More than 75,000 Kaiser Permanente health-care workers are poised to walk off the job within days as labor negotiations remain stalled over pay, outsourcing and staffing problems, in what could be the biggest health-care strike in U.S. history, with direct implications for thousands of patients nationwide.
A coalition of unions representing Kaiser workers had previously notified the company that a three-day strike could begin Wednesday in California, Oregon, Colorado, Virginia, Washington state and the District of Columbia. An agreement could still materialize and prevent that from happening, but a strike appears increasingly likely, as the current labor contract was slated to expire after Saturday.
Talks remain contentious, with the union accusing the company of bargaining in bad faith, and the company urging workers not to participate in any strike that would threaten the quality of patient care.
The dispute comes against a backdrop of reinvigorated U.S. labor action, with unions asserting themselves amid surging inflation and post-pandemic labor shortages. The United Auto Workers recently began walkouts at the Big Three U.S. automakers, while a five-month Hollywood writers strike recently ended.
But it can take weeks or even months for consumers to feel the impact of work stoppages in manufacturing and entertainment. A shortage of workers in certain sectors of health care, on the other hand, could immediately affect patient care.
Kaiser said it still hopes to avert a strike before Wednesday and is prepared to keep its facilities running in the event that a stoppage does occur. The D.C. area is likely to see a smaller impact than other states, a Kaiser spokesperson said, as the Virginia and D.C. members include just 400 pharmacists and optometrists who plan to strike for just 24 hours. No personnel will strike in Maryland.
In a statement late Saturday, a Kaiser spokesperson said the company and the union “continue to make progress on key issues,” citing a redesigned performance sharing plan and tentative agreements on education, the use of temporary workers, tracking vacancies and dispute resolution. “Operations will continue as normal on Sunday morning, and we will continue to honor all current contract provisions,” the Kaiser spokesperson said.
“In the case that a strike does begin on Oct. 4, we have contingency plans in place to ensure members continue to receive safe, high-quality care for the duration of the strike,” the Kaiser spokesperson said, adding: “Our hospitals and emergency departments will remain open.”
Still, patients would be likely to see longer wait times and a lower availability of outpatient services should the strike occur, according to John August, a former health-care union organizer who is now a program director at Cornell University’s School of Industrial and Labor Relations. In the event of a strike, patients would probably still be able to see doctors and nurses, but there could be a degradation of services such as pharmacy and lab work, he said.
“If you have a doctors appointment, it’s likely it will be delayed, and you won’t get the ancillary services you need in relation to that visit,” August said.
The Cornell school counted 101 strikes at 185 health-care and social-assistance facilities since the start of 2021, although none of them compare to the scope and reach of a potential Kaiser strike. Last year, in what was then the largest private-sector nursing strike in U.S. history, about 15,000 Minnesota nurses walked off the job for three days.
The Kaiser unions have argued that there is already a critical shortage of employees at the company’s facilities.
A few workers who spoke to The Washington Post say Kaiser has historically been a gold-standard employer in the health-care industry, but they say it’s now struggling with “dire” staffing problems that have worsened a mental health crisis that started during the pandemic among front-line providers. Those workers complain of being unable to serve patients effectively because there are too few people to handle the crushing workload.
“People leave in tears some days because of their assignments,” said Henry Perez, a unit assistant at an intensive care facility in Modesto, Calif. “There is no reason why we should be doing the work of two to three people. The patient care has suffered tremendously and it feels like we’re still in a pandemic.”
The unions have asked Kaiser to hire at least 10,000 employees by the end of 2023, and they chafed at a company proposal offering annual pay increases between 2 and 4 percent, saying they don’t match the rising cost of living.
Outsourcing is also a sticking point. Under an earlier labor agreement, the company was limited in its ability to outsource work to subcontractors. The company has refused to extend that language, the union coalition said.
Caroline Lucas, executive director of the coalition of unions, said Friday that health-care workers plan to keep negotiating with Kaiser through the weekend, although “there can be no agreement until Kaiser executives stop bargaining in bad faith with front-line health-care workers over the solutions needed to end the Kaiser short-staffing crisis.”
The company said in its Thursday update that it remains committed to reaching an agreement.
It acknowledged concerns about staffing and burnout, but said every provider in the nation is facing those issues because 5 million health-care workers left their jobs in the “Great Resignation” of 2021 and 2022. The company said it has already hired 9,800 people for union positions this year and is on track to reach the milestone of 10,000 by early October.
“Given the progress being made in national bargaining, there is no reason to strike,” reads an unsigned statement posted on Kaiser’s website Thursday. “We will ask our employees to reject any call to walk away from their jobs, their patients, and their colleagues.”
Health-care providers have struggled with staffing issues since 2020, when a flood of coronavirus patients left them working long hours. Case numbers subsided in 2022 but the staffing problems remained.
“We just saw a mass exodus in the health-care field,” said Megan Mayes, a patient care representative at a Kaiser facility in Hillsboro, Ore. Mayes said a lot of her colleagues have left the industry altogether, taking jobs elsewhere that offer better pay for a less frenetic work schedule.
Catherine Engler, who works at a Kaiser facility in Carlsbad, Calif., said the staffing issues have never been this bad in her 36 years as a nurse. There are three nurses in her clinic, she said, and there’s typically no replacement when one of them takes time off.
“We see anywhere from 50 to 100 appointments in a day, with appointments ranging 15 minutes to an hour, and if you’re down a person the time crunch is there,” Engler said. “It causes a delay in care, in patients not being able to make it in on time.”
Engler said she sees a shortage of not just nurses but also receptionists, technicians, lab workers, pharmacists and other workers in roles that contribute to the smooth operation of a clinic. She said she increasingly finds herself taking on work that administrative staff should have handled, recalling a patient who planned to discontinue a critical treatment because of a billing issue.
A union proposal submitted in early August calls for 7 percent annual raises for the first two years of a four-year contract, tapering down to 6.25 percent in the third and fourth year. It would also set a $25 per hour minimum wage across the company and create a joint committee to handle retirement investments.
The company’s Sept. 25 proposal includes wage increases of 4 percent in each of the first two years and 3 percent in the third and fourth years for Northern California and Washington, with 3 percent annual raises for facilities in other parts of the country. Kaiser wants to set minimum hourly pay rates of $21 to $23 for 2024, to be increased by $1 each year until 2026.
Kaiser last year reported a net loss of $4.5 billion on $95.4 billion in annual revenue.