A militant union leader as well as a registered nurse with many years in direct patient care, Costello serves as co-chair of the Labor Party's Interim National Council. The CNA leader pointed out that management attacks on nurses' working conditions are also an assault on patients. Due to HMO and Medicare rules, she said, hospitals make money through quick discharges or by not admitting patients. The hospitals' drive for profits has led to a re-engineering of patient care, Costello said. They unilaterally redefined the skill level needed to perform complex care and substituted cheaper workers while increasing the number of patients that RNs were responsible for.
Nurses face speed-up, which brings the constant worry of error.
So we're gradually becoming very united in our insecurity. The CNA was forced to fight an 18-month war with the Kaiser health care group to defeat massive wage and benefit takeaways, a war the nurses' union won through a public campaign and a series of brief strikes, Costello said. A ballot question initiated by CNA helped shift the terms of the debate, Costello suggested. The legislation would have taxed health care profits and put the money back into the public health system and outlawed certain compensation arrangements that cause HMOs and physicians to deny care. Great fortunes are being made through health industry mergers while nurses are downsized, doctors told how to practice and patients denied care, Costello said.