Two thousand mental health workers at Kaiser Permanente in Northern California have entered the second week of their indefinite strike over intolerable working conditions, chronic understaffing and the rights of their patients to mental health care. Their courageous struggle must be expanded and supported by health care workers across the country and internationally, as well as among broader sections of workers.
The situation within all hospitals is untenable, and workers are exiting the profession in droves. Staffing in every state is at crisis levels, and health care workers are unable to provide high quality care to their patients. The erosion of health care is a great crime that is being carried out, not just against specific sections of workers and patients but against all of society.
For over a decade, Kaiser Permanente, the integrated insurance and health care giant, has failed to provide its 8.6 million members with timely mental health care, potentially transforming basic mental health needs into life-or-death crises. The disaster that is Kaiser’s mental health system long predates the COVID-19 pandemic, but the mass influx of ill patients has stressed the system to a whole new level. The rampant spread of the deadly virus has also left its mark on the psyche of the population, leading many to struggle with Post Traumatic Stress Disorder (PTSD). The unending spread of new variants is intersecting with a growing movement by workers everywhere against the subordination of human life to profit and share values.
Striking mental health workers, members of the National Union of Health Care Workers (NUHW), describe the mental anguish they experience by not being able to provide routine quality care to any of their patients. Some patients are waiting two months or longer to be seen for conditions that require weekly or biweekly care. Numerous providers attest that they are regularly pushed by Kaiser to meet unrealistic patient quotas, squeezing additional patients into an already packed schedule. High patient loads also impinge on administrative time, which is needed by providers to write notes and follow up with patients.
The issues they face are a terrible testament to the grim reality facing the health care system. Health care workers are past the breaking point and are beginning to fight back. Earlier this month, 15,000 Minnesota nurses overwhelmingly approved strike action. More than 6,200 Michigan nurses will soon also carry out a strike vote. In California, 8,000 Bay Area Sutter nurses remain without a contract. This fight is deeply tied to workers’ struggles around the world, with health care workers from Turkey to New Zealand to Sri Lanka opposing the same basic conditions, greatly exacerbated by the response of the ruling class to the deadly virus.
Health care and the crisis of capitalism
At the root of this crisis is the fact that under capitalism, the provision of health care, like all other social needs, is dictated by the profit motive. The profits of giant hospital chains, insurance companies and others dominate every aspect of the system, leaving health care out of reach for millions and public health infrastructure crumbling under the weight of decades of cost-cutting and understaffing. It was this failed system has allowed the COVID-19 pandemic to batter health care.
Biden was elected on the promise that he would “follow the science.” Yet in the past 1½ years his administration has openly pursued a policy of perpetual mass infection, not only continuing but ramping up the Trump administration’s “herd immunity” strategy. These decisions were made because the measures necessary to fight the pandemic conflict with the profit interests of the financial elite, summed up in the ghoulish phrase, “The cure can’t be worse than the disease.”
Allowing COVID-19 to spread unchecked has set the stage for new surges, new mutations and the erosion of the efficacy of existing vaccines and treatments. Over 1 million deaths in the US have left behind many times more grieving family members and loved ones. Children are growing up in their formative years with intense levels of grief and trauma, having to learn to live without a primary caregiver and fearing every day that they could catch COVID-19 and pass it onto their family. Then there is the further impact of Long COVID devastating the lives of tens of millions as they find themselves saddled with cognitive issues, chronic fatigue and other debilitating symptoms.
In any rational society, this crisis would be met with a massive reallocation of resources towards public health, including the hiring of thousands of mental health professionals and free access to mental health care. Instead, the exact opposite is being done. Staffing shortages are worsening, as exhausting workloads, illness and safety concerns drive professionals out of the health care sector in droves. Entire hospitals and outpatient facilities are closing due to a lack of resources.
Far from fighting against the subordination of health care to private profit, the trade unions enable and support the capitalist parties and health care companies. The NUHW is appealing to the Kaiser board and Democratic politicians to pressure management and enforce legal regulations for timely access to mental health care. These are the same people who have seen their stock portfolios soar throughout the deadly years of the pandemic, social criminals who have pushed through cost-cutting concessions and halted public health measures, causing hundreds of thousands of preventable deaths.
The trade unions have worked to suppress and block the opposition of nurses and health care workers by pushing through sell-out contracts and isolating powerful struggles, claiming “victory” while providing “raises” well below inflation—in reality, real wage cuts—and offering nothing concrete to address staffing issues or other demands of literal life-and-death importance. In exchange, trade union bureaucrats are rewarded with rising salaries and promotions. The interests of the union executives are not aligned with but entirely antagonistic to the interests of the workers themselves.
The way forward
The mental health workers have demonstrated immense courage standing up to a health care giant like Kaiser Permanente. But their struggle is being actively isolated and starved by the NUHW. A united struggle requires the development of a new strategy and new organizations which are capable of challenging not only Kaiser management but the corrupt union bureaucracy, and enforcing democratic, rank-and-file control over the conduct of the strike.
This means forming a rank-and-file strike committee uniting mental health workers at every hospital in order to establish direct lines of communication with other Kaiser workers, Sutter, Stanford, University of California and other nurses to build up support for statewide strike action.
What would the strategy for victory be of a rank-and-file strike committee?
First, for the strike to be victorious, mental health workers must appeal for the broadest possible support in the working class. First of all, this requires the fight for unity with health care workers throughout the Kaiser system, and the preparation of common action. This includes the 18,000 Northern California Kaiser nurses in the California Nurses Association (CNA) whose contract expires on August 31.
Kaiser mental health workers must learn from the experiences of the past year. In Northern California, 700 Kaiser stationary and biomedical engineers were isolated and starved on the picket lines by the International Union of Operating Engineers (IUOE) and forced to return to work without a contract.
In mid-November 2021, 32,000 Kaiser workers across California and Oregon were set to strike but were betrayed when the union canceled it at the eleventh hour and rammed through a sellout contract. It contained sub-inflation wage increases and no guarantees on staffing ratios but included $50 million in funding for the bureaucracy through the Labor-Management Partnership and other corporatist schemes.
Second, Kaiser mental health workers must have their incomes protected throughout the strike. Full strike pay will show Kaiser that the mental health workers have the ability to remain on the picket for as long as it takes until their demands are met. The rank-and-file strike committee must demand that the assets of not only the NUHW but also the CNA and the California AFL-CIO be placed at the disposal of the strike. The six-figure salaries of top union officials must be suspended for the duration of the strike in order ensure that the strike is as well-provisioned as possible.
Third, the rank-and-file strike committee must fight to develop democratic control over the struggle. There can be no premature shutdown of the strike before a contract has been ratified which meets workers’ demands. The committee would organize broad discussion among strikers to determine what their “red lines” are, beyond which they will not accept any agreement. It would also fight for rank-and-file control and supervision over contract talks. Any agreement worked out behind closed doors will only be to the detriment of workers. Negotiations must be livestreamed.
Committees such as these are being built by health care workers around the world. Last November, Kaiser nurses founded a committee to oppose the cancellation of their strike and the union-backed sellout contract. In May of this year, a nationwide health care rank-and-file steering committee was founded by nurses around the US. Teachers, autoworkers, railroaders and other sections of the working class are also building committees to fight for independent workers’ power. Kaiser mental health workers will find in this growing network a powerful base of support for their strike and a means of breaking through the isolation.
The World Socialist Web Site stands ready to assist any way it can. For more information and for discussion on rank-and-file committees, contact us by filling out the form below.
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