The Kaiser Strike Is as Much About Patients as It Is About Workers and More Notes from the Picket Line
By Jim Miller
During what many media observers have called a “hot labor summer” that has included large strikes by writers, actors, autoworkers, and other unionized sectors of the American workforce, the largest walkout of healthcare workers in the history of the United States is particularly noteworthy.
The strike of over 75,000 Kaiser healthcare staff, including many here in San Diego, has big implications not just for those workers, but for anyone who has or ever will need to negotiate the healthcare system when their quality of life or survival is at stake.
As of this writing, the three-day walkout has ended without final resolution so another action could be in the offing in the coming weeks. The San Diego Union-Tribune reported that Kaiser has issued a statement claiming “’tentative agreements’ have been reached on wages, benefits, and hiring”, but the striking unions still insist “persistent understaffing and wage proposals … do not meet the expectations of a workforce that helped communities through the COVID-19 pandemic.”
Whatever the outcome of this strike, the clear message it is sending is that the American healthcare system is broken and the corporate model that is driving it has caused a huge exodus of healthcare workers as well as historic levels of burnout amongst those who have stayed in severely understaffed hospitals.
As Craig Spencer, an emergency room doctor and professor of Public Health at Brown University, recently observed in an insightful New York Times column:
As health care has become more corporate in recent decades, physicians have also increasingly felt caught in the liminal space between their Hippocratic oath and the demands of health insurance companies. Providers routinely speak about “moral injury”: the feeling of guilt about being unable to care properly for patients in the face of hurdles like preauthorizations, diminishing reimbursements or unmanageable patient loads.
The result of this is clear to anyone who has ever had to spend a long period of time in a hospital: the drastic understaffing of the American healthcare system has deeply damaged the ability of even the most excellent doctors, nurses, and staff at all levels to adequately care for patients.
As Spencer rightly argues, “Research suggests better staffing ratios improve patient outcomes and lower costs while reducing worker burnout” and this would result in better and more affordable patient care.
In fact, pretty much everything that those privileged enough to have health care complain about from insane automated phone trees or long delays for treatment to scheduling even basic appointments comes down to a lack of adequate staffing levels. So, when you are stuck in the nightmare phone maze at Kaiser or find yourself cursing the inane bureaucracy you need to navigate just to get basic care, you have the corporate model that has Taylorized American healthcare and made it more “efficient” by cutting human labor costs to thank for it.
It's not the healthcare workers who have done this, it’s the corporatization of American healthcare. And it’s the workers and the patients who suffer the consequences.
On a personal note, I recently had the good fortune of having my life saved by a team of healthcare workers that included surgeons, doctors, nurses, and staff at all levels at both Kaiser and UCSD. To a person, they were excellent caregivers who really cared about my health and me. The only times where things were difficult came because of understaffing that resulted in delays or a lack of continuity in my care.
Not a single person involved in my care would have chosen it to be that way. But, as Spencer points out above, the system puts healthcare workers at all levels in a “liminal space between their Hippocratic oath and the demands of health insurance companies.”
It is also worth noting how healthcare workers went from being “essential worker” heroes, to afterthought zeros assailed by anti-science zealots and politically motivated bad actors in a very short time from the heart of the Covid-19 pandemic to the present.
After what so many of them endured during that horrific time, they deserve so much better, and it should be our moral obligation as a society to ensure that they are adequately compensated and that the mental and physical consequences they have endured due to this trauma are effectively dealt with. The burnout factories that American hospitals have become need a systemic overhaul, and, even if the Kaiser workers win their strike, this fundamental problem with healthcare in the United States isn’t going away anytime soon.
As Senator Bernie Sanders put it in a recent public statement:
[Kaiser workers] are the people who are there when our babies are born, when we are struggling with disease and illness, and when our loved ones die.
They are there for us when we need them most. Today, we must be there for them in their time of need.
Let’s be clear. These health care workers are not only fighting for the rights and benefits of their members, they are also striking for their patients – for us . . .
And the question we should be asking is: how is it that Kaiser – which just reported $2.1 billion in net income during the second quarter of 2023 alone – cannot afford to pay their employees better wages?
How is it that Kaiser – which pays its CEO more than $15 million and gave its former CEO a retirement package of $35 million – can't afford better staffing ratios to improve worker well-being and patient care?
Thus, if you want better care when you need it most, support the striking Kaiser workers and be diligent in your advocacy for the dignity and well-being of them and the need for free, easily accessible healthcare for everyone, regardless of class or social status. Healthcare should not be a luxury for the more affluent, but rather a basic human right.
Positive Signs in the UAW Strike?
In historian Heather Cox Richardson’s Substack blog, “Letters from an American,” she observes that the UAW may have gained a very important concession at the bargaining table last week:
UAW president Shawn Fain announced that General Motors has agreed to include workers at plants making batteries for electric vehicles in the UAW’s national labor agreement.
While the UAW wanted—and appears to be obtaining—higher wages, its leaders were especially concerned about what the transition to EVs would do to workers. Fain said that automakers had been planning to phase out the engine and transmission plants worked by union laborers and replace those jobs with lower-wage jobs in non-union battery plants. Until now, automakers had said it would be “impossible” to permit the battery plants to be covered by the union umbrella.
Fain called the agreement a “transformative win” and, in light of that agreement, announced that the UAW will not expand its strike into GM’s most profitable plant in Arlington, Texas. Fain said he expects that Ford and Stellantis, which includes Chrysler, Dodge, Jeep, and Ram, will agree to the same deal, and labor scholars agree
Thus, if true, the UAW strike may end up being not just a big win for a more newly-aggressive class conscious labor movement but a victory for those advocating for a just transition to a greener economy that does not leave workers behind. I’ll have more on this next week as the situation evolves.
Are Corporations Underestimating the Power of Organized Workers? The New York Times ran a feature analysis of the current strike wave and pondered whether corporations had failed to adjust to the new social and economic reality presented by the post-pandemic workforce. Here’s the takeaway:
The answer, many union and management experts say, is that employers are increasingly miscalculating — acting from a template that applied in previous decades, when employees had little leverage, and underestimating the frustration and resolve in the post pandemic workforce.
This is welcome news for those hoping that the recent surge in labor activism will finally help bring more power to workers and end decades of brutal corporate dominance that has played a central role in increasing economic inequality, distorting our politics, and undermining our democracy.
As we sit at the inflection point between democracy and authoritarianism, increased worker power will only help push the country in the direction of more equity and grassroots activism that insists that every American’s voice matters, not just the dictates of the corporate sector.