With God on our Side: The Struggle for Workers’ Rights in a Catholic Hospital by Adam D. Reich (review)

This is an engaging book written by a former doctoral student and onetime volunteer organizer for the Service Employees International Union (seiu). Reich, now an assistant professor at Columbia, is also the son of Robert Reich, former Secretary of Labor in Bill Clinton’s cabinet and a progressive labour economist. For a year and a half the younger Reich joined the multi-year struggle (2004–2010) to organize Catholic Santa Rosa Memorial Hospital in northern California into the seiu, a campaign that at first failed because of a strong “antiunion campaign led by management and backed by the hospital’s religious leadership.” (2) In addition, management was able to appeal to workers’ commitment to an ethic of caring in their jobs. Although a progressive order of nuns ran the hospital (and a dozen others in California, Texas, and New Mexico) on a not-for-profit basis, Reich paints a portrait of major conflict between the hospital and the union, each of which claimed moral authority. While the nuns played more managerial roles when lay nurses and health care workers were brought into the hospital and market values prevailed, the ideal of feminine self-sacrifice associated with nursing generally and with Catholic values in particular remained an important context. This case study illustrates the struggle between very different cultural views and values where unions are characterized as the opposite of altruism, as mainly interested in economic and political issues, and thus as enemies of Catholic values and teachings. Since Catholic hospitals are major players in the American health care system representing 15 per cent of hospital care in 2009, this is a significant tale filled with twists and turns over the course of the early 21st century.

In this short space it is impossible to relate all the developments of the two campaigns to unionize; though it failed, the first organizing drive of 2005–09 was followed by a significant and largely successful effort to create a powerful religious and political coalition that later supported unionization. Grassroots organizers realized that they needed to create a vision for healthcare that connected workers and their communities and that had the power to challenge the hospital’s moral authority. However as the workers’ struggle matured and inroads were made with community and hospital leaders, seiu support collapsed in January 2009 in the face of an intensified struggle with the local, the United Healthcare Workers West, which championed union democracy and criticized the international’s centralized model of union building. The seiu realized it was not going to be able to implement a centralized, all-encompassing strategy to achieve a nation-wide settlement with Catholic hospitals in the US and it thus abandoned the campaign and put the local into receivership, thus forcing the withdrawal of the application to unionize Santa Rosa Memorial Hospital.

What changed? Reich gives much of the credit to two prominent Catholic activists who developed strong ties with community and religious leaders, as well as aiding workers to tell their stories in such a way as to motivate all to get a fair agreement. Strategic allies became an important force in making the newly minted National Union of Healthcare Workers’ drive a success in 2010. Reich points to several factors that turned the tide. The length of the campaign helped to institutionalize the idea of forming a union while the cultural strategy, centred on the experiences of the workers themselves, helped to get concessions. Community support of the workers signalled an important shift in how the union was viewed – no longer was a vote for the union seen as a vote against the hospital or as an attack on altruism. Reich argues throughout the book that unions need to understand and act on cultural as well as economic and political values. Engaging with workers means recognition of the emotional investments in their work with patients. The moral authority of the hospital has to be...