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Editorial: Final Victory
Barre-Montpelier Times Argus, June 3, 1998

   Congratulations to Copley Hospital and the nurses union for settling their divisive month-long strike. Now that the picket lines have dissolved, both the nurses and the administrators can get back to the really important task: caring for patients.

   As in all adversarial proceedings such as strikes, it's tempting to spend time assessing who won and who lost. Both sides at Copley can claim a victory of sorts, since neither got all it wanted, The nurses in particular should feel good about having acquired greater certainty about their working hours and greater security about maintaining their areas of specialization.

   But the Copley strike has never been just about Copley. What might the strike and its settlement augur about the fate of other Vermont hospitals?

   Small hospitals such as Copley will always be especially sensitive to market pressures. Unless they keep their costs down, they may have to cut staff or eliminate the kinds of specialized services th at everyone wants in a local hospital.

   And that's not the worst that could happen. Hospitals that can't negotiate the financial shoals don't just disappear. In the modern merger crazed economy, they get swallowed up by bigger entities, often jeopardizing the community spirit that made them so prized by the people who depended upon them.

   It was fortunate for the Morrisville community that the Copley strike was settled before any of these things happened. But what about the state's largest hospitals? What does the Copley strike have to say about their future?

   Union drives at Rutland Regional Medical Center and Fletcher Allen Health Care will undoubtedly take heart from the perceived victory of Copley nurses. But it's critical to remember that the biggest obstacle to improved patient care isn't insensitive hospital administrators. It's rather a managed care system that forces those administrators to worry about things other than their patients.

   Perhaps hospital administrators could try to involve staff more fully in making the important decisions. The difference between the approach at Rutland Regional Medical Center, where staff members participated in planning personnel cuts, and that at Fletcher Allen Health Care, where expensive consultants decided where the hatchet would fall, suggests that management can either help or hinder needed reform.

   But hospitals, no matter what their size, simply cannot ignore the pressures that managed care exerts upon them. When faced with union demands for higher wages and greater job security, hospital administrators are correct to say that controlling costs and maintaining flexibility are both crucial to long-term survival.

   Until America faces its unresolved conflict over with the managed care system, the kind of dispute that flared at Copley will recur at other health care institutions, both in Vermont and elsewhere. If Copley nurses look at the resolution of their strike as a victory for patient care, it's clearly not the final victory.