Kaiser Permanente Reaches Tentative Deal With Health Care Workers The proposed settlement follows a three-day strike involving thousands of unionized workers in several states. Share full article


Kaiser Permanente and the Coalition of Kaiser Permanente Unions have reached a tentative agreement following a week-long labor dispute. The agreement comes after a three-day walkout by over 75,000 healthcare workers, which caused disruptions in appointments and services at hospitals and clinics. Many healthcare organizations have been facing labor disputes amidst severe staffing shortages caused by the pandemic. The frontline workers expressed their exhaustion and frustration. The tentative agreement is seen as a positive step forward, with the union officials expressing gratitude for the support of acting U.S. Labor Secretary Julie Su. Kaiser Permanente officials also posted a statement confirming the agreement on social media. Further details regarding the agreement are expected to be disclosed later. Kaiser Permanente, known for its network of hospitals and doctors, provides health coverage for 13 million individuals across eight states.  
A week ago, a 72-hour strike took place involving low-wage workers, including medical assistants, laboratory technicians, receptionists, and sanitation staff members. These employees formed picket lines around multiple Kaiser buildings, demanding that Kaiser prioritizes patients and respects and values healthcare workers. The strike resulted in Kaiser moving many appointments online and postponing non-urgent procedures, such as colonoscopies and mammograms. While contingency workers were brought in, over 50 labs in Southern California were shut down, and numerous other facilities across the West Coast either closed or had limited hours. This strike was recognized as the largest by healthcare workers in recent U.S. history.

Acting Secretary of Labor Julie Su from the Biden administration became involved in the Kaiser stalemate. She traveled to San Francisco to meet with representatives from both sides, aiming to facilitate a resolution. However, negotiations did not resume until over a week after the strike began, with talks breaking off. In response, the labor coalition threatened another week-long walkout in early November if a contract settlement couldn't be reached beforehand.

Kaiser's newly reached deal comes at a critical moment in the health labor market. The industry has experienced a significant exodus of staff members, resulting in a shortage of healthcare workers compared to the demand. This situation has created a sense of urgency for both workers, who face record levels of burnout while trying to treat patients amid staffing shortages, and employers, who are under pressure to retain their workforce and offer attractive packages to attract new workers.

Analysts suggest that the current landscape has provided union workers with leverage at the negotiating table, and many are taking advantage of the opportunity. In various locations, more than a dozen health worker strikes have occurred this year, including in New York City, California, Illinois, Michigan, and others. For instance, around 1,500 health workers went on a five-day strike against Prime's St. Francis Medical Center in Lynwood, California, citing dangerous short-staffing practices. Pharmacy staff workers at select Walgreens stores in Oregon, Washington, Arizona, and Massachusetts also walked out on the same day, highlighting excessive workloads endangering safe prescription filling. Some of these workers organized their actions through social media platforms like Facebook and Reddit, despite the absence of a formal union.

While Kaiser and other companies face pressure to limit expenses, they also emphasize the need to provide affordable care. Kaiser, with an operating revenue of $95.4 billion, reported a loss of $1.3 billion in 2022 but has returned to profitability in recent months. The ongoing challenges in the healthcare industry have prompted discussions around nurse-patient staffing ratios, with the New York State Nurses Association entering a new contract with Mount Sinai Hospital that incorporates an enforcement mechanism for such ratios.  

Consensus opinion suggests the U.S. economy is on course for a soft landing. This explains why the S&P 500 Index (.SPX) has climbed more than 20% in the past 12 months. The trouble is that the consensus often turns out to be wrong. In early 2007, most economists also expected a mild fallout from the U.S. housing downturn. Going further back, investors remained relatively upbeat after the stock market crash of October 1929, even as the United States teetered on the brink of depression. The maverick British economist Bernard Connolly argues that current expectations of a gentle descent are equally deluded.

Connolly is best known for his 1995 book “The Rotten Heart of Europe”, a withering critique of the European Monetary Union that cost him his job with the European Commission. His latest book, “You Always Hurt the One You Love: Central Banks and the Murder of Capitalism”, won’t make him any friends in monetary policymaking circles. In Connolly’s view, central banks – chiefly the U.S. Federal Reserve – are responsible for a succession of financial disasters over the past quarter of a century. Now, he says, they’ve taken us to the brink once again.

Connolly’s beef is not with individual central bankers but with their economic models. The canonical framework, he says, ignores the fact that economic and financial activity must be coordinated across time. Central bank models assume that the economy never strays far from equilibrium, and that economic shocks, when they occur, are random, unpredictable and self-correcting. The central banker’s bible is “Interest and Prices” by the American economist Michael Woodford, published in 2003. Yet “in the index to the 800 pages of Woodford’s book,” says Connolly, “there is not a single entry for ‘risk’, ‘uncertainty’, ‘banks’ or ‘finance’.”

In the real world, things are rather different. Connolly is concerned with how economic activities take shape over time: how current spending and saving connect to future consumption, and how current investment meets future demand. The economy isn’t always in balance. Intertemporal coordination breaks down, Connolly claims, when real interest rates are out of line with society’s time preference, which is the rate at which people, on average, value present over future consumption. Problems also occur when interest rates are not aligned with corporate profitability.

On this basis, Western economies have been trapped in a state of disequilibrium for more than a quarter of a century. The rot set in during the mid-1990s when the United States experienced an unexpected upturn in productivity growth. Rising corporate profitability, according to Connolly, should have been accompanied by higher interest rates. Instead, Fed Chair Alan Greenspan chose to keep U.S. interest rates low, thereby helping to stoke a stock market bubble. Bolstered by their paper wealth, American households saved less and brought forward consumption from the future.

When the inevitable market crash came in 2000 a hard economic landing beckoned as demand dried up. The Fed responded by slashing its benchmark interest rate to 1% in 2003, thereby inflating another bubble, this time in residential housing. Once again, households consumed part of their bubble wealth by taking out home equity loans worth hundreds of billions of dollars a year.

When the housing bust arrived in 2007, followed by the bankruptcy of Lehman Brothers a year later, central bankers were again blindsided. The global economy was poised to fall into an even deeper hole. The Fed responded by reducing interest rates to zero and employing various tools to lower bond yields. Central bankers staved off another Great Depression and asset prices eventually rebounded.

In his market reports from the early 2000s onwards, Connolly constantly maintained that Western economies were trapped in a state of intertemporal disequilibrium – with genuine savings increasingly replaced by bubble wealth and consumption bolstered by debt. These economic imbalances prevented central banks from returning interest rates to normal levels. Whenever they attempted to do so, the economy would threaten to collapse.

This insight enabled Connolly to anticipate both the Great Recession that started in 2008 and Europe’s sovereign debt crisis which followed soon after. Nothing fundamentally has changed in his analysis. Greater and greater amounts of bubble wealth have been required to sustain spending. Central banks have found it impossible to normalize interest rates. The Fed aborted its previous attempt to raise rates in early 2019 after the U.S. economy hit the rocks and the stock market plunged. When Covid-19 arrived, short-term rates returned to zero.

Connolly describes real interest rates as being on a conveyor belt, heading deeper into negative territory. He predicts that yields on long-dated bonds will eventually end up below short-term rates. Such an outcome would be disastrous for capitalism since problems of economic coordination would become even more intractable. The financial system could not operate with a permanently inverted yield curve. Governments would have to take up the role of allocating credit. The direction of travel is towards full-blown socialism, according to Connolly. Unless that is, liberalizing economic reforms are enacted that boost productivity and allow interest rates to rise.

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Reuters Graphics

In this analysis, monetary conditions are not so different to those that pertained before Lehman failed. Central banks are primarily focused on containing inflation, as they were before 2007. They remain blind to underlying economic and financial imbalances. The Fed’s policy rate is back where it was in 2007. Connolly says the financial system can’t tolerate even this relatively “normal” rate. There’s simply too much debt and bubble wealth out there. Though the yield curve has been inverted for some time, Connolly argues that the danger point occurs when long-term borrowing costs converge with short-term rates. This happened in mid-2007 and again in recent weeks.

Another financial crisis is not far away, in Connolly’s view. When markets collapse, the central bankers will return to their old ways, cutting interest rates and boosting asset prices. Under those circumstances, long-dated government bonds should provide the best protection for investors. For example, U.S. Treasury Inflation-Protected Securities, whose face value rises in line with consumer prices, currently yield around 2.4% for a security maturing in 30 years. That’s a fair return in normal times and could prove an outstanding investment if Connolly’s analysis turns out to be even half correct.

Reuters Graphics
Reuters Graphics

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