In the US we have an independent oversight body called the Joint Commission that sets standards for medical facilities and inspects facilities for compliance. They can be extremely hard nosed when it comes to complying with their standards of care, sanitation and performance. Unions aren't the answer for this. Over here union garbage workers can make 6 figures. So the comparison seems backwards! I, too have seen overworked nurses, but usually due to a shortage of trained talent. If some people in this country think that the answer to better health care is to turn it all over to the government, they're going to be in for a shock when it does come about.