“We can’t survive doing the work that we’re asked to do, the way that we’re being asked to do it with the lack of support we’re being asked to do it with,” says nurse Nicole Brun-Cottan. Tens of thousands are expected to strike in the Kaiser Permanente health system. In this episode of “Movement Memos,” Kelly Hayes talks with three nurses who voted to authorize a strike about what’s at stake in their struggle, and how the pandemic has affected frontline labor.
Note: This is a rush transcript that has been lightly edited to improve clarity. Copy may not be final.
Kelly Hayes Welcome to “Movement Memos,” a TruthoutPodcast about things that you should know if your goal is to make a difference in the world. I’m your host, writer and organizer Kelly Hayes. This show focuses on building relationships and analyzing data to create movements that win. Well, it’s Striketober, so this week, we are talking about labor. During the pandemic health care professionals were applauded literally and metaphorically for their commitment to patient-care, despite PPE shortfalls, traumatizing work conditions, and the loss or loved ones of coworkers and family members. Kaiser Permanente nurses don’t feel that love at all when they are negotiating.
I spoke recently with three nurses from Oregon Federation of Nurses and Health Professionals (AFT, AFL-CIO) who are currently fighting Kaiser, the largest managed-care organization in the U.S. The company calls itself “an integrated managed care consortium” — which means that Kaiser members are insured by the same company that provides their medical care. It’s a profitable model that netted the company $6.4 billion last year. Kaiser operates in eight states as well as Washington, D.C., and has 39 hospitals with over 700 medical offices and more than 300,000 employees.
Kaiser believes business is good. However, the company claims that in order to make health care more affordable, it must pay its workers less. Although most Americans agree that U.S. health care is too expensive, it seems particularly outrageous that nurses and other healthcare workers are being paid too much, given the current pandemic. I personally believe we owe health care workers in this country a debt we can’t possibly repay: these people have provided care to the sick and dying, risking their own lives and the lives of their families, and, at times, losing their colleagues to the virus, so that we might have care. According to the World Health OrganizationBetween 80,000 and 180,000 health care workers could have died from COVID-19 between January 2020 and May 2021. The United States has nurses have taken the bruntThese losses.
Billionaires have made a fortune while ordinary people struggle and die during this crisis. We have seen mass deaths and skyrocketing levels inequality. Now, workers, including nurses are fighting back against companies who would further devalue their lives.
Kaiser currently proposes a two-tiered payment system. Workers say it would ruin the quality of care and increase nursing shortage. Norberto Gomez (Stailworkers Local 7600 Vice President), who has been a mobility technician for Kaiser for 23 years, is currently the Vice President of Steelworkers Local 7600. told Labor Notes that Kaiser’s proposal would put some of the company’s new hires “behind the starting rates at McDonald’s or Amazon warehouses.” As Gomez put it, “If given a choice between flipping burgers or moving Covid patients to the morgue for the same money, it’s a no-brainer.” Current Kaiser employees would receive a meager 1 percent raise per year.
Nearly 3400 workers from Kaiser Permanente, Oregon voted to authorize strike action on October 11. With a 90% participation rate, 96 per cent of those who voted to authorize a striking voted. These workers are part of a 21 union Alliance of Health Care Unions that represents 52,000 workers. 35,000 of them have authorized strikes. I spoke to three nurses from Kaiser Permanente Portland about their vote to authorize a strike and their beliefs about the fight.
Hannah WinchesterHannah Winchester is my name. I am a home-health physical therapist. I am also our laborpartner. I’m part of the professional bargaining team. I’ve worked for Kaiser for the last four years, and I voted to authorize a strike because I want to make sure that our contract protects the future of health care for those that provide it and those that receive it.
Nicole Brun-Cottan: My name’s Nicole Brun-Cottan. I’m an acute care and critical care physical therapist in a high acuity hospital and a member of the professional bargaining unit bargaining team. I voted for a strike to ensure patient care and access to our services.
Dylan OlsonDylan Olson: I am Dylan Olson. I have been with Kaiser for 14 years as a mental therapist in the emergency room doing crisis evaluations. I voted to authorize the strike, as part the bargaining team, because patients need better staffing. They need faster turnaround times. It is not ethical that it takes six to eight weeks to get into therapy.
HW While it seems like in our current climate, COVID is the reason for a lot of conversation, it’s definitely a reason for our employer to make the decisions that they’ve been making…. But I believe we got there much earlier than that. We have come a long way since then, I believe, because we tried to make health insurance affordable and associated it with an economic request rather than a quality of care ask. Now, we are at the breaking point. We’re at this cusp, and it simultaneously lined up with our contract ending, that all of these things have really come to a head, but I think it’s really been happening for quite some time.
NBC: I think that there’s been a narrative about the affordability of health care specifically that Kaiser Permanente is pushing. The implications of this narrative are [that] health care is very expensive, we need to make it more affordable so that more people have access to it, and what’s implied is, and the way that we’re going to make it more affordable is by paying labor less. For me, the lens that I look through this contract negotiation with is what is it that’s going to get me help as a frontline health care worker so that I can provide the care to patients that they deserve and that is part of what I signed up for when I agreed to do this work, and went through the training to do this work?
DO: I’ve been with Kaiser for 14 years and we’ve definitely had bumpy patches in the past but this past couple of years, it seems like [it]It was more contentious. And, I wasn’t that surprised to see their proposal this year.
KHKaiser employees report that the company’s understaffing levels have reached crisis levels. Nurses claim that the company offers high-paying signing bonuses and pays travel nurses up to $10,000 per week to bridge the gap. This is in an effort to keep the care systems running smoothly. What is the rationale for cutting pay for new employees in the face of an ongoing nursing shortage?
NBC: We do not have the staff that we need to do the work that we’re being asked to do. As far as the nurses go, and it’s true broadly across health care, there is a staffing shortage. Since the early 2000s, this staffing shortage was predicted. So when we see the employer using COVID and the pandemic as a license to make changes in our contract and the way that they run operationally, it’s really disingenuous because not only did we have a pandemic that changed the game, but we also had a problem that was predicted, that we understood was coming based on a bunch of aging baby boomers who, both needed care and were retiring from the health force in droves. So what they’re offering is especially stark when you compare it to the context that they’re offering it in. If we know we’re in a staffing shortage and we’ve known that was coming for a long time, and we know that it’s been worsened by social conditions and the pandemic, how is it possible that they would imagine that they would offer to pay less for the labor that we provide?
HW: While I believe that staffing is our number one question, it’s important to consider not only how to get people in the door but also how can we stop this staffing crisis getting worse. How can we fix it? What are the root causes of these problems? What is the root reason for where we are today? Why aren’t people walking out of health care at an overwhelming rate? Why are people leaving this company. Why is it that people are abandoning their careers and trying to figure out the real problems and what we can do within our reach to fix them so that patients have access to healthcare? Because that’s a really scary future if things keep continuing the way that they’re going right now, not just for us as healthcare workers, but for us as patients… for our communities, for our families, for our friends.
It starts with the things that we’re asking for with this contract… to not accept these really dangerous proposals that they’re giving to us to further affect that. This will only make the situation worse. At this point in time, the proposals that Kaiser’s offered are really focused on economics. Again, they want to… they’ve always said they want to stay affordable, and it sounds like to stay affordable, they just mean that they want their costs to be affordable. What they’re offering is a 1 percent raise, and then for some regions, a 1 percent bonus, although in some other regions, not everywhere, like Hawaii and Georgia, they would only get a 0.5 percent bonus. There are inequities as well in what they’re offering depending on what region you’re in.
The other thing is they’re actually wanting to decrease the wages. They’re wanting to create this two-tiered wage system for new employees starting in 2023. So somehow, the work that we’re doing now will not be worth the same in a year and a couple of months, despite the fact that for the past 20 months, we’ve been breaking our backs, social security has gone up now, they got a 5.9 percent COLA, CEO wages have obviously gone up, managerial wages have obviously gone up, minimum wage is going up. According to what they consider fair, health care workers won’t be worth as much in 2023.
KH: I find Kaiser’s arguments about making health care more affordable especially disturbing because they play on the fears and bitterness of people who have been victimized by the profit-based healthcare system, or who are simply terrified of getting sick because they don’t want to bankrupt their families. Even those of us who are lucky enough to be insured know that we’re probably one pricy diagnosis away from financial catastrophe, and a lot of people are already there. Patients who can’t afford health care deserve help. But who is responsible for their suffering under this profit-based system? It reminded me of how public school teachers are vilified for their inability to afford health care. Chicago’s neoliberal mayor seeks to find a victim. She points to the collective bargaining agreements that have secured benefits for teachers and says they need to make sacrifices. Because if she can direct our anger at the teachers, she can avoid questions, like, why is our public school system so underfunded, and why aren’t we all getting the same benefits the teachers are getting? Kaiser’s arguments similarly vilify its nurses, who it claims are paid “above market rate.”
According to Axios, “the median pay of a health care CEO in 2020 was more than $9 million, up from 2018 and 2019. Thirty CEOs made more than $30 million each.” In recent years Kaiser’s CEO compensation has ballooned to $16 million — that’s a 166 percent increase since 2015 and double the salary of Blue Cross Blue Shield’s CEO. Some might call that “above market rate.” At Kaiser, over 36 executives make over $1 million dollars, and somehow, these are the people who are arguing that nurses and technicians are overpaid.
HW: We’ve been backed into this corner where, as Nicole said, it’s our responsibility to make health care affordable. That’s not the case. It’s not our responsibility. It’s not our responsibility to provide the highest quality patient care.
We will not compromise on quality. We cannot sacrifice the quality of the care that we are wanting to and we’re tasked with providing just to stay affordable. I think that it’s really difficult to look through that other side of the lens… that sometimes these demands might seem like they’re high. They might seem like they’re costly, but what’s the benefit of them and what’s the risk if we don’t get them? I think what we’re asking for and what the teachers were asking for, and in a lot of other labor struggles, what they’re asking for, is completely appropriate. It’s not their responsibility to fulfill this affordability ask.
NBC: Kaiser Permanente’s model of care delivery is slightly different from other models, as Kaiser Permanente is both the provider and the insurer. So other health care organizations do best when their beds are full, because they’re billing out for their services to other providers. Whereas with Kaiser, it’s a giant kind of pool of money. And I think it’s really important to note that we are Kaiser Permanente members, the vast majority of people who work for Kaiser also get their care at Kaiser.
So when you look at a movement that’s involving eight different regions where Kaiser provides care and you see that 24,000 members of UNAC [United Nurses Association of California]Nearly 7,000 members and 3,400 members OFNHP members have voted to walk off. This is a sign that those who work in the building providing care are concerned about what level of care they will receive if the plans for the future are implemented.
KH: The U.S. Bureau of Labor Statistics announced on October 12 that 4.3 million Americans, or 2.9% of the total workforce, had quit their jobs in August. A survey by the American Association of Critical-Care NursesRespondents indicated that 66% of them have considered quitting nursing after their experiences with the pandemic. 92 percent of respondents said they believe “the pandemic has depleted nurses at their hospitals, and because of this, their careers will be shorter than they planned.” A survey of Kaiser’s nurses found that 42 percent of the company’s nurses are considering leaving the field, and over 60 percent say they are considering leaving Kaiser. And yet, these nurses have chosen to fight, not only for the pay they deserve, but for the wages of future employees, and they’re fighting at a time when labor power in the U.S. is rising. I wanted to know more about the changes that have occurred for these workers in the past year and a half and in recent months as factory workers, coal miners, and other workers have withheld their labor or authorized strike action.
HW: I personally am seeing people that previously, maybe a couple of years ago, the last time we were bargaining, would have been uncomfortable standing up for what we’re fighting for right now. The prior mentality of “keep your head down, go to work, do your job, go home, and everything will be fine” is a little bit out the window, I think, at this point. I think it’s with this large movement, with this understanding and this momentum of standing up for what you need and what is important in your workplace has really, in my experience, brought people out of the woodwork to feel comfortable enough to use their voice and use their power, use their union, use their resources, to stand up for what they believe is right and what they believe they really need to do their job. Striketober is a great organization. Definitely love the name, and I think it’s exciting. It’s exciting to see these people feel comfortable enough to hear their own voice and to use it.
Throughout our conversations, throughout our bargaining, our group has asked ourselves, “What do we want to stand for? What do we want our work to show?” We want our work to be safe, sustainable, and ethical. Just like Nicole mentioned, the path that we’re on right now with… I think this is a little bit larger than just us here in this conversation… but the path that we’re on right now with our healthcare system is not sustainable. There’s become this giant divide of those that do the work and those that direct the work. Unfortunately, the people that are directing the work are now no longer necessarily nurses, they’re no longer healthcare workers, they’re no longer therapists or even physicians.
They’re MBAs [people with a Master of Business Administration degree]. They’re people that know numbers and they know graphs and they know charts, but they don’t know people. They don’t know our patients. If we continue down this path, I believe that the divide will continue to grow. There’s just such a giant misunderstanding, as we’ve seen in these conversations during our bargaining so far, where it’s shocking. It’s so unfortunate to see what they think our workplace is like, what they think our work is worth, and what they think our troubles are… are our own, are self-created. We’ve also had conversations before about burnout versus moral injury. Burnout is, and what we get forced down our throats, is this understanding that we don’t know how to manage our own stress. We don’t know… just go get a pedicure, go get a massage, take some deep breaths, and everything will be fine.
But what we’re seeing in our workplaces so greatly right now is moral injury… that you can’t just walk away from it. You can’t just box breath it away. This is unsustainable. What we’re doing right now in the conversations that we’re having isn’t just for us right now. This isn’t just about a 1 percent versus a 4 percent raise. This is about stopping something from causing serious damage to the health care system. It’s also about acknowledging that those who provide this work and those who provide it need to have a greater voice and more control. This can’t continue to be whittled away. We’ve got to keep the patient at the focus. We’ve got to keep the patient at the center, not a dollar sign.
NBC: The pandemic isn’t over and I have concern that if we continue on the path that has been laid out in front of us, that we really compromise the ability of our systems to take care of our communities. And it’s been evident for a while that the social fabric was wearing pretty thin, right? We can see that teachers all over the board are struggling to get their work done when we look at the indicators of health in major institutions, public services, and health care. And we’ve been hearing that reported for almost a generation now pretty consistently. But I do feel that we’re at a tipping point and I think that we’ve reached a point where people have been pushed so hard, that kind of like Hannah said, they’re coming out of the woodwork, they’re coming out of their holes because the conditions are so unsustainable that they can’t survive. We can’t survive doing the work that we’re asked to do, the way that we’re being asked to do it with the lack of support we’re being asked to do it with.
And I think there’s a level of exhaustion and personal strife that pushes people into action and that makes you…. Talking to our members, I talk a bit about solidarity and how to solve a problem you cannot solve by yourself. I believe that we have reached a point in our individualistic society. [a]A critical mass of problems that are beyond the reach of individuals. This is part. I think that’s part of what the groundswell of Striketober is about. I am also excited to be a part of this. It is encouraging to see people feel called. And I hope that that call to action makes them feel brave because we’re going to need it.
And I think that it’s important to think about how traumatized the people that we’re talking about are. I heard a friend, he was talking about a conversation that he was having with some nurses and some other people at a party and he referred to the people that weren’t nurses as civilians. I thought about this for a moment. As we started to socialize again this summer, I thought about my own experiences. I was talking with family and friends and realized that my experience over the past two years was very different from theirs. And I think that I’ve really resisted any metaphors that have compared the pandemic to a war, because I think that so much of the time in conditions of war things are so much more stark and untenable than they have been for us.
There are still aspects of what happened that make it feel like you survived a war. I really do feel different than a lot of the people that I interact with casually after what I’ve seen in the last two years. Some of it has to do just with the trauma of seeing so many people die, many of them alone, because they couldn’t have visitors. Some of it has to do with me being truly, completely, and having the illusion taken away that I was essential or valuable to my community. Because it’s nice to be called a hero, but actually the way that you know that people care is by how they treat you. I would like to share that feeling, and how many of my coworkers feel like that, and then being pushed by an employer to the point that we feel we must walk out as exhausted and as torn as our communities.
I just want to reinforce, we don’t want to walk out of the job in October or November in the pouring rain several weeks before the holidays come, because we’ve been spoiled and we’re not going to continue to get the benefits that we’ve had. The things that it takes to push a workforce to do that at this level, I’m not sure that people broadly realize what’s been going on behind the veil. This makes me feel particularly resentful at my employer for framing it in the way it has. It’s just like an extra slap in the face.
DO: I spoke with people about the Nabisco baker strike, and my sister is a member of IATSE. [The International Alliance of Theatrical Stage Employees] and in conversations with people in other areas that are also in unions that are also striking or voting to strike, it’s that divide that the pandemic made even sharper. So, these executives who are making these decisions were so far removed from the horrors that a lot of us have experienced in the last year and a half and they’re making these decisions with a background as an MBA. Not as a healthcare worker. Not as a therapist. Not as a frontline baker. It’s unfortunate what we all had to go through to get to this level of solidarity. But, it’s really exciting to see everybody stand up for themselves. Nurses, engineers, and housekeeping staff as well as IATSE and John Deere are all included. It’s amazing to see everybody finally taking a stand and seeing that solidarity it’s amazing. It makes me feel so happy. It’s a wonderful feeling.
KH: I think the feeling of moral injury Hannah was referring too runs deep for many U.S. employees right now. People aren’t simply burnt out, because we’ve all had a rough year and a half. They’re fed up, because they’ve experienced new levels of dehumanization and disposability. This is a crucial moment for labor, as well as for our health system. Personally, I believe that we won’t have justice for patients or providers until we have universal health care, but while we are living under this system, we have to support nurses and other health care workers who are squaring off with wealthy executives. We must insist that anyone who is going to suffer a financial loss in the name of making healthcare more affordable should be the executives and pharmaceutical companies, as well as the monopolistic hospitals and healthcare executives. We can also support nurses, health care workers and their stories and demands. This is a moment with great potential for U.S. employees. We must support striking workers and increase their demands if we want to see all these sparks become something more dramatic. Join them at the picket line. Some friends and me read to children on picket lines during the 2012 Chicago teachers strike. This was so that parents could interact more with the general public. There are many ways you can show your support and how to show it. What’s important is paying attention to the needs of the workers you are looking to support. Listen to their needs and amplify your message. I just want to remind everyone, that unionizing our workplaces is one of many important ways we can support the greater fight for worker power. It is a blessing to have people who put in the work. Truthout before I came along, because without their efforts, we simply wouldn’t be the publication that we are.
I want to thank Hannah, Nicole and Dylan for talking with me about their experiences and the fight they’re waging. I want to thank all our listeners for joining me today. Remember that our best defense against cynicism, is to do good and remember that what we do matters. Until next time, I’ll see you in the streets.
- If you need help keeping track of who’s on strike, or potentially going on strike, Jonah Furman’s substack, Who Gets the Bird?It’s worth checking out.
- I recommend reading this article if you are interested in learning more about ongoing labor struggles. Dissent Magazine’s BelaboredPodcast with Sarah Jaffe, Michelle Chen
- Did you know that South Korean workers recently staged an all-day general strike? You can Learn more about it here.
- Are you interested in supporting a strike fund? United Left recently formed a Twitter threadThese links will take you to multiple strike funds.