× Expand David Dayen Kaiser workers fronted rallies and marches in several cities on Labor Day, including in Los Angeles. If they go forward with a walk out, it would be the largest strike in the U.S. since 1997.

In Hollywood, the Service Employees International Union's purple signs on Labor Day read “Fed Up with Kaiser Greed” and “Corporate Healthcare Is Failing Patients.” But in front of thousands of healthcare workers, activists and patients, Congresswoman Maxine Waters was even more direct. “Kaiser,” she shouted, “we're not taking any more shit off of you! We're not going to be nice anymore!”

Over 80,000 technicians, nurses, and medical personnel at Kaiser Permanente, organized through a coalition of several unions, including SEIU's United Healthcare Workers division, have authorized a strike scheduled to begin in October. A whopping 98 percent of union members voted to walk out. If they go forward, it would be the largest strike in the U.S. since 1997, when 185,000 United Parcel Service workers walked off the job.

Already, 4,000 mental health technicians at Kaiser Permanente, members of the National Union of Healthcare Workers, have been engaging in a series of actions since the beginning of June.

Workers fronted rallies and marches in several cities where Kaiser operates on Labor Day, including Los Angeles, Denver, Portland, Oakland, and Sacramento. In Los Angeles, they marched to a Kaiser medical facility and sat down in the streets in a civil disobedience action that resulted in arrests. Sacramento and Oakland also saw arrests on Monday.

It was a remarkable turnaround for a company that serves 12.2 million patients in eight states and the District of Columbia, and was not too long ago considered a model for successful labor-management relations. Kaiser Permanente’s use of unit-based teams (UBT), groups of front-line employees empowered to drive solutions for better patient care, has been lauded by its unions for years.

But now, workers at Kaiser say they are frustrated by a company that earned $5.2 billion dollars in profits in the first half of 2019, despite its nonprofit status, and holds a whopping $37 billion in reserves. They allege that Kaiser has forced chronic understaffing and reversed its longtime collaborative approach.

“They are making record profits, and it seems that their focus is all about profits and numbers and not about people,” says Eric Jines, X-ray technician at Kaiser Permanente's Los Angeles Medical Center on Sunset and a member of SEIU-UHW. “People are having to do two to three jobs at one time, taking the focus off of patient care. So they are making big profits, but yet they are not investing back in the community.”

Denise Ellis, a 21-year clerk at a Kaiser Permanente medical office in Brea in northern Orange County, echoed these comments at the Monday morning rally in Los Angeles, lamenting about chronic staffing issues and always having to work alone. “We all have a responsibility to our patients,” Ellis said.

She was joined by presidential candidate Senator Kamala Harris, who did not reference the Kaiser situation in her five minutes of generic remarks about the importance of Labor Day (though she did stress the “right to strike”). Representative Waters, however, was blunt about the need for Kaiser to improve its labor practices. She even led the march from the rally to the Kaiser facility on Sunset Boulevard. “We want them to act like a good nonprofit,” Waters told the Prospect. “Not like a big corporation.”

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A few years ago, Jines says, a turnover in management led to a new philosophy that was more focused on short-term profits. This shows through in Kaiser Permanente CEO Bernard J. Tyson making $16 million a year. Thirty-six executives each make more than $1 million annually.

“Kaiser has been hijacked by greedy corporate executives, who have figured out a way to line pockets at the cost of the patient and the workers, and it's just wrong,” says Jines. At the Los Angeles rally, Jines noted that a Kaiser executive recently complained that housekeepers making $44,000 a year make too much money. “Bernard Tyson makes $44,000 a day,” he said to cheers.

Meanwhile, many Kaiser union members have already become victims of corporate outsourcing. Jesse Felix, a courier of pharmaceutical samples, saw his department cut in half in 2018, and lost his job. “They outsource for less wages and no benefits,” Felix said at the rally. “It was a backstab. Management—they don't appreciate the value of what we do.”

Many Kaiser Permanente staff say that the short staffing creates dangerous conditions for many patients.

“I've been there for 14 years and never seen this many patients needing this many services,” says Alicia Cruz, an NUWH member and a mental health therapist at a Kaiser facility in San Francisco. Cruz says that she has seen the quality of mental therapy degrade at Kaiser, as suicidal teens are forced into group therapy because there aren't enough slots for individualized sessions.

“As a therapist, I would never put 20 families in a room. It doesn't feel right, but we do what we can and we try to service our families and provide them with care,” says Cruz. “I keep having to apologize to these families, and that's just not what I want to be doing.”

The stress of not being able to do their jobs has caused such emotional pressure that many employees find themselves debating whether to stay with Kaiser to treat their current patients, or leave for another healthcare system, where they feel they can more adequately provide care.

“Most people in this field are not working like we are working. They are not seeing patients back-to-back. They are not having the caseload that we have,” says mental health therapist Tanya Veluz, an NUWH member who practices in southern California. “We are losing staff all the time. People are getting burned out, and the morale is very low”.

In Veluz's department at Kaiser's facility in Pasadena, she estimates that 25 percent of the mental health therapists have turned over in the last year, forcing many patients to restart therapy all over again with a new therapist who doesn't know their issues.

“When you have someone in front of you in tears, crying, desperately needing to come back and you don't have another appointment for [three months], that's hard.” says Veluz. “It's heartbreaking.”

Workers have been operating without a contract since September 30 of last year. The unions mobilized a bargaining committee in 2018, but they say Kaiser walked out on the negotiations. The union coalition subsequently filed an unfair labor practice charge with the National Labor Relations Board, which the board upheld in December 2018.

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Union demands include a restoration of labor-management partnerships, including good-faith bargaining on a new contract; safer staffing levels; building the workforce to account for future shortages of accredited personnel; and increases to wages and benefits.

The situation reveals the often pernicious role of hospitals in America's often inadequate healthcare system. Hospitals are often downplayed by politicians in favor of more recognizable villains like insurance and pharmaceutical interests. The labor action could shed light on profiteering at the healthcare provider level, and the effect on patients and medical professionals.

Ultimately, many Kaiser union members say that the key to success will be their patients advocating for them.

“We need to get the word out, and our families need to complain,” says Cruz. “Then, maybe they will be forced to get more staffing”.

Marchers in Los Angeles chanted “What's this about? Patient care!” as they reached the Kaiser facility. Said Representative Waters, “We want the old Kaiser back.”

David Dayen reported from Los Angeles. Mike Elk reported from Pittsburgh.