South Central Federation of Labor President Kevin Gundlach addresses a rally in support of Group Health workers seeking union representation on Monday, Oct. 13. (Photo by Erik Gunn/Wisconsin Examiner)

On Oct. 13, Group Health Cooperative held what appeared to be its largest membership meeting in at least a decade. Scores of GHC patients filed into the Alliant Energy Center’s Exhibition Hall, packing the meeting room until there were no seats left. They voted unanimously to direct their cooperative to change course and voluntarily recognize GHC workers’ chosen union. 

This win was a long time coming for GHC workers like me. We are unionizing for many reasons. Personally, I started working as a family medicine physician at GHC 22 years ago, and was excited about working for a primary care-based, member-owned cooperative that valued clinical staff voices. But GHC has changed. Through my union involvement I’ve come to see that many of my coworkers also face struggles with high turnover and understaffing, unfair pay and discipline and racial inequities. These struggles collectively hurt our ability to provide excellent patient care.

By supporting each other and working together through a union, we can better advocate for ourselves and improve our ability to provide the best patient care. Our input as employees is not only useful, but critical, to making GHC the best it can be.

But since we announced our intention to unionize in December, GHC has waged a relentless union-busting campaign. Following the legal counsel of antiunion law firm Husch Blackwell, administrators have engaged in surveillance and other intimidation tactics, and even used union activity as a factor in discipline. Their actions are under investigation by the National Labor Relations Board. GHC has also consistently parroted legal arguments straight from the Trump administration’s attacks on workers’ rights. 

GHC’s most fundamental attack, however, has been on our ability to choose for ourselves what our union looks like. We are creating a union of providers and nursing staff in primary and urgent care and closely related units – basically, the generalists you first see when you get care – since we all share issues in common and would benefit from bargaining together.

But GHC administrators are seeking to forcibly add on workers in specialty care units like optometry and radiology who haven’t even sought collective bargaining. Why? They hope to dilute our Yes votes and make it impossible for us to win a union election. They like to claim that the National Labor Relations Board sides with them, and that these specialty care workers must join with us – but don’t believe it. While the NLRB has said that the employer’s version of our union was feasible, they also said they weren’t offering an opinion on the appropriateness of a primary and urgent care union. GHC is still free to recognize the union we chose. 

GHC has also been confused, or is misleading, about what it is we’re asking for. Speaking with Wisconsin Examiner’s Erik Gunn, GHC representative Marty Anderson said “voluntary recognition” wasn’t likely, because they’d want “an NLRB sanctioned and overseen vote.” But voluntary recognition is an NLRB-sanctioned process: all GHC needs to do is tell the NLRB that they recognize our chosen union, either with or without an NLRB-sanctioned card check or secret-ballot demonstration of majority support. That’s voluntary recognition. It would save everyone further time and expense, not to mention cultivate a positive relationship between both parties going forward. We look forward to a collaborative relationship with GHC as we move forward as a union. 

Attending the meeting on Oct. 13 and seeing the support from our patients and community was truly heartwarming. It reinforced my decision to become active in our union movement – both for ourselves and for the care that we provide to our dedicated patients. Excellent patient care is at the heart of our union movement.

And GHC patients have made it clear, with a unanimous vote, that they stand shoulder to shoulder with their caregivers. As a cooperative where members stand “at the top of the leadership chart,” GHC’s Board should respect membership’s vote by voluntarily recognizing our union, effective immediately. To do anything else is unthinkable in any cooperative that claims to be democratically run.

To show your support, please send an email to the GHC Board telling them to respect the will of the membership and recognize our union: https://act.seiu.org/a/ghc-board-1.

Nisha Rajagopalan, MD is a family medicine physician at GHC’s Hatchery Hill Clinic.

South Central Federation of Labor President Kevin Gundlach addresses a rally in support of Group Health workers seeking union representation on Monday, Oct. 13. (Photo by Erik Gunn/Wisconsin Examiner)

A stalemate between Group Health Cooperative of South Central Wisconsin and employees who have been seeking union representation for the last 10 months shows little sign of breaking soon.

At a mass meeting Monday at the Alliant Center in Madison, members of Group Health, sometimes called GHC for short, passed a motion directing the co-op to voluntarily recognize the union as the employees originally petitioned in December — covering three departments and a series of health care professionals.

The motion set a deadline of Friday, Oct. 17. Marty Anderson, Group Health’s chief strategy and business development officer, said Thursday that action on all the motions would likely be deferred, probably until November.

“We communicated clearly ahead of the meeting that all motions are advisory in nature,” Anderson said. “Any deadlines that would be in any of the motions would also be advisory in nature.”

Monday’s mass meeting was the first of its kind for Group Health members to ask questions of the co-op administration and express their opinions about the union drive. About 172 people attended, according to a Group Health spokesperson. Group Health has more than 50,000 Class A and Founding members — the two groups that were considered eligible to attend, according to the co-op.

In the spring, a volunteer committee met with the board to argue in favor of recognizing the union. 

People attending the Monday meeting described the crowd as strongly supportive of the union, and the voice votes in favor of recognizing the union and other motions favored by union supporters were unanimous, according to Service Employees International Union (SEIU) Wisconsin. 

Growing dissatisfaction 

At a rally outside the Alliant Center before the meeting, South Central Labor Federation President Kevin Gundlach, a Group Health member, charged that the co-op “has lost its way” in its response to the union organizing drive.

“We want GHC to listen to the workers,” Gundlach said. “And these workers know, and it says on my shirt here” — he pointed to his chest — “it’s better in a union.”

Group Health has rejected charges that it’s trying to thwart the union drive, contending that it simply wants health care employees in all departments to take part in the union representation vote — not just those from departments and job classifications that were included in the original union petition.

Union supporters say that claim is disingenuous and a ploy to “dilute the vote,” in the words of several workers interviewed — racking up votes against the union from employees in departments that don’t have the same concerns.

Anderson denied the charge. “We don’t know” what the votes will be, he said.

According to workers involved in the union drive, the Group Health union campaign grew out of increasing dissatisfaction in specific co-op departments with working conditions and what they contend was a lack of input into the co-op’s practices.

“I feel like we can improve the patient care that we provide through unionization and through increased involvement in decision-making,” Dr. Nisha Rajagopalan, a family physician who has worked at Group Health for 22 years, said Thursday.

Pay practices, employee turnover and a voice at the table are all reasons employees have cited for supporting the union.

“GHC leadership stopped collaborating with us and despite our many patient care concerns and our many meeting requests,” said Julie Vander Werff, a physician assistant, the lead speaker at the Monday rally.

Who should be in the union?

Complicating the organizing campaign is the conflict over exactly who among Group Health’s workers should be included in the union.

Union supporters involved in the organizing drive originally proposed that the union represent a bargaining unit of about 220 people. They were doctors, physician assistants, nurse practitioners and nursing staff in three departments: primary care, urgent care and dermatology. Their petition also included physical therapists, occupational therapists and health educators.

The petition was filed Dec. 12, 2024. Group Health filed a brief asserting that the unit the employees sought “was an inappropriate unit,” said Anderson, the Group Health executive.

To resolve the differences, a National Labor Relations Board staffer held a meeting on Dec. 30 in Madison, where he moved between separate rooms, one housing Group Health executives and the co-op’s lawyer, the other housing SEIU Wisconsin staff and Group Health employees leading the union drive.

The NLRB staffer suggested to the union group that they narrow their petition to a single clinic, Group Health employees wrote in a letter to the Group Health board of directors Feb. 10, 2025. Hoping to get an agreement, they took the suggestion.

Group Health opposed the single-clinic unit, however. In subsequent hearings the co-op management’s lawyer argued the vote should include all direct care employees, including in departments that weren’t part of the union’s original petition.

After reviewing briefs from both sides, the NLRB regional director in Minneapolis who heard the case ruled that the single clinic unit that the union had proposed would not be an appropriate bargaining unit. The decision issued by Regional Director Jennifer Hadsall stated that the unit proposed by the employer, Group Health, was appropriate and set an election among all the co-op’s health care employees.

SEIU Wisconsin, however, moved to block the election. A raft of pending unfair labor practice charges against the employer could scare employees from voting for the union, SEIU charged. Hadsall agreed to block the vote until the charges are resolved.  

As a result, the vote is on hold. The NLRB investigation of the charges is on hold as well, because of the federal government shutdown.

Shared concerns, conflicting concerns

In her order, Hadsall also included a footnote that states she did not address the unit that the employees had originally asked for because it had not been formally litigated.

“We had always argued that we are a clinically integrated organization,” Anderson said. “Our staff floats between various parts of the organization and different clinics. And the bargaining unit was established [consisting of] all of our clinical sites and all of our direct care employees.”

But pro-union employees say there are concrete differences between employees who are in the groups that they had originally included in the union petition and the rest of the Group Health staff — including direct care providers.

“Initially our bargaining unit included employees who were in primary care and urgent care,” said Rajagopalan, the family doctor. “We practice similarly and we share the same concerns. There are other departments within GHC that don’t share the same concerns [and] practice very differently than we do. That’s why our initial bargaining unit is an appropriate unit.”

Pat Raes, president of SEIU Wisconsin and a nurse at UnityPoint-Meriter hospital in Madison, said that throughout her health care career she’s seen many workplaces where only some groups of workers are unionized.

“At the bedside or at the side of the patient, it doesn’t make a difference because the priority is patient care,” Raes said. “It’s not whether you’re unionized or not.”

Addressing the rally before Monday night’s meeting, Steve Rankin said it was “entirely normal” for workers in a single workplace to be represented by different unions or no union depending on their department or position.

“There is no reason that everyone at Group Health has to be in the same union,” said Rankin, who joined Group Health when it was founded in 1976 and has been active in marshalling Group Health patients to support the union effort. “We call on GHC to recognize the bargaining unit chosen by the workers themselves and to commit to bargaining in good faith toward the contract.”

While the board has yet to consider the motion that was passed at Monday night’s meeting, Anderson said Thursday that voluntary recognition was unlikely. 

“We want an NLRB sanctioned and overseen vote,” he said. “That’s always going to be our criteria.”

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