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By Bob Peterson / Rethinking Schools

long history of being staff-dominated.

And it has. In New Orleans, following Katrina, unionized teachers were fired and the entire system charterized.

But it recognizes that our future depends on redefining unionism from a narrow trade union model, focused almost exclusively on protecting union members, to a broader vision that sees the future of unionized workers tied directly to the interests of the entire working class and the communities, particularly communities of color, in which we live and work.

It requires confronting racist attitudes and past practices that have marginalized people of color both inside and outside unions.

Having decimated labor law and defunded public education, Walker proceeded to expand statewide the private school voucher program that has wreaked havoc on Milwaukee, and enacted one of the nation’s most generous income tax deductions for private school tuition.

For nearly a decade we pushed for a full-time release president, a proposal resisted by most professional staff.

“Social Justice Unionism: A Working Draft”

Social justice unionism is an organizing model that calls for a radical boost in internal union democracy and increased member participation.

business model that is so dependent on staff providing services

building union power at the school level in alliance with parents, community groups, and other social movements.

The importance of parent/community alliances was downplayed

instead of helping members organize to solve their own problems.

Our challenge in Milwaukee was to transform a staff-dominated, business/service-style teachers’ union into something quite different.

only saw the union newsletter after the staff had sent it to the printer.

Key elements of our local’s “reimagine” campaign and our subsequent work include:

Building strong ties and coalitions with parent, community, and civic organizations,

broader issues

action.

earliest victories was securing an extra $5/hour (after the first hour) for educational assistants when they “cover” a teacher’s classroom.

lobby

enlist parents

we amended the constitution

consistently promoting culturally responsive, social justice teaching.

encourage members to lead our work.

release two teachers to be organizers

appear en masse at school board meetings

to shift certain powers from the staff to the elected leadership

new teacher orientation and mentoring are available and of high quality.

The strength of the Chicago Teachers Union (CTU) 2012 strike,

rested in large part on their members’ connections to parent and community groups

Karen Lewis

Portland, Oregon, and St. Paul, Minnesota

In Milwaukee, our main coalition work has been building Schools and Communities United,

We wanted to move past reacting, being on the defensive, and appearing to be only against things.

Key to the coalition’s renewal was the development of a 32-page booklet, Fulfill the Promise: The Schools and Communities Our Children Deserve.

concerns of the broader community beyond the schoolhouse door

English and Spanish

Currently the coalition’s three committees focus on fighting school privatization, promoting community schools, and supporting progressive legislation.

schools as hubs for social and health support,

This work reminds me of the words of activist/musician Bernice Johnson Reagon, of Sweet Honey in the Rock: “If you are in a coalition and you are comfortable, that coalition is not broad enough.”

Our new professional staff is committed to a broader vision of unionism with an emphasis on organizing.

We need to become the “go-to” organizations in our communities on issues ranging from teacher development to anti-racist education to quality assessments.

nonprofit organization, the Milwaukee Center for Teaching, Learning, and Public Education

We provide professional development and services to our members

reclaim our classrooms and our profession.

We partner with the MPS administration through labor/management committees

multiple committee meetings, inservice trainings, book circles (for college credit), and individual help sessions on professional development plans or licensure issues.

we offered workshops that drew 150 teachers at a time.

More teachers were convinced to join our union, too, because our teaching and learning services are only open to members.

mandate 45 minutes of uninterrupted play in 4- and 5-year-old kindergarten classes

We also won a staggered start

convincing the school board to systematically expand bilingual education programs throughout the district.

school-based canvassing around issues and pro-education candidates, and organizing to remove ineffective principals.

With the plethora of federal and state mandates and the datatization of our culture,

It’s clear to me that what is necessary is a national movement led by activists at the local, state, and national levels within the AFT and NEA—in alliance with parents, students, and community groups—to take back our classrooms and our profession.

social justice content in our curriculum

waiting to use any perceived or real weakness in public schools as an excuse to accelerate their school privatization schemes,

On the other hand, speaking out can play into the hands of the privatizers as they seek to expand privately run charters

including participation on labor/management committees, lobbying school board members, and balancing mass mobilizations with the threat of mass mobilizations.

In the end, we recognize a key element in fighting privatization is to improve our public schools.

In Los Angeles, an activist caucus, Union Power, won leadership of the United Teachers Los Angeles, the second largest teacher local in the country.

Trade in Services Agreement (TISA) This agreement is being negotiated on the sidelines of the World Trade Organization by a group of 23 governments representing 50 countries, including Canada, the United States, the European Union, Australia, Mexico and South Korea.

reforms to national public health systems to promote 'offshoring' of health care services. .

Trans Pacific Partnership (TPP) This free trade zone of twelve countries including Canada, the United States and Japan, would encompass about 40 per cent of the world's economy. It is believed that the negotiations for this deal could be concluded as early as next month.

medicines in both the United States and abroad.

Transatlantic Trade and Investment Partnership (TTIP) The United States and the European Union have just completed their eighth round of talks for this agreement.

intellectual property rights that would prolong monopolies on pharmaceuticals and reduce access to affordable and lifesaving generic medicines.

"deinstitutionalization," resulted in the virtual emptying, and subsequent closure, of many psychiatric facilities across the country (Can J Psychiatry 2012;57[2]:Insert 1-6).

The comprehensive community support systems that were meant to sustain deinstitutionalization never fully materialized.

In 1959, the nation had 65 000 beds in mental health facilities (Can J Psychiatry 2012;57[2]:Insert 1-6). Today, there are just 10 653 beds (www.who.int/mental_health/evidence/atlas/profiles/can_mh_profile.pdf).

But transinstitutionalization isn’t the sole factor at play in the disproportionate incarceration of the mentally ill, several experts say. They point to Prime Minister Stephen Harper’s "get tough on crime agenda" as also having had a substantial impact on the numbers of incarcerated.

As a corollary, the conditions of confinement essentially increase the rate of mental illness

Has a doctor   85.1% Heavy drinkers          17.9% High blood pressure 17.7% Overweight or obese adults 54.0% Overweight or obese youth (12-17)          23.1% Physically active (leisure time)       53.7%

In 2014, roughly 3.4 million Canadians aged 12 and older (11.2 per cent) reported that they did not receive health care when they felt they needed it. Overall, females (12.4 per cent) were more likely than males (10 per cent) to have reported an unmet health-care need. Among age groups, unmet health-care needs were lowest for those aged 12 to 19 and those aged 65 or older, and were highest for those aged 20 to 54. Source: Health Canada

Top 10 Causes of Death in Canada (2012) Ischaemic heart disease       13.8% Alzheimer’s and other dementias   9.5% Trachea, bronchus, lung cancers     8.1% Stroke             5.4% Chronic obstructive pulmonary disease     4.5% Colon and rectum cancers   3.7% Diabetes mellitus      2.7% Lower respiratory infections           2.3%

Breast cancer             2.2% Falls    1.9% Source: World Health Organization International Comparison of Health Spending  Canada           OECD Average           Canada’s OECD Ranking Total Health expenditure as a percentage of GDP            10.2    8.9       10/34 Total Health expenditure per capita           $4,351            $3,453            10/34

Public expenditure on health per capita   $3,074            $2,535            13/34 Public share of total health expenditure   70.60%          72.70%          22/34 Hospital expenditure per capita     $1,338            $1,316            15/29 Physician expenditure per capita   $720   $421   27-Apr Drug Expenditure per capita          $761   $517   2/31 Source: OECD Health Statistics 2015           

Stealth privatization of health care makes accountability worse As a result of increased contracting out, home care has seen more low and inconsistent wages among workers, as well as declining quality and availability of care. In a response to the Ministry of Health’s 2016 Patients First discussion paper, OPSEU/NUPGE indicated that there is a dire need for increased funding to hospitals and Local Health Integrated Networks (LHINS) that have not seen an increase in funding in more than 4 years, as well as a need for health care to stay public to ensure transparency and accountability.

This historic Charter Challenge case will be heard in the Saskatchewan Court of Queen's Bench from November 14 - 25th, 2011.

In those cases, the new standard would also require one washroom per inpatient.

Dr. Michael Gardam, director of infection prevention and control at the University Health Network

“There’s more than enough evidence to support 100% single rooms for hospital patients,”

There is evidence … and I don’t think you need the randomized controlled trial to prove that. Frankly, it’s kind of common sense.”

studies indicating there are overwhelming benefits of single-bedded rooms on patient outcomes

The advantages included reduced medical errors, fewer falls as well as improved patient confidentiality, privacy, sleep quality, doctor-patient communication and the ability to accommodate family members (see Table 1).

Editor’s note: First of a three part series. Part II: Private rooms: The fiscal advantage Part III: Evidence-based design in hospitals

Health care organizations are increasingly asked to reduce costs, lower wait times

Value Stream Mapping (VSM)

Signatories to the letter include Hamish Meldrum, chairman of the British Medical Association, Brendan Barber, general secretary of the Trades Union Congress, and representatives of the British Red Cross and leading health insurers.

The current coalition government is expected to produce a white paper on social care by April in response to recommendations from the independent Dilnot commission into the funding of care and support, published in July 2011 (BMJ 2011;343:d4261, doi:10.1136/bmj.d4261).

Andrew Dilnot, an economist, recommended a new partnership model under which people would pay up to a maximum £35 000 (€42 000; $55 000) towards the cost of their care and be eligible for full state support beyond that.

He has since said that the country’s economic woes should not be an excuse for inaction and argued that it was “nonsense” for anyone to suggest that reform would be too expensive to implement (BMJ 2011;343:d7689, 28 Nov, doi:10.1136/bmj.d7689).

One early indicator is the resurrection of the house call.

Now, there is a mass of mobile app developers swarming to revitalize this home-based care model. Pager, for example, is the brainchild of sharing economy pioneer and Uber co-founder Oscar Salazar. It markets itself as allowing users to see a doctor within two hours in the patient’s home, office, or hotel room. Companies like @mendathome, @HealApp, @medicast, and firstlineapp.com deliver similar services and are creating access and price competition.

In 2014, Uber delivered free nurse-administered flu shots to customers in Boston, New York, and Washington. Another company is seeking to enable hospitals to easily rent-out their bulky and unused medical equipment or, conversely, temporality access specialized equipment quickly and without the sizeable expense of purchasing.

allows for the home to become the site of much more care.

Sharing economy models of diagnostics are emerging both for clinicians and for their patients.  Figure1 is a Toronto mobile health start-up and peer to peer network that has created an “Instagram for doctors”, allowing medical professionals to seek input on complex cases by posting relevant images and information. And well established websites like CureTogether.com and PatientsLikeMe.com have fostered a peer coaching culture that lets patients share stories of treatment regimes and generate real-time research networks.

More recently, @Crowdmed has launched a crowd-sourced diagnostic service that uses “medical detectives” to better characterize rare and complex conditions.

How long will it take before hospitals start leveraging their idle operating room and facility hours to generate revenues and improve the timeliness and quality of procedures (AirOR)? We can already request a personal support worker or registered nurse through start-up services like eAdvocate and myPSW. We should expect established providers to emulate these start-ups, just as the traditional taxicab companies have started to emulate Uber. CCACs, for example, may use sharing economy-like services to match patient needs with clinicians and patient support workers.

As decentralization takes hold and more care moves from institutions and medical offices into the home, how will we deal with our overbuilt capacity? 

Can we trust clinical professionals to self-organize within their scopes of practice?

Will Falk is the Managing Partner – Health Industries at PwC Canada, an Executive Fellow at the Mowat Centre and an Adjunct Professor at the Rotman School of Management at the University of Toronto. Follow Will on Twitter @willfalk

Since the President’s State of the Union message where he announced his plan to push corporate trade agreements and seek Fast Track trade promotion authority, the movement against Fast Track, the Trans-Pacific Partnership (TPP) and globalized trade has grown. Instead of the bump in support that Obama expected after the State of the Union,opposition has increased inside Congress and in the grass roots.

Home-care work is a perfect example of a field where unions have not been the norm, but where the mothers and grandmothers who made a living caring for others decided to use their voices to demand the ability to make enough money to care for themselves too. 

Sarita Gupta is the Executive Director of Jobs With Justice and the Co-Director of Caring Across Generations.