Don Miller has got a beef with his bosses. Sure, he enjoys his job as an emergency-room nurse at Swedish Medical Center. And, as a gay man, he particularly loves his company's comprehensive fairness policy, which bars discrimination on the basis of "race, color, age, sex, marital status, sexual orientation, religious belief, national origin, ancestry, political affiliation, ability to speak English or disability."

It's just that in one respect, he doesn't believe Swedish Health Services--one of Seattle's biggest health-care providers, with multiple campuses and around 7,000 employees--lives up to its own ethical standard. Despite earlier promises from management, and in sharp distinction to other area hospitals, Swedish has refused to implement domestic partner benefits for its gay, lesbian, and single employees in stable family relationships.

Miller is not alone in being upset. Rebecca Duke, a family-practice physician at Swedish, says she was distressed when she was unable to cover her lesbian partner, another Swedish physician, who took six months off to have a baby. And Bruce McIntosh, also gay and a technician at Swedish/Providence, says it's simply a question of principle. In his view, Swedish has a moral obligation to offer the benefits to employees, especially given the company's earlier commitments.

In early 2000, Swedish management was locked in contract negotiations with two of Swedish's unions--SEIU Local 1199NW, which represents the company's nurses, and SEIU Local 6, covering other employees. When the unions raised the issue of domestic partner benefits, management negotiators said they were already examining the issue and intended to implement changes in the fall to bring Swedish into line with prevailing community standards. With that promise, the unions believed they had a good faith deal in place, states Dale Hitsman, an 1199 official.

"They told us they would implement domestic partner benefits on their own if that was the trend," Hitsman says, "so we didn't see the need to negotiate it further."

Instead, after the unions ratified new multi-year contracts, Swedish decided not to implement the benefits, citing cost concerns. In response, the nurses' union formed a committee of concerned employees, including Miller, which worked until June 2002 compiling information in the hopes of proving that other local companies already offered the benefits without excessive costs.

The committee found that many other major health-care providers in the area--Group Health Cooperative, Valley Medical Center, Fred Hutchinson Cancer Research Center, Virginia Mason, Evergreen Hospital, Harborview Medical Center, UW Medical Center, and Seattle Mental Health--offer domestic partner benefits. As do more than 100 other Washington companies, most of which added the benefits in recent years.

Moreover, for most of those companies, anywhere from less than one percent to five percent of their employees took advantage of the benefits, with the average falling between two and three percent. "We knew cost was a concern, but it turns out to be pretty minimal," Hitsman contends, adding that many companies offering benefits don't track affected employees because their numbers are so low.

Presented with the data, Swedish human resources vice president Rena Irwin said she was impressed by the committee's evidence, and said she would recommend the company implement the policy, Miller says. Nonetheless, despite Irwin's support, in September CEO Richard Peterson again ruled Swedish would not offer the benefits. "He admitted Swedish is behind the times, but said it was a financial decision," Miller recalls.

When asked about the issue, Swedish says the company expects a $10 million increase in employee health-care costs in 2003, even without domestic partner benefits. "We are still planning to add that benefit at some point, but this just wasn't the year to make it happen," explains Mike Shay, Swedish's director of compensation and benefits.

Still, Hitsman counters that "Valley has no more money than Swedish, and they switched." Valley Medical voluntarily introduced such benefits last January; as of June, only 12 of Valley's 2,200 employees had signed up, Hitsman's data shows.

Barbara Frye, director of labor programs for the Washington State Nurses Association, agrees cost concerns are a red herring: "I don't believe that the question is money--it's ignorance." She believes that, given the severe nationwide shortage of nurses, not offering such benefits will compound negative trends in recruitment and retention.

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