Over 80,000 workers employed by the Kaiser Permanente Health Maintenance Organization are taking a strike vote this week. Nurses, x-ray technicians, phone operators, janitors and other workers, belonging to eleven different unions (under the umbrella Coalition of Kaiser Permanente Unions), are demanding higher wages, decent health benefits and increased staffing.
Kaiser is the largest managed healthcare organization in the US, with 12 million members in nine states and Washington, DC, and 217,000 employees. Kaiser Foundation Health Plan and Kaiser Foundation Hospitals had $79.7 billion in operating revenues in 2018.
Kaiser workers in California point out that emergency rooms are overcrowded, putting patients at risk, and that they are forced to perform two or three jobs.
Voting in the states where Kaiser operates, California, Colorado, Maryland, Oregon, Virginia, Washington and the District of Columbia will take place during the month of August and into September.
The union coalition has offered no explanation of why it will take six weeks for all workers to vote. If a strike were to take place in all the Kaiser clinics and hospitals, it would occur in October, two months after the voting began.
A walkout against the mammoth Kaiser Permanente system would involve the most workers since the 1997 United Parcel strike by 197,000 workers.
The healthcare giant, which claims to be a non-profit institution, collected over $3.2 billion in income during the first quarter of this year, an increase of 127% relative to $1.4 billion in the first three months of 2018, from a combination of 150,000 more subscribers and lower costs from a weak 2019 flu season. In 2018, the hospital and healthcare plan made $2.5 billion in income.
Kaiser, like other HMOs, profits by limiting the provision of medical services, which have been pre-paid by health insurance; it uses a variety of techniques, such as deductibles and out-of-pocket charges, to manage and lower demand. Its doctors are pressured and encouraged through profit-sharing schemes to limit their time with patients.
The issues being raised by Kaiser health workers are long-standing.
Beginning in 2003, Kaiser turned to technology design firms to study how healthcare workers interact with each other and with patients in order to reduce time spent on so-called “high value activities,” such as dispensing medications.
Kaiser workers have been without a contract since last September. There is no doubt that they are ready to fight. The biggest obstacle, however, are the unions that claim to represent them, which have done everything to prevent a unified and sustained struggle against the healthcare giant. Instead the unions have called isolated protests, largely public relations stunts, and isolated and made impotent strikes of short duration.
In March 2018, 18,000 Kaiser registered nurses voted overwhelmingly to strike at California hospitals and clinics to protest eroding patient care standards and increased workloads.
In December 2018, Kaiser mental health workers held a five-day strike, protesting long delays in the provision of mental health care, and calling for the formation of crisis teams to respond to health emergencies.
In June 2019, Kaiser unions called off a strike by 4,000 California health workers, clinical social workers, therapists, psychologists, nurses and others, claiming that there had been “progress at the bargaining table in recent weeks.”
Whatever was meant by “progress” turned out to be insignificant. Mental health workers report that the same issues over which the strike was called still persist today.
Undoubtedly, the present prolonged voting procedure that postpones any possible strike action until October at the earliest, is just another means saddling Kaiser workers with a contract worked out behind their backs.
At the same time, California supermarket workers overwhelmingly approved a strike on June 24 and 25. The strike by 60,000 grocery workers would target four chains: Vons/Safeway, Albertsons, Pavilions and Ralphs/Kroger. Over 10,000 supermarket workers in Oregon also voted overwhelmingly to authorize a strike.
The chains are offering less than one percent annual wage increases coupled with givebacks in health benefits. Management claims that these four chains need to keep labor costs down because of increased competition from non-union chains, such as Walmart.
This would be the first strike since the four-month walkout of 2003 and 2004, which resulted in a sell-out by the United Food and Commercial Workers aided by the national AFL-CIO and its President Richard Trumka.
In that struggle, the unions did nothing to stop the supermarkets from hiring scab labor at stores and distribution centers. The union allowed health benefits to expire; it then slashed already inadequate strike benefits. In the meantime, it worked out a deal that saved the supermarket chains over $400 million in the course of the contract.
The 2004 betrayal became a model for similar sellout deals elsewhere, dismantling health benefits and worsening working conditions for new hires in Washington, DC, Baltimore and other cities.
The AFL-CIO and other unions are doing everything to prevent a strike by 150,000 healthcare and supermarket workers, along with another 150,000 GM, Ford and Fiat Chrysler workers whose contracts expire in mid-September. Tied to the Democratic Party and the defense of American capitalism, the unions have sought to suppress every expression of resistance of the working class in order to keep wage increases at or below the rate of inflation and continue the expansion of the stock market bubble.
The AFL-CIO is particularly concerned that a strike would quickly evolve into a political confrontation between the working class and California Governor Gavin Newsom, Washington Governor Jay Inslee and other Democrats who are posturing as supposed friends of workers for the 2020 presidential elections.
The union executives whose salaries put them in the top five percent of income earners or higher live in a different universe than healthcare and supermarket workers who are barely scraping by in cities that have some of the highest cost of living in the US. UFCW International President Anthony Perrone, for example, pocketed $341,398 in salary and union disbursements last year, nearly 20 times what a “courtesy associate” makes at a Vons supermarket in southern California.
In the first six months of the year, there have been 15 major work stoppages in the US, compared to 20 all last year, with teachers and healthcare workers leading the fight against years of stagnant and declining real wages. This is part of a resurgence of the class struggle internationally against austerity and social inequality.
In this fight, workers are increasingly coming into conflict with unions. That is why Kaiser Permanente and supermarket workers must take these struggles out of the hands of the trade unions by forming rank-and-file committees to prepare a nationwide strike. At the same time these committees must reach out to workers and youth in their communities and link up their struggles with the autoworkers and other workers across the US and Puerto Rico, in Mexico and around the world.