[Kaiser health care workers launched the biggest such strike in US
history earlier this month. Their contract agreement, announced late
last week, shows the landmark strike secured big gains for workers and
patients alike.]
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THIS MONTH’S KAISER HEALTH CARE STRIKE WON BIG FOR WORKERS AND
PATIENTS  
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Michael McQuarrie
October 17, 2023
Jacobin
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_ Kaiser health care workers launched the biggest such strike in US
history earlier this month. Their contract agreement, announced late
last week, shows the landmark strike secured big gains for workers and
patients alike. _

Striking Kaiser Permanente workers hold signs as they march in front
of the Kaiser Permanente Vallejo Medical Center on October 6, 2023 in
Vallejo, California., Justin Sullivan / Getty Images

 

Earlier this month the Coalition of Kaiser Permanente Unions staged a
three-day unfair labor practice (ULP) strike
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in response to Kaiser’s unwillingness to seriously negotiate with
the coalition in the months leading up to the contract’s expiration
on September 30. The seventy-five-thousand-worker strike was the
largest health care workers’ strike in US history, surpassing a
strike of fifteen thousand Minnesota nurses
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in 2022.

By all accounts, the turnout for picket lines at Kaiser’s
thirty-nine medical centers was very strong, and enthusiasm was high.
Picket lines had DJs, people in costumes, drummers, and plentiful
food, all of which contributed to a generally fun and energetic vibe
that was only challenged by an early-fall heat wave. There were even
other locals that struck in sympathy, such as Engineers and Scientists
of California Local 20 members, who were very visible on the Kaiser
picket lines last week despite having a contract expiration date later
this month.

The coalition promised to strike again in November if progress
wasn’t made in contract negotiations. Its show of force seems to
have paid off. At 3:00 a.m. on Friday, October 13, the coalition
reached an agreement with Kaiser that will have annual raises of 6
percent in the first year and 5 percent in the remaining three years
of the four-year contract (resisting Kaiser’s goal of holding the
coalition to the standard negotiated in other Kaiser contracts), a
$1,500 ratification bonus, increased minimum wages for all Kaiser
workers, preserved health care and other benefits (with improvements
for retiree health care), and eliminated regional differences in wages
(Kaiser wanted to increase regional differences).

Kaiser workers have lucrative performance bonuses that Kaiser wanted
to reduce. The agreement preserves them. A portion of them will be
tied to financial goals, but the union successfully tied a portion to
aggregate patient outcomes — namely, lowering the blood pressure of
Kaiser patients and vaccination rates. Dave Regan, the president of
Service Employees International Union – United Healthcare Workers
West (SEIU-UH), notes that the union is fine positioning itself in
alignment with the common good as well as the good of coalition
workers, in opposition to Kaiser’s emphasis on financial outcomes.

Importantly, Julie Su, the acting secretary of labor, flew to
California for the final round of negotiations, which was agreed to
after the coalition’s strike. Her role in achieving the settlement
has been acknowledged by both the coalition and Kaiser. Coalition
workers were very pleased that she came in talking about how she grew
up as a Kaiser member in California and has a personal investment in
the resolution of contract negotiations. Su played an active role,
even in the all-night bargaining session that finally resulted in the
agreement. One negotiating team member noted that “she was literally
in the room with us, doing the work.”

The success of the strike appears to have caught Kaiser by surprise,
prompting the company to quickly agree to a new round of contract
negotiations. But Su’s presence, while perhaps not the decisive
factor, was clearly appreciated by union members and leaders. It also
suggests that Su, who began in her current role earlier this year,
might be a better ally than the Biden administration was to the
railroad workers
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in 2022.

As with the strikes that have hit Hollywood
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and the Big Three automakers
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one that nearly hit UPS
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inflation, the pandemic, and a tight labor market have all contributed
to the circumstances around the Kaiser strike. The inequality that has
been continuously growing through financial bubbles and waves of the
pandemic is stressing workers, even those in relatively good jobs like
unionized manufacturing and health care. Workers are clearly tired of
bearing the brunt of bad managerial decisions, and of submitting to an
institutional context that favors corporations and the wealthy over
working people and their communities.

But all of these strikes also involve industry- and company-specific
issues. Health care workers bore the brunt of the COVID-19 epidemic.
Thousands died
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Tens of thousands left the industry. Kaiser workers reported living in
their garages or otherwise having to isolate for months from their
families. The ones who remained have been stressed at work
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due not just to the pandemic but also to widespread short staffing,
which both undermines patient care and exhausts the workers who
remain.

The contract addresses these issues in a number of ways. It increases
shift differentials for the first time in thirty years, an outcome
strongly desired by Kaiser workers that stabilizes the workforce.
Kaiser has wanted to increase outsourcing and subcontracting to
increase financial performance and deal with the staffing issues. In
this round of negotiations they were targeting “revenue cycle”
workers (people who deal with billing and reimbursement — a job that
has become much more important and much more complicated). The
coalition preserved the protections and expanded its own approach to
dealing with staffing shortages: facilitating the training of new
health care workers by funding tuition through Futuro Health and
developing a readily available workforce through AlliedUP, a
worker-owned and unionized staffing agency (which started in
California but is now being expanded across Kaiser’s footprint).
Funding for Futuro Health dropped by $20 million in this contract, but
the last round of funding had not been fully spent anyway. Finally,
the coalition agreed to limit some internal bidding rights that Kaiser
felt were being abused and otherwise made organizing staffing more
difficult than it needed to be.

Ethan Ruskin, who has been a health educator at Kaiser’s San Jose
Medical Center for twenty-two years and who serves on UHW’s
executive board, told _Jacobin_ that Kaiser underestimated the
coalition and its willingness to strike, something that seems
pervasive
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in contract negotiations across industries this year. But for workers
whose job is to help people, like teachers and health care workers,
the decision is especially fraught. As Ruskin said, “People don’t
go on strike for wage increases” — the stakes have to be much
higher.

There has not been a major strike at Kaiser in decades, but that
doesn’t mean workers have been content. Kaiser’s approach to the
negotiations radically underestimated the degree of stress and anger
that’s been intensifying among health care workers since the
pandemic, as well as the level of organization achieved within the
coalition.

In broader terms, financialization
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is having a big impact on health care delivery. Financial performance
is more and more important to health care managers and executives.
This process is impacting patient care, as health care operations are
eyed more for their potential for financial extraction than whether
they are meeting the needs of patients. Kaiser, a nonprofit health
care provider with a distinctive integrated model that is organized to
improve the overall health of its clients while keeping costs low, is
consistently profitable. But increasingly those profits have been used
to fund acquisitions outside of its footprint, venture capital
investments, and a $56 billion unrestricted investment portfolio. The
lauded labor-management partnership at Kaiser has been increasingly
stressed, and Kaiser has been having difficulty sustaining its
standing as one of the best health care employers in the country.

By resisting efforts to subcontract work, protecting small groups of
workers that were targeted for outsourcing, and eliminating regional
differences in pay, the new contract helps reestablish Kaiser as the
leading health care employer. This will likely help to prevent other
health systems from poaching Kaiser workers in moments of extreme
short staffing, a drain that only makes remaining Kaiser workers’
jobs harder and increases incentives to leave.

Ruskin is most pleased that the coalition stood up against Kaiser’s
efforts to divide the workforce, saying, “This matters because once
again we stood for a small number of workers that were being targeted
and didn’t trade them off for higher wages or something in
negotiations.” Worker solidarity can be hard to maintain in moments
of intense conflict with employers, but Kaiser workers stayed the
course and stood up for that principle.

The Coalition of Kaiser Permanente Unions has now set the standard for
Kaiser unions in contract negotiations — rivaled only by the
California Nurses Association contract negotiated at the end of 2022
(though notably, nurses have considerably more power than any other
bargaining unit in hospital labor relations). Given that Kaiser
initially set out to hold the coalition to the standard of the
contract negotiated by the other labor alliance, and specifically its
wage increases of 3 percent in the first two years and 2 percent in
the next two from 2021 to 2025, this was a significant victory that
pushes back against the financialization of Kaiser and the
deterioration of Kaiser labor relations since the heyday of the
labor-management partnership.

The new contract is also a major victory for the union members who
organized a successful strike across thirty-seven medical centers in
several states. The organizing this required will be a resource that
the coalition unions can continue to benefit from going forward. UHW
members have since been on strike at Prime Healthcare as well, and
have authorized a strike at Tenet’s California facilities, all while
trying to negotiate several first contracts.

Ultimately, the financialization of health care will only be resisted
by workers and patients. This strike and contract victory at one of
the largest health care providers in the country can help point the
way to better community well-being and a stronger labor movement.

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* Coalition of Kaiser Permanente Unions; Kaiser Permanente; US Health
Care;
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