative please call with the following message: I am registered nurse calling in support of H. 1282, the patient safety/safe RN staffing bill.) * I want to see this bill voted favorably by the health care committee before the fall session ends. Please be courteous and respectful, but firm in your position. Again, please do not be discouraged - your patience, persistence and perseverance will pay off! To be connected with your legislator’s office: House switchboard: 617.722.2000 Senate switchboard: 617.722.1455 To email your legislator on this issue go to www.massnurses.org. Click on the box in the upper right hand corner labeled "Write to your Legislators" and follow the prompts. You will be given a form letter that you can personalize, and with one click send to your state senator and state representative. If you do not know who your legislators are, go to <http://www.massnurses.org>, click on "Legislation & Government" on the menu on the left. Then click on "Find my legislators" on the menu on the right. If you have any questions, please call the MNA Department of Legislation and Government Affairs at 781.821.4625 x725 or reply to this email (please do not use the "reply to all" function). Thank you. Department of Public Health Report of 76% Increase in Hospital Injuries and Complaints Echoes View of Front Line Nurses Who Have Reported Similar Safety Problems in Massachusetts Hospitals Coalition of Health Care Advocates Point to Legislation to Regulate RN-to-Patient Ratios as Key to Improving Care and Preventing Errors and Injury to Patients Massachusetts Nurses Association, October 28, 2003 <http://www.massnurses.org/News/2003/10/dphreport.htm> Canton - A report released today by the Department of Public Health detailing a 76 percent increase in the number of hospital injuries, errors and patient complaints supports the experience of front-line registered nurses in Massachusetts, who have been reporting similar findings to state officials for a number of years. The incidents identified in the DPH report released today have been attributed to understaffing of registered nurses in a number of previous studies published in the nation’s most prestigious medical journals, including the Journal of the American Medical Association, the New England Journal of Medicine and in a landmark report on hospital patient safety by the Joint Commission on the Accreditation of Health Care Organizations. In June an independent study of registered nurses in Massachusetts found that poor RN-to-patient ratios are resulting in significant harm and even death for patients. According to the survey, 87 percent of nurses reported having too many patients to care for, with devastating results for patients ... Hospitals report increase in errors Leading causes: falls and surgical blunders Stephen Smith, Boston Globe, October 29, 2003 <http://www.boston.com/dailyglobe2/302/metro/Hospitals_report_increase_in_erro rs+.shtml> Mistakes reported by Massachusetts hospitals soared by 32 percent during the past three years, according to a sweeping review of medical errors released yesterday by the state Department of Public Health. In the latest period measured by state researchers, stretching from July 1, 2002, through June 30, hospitals reported 757 errors that resulted in injury to patients, including 65 deaths. That compares with 574 mistakes in 2000. Falls by patients that could have been prevented were the leading cause of injury, accounting for half of the incidents, but hospitals also reported operations being performed on the wrong limb or organ and episodes in which sponges or surgical tools were mistakenly left inside patients. Authors of the report and a hospital trade association said the increase in error reports reflects greater vigilance by medical centers in reporting their mistakes, rather than a true spike in errors. The Massachusetts Nurses Association disputed that account, contending that hospital workers are spread too thin to give quality care to patients who are increasingly sicker and older. ... Safe nurse staffing ratios is good for California's health Patients in Long Beach, San Pedro and the rest of California can soon rest assured that when they are admitted to a hospital, a registered nurse will be at their bedside to care for and advocate for them. Long Beach Press Telegram, October 11, 2003 By Jan. 1, all hospitals must be in compliance with the state law that mandates safe RN staffing ratios, the number of patients assigned to each nurse, for all hospital units in all California acute care facilities. Many hospitals, including Long Beach Memorial and San Pedro hospitals, have already hired hundreds of RNs to fill these ratios, and that is good for patients. But this has not always been the case. The California Nurses Association (CNA) sponsored this law to reverse the degradation of patient care conditions caused by years of managed care and corporate business practices that put hospital profits ahead of patient safety. As bedside nurses we were outraged to see the money the hospitals received in reimbursement from Medicare and other reimbursement sources squandered and misused to fund record executive compensation, numerous outside high paid consultants, failed computers systems, and other nonessential items while direct patient care was cut. RNs who work in these hospitals are required by law to be patient advocates. We could no longer sit back and allow patient care to be compromised and see lives lost. CNA, joined by RNs and patients across the state, campaigned for years to pass the safe staffing law in 1999 and it continues to have broad public support. A September poll found 77 percent of likely voters think strong standards are necessary to protect patients, including clear rules on safe nurse-to-patient ratios. Repeated studies have documented that there is a decrease in medical errors, complications, and patient mortality when staffing ratios are required by law and not subject to the whims of hospital administrators. The staffing ratio law will save thousands of patients' lives and will also save community hospitals money by improving patient outcomes, and cutting patient stays and re-admissions. Rather than continue efforts to overthrow the law, as proposed by several administrators in a Press-Telegram commentary (Sunday Forum, Oct. 5), the hospitals owe it to their patients to work with us for the benefit of our community. Hospital administrators' complaints that safe staffing is an unfunded mandate fail to meet the credibility test. California has approved more funding for nurse education and training programs than the federal government. The Davis Administration last year initiated a $60 million Nurse Workforce Initiative. One beneficiary, with the support of CNA, was Long Beach Memorial, which was awarded a $2.5 million grant to train ancillary workers to upgrade their skills to become RNs. CNA is also tackling the nursing shortage with programs to reverse a disastrous turnover of RNs from our hospitals, the worst in decades. CNA has negotiated professional wages, benefits and pension packages that, accompanied with new safe staffing standards, finally make nursing an attractive profession once again. Long Beach Memorial, which hosts nursing students in training from Long Beach City College, again provides a case study. In the class just prior to the landmark CNA contract at Memorial last year, only one City College student returned to Memorial as a staff RN. From the graduating class last summer, following our agreement, 175 RNs came to Memorial, of whom 100 were new nurses. Since these ratios have begun to be implemented, we are witnessing unprecedented increases in the number of people signing up for nursing school programs and reentering the profession they were forced out of by corporate greed. Retention also produces substantial savings for the hospitals. Hospitals spend about $42,000 to replace each general medical and surgical unit RN, and $64,000 to replace each specialty RN, according to one recent national study, and spend billions every year on temporary agencies, all expenses that will be reduced by assuring hospitals can keep their present workforce at the bedside. Public safety standards are not a new concept. We have ratios for airline pilots and daycare centers, and minimum regulations for clean air and water. Hospital patients deserve no less protection. With the help of the new staffing ratio law, our community has our promise that we will stand by our patients to ensure that their care is never compromised. Margie Keenan, RN, Long Beach Memorial Mary Bailey, RN, Long Beach Memorial Rise Barrows, RN, St. Mary Medical Center Ronnell Wilson, RN, St. Mary Medical Center Nancy Giallombardo, RN, Little Company of Mary-San Pedro Hospital Lora Smith, RN, Little Company of Mary-San Pedro Hospital Mixed reviews for patient-to-nurse Jeanne M. Rideout, Weymouth News, October 1, 2003 <http://www.townonline.com/weymouth/news/local_regional/wey_newwnjeansshnurseb ill10012003.htm> The plea for a new law mandating specific staffing levels for nurses continues amidst claims that the shortage of nurses is getting worse while patients are getting sicker. Representatives from more than 60 health care advocacy groups have joined the effort to pass a law requiring hospitals to staff a certain amount of nurses based on the type of care needed. The majority of hospital wards would require a 4 to 1 patient-to-nurse ratio; other areas with more acute care mandate a lower ratio. "The most important thing patients need to know when entering a hospital is how many other patients is the nurse caring for," Julie Pinkham, executive director of the Massachusetts Nurses Association, said at a Sept. 17 State House press conference. Current staff levels are not safe, she said. ... Labor News: Editorial Comment: The fundamental question of political science: Does power descend from above or rise from below? This same question applies to the trade union movement and other components of the labor and popular movements, as well as to kings and parliaments. A few months ago the draft of a strategic document put together under the auspices of five US international union leaders appeared. Much ink has been spilled over this paper, and even more in response to the leading critiques written in response to it. Here are two of the more widely circulated critiques. Future editions of Seachange Bulletin may carry more of this heated debate. - SE 'The Gang of Five' Union Leaders Plot Radical Takeover of AFL-CIO Harry Kelber, LaborTalk, September 17, 2003 <http://www.laboreducator.org/radplot.htm> A group of five international union presidents, who call themselves the New Unity Partnership, are going ahead with their plan for drastic changes in the organizing methods, structure and functions of the AFL-CIO, without any discussion of their initiative within the labor movement, or even with their own members. The five union leaders, who have banded together to promote their image of what the union movement should be, are: Andrew Stern, president of the Service Employees International Union; John Wilhelm, president of the Hotel Employees and Restaurant Employees (HERE); Bruce Raynor, president of UNITE; Terence O'Sullivan, president of the Laborers, and Douglas McCarron, president of the Brotherhood of Carpenters, whose union withdrew from the AFL-CIO in March 2001. The "unity" group excludes the AFL-CIO's other 59 international unions, takes away the authority of state federations and central labor councils and shows no regard for women, black and Hispanic labor leaders and their members. In an unpublicized, internal memo, the Partnership commits itself to a seven-point program that, it says, will restore labor's strength at the bargaining table and in the political arena. ... The New Unity Partnership: A Manifest Destiny for Labor Joann Wypijewski, CounterPunch, October 6, 2003 <http://www.counterpunch.org/jw10062003.html> Since unions are supposed to be organizations of workers, we at CounterPunch thought the members might like the opportunity to review a document cobbled up by five union presidents outlining big plans to spend the workers' money, consolidate their unions and revamp institutional labor - whether by breaking with the AFL-CIO or destroying it and remaking it in the image of this particular gang of five is not entirely clear. Members aren't likely to get this opportunity through any formal union channels. Published here with an assist from Carpenters for a Democratic Union, the draft program of the New Unity Partnership, or, less alluringly, NUP, is long on the language of management theory ("growth", "density", "market share") and short on such fuddy-duddy concepts as "class", "worker participation", "social movements" or "democracy". That is hardly unusual for union bureaucrats. The twist here is that the NUP project is trading on the progressive credentials of SEIU's Andy Stern, HERE's John Wilhelm, UNITE's Bruce Raynor and, to a lesser extent, the Laborers' Terry O'Sullivan to present itself as the vanguard of militant unionism, holding aloft the banner "Organize or Die!", a rather ugly slogan formulated by their rather ugly partner, the right-wing president of the Carpenters union, Doug McCarron. ... Editorial Comment: Working people, through their unions and other organizations, will not be marginalized or silenced when it comes to life-and-death questions, be it wars of aggression or health care as a right. Here’s a sampling of what’s going on. - SE AFL-CIO: We Will Not Be Closed-Mouth on US Foreign Policy Adopted by the San Francisco Labor Council on September 22, 2003 <http://www.sflaborcouncil.org/ContactUs.html> Whereas, the Bush Administration is spending a minimum of $4 billion per month for the occupation of Iraq and $1 billion per month for the occupation of Afghanistan; and Whereas, the Bush Administration has just requested an additional $87 billion from Congress for the occupation of Iraq; and Whereas, the AFL-CIO Executive Council is refusing to address the interconnection between US expenditures for a disastrous foreign policy and the closing of schools, healthcare clinics - i.e., the under-funding of all public services - to the detriment of the public and workers; and Whereas, the AFL-CIO Executive Council apparently made this decision based on the concept of "unity," forgetting that Labor participated in the great Civil Rights Movement and present defense and organization of immigrant workers, even though some sectors of Labor were hostile to these heroic efforts; and Whereas, the AFL-CIO has declared its intention to unseat Bush and educates workers about the enormous tax cuts for the rich, the millions of jobs going overseas, NAFTA, GATT, etc., it's failure to criticize the Bush Administration's reckless, militaristic empire-building is to ignore the huge fat elephant in our living room; and Whereas, leaders of the Iraqi Union of the Unemployed were recently arrested by the Occupation for demonstrating against staggering unemployment; and Whereas, no weapons of mass destruction have been found or will be found in Iraq, and our Occupation is obviously not what the Iraqi people want; Therefore Be It Resolved that the House of Labor opposes the foreign policy disasters led by the most right-wing president in memory; and Therefore Be It Finally Resolved that Labor raise its voice to demand an end to these illegal occupations, the return of our troops, and the relinquishing of US power to a United Nations mandate whose task it would be to return to Iraq and Afghanistan the sacred sovereignty that is the right of all nations. Respectfully submitted, Walter L. Johnson, Secretary Treasurer Solidarity Appeal Iraqi Federation of Trade Unions, October 6, 2003 <http://lnn.labourstart.org/more.php?id=56_0_1_0_M> Iraqi working people suffered terribly under Saddam's criminal dictatorship. It stopped workers from forming democratic trade unions, electing their own representatives and by forcing them to take part in his wars of aggression, which had led to the deaths of many hundreds of thousands of workers. In turn, this led to the collapse of social and economic structures and the ruination of thousands of Iraqi families. The Workers Democratic Trade Union Movement (WDTUM) established in 1980 played a significant role in opposing Saddam's bloody repression and killings, orchestrated by the state-run yellow unions, which were an agency of violence run by Saddam's secret police. Prior to the fall of the regime, the WDTUM contacted a number of leading trade unionists and called upon them to rebuild a new democratic trade union movement. After the fall of the regime, the WDTUM issued an appeal (10 may 2003) calling upon the Iraqi working people and on leading trade unionists "to unite and to speak with one voice so as to server Iraqi working people who are experiencing poverty, lack of security, and the complete stoppage in all of walk of life. The statement also called upon Iraqi true trade unionist to a meeting to discuss the formation of a national preparatory committee that carry the task of establishing proper base for a free and democratic trade unionism" ... Rising Health-Care Costs at Heart of Labor Strife Employers' attempts to reduce medical benefits roil Southland workers across industries. Nancy Cleeland & Marla Dickerson, Los Angeles Times, October 14, 2003 <http://www.latimes.com/business/la-fi-health14oct14,1,5310682.story?coll=la-h ome-headlines> When Southland supermarket workers went on strike Saturday, their main beef was an employer proposal to cut back their health plan. Mechanics with the Metropolitan Transportation Authority are upset over the same thing. And health benefits are key to the contract fight that has prompted a sickout by Los Angeles County Sheriff's deputies. Around Southern California and across the country, attempts by employers to curtail medical benefits have become the top issue in labor contract talks, setting off a wave of strikes and other job actions that are likely to escalate as health insurance costs continue to balloon. "It's at the core of every major contract struggle," said Kate Bronfenbrenner, director of Labor Education Research at Cornell University. "And it's going to be an issue until we see some national solutions." In fact, at least half the strikes in California this year have been staged over health benefits, according to Ken Jacobs, a researcher at the UC Berkeley Labor Center. He counted 11 such work stoppages in a four-month period this year in Northern California. They have affected the public and private sector, small and large employers, skilled and unskilled workers. At a Dodge dealership in Colma, 15 mechanics are walking the picket line to fight for their health benefits. In Southern and parts of Central California, 70,000 supermarket workers are doing the same.Those workers join wireless technicians, auto workers and other union members nationwide who have agreed to wage freezes and plant closings but draw the line at paying more for health insurance. ... A Watershed Strike Kelly Candaele & Peter Dreier, The Nation, October 23, 2003 <http://www.thenation.com/doc.mhtml?i=20031110&s=dreier> The strike of 70,000 Southern California retail food workers, which started on October 11, may be the first in a series of battles that could ultimately shape the future of labor-management relations throughout the United States. The United Food and Commercial Workers (UFCW), one of the nation's largest private-sector unions, has geared up for what could be a prolonged job action. "If they break our backs here," noted Sean Harrigan, UFCW States Council director, "they [employers] will view this as an opportunity to pillage UFCW members and their union contracts throughout the country. This is a real watershed." The last strike in the Los Angeles retail food industry occurred twenty-five years ago. The employers - Vons and Pavillions, Ralphs and Albertsons - want to slash the health and retirement benefits of their cashiers, baggers, deli clerks and other employees. The companies' representatives refused to discuss the details of their contract proposals, but according to UFCW Local 770, the grocery chains have demanded what amounts to a 50 percent reduction in workers' medical coverage, including increased prescription drug costs and cuts in retirement benefits. Additionally, the companies want to initiate a "second-class" wage system, with new hires doing the same work as current employees but for much lower pay. ... Keynote Address to National Labor Assembly for Peace Bill Fletcher, Jr., USLAW National Assembly, Chicago, October 25, 2003 <http://www.uslaboragainstwar.org/news/news.php?news_id=2004> Good morning. On behalf of TransAfrica Forum and United for Peace and Justice, I wish to thank you very much for inviting me to speak before this Assembly today. Let me pose two questions to you: when does silence become complicity? When does ignorance become culpability? These are two questions with which organized labor must today grapple because these two questions haunt our movement like an apparition in the night. The US trade union movement, as redefined and reorganized by Samuel Gompers in the late 19th century, made a choice. The choice was both ideological and strategic. It essentially came down to a definition of trade unionism as being a movement to protect jobs. Despite A. Philip Randolph’s aphorism to the effect that the essence of trade unionism is social uplift and further that trade unionism is the voice of the dispossessed, that simply has not been a consistent truth in the USA. The US trade union movement, overall, defined itself in relationship to US business and to the US political state. It accepted the notion that there was a commonality of interests that could be summarized in a particular, indeed, in a peculiar notion of patriotism. Don’t get me wrong. There were criticisms of US foreign policy that were offered by organized labor, but the US trade union movement did not, by and large, see itself as having a role as a central critic of US foreign policy. Nor did it place a premium on building solidarity with workers in other countries. Ironically, the fact of US unions being termed "Internationals" was the result of their expansion from the USA into Canada, and later an attempt to expand into the Caribbean, an expansion to accompany US imperial expansion. These unions, however, were not seen as a partnership with the workers of these countries, but seen as US-based initiatives. A further irony of this, and I mention it as an anecdote, is that the efforts by several US so-called Internationals to expand into Cuba - following the Spanish-American War - came to an end when the US-based unions could not determine who, definitively, were black workers vs. who were white. ... USLAW Dodges Bullets, Stays Course 200 Delegates and Observers Meet At Chicago Teamster City to Plan Strategy and Establish Ongoing Structure Bill Onasch, Labor Advocate Online, October 26, 2004 <http://www.kclabor.org/lap.htm> Last January, I was fortunate to attend what will prove to be a milestone in US labor history - the founding of US Labor Against the War. Not since the days of Gene Debs and Mother Jones had there been such substantial organized labor opposition to a war before it was even launched. This past weekend, October 24-25, I was privileged to be a delegate to USLAW’s second major gathering - the National Labor Assembly for Peace. In preparation for the event the organizers issued this brief history of USLAW’s accomplishments. It is worth reviewing. In the months preceding the invasion of Iraq, hundreds of local, state and national unions, central labor councils and other labor organizations took official positions opposing war on Iraq. This led to the founding, on January 11 in Chicago, of US Labor Against War (USLAW). By the time the invasion of Iraq was actually launched on March 20, labor organizations representing almost one-third of all organized workers in the US were on record opposed to the war. This laid a foundation for the unprecedented decision of the AFL-CIO to break with the Bush administration’s policies in Iraq. ... US Labor Against the War Kim Scipes, Z Magazine, October 28, 2003 <http://www.zmag.org/content/showarticle.cfm?SectionID=19&ItemID=4416> "Bring the troops home NOW" is not only the slogan of a growing portion of the US peace movement, but it now part of the ratified program of US Labor Against the War (USLAW). Meeting in Chicago this past weekend (October 24-25), 154 delegates representing approximately 500,000 trade union members from all over the country held the first National Assembly of USLAW, and established the organization. The purpose of the new organization is to force the AFL-CIO to address the US occupation of Iraq as well as the escalating war in the US against working people. The delegates specifically stated their recognition that people of color and women were those being most directly and extensively attacked. Bill Fletcher, Jr., Executive Director of TransAfrica Forum, gave the key note address to the delegates on Saturday morning. Setting the tone of the conference, Fletcher asked, "When does silence become complicity? When does ignorance become compliance?" And then he answered, "Silence and ignorance are no longer acceptable." USLAW grew out of frustration by a range of labor activists and leaders against Bush’s invasion of Iraq and the basic acquiescence by the AFL-CIO leadership. (In fairness to AFL-CIO President John Sweeney, he did co-author a letter to Bush and Tony Blair with British trade union leader John Monks in January 2003 advising the governmental leaders not to invade Iraq unilaterally, and to seek peaceful solutions before invasion. Sweeney has been rarely heard on Iraq since the invasion.) The AFL-CIO has consistently and continues to separate domestic developments from foreign affairs. ... Labor Party Challenges Presidential Candidates to Endorse Just Health Care Labor Party, November 3, 2003 <http://www.thelaborparty.org/a_releas.html> Washington - The Labor Party challenged today each of the major Presidential candidates to take an important step toward solving the nation's health care crisis by adopting, as a key component of their campaigns, the Labor Party's Just Health Care plan. In a letter to President George W. Bush and nine candidates for the Democratic Presidential nomination, the Labor Party outlined its call for national health insurance, demonstrated its innovative and equitable funding mechanism and challenged each candidate to endorse the program. "There is absolutely no excuse for any candidate to oppose Just Health Care. By eliminating administrative waste and profit, this country can afford to cover all its residents with quality health care from birth to death. We challenge the candidates to solve the health care crisis by pledging to implement Just Health Care," said Mark Dudzic, National Organizer of the Labor Party. The Labor Party is the nation's only political party with a comprehensive solution to the health care crisis that ensures coverage for all residents, raises revenues in an equitable fashion and provides a Just Transition for displaced health industry workers. By eliminating administrative waste and profit in the health care system, the United States can provide comprehensive health care coverage to every resident of the United States for the same total amount of money (an estimated $1.213 trillion for 1999) that we now spend. A briefing paper detailing the Just Health Care financing plan is available at <http://www.justhealthcare.org>. ... Editorial Comment: What’s really going on in Colombia? Drummond Watch Two Unionists, David Vergara and Seth Cure, disappeared on September 29, 2003. They were released on October 17. Thanks to all who participated in the action alert. <http://www.nomorevictims.org/drummondwatch> The International Labor Rights Fund (ILRF) and the United Steelworkers of America filed a suit against the Drummond Company, an Alabama-based mining corporation with facilities in La Loma, Colombia, on behalf of the families of slain workers and their labor union. The suit, filed in US District Court for the Northern District of Alabama on March 14, 2002, charges the company with hiring paramilitary gunmen to torture, kidnap and murder union leaders. ... 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