Some 2,600 mental health workers organized in the National Union of Healthcare Workers (NUHW) are in the second week of a strike at Kaiser Permanente facilities in California. The strike was called over deteriorating conditions and the demand of the NUHW for labor-management committees to decide outsourcing and staffing levels.
Although the NUHW has called the action a “week-long statewide strike,” in reality it is a series of piecemeal actions affecting different facilities each day. The action is not coordinated with the NUHW’s parent organization, the California Nurses Association (CNA). Kaiser nurses represented by the CNA are working without a contract, but remain on the job.
Reporters from the World Socialist Web Site spoke to workers at several different locations and distributed a statement on the strike. Many workers explained that the mental health system has deteriorated over the past decade as Kaiser has sought to increase its profits.
In 2013, the California Department of Managed Health Care (DMHC) fined Kaiser $4 million for failing to meet standards requiring equal care for mental and physical health. The DMHC found that Kaiser did not provide “accurate and understandable” information about its mental health services and did not ensure that patients could easily and quickly see a clinician.
These problems are the result of widespread understaffing, an issue that workers in many branches of health care face. Rather than fix the problem, Kaiser paid the $4 million fine and has not substantially changed staffing levels.
“Over the past six to eight years, Kaiser has really changed,” said Karen, who performs intensive outpatient work with teens. “They used to care about the quality of care, but now it’s just run as a corporation for profits.” Karen has worked at Kaiser Permanente for 16 years and seen major changes with the passage of the Affordable Care Act (ACA), widely known as Obamacare.
“Over the last three months, we’ve seen a huge influx of new patients,” she said. “The County of Alameda has contracted with us for mental health patients. We’re getting a lot of bilingual patients and working with the highest risk teens now. Treatment is especially intensive at the beginning. To do a good job with some of these teens you sometimes need four appointments a week to start.”
Many health care workers commented on the huge toll that increased deductibles and co-pays have had on patients and their families. Karen continued, “For 14 years, Kaiser didn’t have any co-pays for these mental health treatments. Now, with some of the plans, it can cost patients $100 a visit, which just isn’t affordable.”
Gene, a marriage and family therapist, saw the problems with mental health care as part of a broader problem in society. “We see more and more kids, teenagers, having trouble with depression, and suicide seems to be climbing. The terrible irony is that inpatient beds are shrinking across the country for psychiatric care, which is really a calamity.
“The rich guys are running the show, which in health care means the insurance companies. People tend to suffer under capitalism. Everybody knows that, but you can barely say the word ‘socialist’ in this culture.”
Victoria, one of the bilingual workers who treat teens, spoke to our reporters about the $4 million fine from the DMHC. Victoria said, “They fixed that by getting the first appointments quickly to meet the laws, and then delaying the follow-up appointments. I get to see a lot of patients only once a month, but for effective care I should see them every two weeks.”
Despite making record profits and enrolling record numbers of new patients through the ACA, Kaiser has not significantly raised its staffing levels and is looking to cut its employees’ pensions.
“They’re trying to get everyone off of pensions and onto 401K’s,” said Ed, who has worked at Kaiser for 22 years. “They point to how much better our pension is than a lot of other workers, but what everyone needs to understand is that most of us could make twice as much at a for-profit. Our pension is part of our pay.
“It’s something workers all over are facing, the shift from defined benefit plans to defined contribution plans. Wisconsin is a great example. Governor Walker attacked pensions and there were mass protests. But then they re-elected Walker. That’s something I’ll never understand.”
Speaking about the WSWS’s call for a general strike in Wisconsin in 2011, Ed said, “They would have had immense support if they had demanded that.”
The NUHW’s parent organization, the CNA, called off a similar strike of nurses planned for this week. The unions maintain a separation between their workers even at the same workplace and when both are without contracts. The CNA is currently in contract negotiations with Kaiser over the same kinds of staffing issues as those at the center of the NUHW dispute. The CNA had scheduled a strike to begin after the NUHW strike ended, but called it off at the last moment, saying Kaiser was willing to make concessions.
The unions have supported this divide-and-conquer strategy, by which health care providers such as Kaiser and Sutter Health are able to negotiate piecemeal with isolated groups of workers.
Jeremy, a clinical social worker, explained, “They pit our union against another union and we don’t support each other, which weakens all unions here.”
The NUHW, backed by financing from the CNA, broke away from the Service Employees International Union (SEIU) in January of 2009. After a series of representation votes bankrolled by the CNA to pry dues away from the SEIU, the NUHW affiliated with the CNA as part of a payment plan for the millions the CNA had invested.
All three of these unions work to isolate their workers. In the Sutter Health strikes of 2012 and 2013, in the nurses strike at Kaiser over Ebola last November, and in the current contract negotiations at Kaiser, all three unions have opposed any discussion of the broader attack on health care and pensions being carried out by Democrats and Republicans alike.