color photograph of kaiser permanente health care workers protesting outside. they hold signs on purple, white, and yellow paper with slogans in support of workers rights like "respect and value healthcare workers." in the top left corner, the prism logo is overlaid. from the left side, a yellow text box emerges with white text that reads "Kaiser workers continue negotiations after massive 3-day strike." below it, a black text box with white text emerges from the right side and reads "If an agreement isn’t reached, workers plan to go on strike for longer in November."
Los Angeles, CA - October 04: Kaiser Permanente health care workers walk the picket line in Los Angeles as they begin a three-day strike involving more than 75,000 Kaiser workers on Wednesday, Oct. 4, 2023. (Photo by Sarah Reingewirtz/MediaNews Group/Los Angeles Daily News via Getty Images)

More than 75,000 workers at Kaiser Permanente facilities nationwide went on strike for three days last week, participating in the largest-ever walkout of health care workers in U.S. history. Kaiser workers called for the walkout on Oct. 4 in response to what they say is bad-faith bargaining by company executives.

“We feel [the strike] went great,” said Juanita Kamhoot, a certified nursing assistant at the Kaiser Permanente Sunnyside Medical Center in Clackamas, Oregon. “[Union members] felt like they were powerful. They felt that Kaiser executives were not listening because we’ve been trying to talk to them at the table for so many months, and [going on strike] was the only way.”

Workers are calling on Kaiser to provide across-the-board pay increases of up to 6.5% and hire an additional 10,000 workers to fix a staffing shortage that has plagued Kaiser Permanente facilities. While understaffing has been an issue for years, burnout, retention, and recruiting issues in the medical field have significantly escalated since the start of the pandemic. An employee in a Kaiser dental office told Prism that there are often cases where patients need to wait several months to get a cavity filling, often resulting in further complications.

“Frontline health care workers continue to await meaningful action by Kaiser executives to address our key priorities, including safe staffing, outsourcing protections for incumbent healthcare workers, and fair wages to reduce turnover,” said Gwendolyn Holloway, a contact lens technician at Kaiser Permanente Vallejo Medical Center in Vallejo, California.

Kaiser employees have now returned to work, but without a new contract, many are struggling under present conditions. Some Kaiser employees are unable to afford to live in the city they work in, forcing them to commute for hours before and after a shift or even sleep in their cars. Understaffing continues to lead to rapid burnout and poor patient care. While the strike pressured Kaiser Permanente enough to finally offer a more serious proposal, offering a minimum wage of $21 ($23 in California) and additional investments in employee education, the future of the workplace is unclear until a contract is finalized.

“When I spoke to bargaining team members, [they said] it looks pretty but not good enough,” Kamhoot said.

The striking employees, represented by the Coalition of Kaiser Permanente Unions (CKPU), included ultrasound sonographers, radiology technicians, surgical technicians, housekeepers, dietary workers, and other staff from California, Colorado, Maryland, Oregon, Virginia, Washington, and Washington, D.C. The CKPU represents about 40% of health care workers at Kaiser Permanente facilities. 

The union began its national bargaining process in April, but representatives say negotiations were hampered by unfair bargaining practices from Kaiser, including refusing to provide the union coalition with key data it needs to assess the impact of bargaining proposals. Unions have filed several charges of unfair labor practices against Kaiser with the National Labor Relations Board. 

“They would show up for five minutes, and then they would leave, or they would show up for 15 minutes and leave and not come back for a couple of days,” Kamhoot said. “You fly to California, and you’re supposed to have your negotiations. And they come sit for 15 minutes, and it’s supposed to last three days.”

Kaiser has denied the allegations of bad-faith bargaining. 

“Kaiser Permanente remains committed to reaching an agreement that is good for our employees, our members, and our organization, and we will continue to bargain in good faith with the Coalition,” the company said in an Oct. 5 statement.

As of Oct. 12, the union and Kaiser Permanente have tentatively agreed to adopt a minimum wage of $21/hour starting in 2024, increasing by $1 each year through 2026. Kaiser has also agreed to a 40% increase to the company’s education fund to help current employees afford the training required to move into higher-paid classifications, a move that could help with retention. Kaiser has also agreed to reduce the use of its registry of traveler staff and avoid using it to meet regular workforce needs.

A major sticking point in the negotiations continues to be the company’s practice of outsourcing and subcontracting, cost-cutting measures that workers say reduce the quality of patient care. A 2021 study published in the Mayo Clinic Proceedings found that health care outsourcing can result in harmful medical errors, inconsistent standards of care, and a decline in patient and employee satisfaction.

“Now more than ever Kaiser Permanente needs to retain and attract qualified health care professionals,” said Kathleen Coleman, a medical assistant at a Kaiser facility in Colorado. “Outsourcing and subcontracting would have the opposite effect.”

On the third day of the strike, Kaiser Permanente and the union scheduled additional bargaining sessions for Oct. 12 and 13. But if talks break down, the union has told Kaiser Permanente that a longer strike could take place Nov. 1-8. On Oct. 31, a contract covering workers in Seattle will expire, allowing an additional 3,000 Kaiser workers in the city to join the picket lines if a November strike takes place.

“Frontline health care workers remain ready to continue taking the necessary steps to protect our patients from the dangers of the Kaiser short-staffing crisis and to defend our rights,” said Georgette Bradford, an ultrasound tech at Kaiser and a member of the union’s bargaining team.

While only three days, the October strike hinted at the negative repercussions that could hit Kaiser Permanente if the company and the union fail to come to an agreement. Kaiser Permanente serves 12.7 million people in the U.S., and some patients trying to get non-emergency services and elective surgeries experienced delays, postponed appointments, and difficulty getting information

Kamhoot emphasized that workers do not want to strike, but it is necessary to get Kaiser to address the challenges facing employees and patients––most critically, short staffing. She has worked for Kaiser for 25 years and said she cried when she found out they had to go on strike.

“We will do it again if we have to, and it’s so sad that we will have to do that just so Kaiser will continue paying attention to us,” Kamhoot said. “It’s not something someone on a $19-, $21-, $23-an-hour income can afford, but they are willing to do it.”

Sravya Tadepalli is a freelance writer based in Oregon. Her writing has been featured in Arlington Magazine, Teaching Tolerance, the Portland Tribune, Oregon Humanities, and the textbook America Now. Sravya...