Democratic presidential nominee Joe Biden “will be the most pro-union president since [Franklin Roosevelt],” Jill Biden said of her husband Monday during a teleconference sponsored by a nurses’ union. “He will govern with the understanding that health care is a right, not a privilege.”
The message from the former vice president’s wife may resonate in North Carolina, home to one of the largest union battles in the South. A battle that could signal rising unionization, and less employee freedom, statewide. HCA Healthcare, the nation’s largest hospital system, is fighting the National Nurses Organizing Committee, the country’s largest registered nurses union. The push to unionize 1,600 registered nurses at HCA-owned Mission Health will be decided Wednesday, Sept. 16, when the National Labor Relations Board counts the votes.
The union election will affect health care across western North Carolina. Mission Health controls a dominant 49.5% market share in 11 counties, according to Modern Healthcare. The system’s own consultant dubbed Mission Health “the only major producer of hospital services in Western North Carolina,” said an Urban Institute 2015 report on the system.
Both sides have pilloried each other for endangering patient safety. Anti-union nurses say strikes would leave patients to “suffer and struggle to survive.” Union organizers say that Mission Health failed to protect workers and patients from the coronavirus.
Unions make businesses less productive and more costly, says Russ Brown, who HCA hired to educate nurses against unionization.
“This is a California union, and they have brought a lot of problems with them,” Brown said. “Just like any other union, they want to make you think this about health care, safety measures for nurses during COVID. That’s not how they do business. … They’re there to collect dues and make money.”
Jill Biden promised to bolster unions in the health care industry. She never mentioned Mission Health by name, but during the event union advocates repeatedly blasted HCA Healthcare.
“Using our collective power is the only way we can win for these patients,” said Katie Dawson, representative of National Nurses United.
North Carolina, a right-to-work state, has the second-lowest unionization rate in the nation. Only 2.3% of workers were unionized in 2019, putting the state behind only South Carolina, according to the U.S. Department of Labor’s Bureau of Labor Statistics.
But with an election pending, union activity is heating up in North Carolina.
In K-12 schools, labor organizers are targeting the Opportunity Scholarship Program. Tamika Walker Kelly, the president of the N.C. Association of Educators, sued to overturn the Opportunity Scholarship Program as unconstitutional.
University employees filed a lawsuit against the UNC System, arguing workers risked COVID-19 exposure due to unsafe conditions. The N.C. Public Service Workers Union, UE local 150, also organized protests.
A union victory in Asheville could expand union activity in the South, experts say. HCA Healthcare controlled 184 hospitals and $51.3 billion in revenue in 2019. Only 37 of those hospitals had a union presence. HCA opposes unionizing Mission Health.
HCA has battled controversy after it bought Mission Health. Elected leaders criticized the hospital’s for surprise billing, falling patient safety grades, and “harrowing” complaints about its quality of care.
Mission Health has said it has hired more nurses, and denies many of the union’s allegations.
“North Carolina is a state that attracts businesses because they’re a state that is labor-friendly,” Brown said. “Big businesses can go in there without having to worry about third parties, unions, making the cost of doing business that much higher.”