Opinion | The unlikely force strengthening health care, education and even marriage

If you needed surgery and could choose your hospital, what questions would you ask in deciding where to go? You’d surely ask about insurance coverage and maybe about the success rate with your type of procedure. If you have enough money, you might ask about a private room. One question, though, that almost no one thinks to ask: Is the staff unionized? That omission is a mistake.

Want to encourage people to get married? A study found that union membership does just that, because of members’ increased income, benefits and job stability.

Conservatives and corporations often paint a cartoonishly villainous picture of unions as greedily grabbing workers’ dues. This foolishness couldn’t be farther from the truth. Unions look out for their members, fighting for higher wages, better benefits and safer working conditions. They overwhelmingly deliver on those promises, including in the pandemic.

But what’s discussed less often is the positive effects of unions that extend far beyond their members, benefiting the general public in surprising and unexpected ways.

Want to improve health care? Astudy of California hospitals found that the risk of dying of a heart attack was 5.5 percent less in hospitals with unionized registered nurses. Another study compared patient outcomes at three sets of hospitals — those with successful, unsuccessful and no union drives — over a nine-year period. They found measurably better patient outcomes in the newly unionized workplaces in 12 of 13 categories potentially impacted by nursing care (urinary tract infections, hospital-acquired pneumonia or sepsis, wound infections and the like). Unions also fight for strict staffing ratios and higher wages, which can decrease adverse outcomes in nursing homes, including during the pandemic.

Want to boost voter registration and turnout? Turns out unions help with that, too.Studies have found that union members were significantly more likely to vote, in large part because unions develop members’ organizational and civic skills, shape members’ political identity and mobilize members politically. Another finding: Even nonmembers vote in higher numbers in places with high union density, which may be because of election-related union activities like phone-banking, door-to-door canvassing and get-out-the-vote drives. The impact is significant for people with less formal education: One analysis found that the probability of union members who didn’t complete high school voting was 11 percentage points higher than nonmembers’ probability.

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Want to fight racism and other inequities plaguing our country? One study discovered that union membership was associated with markedly lower levels of racial resentment among white workers. Research has found that unions reduce the race and gender pay gaps for members and increase intergenerational economic mobility; these results relate specifically to members, but even pockets of greater equity are surely better for society as a whole.

Want to encourage people to get married? A study found that union membership does just that, because of members’ increased income, benefits and job stability.

Want to support education? In recent years, teachers unions have fought for an agenda that also benefits their students. The massive “Red for Ed” teacher strikes in 2018 and 2019 included demands for more education funding and support staff and smaller class sizes. During the coronavirus pandemic, teachers unions have been seeking safer schools, which will help students and families while reducing community spread.

A number of other types of unions have also recently begun using this approach, known as “bargaining for the common good,” which means they press for outcomes that serve the broader community. The recent settlement between the NBA and the National Basketball Players Association is an example: Players negotiated for establishing committees to promote civic engagement and advocate for criminal justice reform, using arenas as voting locations and creating advertising spots to promote voting.

And when unions fight for laws that offer better workplace protections, they apply to all workers, not just their members. States with higher union density are far more likely to have wage requirements above the federal minimum, paid sick day mandates and paid family leave. Unions also have a “spillover” effect: When they’re sufficiently present in an industry, even workers at nonunion peer companies have better wages and benefits, since their employers have to compete with the higher union standards to attract workers. (The converse is also true.)

Workplace safety in particular has been driven by unions — notably the passage of the Occupational Safety and Health Act 50 years ago — and unions have continued to make work less dangerous ever since. Most recently, they’ve played a part in preventing the spread of COVID-19. Unions representing nurses and other health care workers have fought for personal protective equipment for their members, which protects patients and their families, too. Unions representing supermarket workers have fought for masks and hand sanitizer, which protect customers, as well. Unions also make it easier for employee whistleblowers to speak out about safety and health concerns, among other issues.

These improvements don’t have to come at the expense of the economy. Researchers have found that union membership has a positive “net fiscal impact” — meaning members use fewer public benefits and pay more taxes than comparable nonmembers.

Moreover, unions are one of the best weapons against the unsustainable metastasis of income inequality in our country because they allow workers to join together and bargain for a fairer share of the fruits of their labor. In fact, unions are key to ensuring that a middle class exists here, not just a small group of wealthy haves and a much larger group of struggling have-nots. Unions help to create a third group: the have-enoughs.

But our labor law has evolved in a way that makes it much too hard for workers to organize a union. Private-sector union membership is currently just over 6 percent, the lowest it’s been since the New Deal. Meanwhile, nearly 50 percent of nonunion workers surveyed said they would join a union if they could (up from about a third of workers in surveys from prior decades), and a recent Gallup Poll showed that 65 percent of Americans approve of labor unions. We need new laws to make it easier for workers to join unions, like the Protecting the Right to Organize Act of 2019 or the proposals for broad reform from the Harvard Law School Labor and Worklife Program’s Clean Slate for Worker Power project.

In the meantime, on this Labor Day of 2020, remember the full picture of what unions do. They serve their members, yes, but they bring many other benefits, and they’re essential for a healthy, thriving democracy for all of us.