Photo credit: Huck/ Konopacki Labor Cartoons

In the last several election cycles, it has become de rigueur for right-wing candidates to express their anger at teachers and their unions, blaming them for any and all ills of public education, and characterizing them as resistant to change. These attacks have metastasized: formerly the rhetoric of conservatives who one might expect to hate unions, “taking on” teachers unions has become a popular activity for a number of prominent Democrats. At a time when education reform and health care reform are at the center of our national policy agenda, it is curious that there is so much blame and animosity focused on teachers unions, while nursing and other health care unions continue their work relatively unmolested by mainstream politicians.

Nursing and other health care unions continue their work relatively unmolested by mainstream politicians.

Nursing, like teaching, is a female-dominated profession, requiring a similar level of education, and commanding, on average, higher wages than teaching. Nurses provide a public service, and operate within the much-maligned health care system, a system motivated by either too much or not enough of a profit motive, depending on one’s ideological perspective. Yet with the exception of California, where former governor Arnold Schwarzenegger launched a now-famous broadside against the California Nurses Association, [1]  nurses and their unions have not been the target of nearly as much venom as have teachers unions. Republican Governor Chris Christie of New Jersey referred to the teachers union as “political thugs.[2]

However, demonizing teachers unions is not only a sport of right-wing Republicans. Democratic stalwarts of the education reform movement include Arne Duncan, the Chicago Public Schools chief who became Obama’s education secretary; Chicago Mayor Rahm Emanuel and former Washington, D.C., Mayor Adrian Fenty and his schools chancellor, Michelle Rhee, who proved more adept at making enemies than at making change. Fenty, after being voted out of office, said,

the teachers unions are going to have to explain why when every tough decision is made to reform the school system they are at the lead in opposing it …If you are going to be at the front of the line in preventing reform, then I believe that the bad outweighs the good.[3]

So why have these attacks been so relentless, and why have nurses escaped them?

Several factors are important in answering these questions. Some are material, because the corporate search for new profits is central to the education reform agenda.  Others are institutional and structural. The material explanations suggest following the money to understand how and why those who demonize teachers are motivated by potential profit, and why this profit motive is absent in health care, where the private sector may have maximized its profits decades ago. In contrast, more   institutional explanations focus on the nature of the relation­ ship between  education  and health professionals and the populations  they  serve, while structural  explanations focus  on  the different, historically  determined  organizational  structures of education  and health care. While nursing and teaching are similar professions in many ways,  from  education  and  credentials  to employee  demographics, there  are  key differences in these organizations  that leave  educators particularly open to attack.

Follow the Money

The education  reform  agenda  has wrought  an unholy alliance  of liberals (or neoliberals)  and conservatives to push for “flexibility” and freedom-in curriculum, teacher salaries, and hiring and firing-in the name of measurable  student achievement.  But while some people might be motivated by a desire to achieve better educational outcomes, there is clearly more at stake. In fact, the demonization of teachers unions is only the most visible element of a well-financed attack on public education (including but not limited to its unions) by a broad and deep coalition of the wealthy. Thus,  like  their  Republican  counter­ parts, the Democratic champions of “education reform” are amply rewarded by conservative billionaires (such as the Walton family) to support new  policies  and  charter  schools  designed  to upend the status quo-and privatize public education.[4] The group Stand for Children contributes to the campaign funds of candidates from both major  parties  who  sign on  to  their  agenda  of “education   reform”  that  includes diminished teacher tenure and an emphasis on student testing.  A   similar   organization,   Democrats   for Education Reform, is dominated by veterans of finance  and  investment  banking, and supports Democratic   candidates   who  support   policies such as school choice (through charter schools and voucher programs) and holding teachers accountable for student test results. The campaign finance system allows these wealthy backers to support candidates who, once elected, will create more opportunities for their members  to profit. As one commentator put it,

why these corporate Democrats like Emanuel have it in for teachers when they comprise such an important bloc of the Democratic  Party’s base is a puzzle  that can only be solved if one takes a hard look at  the profiteers and privatizers  among their ranks.[5]

K-12 education has been sheltered within the public sector since its inception, which means there is a great deal of profit that could be extracted, if only the private sector were allowed access to some of this taxpayer money. Private profit can be extracted in a number  of ways, from  running charter  schools,  to building  new buildings, selling technology to school systems, and more. In Chicago, where the Illinois chapter of Stand for Children gave significant financial support to candidates in the 2012 elections, a massive round of school closings in 2013 was quickly followed by a request for proposals to open new charter schools, the exact policy that Stand for Children promotes, in the face of massive outrage from teachers and parents.[6]

The American Legislative Exchange Council is leading a wholesale campaign to privatize primary and secondary education.

In addition, the American Legislative Exchange Council (ALEC), which provides primarily state-level legislators with model legislation to further its conservative agenda, is now leading a wholesale  campaign to privatize primary and  secondary  education,  starting  at the state level. Its model legislation, enacted intact or  in  only  slightly  modified  form  in  several states, focuses  on diminishing teachers’ tenure protections  and  paving  the  way for vouchers and charter schools.[7]

While in both health care and education. ALEC’s focus is on privatization, especially pushing public expenditure toward private providers, its efforts to privatize health care do not include directly attacking  health  care  unions. Most health care is already provided by the private sector, even when funded by taxpayers in the form of Medicare and Medicaid, which are essentially the kinds of voucher programs  that ALEC would love to implement in education. Private profit is everywhere in the health care system in insurance  companies,  in  for-profit hospitals, and in private pharmaceutical companies and device makers. In contrast, health care simply has less scope for increased profit. Even publicly funded health care in the United States is marketized, with private providers competing in the Medicare and Medicaid marketplaces.

All (Education) Politics Is Local

The opportunity for profit, however, does not explain the appeal of education reform to voters, particularly at the local level. Also important is how schools are funded. Local citizens, whether or not they are public school parents or students, have a profound influence over  the running of their local schools, including their budgets.   In most   localities,   elected   school boards are responsible for running the school system, and across the  country,  schools  are funded primarily by local taxes. Ina handful of states, voters must pass the school budget each year (e.g., at Town Meetings in many New England states), and in many others, the school board must appeal  to  voters  to achieve  additional funding through special levies and bond issues.  Although   the practice varies widely from state to state, and even between municipalities, in many places school tax bills are separate from property tax bills. Education (unlike, say, roads or policing) is a separate line item on such tax bills. These homeowners are aware of exactly how much the local education system is costing him or her and may consider whether or not the local schools are providing good value for this taxpayer investment.

There is no easy way for an individual citizen to look at her “health tax bill” in the same way property owners see their “school tax bill.” In contrast  to education funding,  there  are  no health care line items on our tax bills. While a significant portion of the health care budget comes from federal and state taxation, it is not funded by local property  tax. Local voters do not have the chance to vote on any health care oversight boards. Rather, health care is overseen by a patchwork of regulators at the state and federal levels, with publicly funded health care primarily regulated by the federal Centers for Medicare and Medicaid Services, as well as by state-level   commissions.   Similarly,   as   most health care regulators are appointed rather than elected, these boards cannot be as quickly colonized by new ideologically  driven individuals, such as the Tea Party members who have won election  to  some  school  boards  (or  become vocal attenders of meetings when not on the boards)  and have  used  this  position  to  rail against  unions  and  school  spending.[8] Indeed, the  general notion of  “liberty” promoted  by these extreme  conservatives has gone  beyond lowering  taxes by cutting spending, to include undoing racial integration policies and modifying the curriculum. Local electoral control over school financing  and  policy  creates  a  strong bond between citizens and their local schools. There is simply no equivalent in health care.

A Long-Term Relationship

With regard to institutional and structural explanations, it is important to consider the relationship many parents maintain with their schools, one that can be fairly long term. In some places, children may attend a district’s schools for up to thirteen years, and families develop an ongoing relationship with teachers and administrators. In most neighborhoods and communities, students attend the same school for between three and six years, cementing an ongoing  relationship  with the teachers in this school. This relationship fosters a long-term investment, which creates an interest in improving the school. A parent may prioritize resolving a problem because his or her child will continue to attend this school, or one in the same district, which in turn creates a space for Parent-Teacher Associations. In contrast, patient interaction with the health care system tends to be sporadic. For most of the non-elderly population at least, visits to a doctor or hospital are only occasional, and only a tiny minority of the  population  has a daily  relationship  with  a provider, let alone one that spans 180 days per year for over a decade. An equivalent patient or patient-family association group for a hospital would necessitate  some sense that the relation­ ship with this hospital would be long term.

Parent-Teacher Associations are subject to political influence and co-optation, by state and national organizations, or by parents with an ideological agenda.

Once Parent-Teacher Associations exist as organizational structures, they are subject to political influence and co-optation, whether by state and national organizations, or by parents with an ideological agenda. As Paul Pierson, whose work on dismantling  the welfare state is well known, has shown, these interest groups become powerful and entrenched and shape the future of the very institutions  that spawn them through  a forceful  policy feedback  loop.[9] The intensity of the ongoing relationship of citizens to their schools distinguishes this relationship from the relationship  with their health care system; most Americans with school-age  children hope  their  children  will  continue  to  attend  a local school for the requisite number of years, while most of those who are in relatively good health hope their attendance at a hospital will be perfunctory and seldom repeated. Even when patients maintain a long-term relationship with a physician, there are no organized groups of patients of a particular doctor  or hospital  that are analogous to parent-teacher organizations.

The Blame Game

Another difference between schools and hospitals or clinics is essentially structural. Most teachers spend most of their time working alone, or with an aide. A school staff includes a team of educators, administrators, support workers, and other professionals (like counselors and social workers), just as a hospital or clinic staff includes a team of nurses, doctors, technical staff and support  workers. However, a teacher is often held solely responsible for the performance of students in her class, as shown in the push to tie teacher evaluations to student test scores. By contrast, the structure of health care means there is no situation where a patient would be under the sole care of an isolated doctor or nurse for an entire year. While doctors may be held legally liable for egregious errors, neither doctors nor nurses are held individually responsible for lackluster clinical outcomes–the clinic or hospital may be rated poorly but not the individual provider.

Teachers are wrongly perceived as fully empowered to make all educational decisions.

However, the supporters of education reform have made clear that teacher tenure is the problem, and tenured ”bad” teachers are the scourge of public schools. Reason, a libertarian magazine, published an illustration accompanying an angry  article  that  asked  “How Do  I Fire  an Incompetent Teacher,” which consists of a flow­ chart parodying  the concepts of just cause, due process, and progressive discipline for an imagined teacher  ”who  is so inept  that virtually  no other teacher, parent or student would object” to the firing.[10] The diagram presents the teacher as a free agent, rather than an employee whose performance and professional  development should   have  been  monitored   by  department heads, a principal, and other administrators, and whose work is routinely subject to accountability standards. Rather than portraying a teacher as a member of a team, the image of the individual teacher in the classroom has enabled the demonizers to hold teachers  solely responsible for the educational  attainment of their students, conveniently ignoring the importance of educational resources and environmental  and social factors that determine student success. So-called education reformers and the media never consider oversight of teachers by principals (or department heads) equivalent to the oversight of nurses by doctors and administrators  teachers are wrongly perceived as fully empowered to make all educational decisions.

It is also important to note the different histories  of  teaching  and nursing  as  professions, which have shaped the formation of their unions and  the  way  the  public  has perceived  them. Teaching has long  been a salaried  profession, with job protections  (and a tenure system)  in place for more than a century.[11] Nursing, how­ ever, was established  as a voluntary endeavor; many  of  the  earliest  nurses  were  nuns  who viewed  this  service  as  part  of  their  religious vocation,  rather  than a  form  of  conventional employment.[12] As such, teachers unions emerged early and protected their members as workers, while nurses unions often first had to convince their members that they needed the same protections as other employees, that they were not simply answering a higher calling to serve.

The California Nurses Association (and now National Nurses United) is an important exception and has skillfully straddled this line, emphasizing the professionalism and service of their members, while asserting that nurses need the same protections as other workers. This is in sharp contrast to some of their predecessor and rival unions (sometimes  ambiguously perceived to be professional associations or licensing organizations) that have frequently acquiesced  to management’s wishes  and have deemphasized collective bargaining.[13]

Union Structure and Strategy

The targeting of unionized teachers, but not unionized health care workers,  by ALEC  and others, is also illustrative of a number of organizational factors. Teachers are massively unionized, with three-quarters  of teachers unionized nationwide and density over 90 percent in many states where they have full collective  bargaining rights.[14] While nursing  union membership varies  dramatically  by  state  and  region,  that national  density figure is only around 20 percent.[15] In short,  nursing  unions  are  nowhere near as powerful as teachers unions; they do not (yet) have the national coverage  and the numbers to advocate for the whole massive profession.  In other words,  teachers  unions  are  a target because they are well resourced and powerful, as shown  in the 2012 Chicago  Teachers Union  strike.  In contrast, nurses unions are powerful in certain  locations, but  do not hold the national power or influence of the American Federation of Teachers and the National Education Association, presenting  a much less powerful threat to ALEC’s interests.

Nurses unions do not hold the national power or Influence of the American Federation of Teachers and the National Education Association.

The fact that nurses lack the same degree of union protection also means that nursing unions are  still  “organizing” unions  and  are  consequently putting much more effort into framing their issues, for example, by focusing on patient care to increase  strength. Teachers unions  are not  emphasizing new  organizing  of teachers, and their servicing mode tends to be a more protective mode, with a focus on existing members.[16] With so few legally organizable  non­members, teachers unions have for decades focused on bargaining  and serving their existing members. They have simply not needed to face outward. However, led by the forthright California Nurses Association (and now National Nurses United), over a dozen unions have  targeted  nurses  as a profession  ripe  for new organizing. Attracting new members in an industry  where  employers  are  spending  mil­ lions  if not billions  of dollars  to  keep unions out, the unions must present their most positive, publicly palatable  face. This means a focus on high-quality patient care and the role  a union can play in improving health care outcomes for everyone,  rather  than emphasizing  the  more quotidian elements of union work, like bargaining  and  grievance  administration. The difference between the strategic orientation of teaching unions and nursing unions is the difference between organizing and servicing, or between protecting one’s ground and making forward progress. Over the past several decades, teachers unions have only had to preach to the choir, while nurses unions have been trying to recruit a larger and larger choir.[17] In addition, strikes by teachers have occurred periodically for years, in some cases drawing widespread public  anger,[18] while  historically, nursing strikes have been quite rare.

The combination of materially, institution­ ally, and structurally driven factors-including historically determined union strategies-means that education, still mostly sheltered from private profit, is primed for attack. The wealthy interests driving these attacks are well aware that unions are not used to honing their message for the general public, and that other interest groups, like school boards and parent-teacher organizations, tend to be controlled by a small number of people and are fairly easy to co-opt. While teachers unions should not be blamed for being under siege, they can still learn from the organizing strategies of nurses unions, focusing on a broadly relevant message that resonates with the public as well as with their members. It is notable that when the Chicago Teachers Union acted as a social movement union, utilizing many of the standard practices of nursing unions, it emerged victorious and with broad public support.

Rebecca Kolins Givan is an assistant  professor in the Department of Labor Studies and Employment Relations at Rutgers University.

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NOTES

[1] Upon  taking  office, Governor  Schwarzenegger suspended mandatory minimum nurse-patient ratios, a law that the California Nurses Association had fought for, for over a decade. The CNA began to  protest  Schwarzenegger  at all  of his public appearances, causing him to refer to the nurses as “special interests.” For more, see Mark Brenner, “California Nurses Lead the Fight against Arnold Schwarzenegger’s  Anti-union Ballot Measures,” Labor Notes, February  18,  2006,  http://www. labomotes.org/2006/02/califomia-nurses-lead­ fight-against-arnold-schwarzeneggers-anti-union­ ballot-measures
[2] Alexander   Mooney,   ”Christie  Takes  Aim  at Union   ‘Thugs,'”  CNN.com, April   7,  2011, http://politicalticker.blogs.cnn.com/2011/04/07I christie-takes-aim-at-union-thugs/
[3] Mike  DeBonis, “Fenty  Says Education  Reform Cost Him  Re-election,” The Washington Post, October 7, 2010, http://voices.washingtonpost. com/debonis/2010110/fenty_presses_education­ reform.html.
[4] Kenzo  Shibata,    ”The    Battle    of    Chicago Teachers Union  vs. Out-of-Town  Billionaires,” Huffington Post, August 22, 2012, http:// www.huffingtonpost.com/kenzo-shibata/ the-battle-of-chicago-tea_b_1812729.html; Joanne Barkan, “Got Dough? How Billionaires Rule   Our Schools,” Dissent  (Winter 2011), http://www.dissentmagazine.org/article/ got-dough-how-billionaires-rule-our-schools
[5] Joseph A. Palermo,  “Chicago Teachers  Union vs.  Mayor   Rahm Emanuel   (The  Democrats’ Scott Walker?),” The Huffington Post blog, September  11, 2012, available  at www.huffing­ tonpost.com/joseph-a-palermo/chicago-teach­ ers-strike-democrats_b_1875598.html
[6] Linda   Lutton,  “Stand   for  Children-Endorsed Candidates Sweep Elections,”WBEZ.01g, March 22,2012, available at http://www.wbez.org/story/ stand-children-endorsed-candidates-sweep-elec­ tions-97524; Linda Lutton, “Just Months after Closing  50  Schools,  Chicago  Issues  RFP  for More Charter Schools,” WBEZ.org, August 13, 2013, available at www.wbez.org/news/educa­ tionljust-months-after-closing-50-schools-chi­ cago-issues-rfp-more-charter-schools-108398.
[7] For much more detail on American  Legislative Exchange  Council’s objectives and model legislation  in education,  see ALEC Exposed, Privatizing Public Education, Higher Ed Policy, and Teachers (Madison:  Center  for Media and Democracy, 2012), available at www.alecex­posed.org/wiki/Privatizing_Public_Education,_ Higher_Ed_policy,_and_Teachers.
[8] Jennifer  Levitz, “Tea  Party  Heads  to School,” Wall Street Journal, April 26, 2011, http:// online.wsj.com/news/articles/SB10001424052748704336504576259543303853376.
[9] Paul     Pierson,     Dismantling     the     Welfare State? Reagan, Thatcher and the Politics of Retrenchment (Cambridge, UK: Cambridge University Press, 1995).See also ”Three Worlds of Welfare State Research,” Comparative Political Studies 33, no. 6–7 (September 2000):791–821.
[10] John  Stossel,  “How  Do I Fire an  Incompetent Teacher?”  Reason.com (October  2006), http:// reason.com/assetsldb/12639308918768.pdf
[11] Patricia  L. Marshall,  Debra  V. Baucom,  and Allison L. Webb, “Do You Have Tenure, and Do You Really  Want It?” The Clearing House 11, no. 5 (May-June 1998):302-304.
[12] Sioban  Nelson,  Say Little, Do Much: Nurses, Nuns, and Hospitals in the Nineteenth Century (Philadelphia:  University   of  Pennsylvania Press, 2001).
[13] The Association for Union  Democracy, “Three Major   Nurses   Unions   Unite   in  AFL-CIO,” Union Democracy Review #177 (Brooklyn, NY: Association for Union Democracy, January­ February 2009), available at http://www. uniondemocracy.com/UDR/183-Three_major_nurses_unions_unite_in_AFLCIO.htm
[14] U.S. Department of Education: National Center for  Education  Statistics  (2007-8),  Schookand Staffing Survey (SASS), available at htlp:/lnces. ed.gov/surveys/sass/tables/sass0708_043_tls.asp
[15] Barry T. Hirsch   and  David  A. MacPherson, “Union Membership and Coverage Database from the Current Population Survey,”Industrial and Labor Relations Review 56, no. 2 (January 2003): 349–54.
[16] Edmund   Heery, Melanie Simms, Dave Simpson,  Rick  Delbridge,  and  John  Salmon, “Organizing  Unionism  Comes   to  the   UK,” Employee Relations 22, no. 1 (2000): 38-57.
[17] An important exception is the Chicago Teachers Union,   which   behaved   like   an  organizing, social movement  union in mobilizing for its successful  strike. See Tom Alter, “‘It Felt Like Community’: Social  Movement Unionism  and the Chicago Teachers Union Strike of 2012,” Labor 10, no. 3 (2013): 11-25.
[18] See, for example,  the history of the Pittsburgh teachers’ strike of 1975. Jon Shelton, “Against the  Public: The  Pittsburgh  Teachers  Strike  of 1975-1976 and the Crisis of the Labor-Liberal Coalition,” Labor 10, no. 2 (2013): 55–75.