Six stormy years and the audacity to confront a challenging future: taking stock of the Kenyan Doctors' Union.

The Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU) was formed in August 2011. Within the last six years, this union has galvanized the Kenyan doctors together, agitated for healthcare policy reforms and successfully negotiated and registered a Collective Bargaining Agreement (CBA). Though political will and the national citizens' psyche on matters pertaining to public healthcare remain a challenge, this union has made its foot prints on the Kenyan conversation space. KMPDU looks forward to engaging local, regional and international health stake holders to improve the state of the country's health care, key among these being to have a national commission handling all the human resources for health.

The health care system in the year 2000: three scenarios.

Because no one can predict the direction that national health policy might take over the next decade, the author outlines three of the more likely scenarios for the year 2000. He first describes seven major forces that have a stake in national health policy: the federal government, the state governments, business, organized labor, the public at large, the health industry, and the opinion-makers. he next indicates three ways these forces might come together (the scenarios), and last, gives a fuller description of the scenarios and the issues each would raise. He demonstrates in depth how the motivations of most of these forces are in conflict with one another and states that no national health policy is likely to emerge until there is a broad compromise that brings most of those conflicts to some sort of viable consensus. He urges those involved in health care to prepare for a range of possible policies such as, but not limited to, those outlined in this overview, and concludes by maintaining that no matter what health policy emerges, health professionals will use their common sense and good faith to make it work, as they always have.

A profile of hospital union election activity, 1985--1994 NLRB rulemaking and results in right-to-work states.

The authors present union election results in non-governmental, short-term hospitals for the 10-year period 1985--1994. The authors include profiles for the periods before (1985--1989) and after (1990--1994) the National Labor Relations Board (NLRB) rulemaking. When comparing the period data, they found that the impact of rulemaking was a reduction in mean bargaining unit size, an increase in the absolute number of elections in hospitals, and an increase in the percentage of union wins. Their examination of hospital union election results in right-to-work (RTW) versus non-RTW states revealed that unions did not aggressively try to organize workers in non-RTW states and, when they did, they were not very successful. When the authors examined only initial recognition elections during the periods before and after rulemaking, as well as the whole 10 years, regression analysis identified three variables significantly related to union wins: the 1989 NLRB rule change, bargaining unit size, and employee participation rates.