Kaiser workers set to strike for better patient care and working conditions

By Katie Ferrari

• Kaiser Permanente made $5.2 billion in profits in the first half of this year and pays its CEO Bernard Tyson $16 million a year. 
• Despite mushrooming profits, Kaiser wants to establish a two-tier wage system that would weaken unions. All new hires outside of the Bay Area would make 15 percent less than workers in the Bay, pay more for their health insurance, and have 401(k)s instead of pensions. 
• To combat this greed, 80,000 Kaiser workers could go on strike in October. It would be the biggest walkout in the United States since the Teamsters went on strike against the United Parcel Service in 1997.
• Workers view this strike as a way to fight for their patients and themselves. They understand that their working conditions are tied to their patients’ healthcare experiences.

On Sept. 2, thousands of union members who work at Kaiser Permanente flooded the streets of Oakland, Los Angeles, and Sacramento to rally against Kaiser’s greed. Despite mushrooming profits, the healthcare consortium is trying to shortchange workers — and patients — in its current contract fight. Kaiser’s contract with the Coalition of Kaiser Permanente Unions (CKPU) expires on Sept. 30, and over 80,000 workers in six states are prepared to go on strike in early October. 

Eleven national unions compose CKPU. It represents the vast majority of workers at any given Kaiser facility, from housekeepers who handle dangerous chemicals and sterilize bodily fluids to social workers, administrative assistants, medical assistants, and ultrasound and radiology technicians. The strike would grind Kaiser hospitals and clinics across six states to a halt. 

October’s walkout would be the largest strike in the country since the Teamsters strike against the United Parcel Service (UPS) in 1997. Even more significantly, this strike would reflect the changing demographics of the country and its working class: the walkout would be led by a majority-minority, three-quarters female workforce. The action would also bring together workers across a range of jobs, pay grades, and education levels, standing in solidarity against an increasingly inhumane employer.

Booming profits for a giant non-profit

Kaiser Permanente is the Cerberus of the healthcare industry. Unlike other health insurance companies, it’s composed of three entities: the nonprofit Kaiser Foundation Hospitals; the nonprofit Kaiser Foundation Health Plan (which sells insurance to Kaiser members); and the for-profit network of clinics, Permanente Medical Groups. 

Kaiser uses its nonprofit status to scoop up tax exemptions, deductions, and grants. In Alameda County, Kaiser enjoys exemptions on about $2.7 billion in property. In 2017, Kaiser hospitals received $95 million in government grants, and in 2010, hospitals claimed more than $475 million in federal income tax exemptions.

For a company that is mostly a nonprofit, Kaiser rakes in giant profits. In the first half of this year, Kaiser Permanente reported $5.2 billion in profits, more than it’s ever made in a single year. The way it chooses to spend its profits reflects its increasingly corporate mindset. In 2017, the company gave CEO Bernard Tyson a whopping 60 percent raise from $10 million to $16 million. Thirty-six of Kaiser’s executives make more than $1 million a year. On top of this, Kaiser has spent $900 million for a new corporate headquarters in Oakland and $295 million on a sponsorship deal with the Golden State Warriors.

Kaiser has a huge presence in California: It is the largest insurer in the state, with nearly 9 million members. It is the Bay Area’s largest employer, with close to 50,000 employees. Tyson is the first Kaiser CEO with an MBA instead of a physician’s degree, and under his leadership, Kaiser has rapidly expanded across the country, fighting labor and shortchanging workers and patients along the way. In our country’s predatory for-profit healthcare system, this behavior is par for the course, whether or not the company in question is a nonprofit organization. 

Kaiser puts profits over patients

Ollie Allen has worked for Kaiser for 20 years. He’s a medical assistant at a chronic pain clinic in Vallejo, CA. He takes pride in his work, cares deeply about his patients, and is frustrated with the company’s greed.

“Kaiser is into trendy and snappy slogans like ‘Thrive,’ but the only people who are thriving are the executives who are giving themselves these exorbitant raises. They’re not looking at how they’re taking away from our staffing. They’re not looking at how the premiums our patients are paying are unreachable.” 

Allen stresses that workers understand the gravity of a healthcare strike and view it as a last resort that Kaiser has driven them to.

“We want people to understand: We do not want to go on strike. It is heart-wrenching that we’d be away from our patients, but we feel like our patients aren’t getting the proper care right now, despite what we’re saying to Kaiser, despite us trying to negotiate with Kaiser to make sure that they invest in their facilities and their workforce.” 

In bargaining sessions, Allen was appalled to hear Kaiser refer to patients as “customers” and workers as “assets”.

“When I was at bargaining and this came out, it really was shocking and very disappointing to hear that our patients were now being looked at as commodities and not as folks in need who are coming to us… When I’m called an ‘asset,’ that means that I’m not your partner. I’m basically a tool that you use to get more profits, and you don’t want my opinion, you don’t want to hear about my concerns, the only thing you want me to do is be quiet and make you money.”

Changes that hurt workers and patients

In its pursuit of profit, Kaiser is trying to switch current employees to a roving and variable schedule and continue outsourcing. If Kaiser gets its way, employees will no longer have a set schedule and report to the same facility every day. Instead, their work lives will become much more unstable: Employee schedules will change every two weeks based on “operational need,” and they will be required to report to any facility within a given region. Allen denounces the proposed system’s impact on workers and patient care.

“The people that you take care of, you become part of those patients’ families. They get used to seeing you. You have a relationship not only with them but with the provider that you work with. You’re elbow-to-elbow with them, and you are in many cases trying to take care of some very sick people. I think that [a roving variable schedule] diminishes the quality of care. It makes the patient a consumer, where just anybody can take care of you. It’s a fast food type of decision-making mindset, where you disregard the importance of the humanity of healthcare.”

He also points out that while Tyson makes $16 million a year, Kaiser facilities are understaffed, a problem that won’t be solved by floating workers around a region.

“There are people who are waiting for very important things, like heart testing, or to get in for surgery…and we’re short-staffed. It doesn’t make a lot of sense to me to have one person do ten different things. You’re asking for mistakes to be made, you’re asking for mental fatigue, and you’re asking for patients not to get the care they deserve. That’s unconscionable.” 

Kaiser also wants to continue outsourcing jobs to lower-paid workers in pharmacy warehouses, call centers, and elsewhere. Allen describes this practice as “basically parceling out healthcare to the lowest bidder. That’s not quality healthcare, to get somebody in just because you can pay them less, and have them take care of patients that we know as our family members, our loved ones.”

A labor-management partnership that only works for Kaiser 

In 1997, CKPU and Kaiser entered into a labor-management partnership, a move made by many unions in the decades since the UPS strike. Under the partnership, unions agreed to work with Kaiser to improve its business model in exchange for an industry-setting contract. While Kaiser workers have undoubtedly and materially benefited over the years, the overall effect of the partnership has been to demobilize ordinary union members’ organizing against Kaiser. 

Workers are now waking up and realizing that even though they’ve kept up their end of the bargain, Kaiser, like other corporations, is not interested in treating their “customers” or “assets” with the dignity and respect they deserve. Kaiser has dropped all pretenses of treating labor like an equal partner. In March 2018, the company walked away from the bargaining table and refused to return unless CKPU agreed to a ban on workers “speaking out on patient care issues and engaging in political activity” like informational pickets. Such a ban would violate federal law, but it took Kaiser a full year to give up on this demand. 

Despite profits of $5.2 billion in the first half of this year and $35 billion in reserves, Kaiser continues to understaff facilities and increase patient load for doctors and is considering raising premiums, deductibles, and copays. Allen says the company also tries to deny care to patients.

“Kaiser is trying not to give you what you need from the jump. If they can get you to go away with an X-ray, that’s what they do. You might need an MRI or a CT scan, but they penny-pinch you.”

The aspect of the partnership that Kaiser is most opposed to is what Allen describes as “spreading unionism so we can raise the benefits and wages of the communities we serve.” Kaiser is expanding into states like Georgia and Virginia, which have right-to-work laws that restrict the power of workers to join and form unions. CPKU wants to organize workers in every state Kaiser spreads to, but Kaiser is bent on weakening the coalition’s unions by introducing a two-tier wage structure. Under this divide-and-conquer strategy, all new hires outside of the Bay Area would make 15 percent less, have to pay monthly premiums for family members, and get a 401(k) instead of a pension. Resentment and mistrust would brew between employees across the country who are paid different rates for doing the same valuable work. New hires outside the Bay Area might reasonably be reluctant to join a union that had agreed to such a bad deal. 

Unions allow working people to fight for one another 

In an era where three billionaires own as much wealth as the bottom half of Americans, medical debt is the leading cause of bankruptcy in the United States, and corporations control the government, unions are one of the few remaining ways working people can fight for each other. When people stand outside on a picket line instead of coming in to work, corporations are forced to listen.  

Tens of thousands of CKPU members are prepared to do just that to win a contract that treats workers fairly and delivers affordable, exemplary care to patients. October’s walkout has the potential to galvanize worker power across the country by taking the public-sector teacher strike wave into the private-sector healthcare industry. 

Striking teachers have highlighted the inseparable connection between their working conditions and students’ learning conditions. The CKPU strike stands to illustrate the same dynamic in the healthcare industry. When teachers are underpaid and class sizes are too big, students and teachers suffer. When Kaiser refuses to reinvest profits in adequate staffing for hospitals and clinics, patients and workers suffer. It’s also worth noting that, as with teaching, the healthcare industry has a majority-woman workforce. Both industries provide care that is seen as traditionally “feminine,” underpay large segments of their workforce, and often run on manipulating workers’ compassion for the children or patients they serve. Luckily for the millions of people whose lives are impacted by Kaiser, its workers are ready to hold the company accountable. As Allen says,

“Our goal is to make this place better, not to be on strike. Nobody wants to do that, but if we have to do that to rekindle Kaiser’s memory and have them remember what their purpose should be, then we gotta do it.”