More than 31,000 nurses and healthcare workers at Kaiser Permanente began an open-ended strike today across 200 clinics and 20 hospitals in California and Hawaii. The walkout, involving a wide range of frontline medical staff, marks a major confrontation between healthcare workers and one of the largest corporate healthcare systems in the United States.
For years, nurses have warned that conditions in Kaiser hospitals and clinics have become unsafe for patients and staff alike. Chronic understaffing is pervasive, routinely driving staffing levels below established standards and forcing nurses to manage excessive patient loads. Exhaustion, injury and burnout are widespread, which raises sharply the risk of medical errors.
Insufficient staffing has produced long delays for primary and specialty care, overcrowded emergency departments and the routine placement of patients in hallways and waiting rooms for extended periods. Nurses are increasingly pulled away from bedside care by expanding administrative demands, reducing the time and attention each patient receives. Together, these conditions undermine care, violate basic medical standards and expose the human cost of a profit-driven healthcare system.
Kaiser Permanente holds enormous financial reserves and has accumulated billions in surpluses that could be used to hire and retain staff, reduce workloads and improve patient outcomes. Instead, management has refused any meaningful resolution of longstanding safety concerns. Nurses describe a calculated strategy of delay and attrition aimed at wearing workers down while conditions inside facilities continue to deteriorate.
Kaiser Permanente’s self-promotion as a “nonprofit” healthcare provider serves to obscure the reality of its operations. While accumulating vast surpluses, the corporation has systematically intensified exploitation inside hospitals and clinics. It generated $12.9 billion in net income in 2024 and $7.9 billion for the first three quarters of 2025.
Leading up to the strike, Kaiser has recruited thousands of travel nurses to replace striking workers and has also taken legal action to break the contract into separate local contracts to pit nurses against each other.
The strike unfolds amid a broad eruption of struggles against war, authoritarianism and social inequality, reflecting a renewed resurgence of working-class resistance.
The urgency of this struggle is underscored by the murder of Alex Jeffrey Pretti, a 37-year-old intensive care nurse at the Minneapolis VA Health Care System, who was murdered by a US Border Patrol agent in Minneapolis on Saturday morning. Pretti, who cared for critically ill patients, including military veterans and dedicated his life to healing, is the latest victim of the escalating conspiracy of the Trump administration to establish a presidential dictatorship.
The killing of Pretti followed the massive demonstration of more than 100,000 workers and young people in Minneapolis on Friday, in which many nurses took part. Healthcare workers in particular are outraged over the efforts of ICE to seize immigrants who are seeking medical care. According to the nurses union, Kaiser invests in companies that run ICE detention centers and “provide health care and living conditions so substandard they border on criminal.”
Some 15,000 nurses in New York City have been on strike for more than two weeks against unsafe staffing, inadequate benefits and poverty wages. Tens of thousands of educators in Los Angeles, 40,000 University of California workers and researchers and growing numbers of logistics workers and public employees nationwide are confronting employers and governments determined to impose austerity despite soaring corporate profits.
The Trump administration has escalated attacks on public health and democratic rights, slashing healthcare funding, undermining vaccination programs and expanding repression through mass deportations and militarized policing. These policies have already driven millions off health insurance and deepened a public health catastrophe produced by decades of bipartisan neglect and privatization.
For months, the United Nurses Associations of California/Union of Health Care Professionals (UNAC/UHCP) has kept Kaiser workers on the job without a contract, isolating them from other sections of healthcare workers and blocking efforts to wage a unified struggle. The union’s role has been to contain opposition, not mobilize it.
To take this fight forward, initiative must remain in the hands of the rank and file. Nurses and health professionals must organize to enforce their democratic decision to strike and resist any attempt by the union bureaucracy to limit or cancel the walkout without their consent.
Kaiser workers should appeal directly to their coworkers in UFCW Local 770—clinical laboratory scientists and technicians—who are scheduled for a separate two-day strike on January 22–23. UNAC/UHCP is part of the Alliance of Health Care Unions, representing 23 locals at hospitals and clinics from Hawaii to Washington D.C. The entire membership must be drawn into joint actions through the formation of rank-and-file strike committees, independent of the union apparatus.
The central issue confronting nurses is that healthcare in the United States is organized around profit, a system defended by both major political parties and reinforced by union leaderships closely aligned with the Democratic Party. Even nominally nonprofit health systems operate according to market imperatives, treating patient care as a commodity and labor as a cost to be minimized.
The strike raises broader political questions about who controls healthcare, who determines staffing, wages and conditions and how workers can organize independently of corporate management and union bureaucracies.
The crisis facing healthcare workers cannot be waged in isolation. Nurses in California, Hawaii and New York must unite with workers in Minnesota and across all sectors in a common struggle against dictatorship, war, repression, and exploitation. This requires a new strategy: the building of rank-and-file committees, independent of the union apparatus and both capitalist parties, to coordinate mass action across workplaces, industries and regions.
The International Workers Alliance of Rank-and-File Committees (IWA-RFC) provides the foundation for this fight. It aims to unify workers globally in a counteroffensive against the capitalist system’s entire agenda—mass layoffs, inflation, inequality, and the turn to authoritarian rule. The Kaiser strike must be transformed into the spearhead of this broader movement, led by the workers themselves.