Janet Daley’s reminiscences of union-run England as it was some decades ago sound eerily familiar, although even Rhode Island, among the states, still has far to fall before matching her experience:

In the 1980s, as now, the justification for nihilistic persecution of the innocent citizen was The Cuts: the diabolical reductions in spending which the Tory government was reputedly making to public services. Except that it wasn’t. For all the determined rhetoric, the Thatcher government never succeeded in reducing public spending. Funding for the NHS — which became, in the language of the spinners, a “toxic” issue for the Conservatives — increased in real terms every year under the Tories.
What produced (or facilitated) the mythology of “Tory cuts” was the capping of local council rates: in order to curb the robber baron antics of Loony Left councils, whose escalation of the rates was killing whole swaths of urban Britain by driving out businesses and property owners, the Conservatives placed a limit on what we now call council tax. The consequence of this was that local councils had to make cuts in services. In the great spirit of Left-wing social conscience, the Labour ones made sure to cut the most high-profile, front-line services in order to milk the public outrage that would do maximum political damage to the government. So it wasn’t the gender equality outreach officers who were first to go: it was Meals on Wheels.

No, we don’t yet have overt extortion from public trash collectors, who’ll dump garbage on the lawns of low “tippers,” as Daley describes. But tactics such as targeting critical, rather than frivolous, services are the same and the end goals are related.
Public-sector unions create a structure that institutionalizes and perpetuates the concept that public employees can exert political pressure to ensure special deals for themselves — although they call them just deserts that they’ve earned. When financial reality requires “Tory cuts,” it’s natural for public employees to consider proving to voters just how critical their services are.
We should take England’s experience as a warning against broadening the reach of government (as into healthcare) and, by extension, the unions that come to dominate it.