LAST MONTH, PATIENT Advocate Home Care became what appears to be the first unionized home medical equipment provider in the United States.

Initially, I believed this was a splendid idea. Among the benefits to unionizing are lower health insurance costs, which enables Patient Advocate to provide better coverage for its employees. Better benefits increase employees' loyalty and decreases the chances they'll leave you.

Also at first glance, a unionized workforce helps level the playing field for small HME providers competing against larger competitors — which might help smaller providers secure large health insurance contracts.

It is difficult for smaller companies to compete with the larger national companies, says Dan Buikema, director of Patient Advocate. But the union is like a big brother who backs you up in a pinch, he explains.

However, not everyone thinks unionizing is a good idea, including Mario LaCute, an HME industry veteran and president of Andover, Ohio-based Seeley Medical.

LaCute told HomeCare that, instead of worrying about insurance contracts, which do not necessarily translate into tangible business, Buikema should focus on wooing referral sources.

“Seeley has abandoned big insurance contracts, because there is no loyalty whatsoever between insurance companies and providers,” Lacute explains. “The relationship-building that needs to occur is between the provider and the physician community, because, ultimately, the physician has to sign the prescription to authorize the service.”

To better illustrate this point, LaCute says becoming a preferred provider with a large health insurance plan is the equivalent of obtaining a fishing license, which, we all know, doesn't guarantee that you'll catch fish.

And, as a final thought, LaCute points out that most people do not base health care decisions on political affiliations. “I think health care is one of those issues that transcends all other affiliations. I might be a Democrat and my doctor a Republican, but that doesn't mean I'm not going to use him.”

And while I applaud Buikema for his creative approach to these tight economic times, I advise those considering the same approach to remember that dropping your line into union waters is still an experiment. After all, fishing is different in every section of the country.

For a closer look at Patient Advocate Home Care's journey into unionization, and the industry's reaction to the idea, please see senior writer Brook Raflo's feature, “Strength in Numbers,” beginning on page 38.