History has an uncanny way of repeating itself, but not always in ways we expect. The existence of the Roman Empire has been used as a metaphor for many years. “Nero fiddled while Rome burned” is based on the fact that the unpopular and decadent emperor did little while 70% of the city burned in 64 A.D., leaving more than half the population homeless. To distract the public from his disregard for the disaster’s impact, he scapegoated the Christians for the fire—who were summarily arrested and executed. He subsequently built his Golden Palace and gardens in land cleared by the fires.

Scientists today point to a similar phenomenon: some of the most powerful “empires” — including our own current administration — who are influenced (and financed) by fossil fuel magnates also “fiddle” while our planet burns, building their own modern-day fiefdoms. The role of climate change in the devastating effects of (formerly “natural”) disasters is undeniable (in spite of the few “climate deniers” who stand to gain huge profits from the coal and petroleum industries).

Transitioning to sustainable energy forms would create more jobs, safer jobs, for those displaced from coal mines and oil fields. Similarly, transforming our health care system into one that provides universal access to all — dramatically weakening, even eliminating, health industry predators: Insurance, Big Pharma and For-Profit Facilities — would necessitate the creation of many productive jobs (more staff to care for patients) for those displaced from these industries. But this would only be possible if the public controlled both energy and health care and demanded that displaced employees be trained and supported for the transition.

Budget cuts, economic woes, and the proliferation of low paying jobs and the new “precarious sector,” have replaced “good jobs” (with pensions, benefits, family supports). This is not the fault of immigrants, marginalized communities or “greedy unions.” These changes in our society’s social fabric are the result of the extraordinary redistribution of wealth that occurred in this country over decades:

•    CEO salaries jumped 940% from 1978 to 2018.
•    The average worker’s salary increased by only 11.9% in that same time period.
•    50 years ago, a US CEO earned 20 times as much as the typical worker.
•    Today, the CEO earns 354 times as much.
•    Share of wealth in the US, 2016: top 1% =39%; top 10%=77%; bottom 90%=23%.
•    This is also reflected in the dramatic shift in the tax bracket for the super-wealthy which dropped from 91% in 1955 to 37% in 2019.

Income inequality in all other developed countries pales in comparison. Inequity in the US looks more like Rome in Nero’s time, than it looks like Denmark or Japan.

Northwell, Montefiore and Mount Sinai are the top three private employers in NYS. Among the top 20 private employers in NY, eight are health systems (empires) including: NY Presbyterian, NYU Langone, Memorial, Cornell and Rochester Med. The top 10 by region include: Finger Lakes: Carestream, Rochester; Hudson Valley: Crystal Run & Nyack (Montefiore), Orange County Regional; Capital Region: Albany Med, Ellis, St. Pete’s; Southern Tier: Arnot Ogden, Lourdes, United Health Services; Central: Crouse, Loretto Health, St. Joseph’s; Western: BlueCross BlueShield, Kaleida, Mercy; Mohawk Valley: A.O. Fox, Bassett, Faxton-St. Luke’s, St. Elizabeth, St. Mary’s; North Country: Canton-Potsdam, Claxton-Hepburn, CVPH, Samaritan.

In 2016, 120 hospital executives and MDs in these Health Care “Empires” were paid at least $1 million with additional bonuses up 13% over only two years. A chunk of that money goes to support candidates, along with their Corporate PACS and Lobbyists.

What does this mean to us as Nurses? We can’t compete financially with these corporate billionaires and enterprises. What we do have are our numbers — and the moral high ground. We are the voice of the disadvantaged, the disabled, the disenfranchised, the underserved, the marginalized, the homeless and the uninsured. We raise our voices against the Death Spiral of draconian Medicaid cuts, decreases in mental health beds and services, hospital closures, bed reductions, and mergers and acquisitions focused on the bottom line rather than the needs of patients. All of these cuts result in staffing reductions rather than the ratios and improvements we have fought for over the years.

Our power to foment positive change is only limited by our own dearth of imagination, willingness to fight, and level of organization. We remain the most respected profession in the country. We thus have a responsibility to fulfill the public’s trust with action. Getting involved in the union is just the beginning.

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