Cedars' filing against union clouding results of nurses' representation vote. (Health Care).

DON'T look for the nurses' imbroglio at Cedars-Sinai Medical Center to be cleared up any time soon.

The prestigious Los Angeles hospital filed formal papers with the regional National Labor Relations Board last week offering evidence that the California Nurses Association employed illegal tactics in a December election that saw nurses vote 694 to 627 in favor of joining the union.

The hospital accuses the union of intimidating nurses, interfering with voting and other election misconduct, all charges the association denies. The union claims that the hospital is actually guilty of those tactics, although it has not filed its own objections given the successful campaign.

The NLRB must first decide whether to hold a hearing on the charges before making a decision, a process expected to stretch out over a month.

The side that loses would be expected to appeal to the Washington-based board, which has the authority to overturn decisions of the regional boards. The appeal can take months, if not longer, prompting union officials to accuse the hospital of filing the objections in a strategic move to change the outcome of the election.

"They hope the longer they drag it out that the nurses who want representation will leave' charged Charles Idelson, a CNA spokesman.

Jeanne Flores, the hospital's senior vice president for human resources, denied the objections were a strategic move, contending that the hospital had clear evidence of union misconduct. Meanwhile, the nurses association has been moving forward on its own, electing union leadership at the hospital in preparation of contract talks.

Health Casts

Is the time right in California to institute a prior approval system for health premium increases?

The Foundation for Taxpayer & Consumer Rights thinks so.

Under such a system, health insurers would have to seek approvals for rate increases from the state, much the way auto, property and casualty insurers now do. It also would allow consumers and others to file objections to proposed rate increases.

With health insurance premium increases in the double digits and even business groups starting to call for reforms, the foundation plans to announce this month that an influential California legislator has agreed to carry a bill for them that would create such a system.

The foundation is preparing a report it says will show that 10 states with prior approval processes for health insurance have seen a slower rise in their premium costs, said Jerry Flanagan, an official with the Santa Monica-based foundation.

Michael Chee, a spokesman for Blue Cross of California, the state's largest for-profit HMO, said prior approval would not work well with health insurance, since costs change rapidly in the health care market place and the most successful insurers react quickly to changing costs.

Laurence Darmiento can be reached at [phone] ext. 237 or at [e-mail]