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What Are Market Adjustments?

Now that we are in the heat of bargaining our next union contract we are faced with a major point of contention with St. Charles: a step system vs. market adjustments. In order to win our first contract we settled without something that is often a standard feature of union contracts, a “step and grade system” for wages that ensures transparency for annual wage increases based on years of experience. Management does not like this system and instead is proposing market adjustments, which allows them to make the decision for who will get raises and by how much.

A market adjustment is not, itself, a bad thing.. We often have market adjustments done in various bargaining units as a way of going beyond the step system to bring wages to match the increased costs of living in particular regions, inflation, or the needs of the market. A step system simply establishes the floor rather than the top for our wages, ensuring the minimum a worker will get paid for their position and experience. When workers have a step system in their contract it does not prohibit market adjustments on top of the set wages, which is exactly what, for example, the PeaceHealth techs recently won. They ended up with wage increases that, for some workers, hit nearly 40% because they received both market adjustments and a step increase.

But when a market adjustment becomes the only mechanism for getting raises, we are putting control entirely into the hands of St. Charles. They get to choose what those raises look like, which is generally how wages work across the non-union world and are part of why tech positions, including at St. Charles, make so much less than, for example, RNs, who have a long history of unionization and step scales. The market adjustments from the last contract worked out pretty well for some workers, less well for others, but we know that the only way to establish consistency and to move towards competitive wages for techs is to push for an established step system that will ensure that all of us know what wages we will get and the metrics for deciding them. Without that, we have to trust that St. Charles will do the right thing, year after year..

St. Charles’ current proposal is to not establish a step system at the start of our next contract—and they have even suggested that some workers, such as Surgical Techs and Radiation Therapy, should get no raises at all. This is unacceptable.We know from looking at hospitals around the country that without a step system, not only will we make less money by relying on market adjustments alone, but the staffing crisis is likely to accelerate because of it.  RNs currently have a downward trajectory for the use of travelers and rates of understaffing, while ours is only going up. They have a step system, while we do not.

We know how expensive it is to live in Bend, and high-level administrators, all of whom make far more than we do despite having no role in patient care, simply do not understand that fact because their high wages ensure they never have to struggle to make ends meet. It is understandable why these executives want to keep our wages down, their goal is to extract profit from our labor, while our goal is to create a sustainable future for our communities. Without establishing a step scale it is unclear how we will make progress towards living wages for the tech unit, and instead will have to rely on more promises from St. Charles. Over the past several years we have seen, very clearly, what St. Charles’ promises are worth.

But this is not a foregone conclusion. We know from our bargaining survey that a step system and dependably rising wages is a top priority. And that is why we intend to fight, both at the table and on the hospital floor, to take power back from management and to put it into the hands of the people who really matter: the healthcare professionals who save lives. We will be reaching out more and more to keep everyone up to date on what’s happening at the negotiating table and to demystify these debates, that way we can get on the same page. Our unity is where our strength lies.

So when St. Charles’ executives tell us that we don’t need a dependable wage system, it’s fair to ask why they think that. Is it because they always do what’s best for their workers, or is it because it’s in their interest to make us think they will. Corporate healthcare executives have built a career on making money on the backs of healthcare workers, especially those who risked everything during COVID-19 to defend our communities from a healthcare crisis. That is why, more than anything, we have to trust each other, the coworkers we depend on day in and day out.

Stability and predictability in our wage schedule is the only option for us to know how much we are going to make and to ensure that the promises are kept. Without that, there is little future for safe staffing or a stable care system for Central Oregon. 


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