The tragedy surrounding UnitedHealthcare has brought renewed focus on cost barriers within the health care system.

A group of Minnesota unions said a nonconfrontational but organized front paid off in recent talks to limit cost hikes for members.

This fall, unionized state workers in northwest Minnesota, who receive care through Essentia, were notified the provider would increase out-of-pocket expenses Jan. 1. In a tiered system, they would move from Level Two to Level Three.

Amanda Stegmaier, information technologist at Minnesota State University-Moorhead, said she was caught off guard, noting the change could have boosted co-pays by roughly $30 per visit.

"I was personally looking at supplemental health insurance," Stegmaier explained. "What could I do to stay at a lower cost level, because being a single mom and one-income household, there's only so much money that goes around."

Stegmaier, a member of the Minnesota Association of Professional Employees, urged colleagues to contact Essentia about the situation. Regional members of other unions like the American Federation of State, County and Municipal Employees did too, and the coalition convinced the provider to keep the cost hike temporary. It goes back to Level Two March 1. Stegmaier acknowledged the issue will likely resurface a year from now but a strong unified message can have an effect.

State employees have the benefit of union negotiators but those involved said voices working together, no matter where their insurance comes from, and can reasonably articulate the plight of health consumers might be able to turn some heads.

Adam Kamp, business agent for the Minnesota Association of Professional Employees, feels it is a key strategy in the current landscape.

"Health care's becoming increasingly corporate, we're seeing more mergers, more buyouts," Kamp observed. "In that instance, it took peaceful, collective action in order to pressure the provider to do the right thing."

Stegmaier stressed keeping costs in check is important in her part of the state, because it allows members to keep going to the clinics that work best for them.

"Good health care in this area is hard to come by," Stegmaier emphasized. "When you find your care team that you're happy with, you wanna stick with them."

Michigan's tipped wage system is on the brink of extinction, with changes set to take effect next month after a state Supreme Court ruling last year mandated higher wages for tip-reliant workers.

The ruling will eliminate tipped wages below minimum wage and raise the state's minimum wage to more than $12 per hour.

Justin Winslow, president and CEO of the Michigan Restaurant and Lodging Association, said the almost 250% increase in the wages of tipped workers would be catastrophic and he said it is happening at the worst possible time, as inflation hits his industry more than others.

"You add that difficult environment to this new policy and you have the recipe for the loss of 60,000 restaurant jobs in Michigan and the closure of one in five full-service sit-down restaurants in Michigan," Winslow contended. "When I say catastrophic I think that's what we mean."

Supporters of the change argued it ensures fair pay and reduces income instability for tipped employees, who can face unpredictable earnings. Tipped wages are set to be phased out Feb. 21.

Winslow pointed out servers are currently earning around $30 an hour, with some making even more, all while enjoying flexible schedules. He emphasized roughly 80% of workers want to preserve the current system. On a positive note, Winslow noted bipartisan efforts are in motion, with similar bills from both parties set to be discussed in a hearing today, to protect tipped wages.

"The new House leadership seems to be making it a real priority to try to get something done in advance of February 21st, so we'll be front and center there making sure they understand and hear from the voices of impacted restaurant workers and restaurant owners."

The Michigan Restaurant and Lodging Association warned as many as 60,000 jobs could be in jeopardy if businesses are required to eliminate tipped wages.


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The faculty of a New York City music school is planning to strike after contract negotiations stalled.

The Manhattan School of Music's Precollege program faculty union has been negotiating a contract since June, and said it has been a protracted effort. The union wants a pay increase aligning with other schools such as Julliard and the Mannes School of Music.

Adam Kent, president of the union, said the school's low pay affects teachers' ability to work.

"There are, as the fall semester is ending, several teachers who are leaving altogether," Kent pointed out. "There are a number of teachers I speak to who tell me they used to teach 10-hour-long days, now they're down to a single student who will take lessons with them at their home instead of at the school."

While the school has said there's not enough money for the pay raise, tax filing data showed the school's president and executives received large pay increases in recent years. Other data noted the school's tuition has risen 58% since 2014.

In a statement, the school challenged many of the union's accusations about why negotiations have taken so long. While the union has been around for a decade, Kent emphasized contract negotiations have always been hard-fought battles.

The union has made concessions regarding the pay increase but Kent feels the school must do its part so the two parties can reach an equitable agreement. When negotiations began, union members gave the school the benefit of the doubt, adding the sentiment changed after reviewing the school's financial data.

"It's clear there's no reason they can't afford to pay us fairly," Kent asserted. "They've never made a claim of an inability to afford these raises at bargaining. Their response has been, 'We just don't have to.' They don't take us seriously. They feel why should we start paying more money for the same work we've had up until now."

Kent pointed out the pay raise is sought to match the cost of living in New York City. The union also wants to keep class sizes at reasonable levels and ensure teachers can easily access remote learning tools when needed through the next contract. A Change.org petition from the union has garnered close to 2,000 signatures.


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Labor analysts say doctors have jumped to the front of the line of healthcare workers forming unions while others in the medical field continue to show interest, including nurses at a hospital in the North Dakota region.

Nurses at the CHI St. Francis Health Breckenridge hospital along the border with Minnesota now have a collective bargaining unit.

Connie Okeson, a registered nurse at the hospital, said she hopes voting to form a union allows her team to illustrate staffing issues. She emphasized they have to fight to make health facilities in smaller towns and cities desirable places to work.

"A lot of new nurses, they're not interested in working in small towns because we don't have all the things they want to do in a hospital," Okeson pointed out. "It's more low-key. But I'm hoping by doing this that we can bring those ancillary services back. And then, maybe more nurses will want to work at St. Francis."

CHI leaders could not be reached for comment. Since coming out of the pandemic, labor organizing in health care has gained a bigger following. Nurses were among those leading the charge, but the Journal of the American Medical Association said the movement has caught on with physicians. Doctors led nearly 30 union drives the past two years, well above yearly averages the past two decades.

St. Francis Breckenridge is a 25-bed critical access hospital serving a handful of communities. Corporate consolidation remains a force within health care and Okeson noted nurses want to be part of the wave giving workers at not-so-big facilities a bigger voice.

"I'm hoping it opens it up for (workers at) other small hospitals to do the same," Okeson stressed.

She added having more input can improve patient care, aiding the reputation of small-town hospitals and making sure they stay on as a key employer for these communities. Negotiations involving her colleagues are expected to begin within the next six to eight weeks.