More than 22,000 Kaiser Permanente health care workers in California are now engaged in contract struggles, determined to fight to defend their living standards and significantly improve a health care system ravaged by the disastrous bipartisan response to the COVID-19 pandemic. Health care workers face unmanageable workloads due to chronic short staffing, wage increases far below the rate of inflation, and continuous occupational exposure to each new variant of COVID-19, and now monkeypox. Under these conditions, health care workers who have dedicated their lives to healing the sick are leaving the profession at record levels.

There is a growing movement to fight back against these conditions. A powerful open-ended strike by 2,000 northern California mental health workers, members of the National Union of Healthcare Workers (NUHW), is now entering its second week. The contract for another 20,000 northern California Kaiser nurses in the California Nurses Association (CNA) expires at the end of the month.

Kaiser workers must understand they face a battle on two fronts. They are fighting against the largest health care “non-profit” in the country and the corporate-backed politicians who defend it. At the same time, they are in a fight against the pro-company health care unions, which are allied with the Democratic Party and integrated into Kaiser’s management structure through the corporatist bodies such as the Labor Management Partnership.

It is critical that Kaiser workers, as well as the tens of thousands of health care workers involved in contract battles in Minnesota, Michigan, New York and beyond, assimilate the lessons of the 2021 contract struggle of 50,000 Kaiser workers on the West Coast and Hawaii, which was betrayed by dozens of unions.

The following conclusions flow from that experience:

Health care workers want to fight in unity

In October 2021, 32,000 health care workers in the Alliance of Health Care Unions (AHCU) voted overwhelmingly to authorize strike action after their contract expired at the end of September. Instead, the unions set a November 15 strike date giving Kaiser as much time as possible to undermine the impact of any strike.

In 2019, the so-called Coalition of Kaiser Permanente Unions, Service Employees International Union-United Healthcare Workers West (SEIU UHW), CNA, NUHW and several other unions blocked a strike and signed a separate sellout deal. In the face of growing demands for a system-wide strike in November 2021, the coalition was forced to call one-day sympathy strikes involving roughly 70,000 workers. Such solidarity strikes have all but been abandoned with unions— which routinely force workers to cross picket lines—but the SEIU and other unions feared if they did not call the limited action their members might organize independently of the union leadership and honor the picket lines of their brothers and sisters.

This also exposed the treachery of the International Union of Operating Engineers (IUOE). On September 18, 2021, 700 northern California stationary and biomedical engineers began an open-ended strike to oppose demands for deep concessions from Kaiser. The IUOE conducted the strike as an unfair labor practices (ULP) action, barring workers from calling for sympathy action or raising any demands other than that the company “bargain in good faith.”

As a result, tens of thousands of Kaiser workers who deeply wanted to fight were ordered to cross the picket line for months. This would not have been possible without the complicity of all the Kaiser unions.

The unions are working for the other side

In mid-November 2021, over 100,000 Kaiser workers across California and Oregon were set to strike, determined to win adequate staffing, manageable workloads, and pay raises exceeding inflation. This powerful movement of health care workers was systematically dismantled and betrayed by the alliance unions.

Only two days before the November 15 strike date, the unions called it off. The AHCU announced a last-minute deal with Kaiser and instructed its members to return to work.

The SEIU-UHW, CNA, NUHW, and other unions called off sympathy actions in southern California, but felt compelled to still hold them in northern California due to the ongoing engineers' strike. Turnout was high for both one-day strikes, demonstrating workers' desire for a Kaiser-wide fight.

The depth of the AHCU's betrayal became even clearer once the details of the 34-document concessions contract were released. Kaiser got everything it wanted. Workers got raises well below inflation and no commitments on their central demand for adequate staffing, other than another useless union-management committee working to rubber stamp terrible conditions behind their backs.

Adding insult to injury, the contract included a provision that begins in the third year, in which workers are eligible for an “attendance bonus” if they take only one of their 10 sick days per year. Given the ongoing and still uncontrolled COVID-19 pandemic, this provision incentivizes workers to come to work sick.

Workers took to social media denouncing the contract and proclaiming their “no” vote. However, the AHCU announced in early December the contract had passed by a wide margin for all workers except the 1,600 members of the United Pharmacists of Southern California. The AHCU conspicuously refused to release vote totals and many workers raised significant questions over the validity of the vote.

After 90 days starving on the picket line on dwindling strike pay, isolated by the passage of the AHCU contract, the IUOE engineers conceded defeat and returned to work. Nearly eight months later, they are still working without a contract.

Kaiser paid the AHCU well for ensuring passage of deal and preventing a major strike. The maze of contract provisions included at least $48 million in payments from Kaiser to the union through a variety of union-controlled funds. These included at least $8 million in payments to the Labor Management Partnership (LMP) and $15 million for the Ben Hudnall Memorial Trust joint training program. Such joint “labor-management” programs have become the mechanism for companies to subsidize the bloated salaries of union executives, most graphically illustrated in the corruption scandal that has led to the criminal conviction of a dozen former leaders of the United Auto Workers, including two of the last four union presidents.

The fight against Kaiser is the fight against the Democrats

In well-rehearsed fashion, the unions make impotent appeals to Democratic Party politicians to curb Kaiser's exploitation of employees who provide health care to 8.6 million people.

The Kaiser unions are tied hand and foot to the Democratic Party. This includes those such as the CNA, IUOE, and NUHW, who are outside of the Labor Management Partnership and occasionally criticize other unions for collaborating so nakedly with management. Federal LM-2 filings for 2021 show the CNA spent $7.8 million on political contributions, mainly to Democratic Party politicians, with $13.5 million from the IUOE and $1.4 million from the NUHW. Neither the CNA nor the NUHW paid a dollar in strike pay in 2021. The NUHW is currently refusing to provide striking mental health workers with strike pay.

Kaiser’s brutal cost-cutting measures are bringing into being the health care system the Democratic Party wants. Democratic President Obama pointed to the cost-cutting and exploitation of Kaiser workers as the model for his so-called health care reform in 2010. Ezekiel Emanuel—an Obama and Biden adviser who infamously said society would be “better off” if people did not live past 75—has boasted about the “Kaiserfication” of the US health care system.

Furthermore, the horrific conditions West Coast health care workers continue to face are the direct product of the bipartisan policies to allow COVID-19, and now monkeypox, to spread unchecked. The Democrats and the Republicans, and the corporations and banks they represent, are well aware mass infection is increasing the burden of both acute and chronic disease in the population.

Five hundred people continue to die of COVID-19 each day in the United States alone. Tens of millions have developed lingering Long-COVID effects. Life expectancy has fallen to wartime levels. The incidence and severity of mental illness have skyrocketed. The corporate and financial elite have no intention of paying for the damage they have deliberately caused. This means workers who receive employer-paid health care plans such as Kaiser must be provided with substandard care: just enough to keep the workforce on the job.

Significantly, the fight to keep COVID-19 mitigations in place came from major cities such as Chicago, New York and Los Angeles where teachers sought strike action. It was the Democratic Party that was tasked with carrying out what Trump and the Republicans could not achieve, the full reopening of the economy. The Democrats were very aware in late 2021 that their reopening plans would not succeed if the health care system fully collapsed. They relied entirely on the trade unions to keep their members working at schools, factories and hospitals while they pushed through pro-company contracts in advance of the winter COVID-19 surge everyone knew was coming.

Every union at Kaiser has gone along with the anti-scientific Democratic Party pandemic policy without any serious resistance. Workers cannot fight through these organizations.

Workers need new organizations controlled by the rank-and-file

Kaiser workers need new fighting organizations, to allow them to wage the united struggle they have been striving for all along. For the reasons outlined above, these organizations must be independent of and opposed to the Democrats, Republicans, and the whole suite of pro-company health care unions.

In November 2021, a group of West Coast Kaiser workers took an important step in this direction, forming the Kaiser Workers Rank-and-File Committee (KWRFC) to carry forward a struggle for their demands. In a November 21 statement, the committee rejected the AHCU-endorsed concessions, and called for the corrupt Labor Management Partnership between Kaiser and the unions to be disbanded and its funds redistributed to striking workers.

These demands were based not on what Kaiser said it could afford, but on what workers know is necessary to ensure the health of the population and proper care of patients.

The lessons of this experience must be brought to bear on healthcare workers everywhere who are entering into struggle. Earlier this month, 15,000 Minnesota nurses overwhelmingly approved strike action. More than 6,200 Michigan nurses are about to hold a strike authorization vote. In California, 8,000 Bay Area Sutter nurses remain without a contract and 700 northern California Kaiser stationary and biomedical engineers are still working without a contract. This fight is deeply tied to workers’ struggles across the world, with health care workers from Turkey to New Zealand to Sri Lanka opposing the same basic conditions.

A fight for the highest level of care for patients, adequate staffing and improved working conditions is directly opposed to the capitalist pursuit of profits in health care. Taking profit out of medicine will not be achieved through pathetic appeals to the powers-that-be, a la Bernie Sanders, but a massive struggle by the working class to end the domination of the heath care monopolies and establish a socialist health care system.

Across many industries, the health and wellbeing of workers are in the same conflict with the profit motive. Railroad workers, dock workers, and truckers are all engaged in bitter struggles against speedup, understaffing, and dangerous conditions.  As the school year begins, educators are forced once again to oversee daily potential super-spreader events.

There are ample resources to meet society’s needs. But the Democrats and Republicans are spending tens of billions on their reckless proxy war against Russia in Ukraine and are actively escalating tensions with China over Taiwan. These resources must be redirected toward the needs of the working class.

Autoworkers are rallying around Will Lehman, a socialist candidate for president of the United Auto Workers who is fighting for the construction of rank-and-file committees. We call on all Kaiser workers who agree with this perspective to contact the World Socialist Web Site today to assist with the building of rank-and-file committees at your workplace.