Kaiser Permanente Union Workers Strike, Mounting Largest U.S. Healthcare Walkout on Record Wages-and-staffing fight prompts over 75,000 employees to stop work


(AP) — Some 75,000 Kaiser Permanente workers walked off the job Wednesday in multiple states, kicking off a major healthcare strike in an extraordinary year for U.S. labor organizing and work stoppages.

Kaiser Permanente is one of the country’s larger insurers and healthcare system operators, serving nearly 13 million people. The nonprofit company, based in Oakland, California, said its 39 hospitals, including emergency rooms, will remain open during the picketing, though appointments and non-urgent procedures could be delayed.

The Coalition of Kaiser Permanente Unions, representing about 85,000 of the health system’s employees nationally, approved a strike for three days in California, Colorado, Oregon, and Washington, and for one day in Virginia and Washington, D.C.

“They’re not listening to the frontline health care workers,” said Mikki Fletchall, a licensed vocational nurse based in a Kaiser medical office in Camarillo, California. “We’re striking because of our patients.”

Early Wednesday, workers at Kaiser Permanente Los Angeles Medical Center cheered as the strike deadline arrived. The strikers include licensed vocational nurses, home health aides, and ultrasound sonographers, as well as technicians in the radiology, X-ray, surgical, pharmacy, and emergency departments.

Brittany Everidge, a ward clerk transcriber in the medical center’s maternal child health department, was among those on the picket line. She said because of staffing shortages, pregnant people in active labor can be stuck waiting for hours to be checked in. Other times, too few transcribers can lead to delays in creating and updating charts for new babies.

“We don’t ever want to be in a situation where the nurses have to do our job,” she said.

Doctors are not participating in the strike, and Kaiser said it was bringing in thousands of temporary workers.

The strike comes in a year when there have been work stoppages within multiple industries, including, transportationentertainment and hospitality.

The healthcare industry alone has been hit by several strikes this year as it confronts burnout from heavy workloads — problems that were exacerbated greatly by the COVID-19 pandemic.

Unions representing Kaiser workers in August asked for a $25 hourly minimum wage, as well as increases of 7% each year in the first two years and 6.25% each year in the two years afterward.

Union members say understaffing is boosting the hospital system’s profits but hurting patients, and executives have been bargaining in bad faith during negotiations.

Tonya Harris, who was on the picket line in Irvine, about 40 miles (64 kilometers) south of Los Angeles in Orange County, said medical assistants like her are often asked to double up with doctors – each of whom has up to 20 patients – instead of working one-to-one.

“You’re running around and you’re trying to basically keep up with the flow,” she said, wearing her strike captain vest over her scrubs.

The single mother with two kids going into college said she also can’t afford to live in Orange County on her current pay.

Kaiser has proposed minimum hourly wages of between $21 and $23 next year depending on the location.

Since 2022, the hospital system has hired 51,000 workers and has plans to add 10,000 more people by the end of the month.

Kaiser Permanente reported $2.1 billion in net income for this year’s second quarter on more than $25 billion in operating revenue. However, the company said it still was dealing with cost headwinds and challenges from inflation and labor shortages.

Kaiser executive Michelle Gaskill-Hames defended the company and said its practices, compensation, and retention are better than its competitors, even as the entire sector faces the same challenges.

“Our focus, for the dollars that we bring in, is to keep them invested in value-based care,” said Gaskill-Hames, president of Kaiser Foundation Health Plan and Hospitals of Southern California and Hawaii.

She added that Kaiser only faces a 7% turnover compared to the industry standard of 21%, despite the effects of the pandemic.

“I think coming out of the pandemic, health care workers have been completely burned out,” she said. “The trauma that was felt caring for so many COVID patients, and patients that died, was just difficult.”

The workers’ last contract was negotiated in 2019, before the pandemic.

Hospitals generally have struggled in recent years with high labor costs, staffing shortages, and rising levels of uncompensated care, according to Rick Gundling, a senior vice president with the Healthcare Financial Management Association, a nonprofit that works with healthcare finance executives.

Most of their revenue is fixed, coming from government-funded programs like Medicare and Medicaid, Gundling noted. He said that means revenue growth is “only possible by increasing volumes, which is difficult even under the best of circumstances.”

Meanwhile, workers calling for higher wages, better working conditions, and job security, especially since the end of the pandemic, have been increasingly willing to walk out on the job as employers face a greater need for workers.

The California legislature has sent Democratic Gov. Gavin Newsom a bill that would increase the minimum wage for the state’s 455,000 healthcare workers to $25 per hour over the next decade. The governor has until Oct. 14 to decide whether to sign or veto it.

More than 75,000 unionized Kaiser Permanente healthcare workers walked off the job on Oct. 4 in the largest healthcare industry strike in U.S. history. Picketing began early this morning in Washington, D.C., and Virginia, with employees following suit at Kaiser facilities in Colorado, California, Oregon, and Washington after a fruitless final attempt overnight to settle a contract with chief executives at the non-profit health system. The strike will last a maximum of three days before the coalition will send members back to work amid further negotiation, though D.C. workers are striking for one day only. 

The eight unions involved in the strike cover 40% of Kaiser Permanente's workforce, many of whom have expressed concerns with insufficient staffing levels they say have persisted since the pandemic, causing lapses in both patient care and the provision of fair labor practices. Though doctors, some nurses, and other workers not covered by the Coalition of Kaiser Permanente Unions will be working throughout the strike in order to keep hospitals and emergency departments open, the organization has asked for patience from the nearly 13 million Americans it covers, who can expect high wait times and rescheduled non-urgent procedures and appointments.

“Kaiser used to hold itself out as the best place to get care and the best place to work, but it is now failing at both. Kaiser can and must do better,” Linda Bridges, president of the OPEIU Local 2 union that represents 8,000 Mid-Atlantic Kaiser workers, said shortly before the workers’ existing contract expired on Sep. 30. 

The resulting strike is the latest to occur as tensions over labor rights ratchet up in numerous U.S. industries. According to the U.S. Bureau of Labor Statistics, 2022 saw a total of 120,600 workers involved in 23 major work stoppages. Along with a United Auto Workers walkout that began in September, the Kaiser strike brings the 2023 total to more than 400,000 with nearly 3 months left in the year. The Kaiser Permanente strike is also a reflection of the widespread problem understaffing has become in the U.S. healthcare industry. Many of the same concerns were expressed by the 7,000 nurses at two New York City hospitals who protested for three days in January. Because of unions’ commitment to prioritizing patient care, strikes in the healthcare industry are subject to special requirements that can make them more difficult to execute, including providing organizations with 10 days' notice. 

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During COVID, “there was sort of a rupture in the relationship between health care workers and their employers,” says Patricia Pittman, director of the Health Workforce Research Center at George Washington University’s Milken Institute School of Public Health. “There’s a sense among the health care workforce, that, frankly, nobody cared about their safety.”

What’s At Stake

The striking workers make up nearly all elements of patient care at Kaiser clinics and include emergency department technicians, pharmacists, housekeepers, and hundreds of other positions. “These are the people who you're going to see from the moment you walk up to the front desk to the nurses [who] are at your bedside,” says Renee Saldana, a spokesperson for California-based SEIU-UHW, the largest of the striking unions. 

In California, where Kaiser is the single largest provider of health care, a May survey of 33,000 workers across health systems conducted by a state healthcare justice union found that a majority of respondents had witnessed delayed or denied patient care due to staffing shortages. Seventy-four percent specifically cited not having enough time to care for patients properly, while 83% reported understaffing in their departments. 

“Leadership is up against the wall already, because so many people are quitting,” says Pittman. The resulting impacts are present at many non-Kaiser hospitals, she adds: “We see it with the CDC reporting this huge spike in hospital-acquired infections and other patient safety episodes.”

The union coalition cites executives’ unwillingness to invest in staffing as a key cause of these issues. The coalition is demanding not only increased hiring beyond the 10,000 new hire goal for 2023 established earlier this week by Kaiser but also higher pay and better training, both of which they say could help prevent high turnover in the face of industry-wide burnout and cost-of-living crises in key states where Kaiser operates. The currently proposed 4% maximum annual wage increase in Kaiser’s contracts is insufficient, the coalition says.

Strikers also oppose a proposed change by Kaiser leaders that would make it easier for jobs to be subcontracted and outsourced to independent healthcare companies, a practice that coalition representatives say prioritizes lower-paid work at the risk of workplace stability.

The strike could also portend similar action in other U.S. health systems, says Pittman, given that Kaiser had for many years been “held up” as a model for labor rights and salary stability in the industry, due in part to forward-looking negotiations in the late ‘90s.

“It's particularly shocking that this could be happening at Kaiser Permanente,” she says, “and sort of does not bode well for the rest of the healthcare organizations in the country.”

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