On Monday, 2,000 mental health workers at Kaiser Permanente in Northern California began their strike over wages, understaffing and massive wait times for patients. The strike includes psychologists, therapists, chemical dependency counselors and social workers under the National Union of Healthcare Workers (NUHW). Pickets on the first day were held at Kaiser facilities in San Francisco, Fresno, Sacramento and San Jose, and rotated to other sites throughout the strike.
The World Socialist Web Site spoke with strikers on the picket line Monday afternoon. Anessa, a clinical psychologist from Kaiser Vallejo with 20 years experience and a doctorate of psychology, explained the conditions at Kaiser. “I can’t see my patients except every 6-8 weeks at a time. My patients are literally languishing, out contending with their own crises for weeks and weeks and weeks and feel so hopeless that they have no other options but to hurt themselves, but to suicide. And if they do try to get more help, they’re then going to our emergency departments. They’re going to higher levels of care when all I want to do is treat my patients.”
According to the NUHW, over the past 18-month period 850 practitioners left Kaiser, an annual turnover rate of more than 10 percent. A recurring theme among strikers on the picket line was feeling ground down from being unable to provide sufficient care. Jeremy, a licensed marriage and family therapist for Kaiser Walnut Creek, said, “The reason I’m out here also is that good patient care can’t be provided by clinicians who are impaired by their working conditions. Our clinicians are so stressed, overworked, and are really passionate about the work that we do. They’re very skilled, but we can’t do great under conditions like this. We’ve been bleeding therapists.”
Hammered by the COVID-19 pandemic and worsening social crisis, health care workers across the world have been fighting back demanding better wages and working conditions. Also at Kaiser, 32,000 health care workers in Southern California were set to strike in December, when the Alliance of Health Care Unions called off the struggle at the last minute and rammed through a concessions contract. Kaiser stationary engineers, who struck for three months last year, remain working without a contract.
In response to those union betrayals, Kaiser workers formed a rank-and-file committee to wage a determined struggle rallying workers in defense of health care. The NUHW is preparing a similar betrayal of this strike. As with the previous strikes by the NUHW in 2015 and 2019 over the exact same issues, the union intends to keep its members isolated and then ultimately push through an agreement that “[falls] short of what members had hoped to achieve in terms of economics and patient care protections,” as the union itself described the last contract.
According to an e-mail sent by the NUHW, the union has proposed to Kaiser a set of raises that fall far below inflation, with 3 percent raises every 6 months starting retroactively in October 2021. The annualized inflation rate currently stands at 8.5 percent, making this an effective pay cut, which can only hurt staffing and retention.
The deterioration of working conditions at Kaiser is longstanding. “It’s been 10 years at least,” said Anessa, “and we have not been able to figure out how to really see patients in a way that all their needs are met and to be able to then have clinicians who are not completely burnt out in the system.”
Major changes at Kaiser began with the Affordable Care Act (ACA). In 2010, when the ACA went into effect, Kaiser had 8.7 million members and made $44.2 billion in revenue (about $5,000 per customer). Now enrollment has risen by almost half to 12.6 million while their operating revenue has more than doubled to $93.1 billion ($7,400 per customer). When adding in money from their financial investments, Kaiser made a record-breaking $8.1 billion in profit for 2021.
Despite these immense profits, Kaiser has consistently left positions understaffed and maintained criminally long wait times for mental health patients. In 2013 the state of California gave them a record-breaking $4 million fine for failing to schedule new patients in less than 10 days (2 days for urgent cases) as required by state law. At times patients had to wait months for an initial appointment. Kaiser was further cited in 2015 for the same problem and began squeezing their mental health workers to prioritize new patients at the expense of actually treating current patients.
The new law, SB 221, promoted by the NUHW, now requires providers like Kaiser to schedule follow-up appointments within 10 days or arrange coverage through another provider. The reality is nowhere near that. “I recently was finishing with somebody and trying to get them into an appointment,” said Jeremy “The next one was nine weeks out.”
A serious struggle in defense of mental health workers means reaching out to and joining forces with other health care workers. Already the stand Kaiser workers are taking is inspiring workers across the country. Casey, a nurse in Idaho, told the WSWS, “To those nurses striking to improve work conditions for yourself and your patients, thank you from a mental health nurse who works in inpatient addiction recovery.”
Liz, a nurse in Southern California, wrote, “I am in complete support of the Kaiser mental health workers’ strike. I understand the horrible conditions they are experiencing and how that affects their patients.
“I’m a registered nurse and worked under horrible conditions pre-pandemic because of the system of profits over lives that reigns in our healthcare system. These horrible conditions that the mental health workers are experiencing did not happen overnight. This system has been purposely created by Kaiser Permanente and the health care giants because it is in the business of profiting off the misery of its patients by not providing mental health services in a timely manner. Kaiser also profits by not providing the staff needed to address the needs of patients and monopolizing the care of patients by not allowing patients to see out-of-network clinicians for their care. This is criminal.”
The conditions exist for a broader nationwide movement in defense of health care. On Monday, 15,000 Minnesota nurses voted to strike.
Anessa had a message for them from Kaiser mental health workers. “I say hold strong. Keep on task to that. Striking is one of the hardest things to consider because we feel guilty that we’re not able to treat our patients. We’re not able to be there that day, that week, those months when we are striking, but really we have to. We have to be able to stop and say ‘this is not OK.’ What we need to do is to stand back and say ‘what is it that needs to be changed?’ so that patients can get better care, so that the nurses, psychologists, the doctors can actually be available, can be healthy enough to support their patients. It’s hard enough work to be frontline as a nurse or frontline as a doctor or frontline as a psychologist.”