THE DIRECTION OF LABOUR‐MANAGEMENT RELATIONS IN THE UNITED STATES HEALTH SECTOR
| Author | Frank H. Cassell |
| Date | 01 March 1976 |
| Published date | 01 March 1976 |
| DOI | http://doi.org/10.1111/j.1467-8543.1976.tb00033.x |
British Journal
of
Industrial Relations
Vol.
XIV
No.
1
THE DIRECTION OF LABOUR-MANAGEMENT RELATIONS IN THE
UNITED STATES HEALTH SECTOR
FRANK
H.
CASSELL*
FORTY
years ago passage of the Wagner Act’ ushered in a new era in labour
management relations in the United States. Employers bitterly fought passage of
the Act itself, challenged its constitutionality after it became law and lost the
challenge.2 With reluctance employers came to terms with the right of employees
to organise into unions and bargain collectively through representatives of their
own choosing. With passage of time, unions and managements came to varying
degrees of accommodation ranging from arm’s-length dealing or containment to
cooperation. Union membership grew and unions prospered. The Wagner Act
was the high-water mark of favourable labour legislation.
Unions, though politically powerful, were unable to prevent passage of the
Taft-Hartley Act of
19473
and the Landrum-Griffin Act of
1959:
both
of
which
were designed to limit the power of unions. Union membership growth in the in-
dustrial sector levelled out and, in the some areas, actually declined.
In retrospect, the greatest impact of unions
in
the forty years since the Wagner
Act may well have been to alter the character of American management and the
relationships between workers and managers
in
the work place, though impact on
wages and politics has not been inconsequential.
In
the public sector, and more particularly the health services areas, history may
be repeating itself. Many of the elements
of
the Wagner Act, Taft-Hartley and its
amendments, especially the right to bargain collectively, have recently
(1 962
and
1969)
been incorporated into Federal Executive Orders
10988
and
11491,
which
affect Federal Government employees. Even more recently (July
1974)
Congress
voted to extend the National Labor Relations Board’s authority to include private,
not-for-profit hospitals.
The Wagner Act was enacted in times of great economic and social change.
Extension of the jurisdiction of the National Labor Relations Board to include the
health industry likewise comes in times of turbulence and change.
Perhaps the most important of these changes is a national commitment to fd-
fil
most,
if
not all, of the nation’s rising demand for health care. The magnitude of
this increase in demand for health services is reflected
in
the growth of personal
health care expenditures which rose seven times from
$10.9
billion
in
1950
to
$76
billion in
1972.
This was fuelled by an even more rapid growth
of
payments
by third parties (thirteen times) and by government (twelve times).s
As
a percen-
tage of G.N.P., health expenditures increased from
4.4
to
7.7
per cent.6
These financial commitments, especially their rapid rate of growth have gener-
ated a widespread demand that the health industry increase its productivity and
control its costs.
The health industry in response has begun to adapt modem management
methods to the industry.
This
development in turn has generated organisational
stresses which
in
many cases have strained labour-management relationships. We
are seeing the industrialisation
of
the health industry.
This
occurs a century and a
quarter after industrialisation of industry began in the United States.
The fact that management and workers
in
industry are
still
working out accom-
modations to each other and to industrialisation
is
a reminder of the magnitude of
Professor
of
Industrial
Relations, Graduate
School
of Management, Northwestern University,
1R
Evanston,
Illinois.
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