A major labor strike is about to begin in the medical sector. This could have serious consequences for U.S. healthcare, staff and patients. Workers and management at Kaiser Permanente have been locked in a stalemate over contract negotiations for weeks. Kaiser Permanente is one of the country’s largest care providers. The company has insisted on a miniscule wage increase and a “two-tier” system of reduced benefits for new employees — despite the fact that Kaiser has amassed billions in profitsDuring the pandemic.
These plans would be implemented. labor organizers claimWorking conditions already dire would get worse: namely, spiraling understaffing crisesThis has created unsustainable pressures on hospital staff and presented risks to patients. Kaiser workers believe that the new contract’s pay reductions, far from mitigating the crisis, would make staff retention and hiring all the more difficult. This clash of interests took place in October came to a headThe strike was authorized by tens of thousands unionized Kaiser employees. If it’s declared, the company will be given 10 days’ notice, and workers will embark on a collective action that could have transformational repercussions.
Management’s Dubious Offers
Kaiser Permanente is well-known for its innovative operational strategy. labor-management partnership, which has allowed for coordination between the opposing interests for a long time. The unionized workforce of the company is represented by Alliance of Health Care Unions(AHU and the Coalition of Kaiser Permanente UnionsIn addition to independent locals, The Alliance consists of 21 unions that represent 52,000 workers. In three of the AHU’s largest unions, over 95 percent of membersThe strike was authorized by voters in October. similarly decisive majoritiesThey were tallied among other Kaiser unions. A number of non-Alliance unions have also voted Labor has made a definitive statement that management’s propositions are a nonstarter.
Kaiser proposes a two-tiered pay and benefits structure. This would include a modest wage increase of 1 % (union bargainers had requested 4 %) Current employees would receive a small increase in compensation, while future hires would get a much less attractive contract. Their pay would be cut by as much as 26 to 39 percent. As labor journalist Alex Press explained in The Washington Post, two-tier plans are a reliable (and transparent, to labor organizers) management tactic — often deployed by capital to hamstring unions by introducing division and conflicting interests.
Truthout We spoke with Shane Burley (communications organizer at). the Oregon Federation of Nurses and Health Professionals (OFNHP) — an American Federation of Teachers (AFT) affiliate that represents over 4,000 Kaiser workers — who commented, “These are the worst proposals we have seen in decades.” The contract as designed was unacceptable to Alliance unions, but management could not be swayed. They decided that collective action was their only option. Management is unlikely to capitulate soon. In the event of a strike, management would likely bring in replacement workers and “contingency staff” to continue care, and patients would still be treated. Even though Kaiser staff would prefer to settle for a fair contract before striking they feel they have been forced to strike because of unacceptable conditions.
It’s important to reiterate that it is not the issue of pay that is most salient — the key motive behind the potential strike is to avoid the acceleration of a severe understaffing crisis. “Even if there wasn’t a staffing problem already, their two-tier proposal would create one,” said Burley. “It’d be harder to attract new members with worse pay and benefits, and these contract provisions would create extra workloads and more difficulty in patient care, which would make it hard to maintain workers.” This cycle of multiplying pressures is approaching a breaking point. Overstressed and shrinking health care workers pose a threat to patients as well as employees.
Overworked, Understaffed
The tremendous strainThe pandemic that has hit those in already-taxing professions has led to soaring dropout rates. COVID surges have forced the national health care workforce to adapt. fractious, denialist patients great personal risk. The resulting staff shortagesHave reduced workloads “unsustainable.”Kaiser is not an exception. 60 percent of Kaiser workers in Oregon42 percent of those surveyed said they were considering quitting their jobs. “When it comes to recruiting and retaining people,” says Nicholas Eng, a registered nurse (RN) first assistant and a shop steward at OFNHP AFT Local 5017, “I see talented colleagues leave, and we struggle to find a new person to fill that role. It is not possible to pay people less. It’s not about the money. It’s about having enough people to do the work well.”
Michelle Back, a Kaiser veteran for 30 years, is an inventory control assistant at the pharmacy department and a long-standing union shop steward in United Food and Commercial Workers Local 7770, which also represents Kaiser’s health care workers. She described the staggering toll that this work exacts: “It’s been really exhausting…. We’ve worked really hard to meet the needs of our members and our communities, at great risk. We’ve had union members pass away, or get COVID at work and come home and spread it to their families. It’s been a really gruesome fight.” These traumas are underscored by the perception of callous disregard on the part of management: Back cites a sense of abandonment, saying that workers feel undervalued and endangered by the company’s unwillingness to address the staffing crisis, as well as failures like the inadequate provision of personal protective equipment.
Even before the pandemic, a staffing crisis existed in Kaiser workplaces. This was a result of bureaucratic cost-cutting, profit-focused restructuring, and other factors. Katie Johnson, a Kaiser oncology nurse is the RN bargaining unit vice-chair of the OFNHPAFT Local 5017. She is also an inpatient contract specialist. Talking with Truthout, she described growing burdens: “For years, Kaiser has thrived on what they call a lean staffing model. Others hospitals refer to it as a skeleton staff. They’re having us do more with less. In my own role, at times, I was asked to do the job of three other people…. You get tired, you get burned out.”
Kaiser has responded to these concerns by a statement that claimsThe main issue is pay rates. Union concerns about understaffing are downplayed. The statement also advised employees not to strike. (Kaiser insists that its employees are not allowed to strike. are actually overpaidThis is because the wage cuts are intended to increase prices for customers. Staff who have suffered the severe strains from the staffing crisis strongly disagree.
“Over the last three years, the lean model has only gotten worse, on top of a pandemic,” said Johnson. “Health workers don’t want to put up with what we’ve been accepting. [At my hospital]We have a turnover rate of 60 percent, whereas the average turnover rate is around 12 percent. We have 30 nurses when we should have 72…. Kaiser executives are trying to cut costs, and they’re doing it on the backs of frontline workers.”
Place lives at risk
These constraints could have — without exaggeration — fatal results. Hannah Winchester, Local 5017 shop steward and home health physical therapist, spoke out about the egregious delays Kaiser patients have suffered lately. She cited delays in scheduling mental health appointments, delays up to six weeks for essential physical therapy, unacceptable wait times for dermatologists to examine potentially-cancerous lesions, and difficulty scheduling mental health appointments. She was told she would have to wait two months to get an appointment to fix a broken bone. Delaying or refusing care can have devastating consequences. “We’ve seen this grow exponentially over a long period of time, and it’s coming to a head now,” Winchester told Truthout. “Health care can’t wait. This isn’t something we can put on the backburner.”
Back describes the devastating effects of the shortage on the pharmacy department. “Now I have only two pharmacists, and we’re doing 7,800 prescriptions a day. I don’t have people taking calls from patients. I don’t have people taking members’ phone calls.” She expressed a concern that patients, including the elderly and vulnerable, have been forced into extended wait timesFor prescriptions, sometimes in waiting areas that could expose them the virus.
Multiple Kaiser staff members also mentioned potential problems that could arise from the use of temporary workers. travel nurses. Kaiser has regularly brought in “travelers,” also called rapid response nurses, to augment threadbare workforces. This reliance can be detrimental in certain cases, staff say. has led to a “skills gap”Travelers may not be familiar with the details of certain procedures in hospitals. These temporary measures can lead to higher error rates and substandard treatment.
The same issues arise from Kaiser’s habit of reassigning managers to patient care, some of whom “haven’t touched a patient in a decade or more,” says Winchester. “They’re brushing up on skills like how to place a catheter, how to place IVs, how to pass meds. I would personally see that as a big risk with someone so fresh on a job, when we’re talking about people’s health care.” Responsibility for any mistakes should not always fall on reassigned or insufficiently trained temporary workers. Management’s decisions set many up to fail — in a field where failure can threaten lives. Also, understaffing contributes to higher rates violence and sexual assaultAgainst staff, which is a growing problem. (In fact, nurses are more likely to be assaulted(Less than police officers.
“I don’t want to think about moving forward, if it’s normal for there to be hours and hours of wait time to be seen at an urgent care clinic or an all-day wait to be seen in the emergency room,” RN Eng says. He and other Kaiser employees described a sense that management’s decisions are forcing them to do a disservice to the patients that they care for deeply. “We will do anything for our patients, which makes it difficult for some of us to face the reality, should we have to walk out. But this is all on Kaiser…. This is all on Kaiser. And should we allow this to get worse?”
Another aspect of the growing antagonism revolves around inequalities within Kaiser workforces. The Alliance alleges a “double standard”Kaiser a much-touted $100 million in grants was promised “to address systemic racism.” However, union advocates claim that Kaiser is neglecting the fact that they could make interventions in their own unequal workforces, which are rife with wage gaps (Black workers have been systematically underpaidFor instance, The Department of Justice also claims that the company was overcharging elderly Medicare recipients, and other forms persist. Winchester stated. TruthoutKaiser has rejected multiple union proposals to address diversity and inclusion. She says that the opportunity to make progress was present — but “when it came time to put pen to paper, they balked. They walked away.”
The U.S. Health Care System at a Crossroads
The U.S. health care system — a usurious, expensive patchwork — lags far behindOther countries with high incomes. The structure of privatized healthcare, which makes coverage unaffordable for many and inaccessible to so many, already produces tens of thousands ofEvery year, there are many unnecessary deaths. Substandard care is the standardThe richest nation on Earth has high levels of health inequality closely tracksThere are no distinctions between race or class. To further undermine the workforce at the country’s largest provider in the midst of the most catastrophic public health crisis in generations is reckless, to say the least. Both workers and union members feel that Kaiser management has not given a thought to worker and patient welfare, despite its relentless focus on profit.
“What does lifesaving care look like when there aren’t enough people to save lives?” wonders Burley. “I can’t think it does anything but put people at risk…. It’s black and white. People will die if there’s not enough staff.”
Yet, should Kaiser’s unions execute this strike and win a better contract, the victory could resound throughout the sector. In the midst of a broader strike waveThe United States labor movement is asserting its power again. This highly visible win could have implications for other health care providers’ workforces if management accepts it.
This conflict has precedents: As reporter Noah Lanard explains noted in Mother JonesThreats of a strike neutralized a two-tier proposal at Kaiser in 2019 — but the inverse also occurred in 1986, when Kaiser pushed through a two-tier proposalby surviving a six week strike. It is not certain that labor will win. A successful imposition of the two-tier contract will likely legitimize it as a mechanism of cost-cutting for other health care corporations equally eager to slash pay — in keeping with the neoliberal austerity policies that have inflictedPublic institutions, health care and other services suffer enormous damage.
The time for collective action is nearing an inflection point. The pandemic continues its stealthy progress thousands of lives per dayAs dropout rates rise, so do the pressures on staff. Kaiser’s workers are making their appeals with great urgency. “This is a plea for us to say: Not only do we deserve more, but our patients — our patients absolutely deserve more,” says Kaiser nurse Johnson.
“Every day when we go to work, we feel like we’re not giving them, one: the care that they deserve; and two: it’s not the care they paid for.”
If the staffing crisis isn’t addressed, it seems certain that conditions will worsen. Unpaid staff who have made extraordinary sacrifices during a pandemic are now being saddled with insufficient pay and resources. This is a matter of public health and life and death. As RN first assistant Eng puts it, “The future without addressing these issues — it’s scary.”
You can contribute to this strike fund here.
