Thread by @matthewstoller

1. Yesterday I wrote up a labor revolt at CVS and Walgreens by pharmacists and technicians. And what I found has some partial answers as to why Democrats are getting crushed by voters even as workers get more militant. mattstoller.substack.com/p/pizzaisnotwo…

2. The problem most people face at work is not 1930s-style Pinkerton hostility, but these guys, the management consulting Bob's. It's alienation from the distant corporate masters who control the workplace.

3. And that's a *direct* result of corporate power and size. Pharmacies used to be locally owned and small. Here's a Salt Lake City directory of pharmacies from 1955. Note they are almost all independently owned, with one small chain.

4. Compare that to CVS, which now touches a third of Americans. Since the 1980s, CVS and Walgreens took over. Here's a list of recent CVS mergers. And it also owns a giant insurance company - Aetna - as well as a middleman for medicine - Caremark - along with thousands of stores.

5. The worker stories coming out of the chain pharmacy world are awful. No bathroom breaks. No time for meals. Unforgiving corporate metrics like demerits for taking too long to answer the phone or fill prescriptions. mattstoller.substack.com/p/pizzaisnotwo…

6. All of this has caused deep concern within the profession. “I am a danger to the public working for CVS,” one pharmacist wrote in an anonymous letter to the Texas State Board of Pharmacy in April. nytimes.com/2020/01/31/hea…

7. The key organizer of this rebellion is an Ivory Coast immigrant who lives in Oklahoma City named Bled Marchall Tanoe (@BledTanoe). She started a campaign called #PizzaIsNotEnough. mattstoller.substack.com/p/pizzaisnotwo…

8. "At the beginning of the pandemic, there was a team spirit, they were called heroes and fed “pizza and coke.” These staff shortages ultimately led to “emotional breakdown, heart attack, migraines, kidney infections and everything that stem from stress,” as well as suicides.

9. The idea that buying pizza for pharmacists, instead of staffing appropriately so they could help and not harm their patients, gradually became an insult.

https://twitter.com/PharmacyPodcast/status/1455706782735687681

10. The anger is raw.

"Working for CVS for 1 month will take 1 year off your life. I only lasted for ~8 months at that crap hole of a corporation.”

"I was at a Walgreens on Friday and a pharmacist started crying cause she was so stressed."

Etc....

11. Interestingly, Tanoe and lots of chain pharmacists actually really like other possible employers - the independent pharmacists, because they see them as patient driven. But the independents also have a boss, which is... CVS.

12. You see, CVS owns Caremark, which sets the terms and reimbursement rates for pharmacies. It sets the revenue for its competitors. Yes this is crazy. But it also means that chain pharmacy employees and independents are aligned. mattstoller.substack.com/p/pizzaisnotwo…

13. Now pharmacists are extremely angry at the chains. They are trolling CVS executives on Twitter.

14. And with the worker shortage, they know they have power. Here's a list of signing bonuses offered in Arkansas. But few want the work, because it is so stressful to be unable to actually do the job well.

15. The problem is of course pervasive throughout the economy, especially in health care. Not just retain pharmacists and pharmacy techs, but nurses and dialysis workers have had it. mattstoller.substack.com/p/pizzaisnotwo…

16. Still, this is where it gets political. Or rather, not political. You see, politics almost never comes up, because few see any relationships between their goals and either party. mattstoller.substack.com/p/pizzaisnotwo…

17. The fundamental driver of the problem for both independent pharmacists and chain pharmacists is the Wall Street driven philosophy of shareholder value. And no one has cleanly broken from that. That's why these guys are buying workers pizza. mattstoller.substack.com/p/pizzaisnotwo…

18. And while pharmacists talk about breaking up CVS and implementing patient centered care, there is still leeriness about organized labor. “Can we trust those in charge of the union?” Tanoe told me. mattstoller.substack.com/p/pizzaisnotwo…

20. Until there's a political connection to the anger that people who work for living feel - both independent businesspeople and employees - the frustration won't translate into political force. mattstoller.substack.com/p/pizzaisnotwo…

21. And that is why, with the American people seeing organized labor more favorably than they have since 1965, the Democrats are losing and the Republicans aren't engaging. mattstoller.substack.com/p/pizzaisnotwo…

22. The first party who figures out a new philosophy will govern for a generation. Until then, I know you're unhappy and your mental health is slipping, and you have an ulcer. Please, this slice is on corporate HQ.

23. If you like this reporting, sign up for BIG, a newsletter focused on the politics of market power and monopoly. mattstoller.substack.com/welcome

24. And please, tell your #PizzaIsNotWorking stories, in health care or elsewhere. How have you been condescended to at work?